What STI tests are appropriate for a sexually active woman without symptoms?

• A. CBC and CMP.
• B. Hepatitis B testing only.
• C. NAATs for chlamydia and gonorrhea; HIV; tests for syphilis and hepatitis B as indicated by risk; consider trichomonas if symptoms or risk.
• D. IgG titers for all STIs.

Answer: (C)

Screening asymptomatic, sexually active individuals relies on tests that can detect infection even when there are no symptoms. Chlamydia and gonorrhea are often silent but can cause serious reproductive complications, so using nucleic acid amplification tests on urine or vaginal swabs is the best approach to identify these infections early. HIV screening is recommended for all sexually active adults at least once because many infections are asymptomatic for years and early detection improves outcomes and reduces transmission. Testing for syphilis and hepatitis B should be guided by risk factors (such as multiple partners, injection drug use, known exposure, or pregnancy in some settings) rather than done routinely for everyone. Trichomonas testing is considered if symptoms or specific risk factors are present, since the infection is more often evaluated in those contexts. CBC and CMP do not screen for STIs and aren’t appropriate for this purpose, and IgG titers for all STIs aren’t useful for detecting current infection.