Screening Adolescents for Sexually Transmitted Infections

Genital infections due to Chlamydia trachomatis are a serious public health problem in the United States. Chlamydia infections remain the most common treatable sexually transmitted infection (STI), with highest prevalence among adolescent females, 1 although the disease prevalence is declining. 2 Screening and treating sexually active adolescent females for C trachomatis reduce the disease prevalence and prevent complications such as pelvic inflammatory disease. 3,4 Modeling studies estimate that screening is cost-effective under widely varying circumstances. The benefits depend on the prevalence of infection in the population and the specific diagnostic test used. 5 Efforts to identify criteria for targeted screening uniformly find age to be the most important risk factor. Moreover, chlamydia reinfection—often within a few months of initial infection—is common and increases the risk of pelvic inflammatory disease. 6 These findings are the basis for recommendations of routine annual screening for sexually active adolescent females younger than 20 years. 7