Screening

In the UK, opportunistic screening for gonorrhoea is not recommended unless there is a clear local public health need. However, screening for gonorrhoea is recommended in any population or setting in which the prevalence of gonorrhoea is ≥1%; below a prevalence of 1%, the majority of initial positive test results are likely to be false positives, suggesting unselected screening would be of limited public health benefit.[51]​​

Men

The US Preventive Services Task Force (USPSTF) cites insufficient evidence to support for or against routine screening in men at increased risk.[65] The Centers for Disease Control and Prevention (CDC) recommends that sexually active men having sex with men should have annual screening for gonorrhoea at any site where exposure has occurred in the past year (urine, rectum, and throat), preferably by nucleic acid amplification test.[26]​ Those at highest risk with multiple partners, anonymous partners, associated drug use (e.g., methamphetamine or other club-related drugs), HIV, and a negative HIV test but receiving pre-exposure prophylaxis (PrEP) for HIV should be screened more frequently, up to every 3 to 6 months.[26]​​ Low-risk asymptomatic men should not be screened.

Non-pregnant women

The USPSTF recommends that all sexually active women under the age of 25 years should be screened for gonorrhoea, and the CDC recommends that this should be carried out annually.[26]​​[65] Women who are 25 years or older should be screened if they have an increased risk for infection.[65] This includes women from a high-morbidity community (as defined by an increased prevalence) or those with individual risk factors (e.g., multiple recent sex partners, a history of an STI, a partner with an STI), and those connected to networks with the incarcerated, to the commercial sex trade, or to drug use. Low-risk asymptomatic women should not be screened. Screening advice varies in different countries.[66][67][68][69]

Pregnant women

The USPSTF and CDC recommend screening pregnant women under 25 years old and those over 25 years old who are at risk for gonorrhoea infection at the first antenatal visit (as listed in the section on screening in women).[26]​​[65] The CDC also recommends re-testing pregnant women during the third trimester if they remain at high risk for gonococcal infection in order to prevent maternal postnatal complications and gonococcal infection in the neonate.[26]​​

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