Table 2:

Canadian (national and provincial) and international guidelines on screening for chlamydia and gonorrhea

Organization	Recommendation
Canadian Task Force on Preventive Health Care (current guideline, 2021)	We recommend opportunistic screening of sexually active individuals younger than 30 yr, who are not known to belong to a high-risk group, annually, for chlamydia and gonorrhea, at primary care visits, using a self- or clinician-collected sample (conditional recommendation; very low-certainty evidence).
Public Health Agency of Canada (2020)22	Chlamydia Screening for Chlamydia trachomatis is recommended for anyone with risk factors for infection. Screening recommendations for the detection of C. trachomatis: Annual screening: Age < 25 yr Gay, bisexual, and other men who have sex with men and transgender populations Targeted screening: Offer screening and repeat screening based on risk factors in those aged ≥ 25 yr
Public Health Ontario (2018)25	Gonorrhea Offer screening to asymptomatic sexually active individuals with risk factors for gonorrhea. In Ontario, risk factors for gonorrhea of particular importance among those with unprotected sexual exposure include: Sexually active women younger than 25 yr Sexually active men who have sex with men Other risk factors as listed in the Canadian Guidelines on Sexually Transmitted Infections23 When performing concurrent testing for gonorrhea and chlamydia, use: Urine NAAT for males Vaginal NAAT (first-line) or urine NAAT (second-line) for females when a pelvic examination is not being conducted Cervical NAAT or vaginal NAAT (first-line) or urine NAAT (second-line) for females when a pelvic examination is being conducted
Ministère de la santé et des services sociaux du Québec (2019)26	Chlamydia Screening at least annually is recommended for: Men and women aged 25 yr and younger who are sexually active with no other risk factors Men and women with new sexual partners or with more than 1 concurrent partner since their last test Individuals who have had an anonymous partner or more than 3 sexual partners in the last year Men who have sex with men Sex workers or their clients (In some cases) Individuals originating from a region where sexually transmitted and blood-borne infections are endemic Gonorrhea Screening at least annually is recommended for: Men (depending on region) and all women aged 25 yr and younger who are sexually active and have no other risk factors Women with new sexual partners or with more than 1 concurrent partner since their last test Individuals who have had an anonymous partner or more than 3 sexual partners in the last year Men who have sex with men Sex workers or their clients (In some cases) Individuals originating from a region where sexually transmitted and blood-borne infections are endemic
US Preventive Services Task Force (2014)84	Sexually active women The USPSTF recommends screening for chlamydia in sexually active women aged 24 years and younger and in older women who are at increased risk for infection (Grade B recommendation). The USPSTF recommends screening for gonorrhea in sexually active women aged 24 years and younger and in older women who are at increased risk for infection (Grade B recommendation). Sexually active men The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men (I statement).
Public Health England (2018)85	Chlamydia Annually or on change of sexual partner, tests should be offered to men and women younger than 25 years who have ever been sexually active. Providers should use every opportunity to offer chlamydia screening across primary care and access to services for sexual and reproductive health and genitourinary medicine.
Australasian Sexual Health Alliance (2018)86	Test for chlamydia in the following situations: Aged < 30 yr and sexually active Partner change in the last 12 months Have had an STI in past 12 months Have had a sexual partner with an STI At increased risk of complications of an STI; e.g., termination of pregnancy or intrauterine device insertion Signs or symptoms suggestive of chlamydia Patient requests a sexual health check

Note: NAAT = nucleic acid amplification test, STI = sexually transmitted infection, USPSTF = United States Preventive Services Task Force.