Chlamydia & Gonorrhea
Chlamydia and gonorrhea are the most common bacterial sexually transmitted diseases (STDs) in the United States today, but many infected people have no symptoms. These infections usually affect the genitals but may also cause infections of other mucous membranes, eyes, or joints. Pregnant women may transmit the infections to their newborns. Often progressing silently, these diseases can cause infertility and other health complications if left untreated. However, both diseases can be cured with antibiotics.
In the United States, reported rates of chlamydia and gonorrhea are highest among adolescent girls (15-19 years of age) and young women (20-24 years old). Many people have both chlamydia and gonorrhea infections at the same time.
Recommendations for Women
- The U.S. Centers for Disease Control and Prevention (CDC) recommends annual chlamydia screening for all sexually active women age 25 and under and screening for other women who are at increased risk. It also recommends annual screening for gonorrhea in all sexually active women at risk for infection, which includes those under the age of 25 and those with a previous gonorrhea infection, other STDs, new or multiple sex partners, inconsistent condom use, drug use, or participation in commercial sex work.
- Likewise, the American College of Obstetricians and Gynecologists (ACOG) recommends annual chlamydia and gonorrhea screening for all sexually active women age 25 and younger and for older women with risk factors, such as having a new sex partner or multiple sex partners.
- The American Academy of Family Physicians (AAFP) recommends chlamydia screening for sexually active women under age 25 and for older women who are at increased risk. It discourages, however, routine chlamydia screening for older, low-risk women. The AAFP recommends gonorrhea screening for all sexually active women at increased risk of infection.
- The U.S. Preventive Services Task Force (USPSTF) recommends chlamydia and gonorrhea screening for all sexually active women under the age of 25 and those at increased risk.
For screening recommendations during pregnancy, see Pregnancy & Prenatal Testing.
Recommendations for Men
These organizations do not recommend routine screening for healthy, sexually active, heterosexual men. Health care providers may, however, use their judgment and consider risks, such as prevalence in the community. It is important to remember that an infected male can spread these diseases and even re-infect a partner if he does not complete treatment.
- For sexually active males who have sex with other males, the CDC recommends chlamydia and gonorrhea screening at least annually.
Sexually active young adults age 24 and younger have higher risk of chlamydia and gonorrhea infection than adults age 25 and older. Your risks are even greater if you:
- Are a woman
- Have had one or both of these infections before
- Have other STDs, especially HIV
- Have new or multiple sex partners
- Use condoms inconsistently
- Exchange sex for money or drugs
- Use illegal drugs
- Started sexual relationships early in adolescence
- Live in a detention facility
- Are a man who has sex with other men
Because reinfection rates are high, the CDC recommends that both women and men who are treated for chlamydia or gonorrhea infection be retested approximately 3 months after treatment or at their next health care visit, regardless of whether they believe that their sex partners were treated. It is important to continue annual screening for these diseases because reinfection is always possible.
Sources Used in Current Review
United States Preventive Service Task Force. USPSTF Recommendations for STI Screening. Available online at http://www.uspreventiveservicestaskforce.org/uspstf08/methods/stinfections.htm through http://www.uspreventiveservicestaskforce.org. Last updated March 2008. Accessed May 24, 2012.
Kimberly A. Workowski and Stuart Berman. Sexually Transmitted Diseases Guidelines, 2010. Morbidity and Mortality Weekly Report. PDF available for download at http://www.cdc.gov/std/treatment/2010/STD-Treatment-2010-RR5912.pdf through http://www.cdc.gov. Published December 27, 2010. Accessed March 24, 2012.
U.S. Centers for Disease Control and Prevention. Chlamydia and Gonorrhea — Two Most Commonly Reported Infectious Diseases in the United States. Available online at http://www.cdc.gov/Features/dsSTDData/ through http://www.cdc.gov. Last reviewed April 22, 2011. Accessed May 23, 2011.
U.S. Centers for Disease Control and Prevention. STD Prevention Conference 2012. Available online at http://www.cdc.gov/nchhstp/newsroom/stdconference2012summaries.html through http://www.cdc.gov. Last reviewed March 14, 2012. Accessed May 23, 2012.
American College of Obstetricians and Gynecologists. Well-Woman Care: Assessments and Recommendations. Available online through http://www.acog.org/. Issued March 29, 2012. Accessed June 1, 2012.
American College of Obstetricians and Gynecologists. Chlamydia Screening Rates Too Low, Reinfection Rates Too High. March 26, 2012. Available online through http://www.acog.org/. Accessed June 2012.
American Academy of Family Physicians. Gonorrhea. Available online at http://www.aafp.org/online/en/home/clinical/exam/gonorrhea.html through http://www.aafp.org. Accessed June 4, 2012.
American Academy of Family Physicians. Chlamydia. Available online at http://www.aafp.org/online/en/home/clinical/exam/chlamydia.html through http://www.aafp.org. Accessed June 4, 2012.
U.S. Centers for Disease Control and Prevention. 2010 Treatment Guidelines, Special Populations. Available online at http://www.cdc.gov/std/treatment/2010/specialpops.htm#msm through http://www.cdc.gov. Accessed June 2012.
American College of Obstetricians and Gynecologists. Spotlight on Chlamydia: Annual Screenings a Must for Young Women. May 8, 2007. Available online through http://www.acog.org/. Accessed June 2012.
U.S. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010 Dec 17; 59:1. Available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5912a1.htm through http://www.cdc.gov. Accessed January 2011.