1. Prevalence rates of sexually transmitted infections (STIs) are higher among adolescents and young adults than other age groups. Males who have sex with males (MSM) and non-white ethnicities carry a high proportion of the disease burden in this population.
2. All sexually active adolescent females should be screened for chlamydia (≤ 25 years) and gonorrhea (< 25 years) annually, and adolescent MSM should be screened for chlamydia, gonorrhea, and syphilis annually.
Statement Rundown: Adolescents and young adults have higher prevalence rates of many sexually transmitted infections (STIs) than those of other ages. Chlamydia and gonorrhea prevalence is highest among young adults aged 20- to 24-years-old, and second highest among adolescents aged 15- to 19-years-old. Non-Hispanic African American females aged 15- to 19-years-old have a 5-fold and 26-fold higher rate of chlamydia and gonorrhea, respectively, than their white counterparts; other non-white ethnicities also have higher rates of STIs. Males who have sex with males (MSM) also carry a higher proportion of STI disease burden. Using evidence from the US Preventative Services Task Force (USPSTF) and the Center for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP) recommends that all sexually active females ≤ 25 years should be screened for chlamydia annually, while all sexually active females < 25 years should be screened for gonorrhea annually. Also, adolescent and young adult MSM should be screened for chlamydia, gonorrhea, and syphilis annually or every 3-6 months if engaging in high risk behaviors, such as multiple sexual partners or illicit drug use during sex. Routine screening for trichomoniasis was not recommended, except as part of a thorough STI evaluation for high-risk individuals. Physician awareness of screening guidelines may assist in early identification and treatment of at-risk individuals, thereby reducing long-term sequelae.
Relevant Reading: Gynecologic examination for adolescents in the pediatric office setting
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