The National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (NAC-STBBI) Statement: Chlamydia and Gonorrhea screening recommendations for non-pregnant adults and adolescents.

Abstract

Background: The National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (NAC-STBBI) undertook a review to adopt, or adapt, the 2021 recommendation for chlamydia and gonorrhea screening issued by the Canadian Task Force on Preventive Health Care (CTFPHC).

Methods: The NAC-STBBI adapted the guideline following the 2014 World Health Organization (WHO) handbook. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and GRADE-ADOLOPMENT methods were also applied to determine the certainty of evidence and strength of the recommendations. The guideline question was "should any screening vs no screening/usual care/any other screening be used for non-pregnant people?". Conflicts of interest were managed according to the Public Health Agency of Canada guidelines.

Results: An environmental scan found 17 guidelines published between 2015 and 2023. Five systematic reviews and 32 original articles were identified and included, addressing screening types, patient values, preferences, feasibility, equity and cost and cost-effectiveness of chlamydia and gonorrhea screening. The search was conducted between October 1, 2019, to May 19, 2023. The certainty of evidence was very low.

Conclusion: The NAC-STBBI suggests universal annual screening for Chlamydia trachomatis and Neisseria gonorrhoeae infections in all sexually active persons under the age of 30 years (conditional recommendation; very low-certainty evidence). The NAC-STBBI also suggests screening every three to six months for adults and adolescents with multiple sexual partners or a new partner since last tested and "opt-out" screening as frequently as every three months for high prevalence populations or communities (conditional recommendation; very low-certainty evidence).