While screening younger women and men who have sex with men for STIs could help prevent more serious health problems across the board, the potential health benefits for straight men aren’t as clear.
“There is insufficient data to draw definitive conclusions about the effectiveness of screening heterosexual men at low risk for gonorrhea and chlamydia,” writes Laura Bachmann, MD, chief medical officer of the CDC’s department of STD prevention, in an e- Mail. “More research is needed.”
And given the low risk of long-term complications in straight men, there’s little momentum to fund this research, says Jeffrey Klausner, MD, an STI specialist at the Keck School of Medicine at the University of Southern California at Los Angeles.
“Nobody said, ‘Well, that’s a $ 20 million question,'” he notes.
And while it makes sense by screening heterosexual men and detecting and treating more STIs to lower STI rates in the general population and in women, he says, studies have not found it.
Given the direct health benefits of screening in women and the lack of evidence to support screening heterosexual men, universal testing efforts simply are not cost-effective, says Dionne-Odom.
“At $ 70 per test, if you test everyone in your community, that’s a lot of dollars that could go into HIV prevention. It could help pregnant women have access to penicillin for syphilis, ”she says. “You can think of all the other places you could argue about where those dollars could be spent.”
Although these recommendations for STI screening focus more on MSM and women, they are not “prescriptive standards,” says Bachmann. “The guidelines advise healthcare providers to always consider each person’s clinical circumstances in the context of local disease prevalence.”
Park would ultimately support extending testing guidelines to include straight men, but that should also go with expanded access to STI testing, she says. Men – especially younger men – do not always have a family doctor or see a doctor on a regular basis. And with the closure of STI clinics, it has become more difficult for people to get tested easily, says Dionne-Odom. Home STI test kits could be a solution, but these kits can also be expensive.
“To reduce stigma, it would be wonderful if we normalized STI tests and said that everyone had to do this,” says Park. “We’re just not there yet.”
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