Screening Adolescents for Sexually Transmitted Infections
Abstract
Genital infections due to Chlamydia trachomatis are a serious public health problem in the United States. Chlamydia infections remain the most common treatable sexually transmitted infection (STI), with highest prevalence among adolescent females,1 although the disease prevalence is declining.2 Screening and treating sexually active adolescent females for C trachomatis reduce the disease prevalence and prevent complications such as pelvic inflammatory disease.3,4 Modeling studies estimate that screening is cost-effective under widely varying circumstances. The benefits depend on the prevalence of infection in the population and the specific diagnostic test used.5 Efforts to identify criteria for targeted screening uniformly find age to be the most important risk factor. Moreover, chlamydia reinfection—often within a few months of initial infection—is common and increases the risk of pelvic inflammatory disease.6 These findings are the basis for recommendations of routine annual screening for sexually active adolescent females younger than 20 years.7