Chlamydia & gonorrhea screening

USPSTF2021Grade B

Screen sexually active women, including pregnant persons, age 24 and younger; age 25 and older only if at increased risk. Same applies to chlamydia and gonorrhea. Men: I statement (insufficient evidence to screen for either).

CDC2021

Screen all sexually active women under 25 annually; women 25+ if at increased risk. Pregnant women under 25, and 25+ at risk, screen at first prenatal visit. MSM: screen at least annually at sites of exposure (chlamydia: urethra, rectum; gonorrhea: urethra, rectum, pharynx); every 3 to 6 months if higher risk. Retest 3 months after treatment.

CDC2021

Gonorrhea (any site): ceftriaxone 500 mg IM once (1 g if ≥150 kg), plus doxycycline 100 mg twice daily for 7 days if chlamydia is not excluded; test of cure 7 to 14 days after pharyngeal infection. Chlamydia: doxycycline 100 mg twice daily for 7 days (alternatives azithromycin 1 g once or levofloxacin 500 mg daily for 7 days); in pregnancy azithromycin 1 g with test of cure at about 4 weeks. Retest all at 3 months.

CDC2024Grade Strong recommendation, high-quality evidence (AI)

Doxycycline postexposure prophylaxis (doxy-PEP): counsel gay, bisexual, and other MSM and transgender women with syphilis, chlamydia, or gonorrhea in the past 12 months about, and offer, doxycycline 200 mg taken as soon as possible and within 72 hours after oral, anal, or vaginal sex (maximum 200 mg per 24 hours). Test for STIs at exposed sites at baseline and every 3 to 6 months. No recommendation yet for other groups, including cisgender women and heterosexual men.