Evaluation of chlamydia and gonorrhea screening criteria: San Francisco sexually transmitted disease clinic: 1997 to 1998

Sex Transm Dis. 2000 Mar;27(3):165-7. doi: 10.1097/00007435-200003000-00009.


Background and objectives: The advent of more sensitive diagnostic testing technologies and competition in public healthcare spending have resulted in a reevaluation of sexually transmitted disease (STD) screening practices in an attempt to target populations at greatest risk. Screening among populations with a < 2% prevalence of chlamydia and a < 1% prevalence of gonorrhea may not be cost-effective.

Goal: To identify subpopulations with a low prevalence of chlamydia or gonorrhea.

Study design: The prevalence of genital chlamydia and gonorrhea among asymptomatic STD patients screened from 1997 to 1998 at San Francisco City Clinic was stratified by demographic and behavioral risk factors.

Results: The prevalence of chlamydia and gonorrhea was 3.4% and 1.1% among asymptomatic women and 4.0% and 1.0% among asymptomatic men, respectively. Two low-prevalence subpopulations identified among asymptomatic patients were women older than 29 years (chlamydia, 1.2%) and men who have sex with women (gonorrhea, 0.8%).

Conclusions: These data identified low-prevalence subpopulations among asymptomatic STD patients. As a result, the STD screening criteria at San Francisco City Clinic were changed accordingly.

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology*
  • Clinical Protocols / standards
  • Cost Savings
  • Cost-Benefit Analysis
  • Female
  • Gonorrhea / diagnosis*
  • Gonorrhea / epidemiology*
  • Humans
  • Male
  • Mass Screening / economics
  • Mass Screening / methods*
  • Mass Screening / standards*
  • Mass Screening / trends
  • Needs Assessment
  • Patient Selection*
  • Practice Guidelines as Topic / standards*
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / trends
  • Prevalence
  • Risk Factors
  • San Francisco / epidemiology
  • Sexual Behavior / statistics & numerical data