More STD Screening on Horizon for Women?
Influential U.S. panel has also drafted guidelines on counseling to prevent chlamydia, gonorrhea
"Age is a strong risk factor for both chlamydia and gonorrhea. Sexually active women age 20 to 24 years have the highest infection rates, followed by women age 15 to 19 years," LeFevre said. "Infection rates among men are highest between the ages of 20 and 24 years."
The new draft recommendations also suggest that women older than 24 get screened for the diseases if they're at special risk. "Risk factors include having a new sex partner, having more than one sex partner, having a sexual partner infected with a STD, inconsistent condom use, a history of previous or co-existing STDs and exchanging sex for money or drugs," LeFevre said.
The task force doesn't think there's enough evidence to support routine screening for boys and men, he said. "Men often have symptoms when they are infected with chlamydia and gonorrhea, and they will go to the doctor for timely treatment of the infection, preventing any serious complications."
Dr. Gale Burstein, a commissioner with the Erie County Department of Health and an adolescent medicine physician with the Women and Children's Hospital of Buffalo, in New York, praised the draft recommendations but noted that they don't include guidelines for the screening of gay and bisexual men, who are at higher risk of infection with the STDs.
In those men, both chlamydia and gonorrhea are linked to higher rates of infection with HIV, the virus that causes AIDS, she said.
In another draft recommendation, the task force says doctors should provide "intensive" counseling to patients at high risk for the STDs. "High-intensity counseling services often involved more than two hours of total contact time, usually in a group," LeFevre said. "But some less intensive approaches were also found to have impact."
For her part, Burstein said, "it's a bit confusing" how doctors are supposed to find the time -- and get reimbursed by insurance companies -- to provide this kind of counseling. "We need more information about the logistics on how to carry this out," she said.
The new draft guidelines are now up for public review.