Chlamydia and Gonorrhea Screening and Follow-Up

Clinical Service Goal

Chlamydia and gonorrhea screening is recommended annually for all sexually active cisgender women <25 years of age^1,2 and should be extended to all transgender men and gender diverse people with a cervix.² Additionally, screening of sexually active young men who have sex with women should be considered in clinical settings serving populations of young men with a high prevalence of chlamydia (e.g., adolescent clinics, correctional facilities, and STD clinics) and should be offered at least annually to all young men who have sex with men at all anatomic sites of sexual contact.¹

Key Foundations

Strategies related to assessment, policy, and environment

Equipping Teams

Strategies that build clinic staff capacity

Service Delivery

Strategies to strengthen processes, procedures, and systems involved in delivering clinical services

Engaging Adolescent Patients and Families

Strategies to educate and build productive partnerships with adolescents and their families+ (These strategies recognize the important role that parents can play in relation to ASRH, even while protecting confidentiality remains a cornerstone of adolescent care).

Strategies

Key Foundations

Equipping Teams

Implementation Tips

Provide expedited partner therapy per state law for individuals who test positive for chlamydia to reduce infection rates
Include all care team members in trainings on screening and treatment guidelines
Include screening and treatment guidelines among job aids accessible to care teams
Designate a point person on the care team responsible for tracking and follow-up of all positive screens
Provide walk-in access to adolescents called back due to positive tests

Tools & Resources

Sexually Transmitted Infections Treatment Guidelines, 2021: Adolescents

Centers for Disease Control and Prevention

Screening and primary prevention recommendations for sexually transmitted infections in adolescents

Sexually Transmitted Infections Treatment Guidelines, 2021: Provider Resources

Centers for Disease Control and Prevention

Job aids, including print-friendly versions of a wall chart, pocket guide, and guidelines; guidelines available via mobile app

Service Delivery

Implementation Tips

Modify the workflow to include routine specimen collection
Have various options available for screening (e.g., urine sample, patient-collected vaginal swab, care team member-collected cervical swab)
When explaining recommended screening, use normalizing and opt-out language, i.e., language that describes the screening will be performed unless the patient declines

Tools & Resources

Chlamydia Screening Starter Guide

Adolescent Health Initiative

Example clinic workflow modifications for chlamydia screening on page 5
Script for chlamydia screening encounters on page 6

Opt-Out Screening

American Sexual Health Association, National Chlamydia Coalition

Brief videos showing care team member using normalizing language to discuss chlamydia screening with patients; printable fact sheets on strategies for implementing opt-out screening and increasing screening rates

Service Delivery

Tools & Resources

STD TAC Billing Toolkit

National Coalition of STD Directors

Toolkit with resources to scale up billing and reimbursement systems and practices for sexually transmitted disease services

Engaging Adolescent Patients and Families

Implementation tips

Provide handout/letter explaining recommendations and protocols for parents and patients at check-in
Provide a section on the health center website that includes

Tools & Resources

Chlamydia Screening Starter Guide

Adolescent Health Initiative

Example parent and patient letters and handouts about chlamydia screening on pages 7-9; also available in Spanish

STD Testing: Information for Parents of Adolescents

Centers for Disease Control and Prevention

Info brief for parents that describes sexually transmitted disease testing recommendations for adolescents

1.Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recommendations and Reports. 2021;70(4):1-187. Published 2021 Jul 23. doi:10.15585/mmwr.rr7004a1

2. Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention. Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources. Centers for Disease Control and Prevention. Updated June 2022. https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm