Health Questions and Answers

Question: Why is screening for STDs important?

Answer:

Many common STDs, including HIV infection, syphilis, chlamydial infection, and hepatitis, can be asymptomatic at some stage in the disease. Screening therefore offers benefit to the individual and can also have societal benefits by identifying infected individuals and preventing the spread of the disease.

KEY POINTS: LOWER GENITAL TRACT INFECTIONS

  1. Trichomoniasis and candidiasis are diagnosed by visualizing the organisms on microscopy of vaginal discharge.
  2. Bacterial vaginosis is diagnosed by the “whiff test” and the appearance of “clue cells.”
  3. Syphilis has several stages: primary (vulvar lesion), secondary (systemic rash), latent, and tertiary (systemic effects).
  4. Primary herpes outbreaks may involve systemic viral symptoms, but recurrent outbreaks involve only local vulvar lesions and are usually of shorter duration.
  5. Treatment of Bartholin’s cysts with marsupialization has the best success rate.

There are no ironclad rules for who should undergo screening. Various criteria can be applied using demographics and risk-scoring systems, or based on site of care. Any system other than universal screening will miss some individuals perceived to be at low risk. One approach is to screen all unmarried women under the age of 25.

Reference:  Baldwin HE. STD update: Screening and therapeutic options Inter J Fertil Womens Med 46:79-88, 2001.

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