Well-Child Care Toolkit

Common Sexually Transmitted Diseases: Screening Criteria and Consequences

Disease	Screening	Consequences
Chlamydia	Screen sexually active males and females (including asymptomatic persons)	Females	Males	Fetus and Newborn
Chlamydia		Pelvic inflammatory disease Ectopic pregnancy Chronic pelvic pain Infertility Increased HIV risk if exposed Eye infections	Epididymitis Infertility Increased HIV risk if exposed Eye infections Reiter's syndrome Chronic prostatitis	Premature delivery Pneumonia Neonatal eye infections
Gonorrhea	Screen sexually active males and females (including asymptomatic persons)	Pelvic inflammatory disease Ectopic pregnancy Infertility Infection of joints, heart valves, or brain Increased HIV risk if exposed	Infertility Infection of joints, heart valves, or brain Increased HIV risk if exposed	Blindness Meningitis Septic arthritis
Human papilloma virus (HPV)	Examine sexually active males and females annually for warts, and screen females with Pap smear	Cancer of the cervix, vulva, vagina, or anus	Cancer of the penis or anus	Warts in throat that can obstruct air passages Anogenital warts
Herpes simplex virus	Examine sexually active males and females for ulcerative lesions; ask about genital pain	Recurrent painful genital ulcers Increased HIV risk if exposed	Recurrent painful genital ulcers Increased HIV risk if exposed	Severe central nervous system damage or death in infants infected during birth; if mother has active lesion(s) during labor, a caesarean section must be performed
Bacterial vaginosis (BV)	Screen asymptomatic pregnant females; screen symptomatic females	Increased risk of pelvic inflammatory disease Increased risk of postpartum and postabortal endometritis	Does not apply	Increased risk of premature delivery
Trichomoniasis	Screen symptomatic females	Possible increased risk of pelvic inflammatory disease Possible increased risk of HIV if exposed	Possible increased risk of HIV if exposed	Trichomonas vaginitis Nasal infections
Hepatitis B virus (HBV)	Be sure that adolescent has been immunized	Cirrhosis Liver cancer Immune system disorders	Cirrhosis Liver cancer Immune system disorders	Liver disease Liver cancer Death
Syphilis (VDRL/RPR)	Screen if requested or if any risk criteria are met*	Serious damage to many body systems Mental illness Increased HIV risk if exposed	Serious damage to many body systems Mental illness Increased HIV risk if exposed	Stillbirth or neonatal death Active syphilis Damage to heart, brain, or eyes
HIV/AIDS	Screen if requested or if any risk criteria are met* Obtain informed consent and provide adolescent-specific pretest and posttest counseling	Immune system disorders Increased risk of other STDs Death	Immune system disorders Increased risk of other STDs Death	Immune system disorders Death

* Screen for syphilis (VDRL/RPR) and/or HIV/AIDS if the adolescent asks to be tested or meets any of the following criteria for risk:

History of STDs

More than one sexual partner in past 6 months

Intravenous drug use

Sexual intercourse with a partner at risk

Sex in exchange for drugs or money

Homelessness

For males: sex with other males

For syphilis only: residence in areas where syphilis is prevalent

For HIV/AIDS only: blood or blood product transfusion before 1985

Source:

Green M, Palfrey JS, eds. Bright Futures: Guidelines for Infants, Children, and Adolescents (2nd ed., rev.). (TableL-1: Common Sexually Transmitted Diseases: Screening Criteria and Consequences). 2002. Arlington, VA: National Center for Education in Maternal and Child Health.) Table was compiled with the assistance of Donald P. Orr, M.D., Indiana University, and S. Jean Emans, M.D., Children’s Hospital, Boston. Consequences columns were drawn primarily from The Alan Guttmacher Institute. Bright Futures materials available online at http://www.brightfutures.org and at http://brightfutures.aap.org.