Screening for sexually transmitted infections.

The high prevalence of STI in many developed countries; their costly physical, psychological, and relationship sequelae; and their association with the acquisition and transmission of HIV necessitate the introduction of screening programs, especially those that encourage opportunistic screening in diverse health care and community settings. This requirement is accompanied by the need for better awareness and education of health care professionals, especially those working in primary care or in sexual health disciplines, and knowledge of local prevalence and other epidemiologic factors to allow cost-effective targeting of high-risk groups. Such programs should be accompanied by the development of effective clinical alliances between those undertaking screening, the diagnostic microbiology laboratories, and clinicians with local responsibility for case management and public health control. The development of new molecular methods of diagnosis for the common bacterial STI permits screening in the community to be extended. This will help detect those asymptomatic persons who would not otherwise access health services but who may act as important vectors in STI spread and who continue to maintain local reservoirs.