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Self-Study STD Module - Chlamydia

Partner Management and Public Health Measures

Partner Management
  • Sex partners should be evaluated, tested, and treated if they had sexual contact with the patient during the 60 days preceding the patient's onset of symptoms or diagnosis of chlamydia.
  • The most recent sex partner should be evaluated and treated even if the time of the last sexual contact was > 60 days before the patient's symptom onset or diagnosis.

Communication is an important part of partner management. According to the current CDC recommendations, patients should be instructed to refer at-risk sex partners for evaluation, testing, and treatment. At-risk sex partners include those who had sexual contact with the patient during the 60 days preceding onset of the patient's symptoms or who have a diagnosis of chlamydia.

The most recent sex partner should be evaluated and treated even if the time of the last sexual contact was greater than 60 days before the patient's onset of symptoms.

If concerns exist that sex partners will not seek evaluation and treatment, or if other management strategies are impractical or unsuccessful, then delivery of antibiotic therapy by heterosexual male or female patients to their partners might be an option. Patient-delivered partner therapy is not routinely recommended for men who have sex with men (MSM) because of high risk for coexisting infections.

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Reporting Requirements

Laws and regulations in all states require that persons with chlamydia be reported to public health authorities by clinicians, laboratories, or both.

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Screening

Screening decreases the prevalence of infection in the population and reduces the transmission of disease. Screening for chlamydia in asymptomatic persons has been found to reduce the incidence of pelvic inflammatory disease in women and the burden of disease in the community. Screening can reduce the incidence of chlamydial PID by more than 50%.

Screening Recommendations: Women
  • Sexually active women aged 25 years and under should be screened annually.
  • Women >25 years old should be screened if risk factors are present.
  • Repeat testing of all women, especially adolescents, 3-4 months after treatment for C. trachomatis.
  • Repeat testing of all women treated for C. trachomatis when they next present for care.
During Pregnancy:
  • Screen all pregnant women at the first prenatal visit.
  • Pregnant women aged <25 years and those at increased risk for chlamydia also should be tested during the third trimester.

The CDC and the U.S. Preventive Services Task Force (USPSTF) recommend that all sexually active women age 25 and under (CDC) or age 24 and under (USPSTF) receive chlamydial screening yearly. These recommendations are supported by American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and American Academy of Family Physicians. More frequent screenings may be appropriate for sexually active adolescents and women with recent C. trachomatis infections.

There is insufficient evidence to recommend routine screening in sexually active young men. However, screening should be considered in settings with a high prevalence of chlamydia (adolescent clinics, correctional facilities, STD clinics).

Page 18 of 21 BackStatusStatusNext
Page last modified: March 31, 2010
Page last reviewed: March 31, 2010
Content Source:Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention


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