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New guidelines urge chlamydia, gonorrhea screening for women 24 and younger

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Sept. 14 (UPI) — All sexually active women and pregnant people age 24 years and younger should be screened for chlamydia and gonorrhea, according to new guidelines published Tuesday by JAMA.

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In addition, women and pregnant people age 25 and older who are at increased risk for these sexually transmitted infections — such as those with multiple partners — also should have routine screening, the guideline authors said.

The guidelines, issued by the U.S. Preventive Services Task Force, an independent, volunteer panel of national experts in prevention and evidence-based medicine, did not recommend screening for these diseases in men.

Previous guidelines issued by the U.S. Preventive Services Task Force had not specified screening for women age 25 and older.

“While the evidence is clear for young women and older women at increased risk, there is not enough evidence to determine whether or not screening men reduces their risk of complications or spreading infections to others,” task force vice chair Dr. Michael Barry said in a press release.

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“We need more research to understand the benefits and harms of screening men for chlamydia and gonorrhea,” said Barry, who is also director of the Informed Medical Decisions Program in the Health Decision Sciences Center at Massachusetts General Hospital in Boston.

Nearly 2 million people nationally were diagnosed with chlamydia in 2019, the most recent year for which data are available, the Centers for Disease Control and Prevention estimates, though this may be an under-count, given that many of those with the disease are asymptomatic.

More than 60% of these cases occurred in people age 15 to 24, and women in all age groups were about twice as likely to be diagnosed with the infection as men, according to the agency.

Meanwhile, there were just over 600,000 cases of gonorrhea across the country in 2019, the CDC said.

Though the infection is more common among men than women, cases are increasing among the latter, the agency said.

Both infections, like all sexually transmitted diseases, or STDs, are becoming increasingly common in the United States, CDC figures suggest.

As with other STDs, chlamydia and gonorrhea are passed from an infected person, usually unknowingly, to an uninfected person during sex, according to Scripps Health.

However, these diseases can also spread whenever there is bodily fluid exchange, simply by touching an infected area.

People infected with these diseases may not know it, due to a lack of outward symptoms, Scripps said.

Age is among the most important risk factors for these infections, with the highest rates of infection among adolescents and young adults, according to the task force.

Other risk factors include new or multiple sex partners, not using condoms consistently when not in a mutually monogamous relationship or having a previous or existing STDs.

The U.S. Preventive Services Task Force issues recommendations on the screening and diagnosis of a number of diseases, based on a review of scientific evidence.

Although men are at risk for chlamydia and gonorrhea, both diseases can lead to serious health complications in women and pregnant people, including infertility, even in the absence of outward symptoms, the group said.

In pregnant people, chlamydia may increase the risk for premature birth and ectopic pregnancy, which means the fertilized egg develops outside of the uterus, according to Scripps.

Pregnant people with these infections can also pass them along to their babies. In the case of gonorrhea, this can cause babies to develop severe infections and vision problems, Scripps Health notes.

This final recommendation applies to sexually active adolescents and adults, including pregnant people, who do not have signs or symptoms of chlamydia or gonorrhea, according to the task force.

Screening can help identify chlamydia and gonorrhea in people without symptoms so they can receive appropriate care, it said.

Although this is true for both men and women, scientific evidence to date does not necessarily indicate that routinely screening men for these disease reduces spread and the risk for other health complications, the guideline authors said.

“Chlamydia and gonorrhea are two of the most common sexually transmitted infections in the United States and can cause serious health problems if not treated,” task force member Martha Kubik said in a press release.

“Screening all sexually active women age 24 and younger, and those who are older and at increased risk, identifies infections so people can get the care they need to stay healthy,” said Kubik, a professor in the School of Nursing at George Mason University in Fairfax, Va.

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