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Chlamydia and gonorrhea screening

In women, chlamydia and gonorrhea usually cause no symptoms but can lead to pelvic inflammatory disease and infertility. The USPSTF gives screening a grade B for all sexually active women 24 or younger, and for women 25 or older at increased risk. (USPSTF, 2021)

USPSTF grade
B
Who
Sexually active women
Ages
24 and younger; 25+ if at risk
How often
See below

When it starts, when it can stop

  • Starts: At 18 in this planner, for sexually active women (the USPSTF recommendation also covers sexually active teens). (USPSTF, 2021)
  • Can stop: Routine screening for all sexually active women ends at 24; from 25 it applies to women at increased risk, with no upper age limit. (USPSTF, 2021)

Who it is for

Sexually active women 24 years or younger, and sexually active women 25 or older who are at increased risk for infection. (USPSTF, 2021)

In My Screening Plan this shows under "Also ask your doctor about" for everyone in the age range. The planner does not ask about these risk factors, so nothing about them is entered or stored.

Test and how often

  • A nucleic acid amplification test (NAAT). It can use urine or a swab, and one sample tests for both infections. (USPSTF, 2021)
  • No set interval: the USPSTF calls it reasonable to test again when a sexual history shows new or ongoing risk factors since the last negative test. (USPSTF, 2021)

Chlamydia and gonorrhea testing by age and group

Chlamydia and gonorrhea screening: USPSTF 2021 and CDC STI Treatment Guidelines 2021
WhoUSPSTF (2021)CDC (2021)
Sexually active women 24 and youngerScreen (grade B)Screen
Sexually active women 25 and olderScreen if at increased risk (grade B)Screen if at increased risk
Pregnant peopleSame as other women (grade B)Under 25, or 25 and older at increased risk; retest in the third trimester if at risk
Men who have sex with womenEvidence insufficient (grade I)Not routine at low risk; may be considered where infections are common
Men who have sex with menEvidence insufficient (grade I)At least once a year; every 3 to 6 months at increased risk

The two agree for women. They differ for men: the USPSTF looked at sexually active men as one group and found the evidence insufficient, while the CDC 2021 guidelines advise yearly testing for sexually active men who have sex with men, at the sites of contact (urethra and rectum for chlamydia; urethra, rectum and throat for gonorrhea). (USPSTF, 2021) (CDC, 2021)

Ask your doctor which tests and sample sites fit your situation.

Where the USPSTF draws the line

Grade C means a small net benefit, so it is offered to some people; D means do not screen; I means the evidence is not enough to decide. (USPSTF grade definitions)

  • Grade I: the evidence is not enough to weigh screening sexually active men. (USPSTF, 2021)

Questions people ask

Who should get tested for chlamydia and gonorrhea?

All sexually active women 24 or younger, and sexually active women 25 or older at increased risk. The USPSTF notes that women 15 to 24 have the highest infection rates. (USPSTF, 2021)

What counts as increased risk for women 25 and older?

The USPSTF lists a previous or current STI, a new sex partner or more than one, a partner who has other partners at the same time, a partner with an STI, inconsistent condom use outside a mutually monogamous relationship, exchanging sex for money or drugs, and past incarceration. (USPSTF, 2021)

Should men be screened for chlamydia and gonorrhea?

The USPSTF found the evidence insufficient to weigh the benefits and harms of screening sexually active men (grade I). Men with symptoms, or a partner with an infection, should see a clinician. (USPSTF, 2021)

How often should you get tested?

The USPSTF found no studies on intervals. It calls it reasonable to test people whose sexual history shows new or ongoing risk factors since their last negative test. (USPSTF, 2021)

How often should gay and bisexual men get tested for chlamydia and gonorrhea?

The CDC advises at least once a year for sexually active men who have sex with men, at each site of contact, and every 3 to 6 months for those at increased risk. The USPSTF found the evidence on screening men insufficient. (CDC, 2021) (USPSTF, 2021)

Should I be tested again later in pregnancy?

The CDC advises retesting in the third trimester for pregnant people at increased risk. Your prenatal care provider will tell you what you need. (CDC, 2021)

What age is chlamydia and gonorrhea testing recommended?

Both the USPSTF and the CDC recommend testing all sexually active women under 25, the age group with the most infections, and women 25 and older at increased risk. (USPSTF, 2021) (CDC, 2021)

Does Medicare cover chlamydia and gonorrhea tests?

Medicare Part B covers one STI screening for chlamydia, gonorrhea, syphilis and hepatitis B every 12 months if you are at increased risk (or at certain times in pregnancy), when your provider orders it. You pay nothing if your primary care provider accepts assignment. (Medicare.gov)

Source

U.S. Preventive Services Task Force, "Chlamydia and Gonorrhea: Screening", final recommendation released September 14, 2021. Read it on uspreventiveservicestaskforce.org. Checked against the live page on 2026-10-28.

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