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Screening for STDs

for Health Care Providers

Table 2. Screening for STDs

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STIScreening Test

Adapted from CDC. Sexually Transmitted Disease Treatment Guidelines--2010. See References.
* * NAAT is not currently approved for this indication by the FDA. There is evidence that NAAT can accurately diagnose pharyngeal and rectal gonorrhea and rectal chlamydia, and many local public health departments and commercial laboratories have obtained Clinical Laboratory Improvement Amendment (CLIA) waivers to perform NAAT on pharyngeal and rectal swabs.

SyphilisNontreponemal tests: RPR (rapid plasma reagin); VDRL (Venereal Disease Research Laboratory test) (some laboratories use a treponemal test as an initial screen, and a nontreponemal test as a confirmatory test)
  • Urogenital infection: Nucleic acid amplification test (NAAT) on first-void urine (men and women); NAAT on vaginal or cervical swab (women)
  • Pharyngeal infection: Routine screening is not recommended because the prevalence of chlamydia pharyngeal infection is low.
  • Rectal infection: NAAT of rectal swab* (for all who report engaging in anal receptive sex)
  • Urogenital infection: NAAT on first-void urine (men and women); NAAT on vaginal or cervical (women) or urethral (men) swab specimen; culture of male urethral or female endocervical swab specimen (For men with symptoms of urethritis, Gram stain of urethral specimen may be done.)
  • Pharyngeal infection: NAAT or culture of oral swab* (for all who report engaging in oral receptive sex)
  • Rectal infection: NAAT or culture of rectal swab* (for all who report engaging in anal receptive sex)
TrichomoniasisWet-mount examination or culture of vaginal secretions (for all women)
HSVSerologic testing for HSV-2; recommended by some experts (for patients not previously diagnosed with HSV). Cell culture and/or HSV PCR are the preferred HSV tests for persons with genital ulcers or other mucocutaneous lesions.

From Prevention for Positives
Primary Care of Veterans with HIV
Office of Clinical Public Health Programs
Veterans Health Administration, 2009