When should you screen for sexually transmitted infections during a woman's health visit?

• A. Annual chlamydia/gonorrhea screening for sexually active women under 25 or at risk; HIV testing based on risk; syphilis/hepatitis B testing per risk; consider extragenital testing as indicated.
• B. Only screen if symptomatic.
• C. Screen only HIV annually.
• D. Screen only if pregnancy.

Answer: (A)

Screening for sexually transmitted infections during a routine women's health visit should be comprehensive and tailored to risk, not just based on symptoms or pregnancy status. The key idea is to perform annual screening for chlamydia and gonorrhea in sexually active women under 25 or those with risk factors, and to conduct HIV testing based on individual risk assessment. In addition, testing for syphilis and hepatitis B should be guided by risk factors (not done universally for everyone), and extragenital testing (such as throat or rectal specimens) should be considered when exposure or symptoms warrant it. This approach helps detect asymptomatic infections early, reducing complications like pelvic inflammatory disease, infertility, and mother-to-child transmission, while focusing resources on those most at risk.