All teens and young adults who are sexually active need to use protection, such as a condom, and should be tested for sexually transmitted infections. Not all sexually transmitted infections have recognizable signs and symptoms that will trigger a visit to a medical provider. While they may have no signs or symptoms, untreated sexually transmitted infections may exact a toll on the body. STIs that can be tested for include herpes, human papillomavirus (HPV), human immunodeficiency virus (HIV), chlamydia, gonorrhea, and syphilis. Depending on the STI, screening may be done via a blood or urine test or a swab and cell culture.
In a study published in 2015 in Sexually Transmitted Diseases, researchers from the Netherlands wanted to learn how the results of a chlamydia test influenced subsequent sexual risk behavior. The cohort consisted of men and women, between the ages of 16 and 19 years, who participated in at least two of the four rounds (n= 6,802) of the Chlamydia Screening Implementation. The researchers found that those who tested positive for chlamydia were more likely to practice more protective behaviors. And, those who had negative results were more likely to practice riskier behaviors. Large differences between the two groups were seen on condom use with a casual partner. Specifically, people who had tested positive for chlamydia were far less likely to report that they never used a condom with a causal partner, and people who had tested negative for chlamydia were less likely to indicate that they always used a condom with a casual partner. The researchers concluded that the chlamydia test results “were associated with subsequent sexual risk behavior.” They advised more research into the responses to the negative test. 1
In a study published in 2015 in Sexually Transmitted Diseases, researchers from several locations in the United States wanted to learn more about the association between HIV and the frequency and types of sexual concurrency in young adults. They also examined other factors, such as condom use. The researchers recruited 261 men and 275 women between the ages of 18 and 30 years from community locations in Los Angeles. During a 12-month period, the participants completed four in-person interviews. Data were collected on four types of dating concurrency. Transitional concurrency occurred when a second relationship began before the first one ended. Single-day concurrency took place when a single-day relationship happened while a person was already in a relationship. Contained concurrency is the beginning and ending of a relationship while still in another relationship. And, multiple concurrency is when someone is in three or more relationships at the same time. At baseline, 47 percent of the men and 32 percent of the women reported some form of concurrency during the previous four months. A striking 26 percent of the men and 10 percent of the women reported multiple concurrencies. Condom use ranged from 56 percent to 64 percent, with the highest in the transitional concurrency. All types of concurrency appeared to increase the risk of acquiring and spreading sexually transmitted infections. Given such high numbers, the researchers suggested that there is a need for more preventive interventions. “It is critical that health care providers discuss the risk of concurrency with their young adult patients.” In addition, “broader media campaigns … could be used to raise awareness of the potential consequences of involvement in extended sexual networks and the part concurrency plays in persistent epidemics of STIs [sexually transmitted infections] in the United States.” 2
In a study published in 2013 in Sexually Transmitted Diseases, researchers from Kansas City, Missouri, investigated the role that pharmacists may serve in screening and treatment for sexually transmitted infections. Participants were recruited from a Kansas City free health clinic between May 3, 2010, and October 14, 2010. A confidential survey was completed by 164 participants. Of these, 86.3 percent indicated an “overwhelming acceptance” of a pharmacist as their treatment provider. The participants were most comfortable with the pharmacist running a urine screen, treating sexually transmitted infections, and discussing the results of the tests. They were a little less comfortable with the pharmacists performing physical examinations. But, almost everyone approved of pharmacists working in collaboration with a physician. The researchers commented that “a pharmacist prepared with the clinical skills to screen a patient for STIs, discuss test results, and then recommend, select, administer, and manage STI medication therapy could prove an invaluable resource and asset to the public health care team.” 4
In a study published in 2009 in AIDS Patient Care and STDs, researchers based in Oakland, California, noted that in 2005 the Department of Emergency Medicine at Alameda County Medical Center implemented an HIV testing program. Was the program working? They did not know. So, the researchers conducted a review of medical records and attempted to identify screening opportunities that were missed. The researchers learned that from April 1, 2005, to November 31, 2006, there were 112,544 age-eligible Emergency Department visits, and 9,130 HIV tests were performed. Ninety-five previously undiagnosed patients tested positive. Of these, 66 were diagnosed during their first emergency visit, but 29 people made a total of 59 visits before testing positive. The researchers noted that “missed opportunities for earlier HIV diagnosis occurred frequently despite an HIV screening program.” 5
In a study published in 2013 in the International Journal of STD & AIDS, researchers from New Orleans; Wilmington, Delaware; and Columbia, South Carolina, wanted to determine if the out-of-pocket costs associated with chlamydia and gonorrhea screening tests were barriers to follow-up and annual screening. The researchers used data from a major health insurance claims database (2006-2010). When they compared the chlamydia patients without out-of-pocket expenses, the researchers found that those with out-of-pocket expenses of $30 or more “had significantly reduced likelihood of receiving re-screening and annual screening.” The researchers found similar results for gonorrhea patients. They concluded that out-of-pocket costs “served as a significant barrier to re-screening and annual screening.” 7
1. Loes C. Soetens, Birgit H. B. van Benthem, and Eline L. M. Op de Coul, “Chlamydia Test Results Were Associated with Sexual Risk Behavior Change Among Participants of the Chlamydia Screening Implementation in the Netherlands,” Sexually Transmitted Diseases 42, no. 3 (2015): 109-14.
