Well-Child Care Toolkit

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
  • 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.
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