Effectiveness of Early Detection and Intervention

Screening can accurately detect gonorrheal infection, and antibiotic therapy can eliminate urogenital infections, prevent complications, and prevent further transmission. Potential harms of screening and treatment include false-positive test results, anxiety, and unnecessary antibiotic use (Glass et al., 2005b).

The USPSTF recommends that clinicians screen all sexually active women who are at increased risk for gonorrheal infection. Because of the lower burden of undiagnosed and untreated genital gonorrheal infection in men than women, USPSTF concluded that there was insufficient evidence to recommend for or against routine screening for gonorrhea in men at increased risk for infection. They recommend against routine screening for gonorrhea in men and women who are at low risk for infection (USPSTF, 2005).

Unlike chlamydial infection, which is relatively evenly distributed across the United States, gonorrheal infection demonstrates marked regional and local variation. USPSTF recommends that clinicians and health systems work with public health officials to understand the prevalence and distribution of gonorrhea in their communities and adjust their screening practices accordingly.

The AAFP and ACOG recommend screening sexually active women, including adolescents, at high risk for gonorrhea. The CDC recommends that clinicians screen all sexually active men who have sex with men for genital gonorrhea at least annually and for rectal and pharyngeal gonorrhea if they are at risk due to exposure. The Infectious Disease Society of America (IDSA) recommends that all HIV-positive individuals be screened for gonorrhea (Glass et al., 2005b).

Women with asymptomatic gonorrheal infection have high rates of morbidity from PID and its sequelae. Screening tests can accurately detect gonorrheal infection in those at risk, and treatment is effective. All high-risk, sexually active women (including pregnant women) should be screened for gonorrheal infection (USPSTF, 2005).

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