Authors' objectives:

This update of the evidence report examines evidence of the effectiveness of screening for gonorrhea in asymptomatic sexually active men and women including adolescents and pregnant women. It reviews studies of screening strategies, individual and population-level risk factors, characteristics and accuracy of tests used for screening, harms of chemoprophylaxis treatment for newborns, and cost effectiveness of universal and targeted screening strategies. This review is an update and includes only studies published since the last recommendations of the U.S. Preventive Services Task Force (USPSTF) were released in 1996.

Authors' results and conclusions: No new evidence was identified that evaluated the effectiveness of population screening to reduce transmission and improve health outcomes. Individual-level risk factors include young age (<25 years), African American race, multiple sex partners or an infected sex partner, inconsistent use of barrier contraceptives, previous or coexistent STDs, douching, use of drugs, and history of incarceration. Contextual risk factors include sexual networks, sexual mixing within a community or neighborhood with high prevalence of STDs, and residence in a community with limited social capital or markers of physical deterioration. New testing technologies, such as nucleic acid amplification tests and nucleic acid hybridization tests, demonstrate high sensitivity and specificity, although studies are methodologically limited. Sensitivity is lower using urine specimens for some tests, and may vary by symptom status.

Authors' recommendations: Recent evidence only addresses key questions about risk factors and new tests. These studies are limited by descriptive, cross-sectional designs focusing on highly prevalent communities and settings, such as inner city STD clinics, that may not generalize to primary care.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/uspstf/uspsgono.htm

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)