Reference — Infection Control
STI Screening & Patient Teaching Reference
Most STIs are found by screening, not symptoms — which makes knowing who gets tested, how to take the history, and what to teach afterward the core preventive skill set. This reference condenses the screening groups, the 5 P’s, and the teaching that prevents the next infection.
Educational use only. Screening intervals and reporting requirements follow current CDC guidance and state law — both change; verify against your facility’s current protocol. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Who Gets Screened
| Group | Screening |
|---|---|
| Sexually active women under 25 | Chlamydia and gonorrhea at least annually |
| Women 25+ with risk factors (new/multiple partners, partner with an STI) | Chlamydia and gonorrhea annually |
| Pregnant patients | Syphilis, HIV, and hepatitis B at the first prenatal visit (chlamydia/gonorrhea per age and risk); syphilis repeated in the third trimester per risk and state rules |
| Everyone 13–64 | HIV at least once; annually or more with ongoing risk |
| Men who have sex with men | Syphilis, chlamydia, gonorrhea, and HIV at least annually (every 3–6 months with higher risk) |
| Anyone diagnosed with one STI | Offer testing for the others — HIV and syphilis in particular; retest chlamydia/gonorrhea ~3 months after treatment |
The 5 P’s Sexual History
Taken in private, with confidentiality stated first, in the same matter-of-fact tone as any other system review.
| P | What You’re Asking |
|---|---|
| Partners | Number and gender of partners; new partners recently |
| Practices | Types of sexual contact — determines which sites need testing |
| Protection | Condom/barrier use — always, sometimes, never (and what gets in the way) |
| Past STIs | Prior infections and treatment for patient and partners |
| Pregnancy plans | Desire for pregnancy and contraception use — frames prevention teaching |
Reporting, Partners & Consent
Reportable diseases
Chlamydia, gonorrhea, syphilis, and HIV are reportable to public health in every state (others vary). Reporting is a legal duty performed by the facility/provider — explain to patients that public-health follow-up is confidential contact tracing, not exposure of their diagnosis.
Expedited partner therapy (EPT)
Most states permit treating the partner of a patient with chlamydia or gonorrhea via prescription or medication sent without an exam. Reinfection from an untreated partner is the most common cause of “treatment failure” — partner treatment is treatment.
Minors
All states allow minors to consent to their own STI testing and treatment (age thresholds and confidentiality details vary by state). An STI in a young child, by contrast, is a red flag for abuse and triggers mandatory reporting.
Prevention Teaching Checklist
- ✦Condoms/barriers with every act — highly effective for fluid-borne STIs; less so for skin-contact infections (herpes, HPV, syphilis) outside the covered area
- ✦Vaccines: HPV (routine at 11–12, catch-up through 26, shared decision to 45) and hepatitis B — frame HPV vaccination as cancer prevention
- ✦Finish every treatment course; abstain until both partners complete treatment (typically 7 days after single-dose regimens)
- ✦Retest for chlamydia/gonorrhea about 3 months after treatment — reinfection is common
- ✦Doxycycline causes photosensitivity and is avoided in pregnancy (the older 'avoid alcohol with metronidazole' rule was dropped in the 2021 CDC STI guidelines — there is no true disulfiram-like interaction)
- ✦Mutual monogamy with a tested partner and reducing partner number reduce risk; PrEP is available for ongoing HIV risk
- ✦No symptoms ≠ no infection — routine screening is the safety net
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with CDC / HICPAC · Infectious Diseases Society of America (IDSA) / SHEA. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →