Under 30 and sexually active? It’s a good idea to get tested for chlamydia and gonorrhea
Canadian Task Force on Preventive Health Care recommends routine screening
Anyone sexually active under age 30 should be offered testing for chlamydia and gonorrhea, according to a new guideline from the Canadian Task Force on Preventive Health Care in CMAJ (Canadian Medical Association Journal).
Chlamydia and gonorrhea are the most commonly reported bacterial sexually transmitted infections (STIs) in Canada and are treatable with antibiotics. Without treatment, these infections can lead to pelvic inflammatory disease, pain and possibly infertility.
“If people are under 30 and sexually active, it’s a good idea to get tested,” says Dr. Ainsley Moore, a family physician and associate clinical professor, Department of Family Medicine, McMaster University, and chair of the Task Force chlamydia and gonorrhea working group. “Many people are asymptomatic and may not seek treatment so we’re recommending opportunistic testing, that is, at any health care visit.”
The guideline recommends that health care providers in Canada offer routine screening (testing) for chlamydia and gonorrhea to all sexually active patients under age 30 not known to belong to a high-risk group. Sexual activity is defined as anyone who has had oral, vaginal or anal intercourse.
Why is the task force recommending screening?
- 1 in 20 sexually active individuals 15-29 years old will get chlamydia.
- Reported rates for this age group are 1.0-1.9% (chlamydia) and 0.2-0.3% (gonorrhea).
- Many people are asymptomatic or do not seek care and are not included in reported cases.
- True rates of chlamydia in 15-29 year-olds may be as high as 5-7%.
- Rising rates in people aged 25-29 years since 2000.
- Screening may reduce pelvic inflammatory disease in females.
This recommendation does not extend to pregnant people, people known to be at increased risk based on sexual behaviours, or patients seeking care for a possible STI. Clinicians should consult national, provincial, or local guidance to provide care for these individuals.
Current practice in Canada recommends screening sexually active people not at high risk up to age 25.
“This recommendation to extend screening to age 30 reflects increasing rates of infection among Canadians aged 25 to 29 years,” says Dr. Donna Reynolds, a member of the working group, family physician and an assistant professor at the University of Toronto. “As it’s an easy test, usually a urine test or vaginal swab, it can be done at any visit to a physician, nurse practitioner or sexual health clinic.”
The recommendations also consider the potential for anxiety and embarrassment for some around screening for STIs and suggest also screening males as the primary source of infection for females for whom the health consequences can be greater.
“Screening males, who are often without symptoms, may reduce transmission and complications for females and may improve health equity for females,” says Dr. Moore.
Target Audiences
- Clinicians – The guideline is aimed at clinicians in primary care, sexual health and student clinics and other settings.
- Public – A public web page offers resources about why it’s a good idea to get tested.
The Task Force engaged Canadians to understand their values and preferences around screening to inform recommendations. They expressed a strong preference for screening.
Get the guideline and related tools here.
About the Canadian Task Force on Preventive Health Care
The Canadian Task Force on Preventive Health Care is an independent panel of health professionals who are experts in clinical preventive health care and guideline methodology. The task force’s mandate is to develop and disseminate evidence-based clinical practice guidelines for primary and preventive care.
Media contact for interviews: Kim Barnhardt, media@canadiantaskforce.ca or kim.barnhardt@cmaj.ca