Bacterial Sexually Transmitted Disease Screening Outside the Clinic--Implications for the Modern Sexually Transmitted...

Area of Science:

• Public Health
• Infectious Disease Control
• Diagnostic Testing

Background:

• Noninvasive nucleic acid amplification tests enable sexually transmitted disease (STD) screening outside clinical settings.
• Limited evidence exists for effective STD screening strategies in nonclinical US settings.

Purpose of the Study:

• To systematically review evidence on chlamydia, gonorrhea, and syphilis screening in US nonclinical settings since 2000.
• To inform local STD programs on evidence-based non-clinic screening approaches.

Main Methods:

• Systematic literature review of studies published since 2000.
• Included screening in correctional settings, sex venues, and at-home testing.
• Focused on chlamydia, gonorrhea, and syphilis.

Main Results:

• Sixty-four articles were reviewed, with data on testing volume and positivity.
• Scarce data were found on treatment of new positives and program costs.
• Correctional setting screening identified many asymptomatic infections; value of other non-clinic settings was unclear.

Conclusions:

• Health departments should develop sustainable STD screening programs in jails and juvenile detention centers.
• Pilot outreach and home-based STD screening programs are needed to identify asymptomatic individuals.
• More data on treatment rates and program costs for non-clinic-based screening are essential.