2. Jocelyn T. Warren, S. Marie Harvey, Isaac Joel Washburn et al., “Concurrent Sexual Partnerships Among Young Heterosexual Adults at Increased HIV Risk: Types and Characteristics,” Sexually Transmitted Diseases 42, no. 4 (2015): 180-84.
4. Sara J. Deppe, Chessa R. Nyberg, Brooke Y. Patterson et al., “Expanding the Role of a Pharmacist as a Sexually Transmitted Infection Provider in the Setting of an Urban Free Health Clinic,” Sexually Transmitted Diseases 40, no. 9 (2013): 685-88.
5. Douglas A. E. White, Otis U. Warren, Alicia N. Scribner, and Bradley W. Frazee, “Missed Opportunities for Earlier HIV Diagnosis in an Emergency Department Despite an HIV Screening Program,” AIDS Patient Care and STDs 23, no. 4 (2009): 245-50.
6. Jarvis W. Carter, Geoffrey D. Hart-Cooper, Mary O. Butler et al., “Provider Barriers Prevent Recommended Sexually Transmitted Disease Screening of HIV-Infected Men Who Have Sex With Men,” Sexually Transmitted Diseases 41, no. 2 (2014): 137-42.
7. L. Shi, Y. Xie, J. Liu et al., “Is Out-of-Pocket Cost a Barrier to Receiving Repeat Tests for Chlamydia and Gonorrhoea?” International Journal of STD & AIDS 24 (2013): 301-6.
Bechtel, Mark A., and Wayne Trout. “Sexually Transmitted Diseases.” Clinical Obstetrics and Gynecology 58, no. 1 (2015): 172-84.
Carter, Jarvis W., Geoffrey D. Hart-Cooper, Mary O. Butler, et al. “Provider Barriers Prevent Recommended Sexually Transmitted Disease Screening of HIV-Infected Men Who Have Sex With Men.” Sexually Transmitted Diseases 41, no. 2 (2014): 137-42.
Chan, Philip A., Justine Maher, Daniele Poole et al. “Addressing the Increasing Burden of Sexually Transmitted Infections in Rhode Island.” Rhode Island Medical Journal 98, no. 1 (2015): 31-34.
Deppe, Sara J., Chessa R. Nyberg, Brooke Y. Patterson et al. “Expanding the Role of a Pharmacist as a Sexually Transmitted Infection Provider in the Setting of an Urban Free Health Clinic.” Sexually Transmitted Diseases 40, no. 9 (2013): 685-88.
Falasinnu, T., M. Gilbert, P. Gustafson, and J. Shoveller. “Deriving and Validating a Risk Estimation Tool for Screening Asymptomatic Chlamydia and Gonorrhea.” Sexually Transmitted Diseases 41, no. 12 (2014): 706-12.
Li, De-Kun, Marsha A. Raebel, T. Craig Cheetham et al. “Genital Herpes and Its Treatment in Relation to Preterm Delivery.” American Journal of Epidemiology 180, no. 11 (2014): 1109-17.
Schick, Vanessa, Barbara Van Der Pol, Brian Dodge et al. “A Mixed Methods Approach to Assess the Likelihood of Testing for STI Using Self-Collected Samples Among Behaviourally Bisexual Women.” Sexually Transmitted Infections 91, no. 5 (2015): 329-33.
Shi, L., Y. Xie, J. Liu et al. “Is Out-of-Pocket Cost a Barrier to Receiving Repeat Tests for Chlamydia and Gonorrhoea?” International Journal of STD & AIDS 24 (2013): 301-6.
Soetens, Loes C., Birgit H. B. van Benthem, and Eline L. M. Op de Coul. “Chlamydia Test Results Were Associated with Sexual Risk Behavior Change Among Participants of the Chlamydia Screening Implementation in the Netherlands.” Sexually Transmitted Diseases 42, no. 3 (2015): 109-14.
Warren, Jocelyn T., S. Marie Harvey, Isaac Joel Washburn et al. “Concurrent Sexual Partnerships Among Young Heterosexual Adults at Increased HIV Risk: Types and Characteristics.” Sexually Transmitted Diseases 42, no. 4 (2015): 180-84.
White, Douglas A. E., Otis U. Warren, Alicia N. Scribner, and Bradley W. Frazee. “Missed Opportunities for Earlier HIV Diagnosis in an Emergency Department Despite an HIV Screening Program.” AIDS Patient Care and STDs 23, no. 4 (2009): 245-50.
Yehia, Baligh R., Wanjun Cui, William W. Thompson et al. “HIV Testing Among Adults with Mental Illness.” AIDS Patient Care and STDs 28, no. 12 (2014): 628-34.
Centers for Disease Control and Prevention. www.cdc.gov .
Planned Parenthood. www.plannedparenthood.org .