- Officials in Canada recommend that people under age 30 who are sexually active get tested for chlamydia, gonorrhea, and other sexually transmitted infections (STIs).
- Experts in the United States say similar guidance should be instituted because of the rise in STIs.
- They say increased testing can help stop the spread of STIs and raise awareness about safer sexual practices.
All sexually active people under age 30 should undergo regular screenings for sexually transmitted infections (STIs) such as chlamydia and gonorrhea.
That’s the recommendation published in the Canadian Medical Association Journal by the Canadian Task Force on Preventive Health Care.
The Centers for Disease Control and Prevention (CDC) recently reported an increase in cases across the United States, making doctors wonder if the guidelines should be instituted in this country.
Dr. Ainsley Moore, a family physician and associate clinical professor in the Department of Family Medicine at McMaster University in Ontario, as well as chair of a task force working group on chlamydia and gonorrhea, said reported rates in Canada are about 1 to 2 percent for chlamydia and 2 to 3 percent for gonorrhea.
But she told Healthline that the true numbers of those with STIs could be much higher. “Reported rates are far lower simply because the untested do not get reported,” she explained.
Her estimate of infection for those 15 to 29 years old is 5 to 7 percent.
With a rate going up since the early 2000s, Moore said, the task force felt it was time to take action.
Wider and regular testing, she said, would help reduce the spread and the consequences of that spread and help “normalize” discussion of testing for and treatment of STIs.
For women, she said, the issue is particularly concerning.
Women who have STIs – particularly if they go untreated for a lengthy period – can contract pelvic inflammatory disease, experience ectopic pregnancies, and even develop infertility.
For men, Moore said, the consequences are not as severe, but they also can be serious.
The most common long-term impact to men, she said, can be epididymitis, an inflammation of the tube at the back of the testicle that carries sperm. The swelling can cause intense pain in the testicle.
What should be done in the U.S.?
Reproductive care experts in the United States say normalizing testing is a good idea.
Dr. Aviva Romm, a midwife and herbalist based in New York, said increased testing can benefit everybody.
Ramm says the opioid epidemic led to a surge in STIs “with an increase of trading sex for drugs.”
She also points out that STDs know no racial, economic, or age barrier.
That, she thinks, is a big reason why universal testing could help.
“In our minds, we have this stereotype of who gets (STIs),” Ramm told Healthline. “You know, we all think: ‘Not me or my college friends.’”
Sometimes, there aren't any symptoms. “People have no idea they have contracted it, and then they pass it along unknowingly,” she said.
In fact, the first case of gonorrhea Ramm saw as a professional was “an upper class married couple.”
“It can be your grandmother, mother, daughter, friend,” she said. “It can be anyone.”
Like Moore in Canada, Romm hopes that more scheduled and regular testing will help people get treated before complications begin and slow the spread. She also wants this to make discussions about STDs less embarrassing.
That, Romm hopes, will spur more “normality” around practicing safer sex.
“About 75 percent of girls have had sex by the time they finish high school,” she said. “And they don’t tend to use condoms. The pill is not enough.”
Since the main protection from STIs – beyond abstinence – is barrier protection, she’d like to see that change.
“This is something we have to make happen,” she said. “We have to normalize this with more testing, more discussion, and more acceptance,” she said.
“The more we destigmatize it, the better off we all are,” Romm said.