STI Screening Recommendations for Bisexual Individuals

Core Annual Screening Panel

The American Academy of Pediatrics recommends that all sexually active bisexual individuals receive annual testing for chlamydia and gonorrhea using nucleic acid amplification tests (NAATs) at all sites of sexual exposure 1, 2
The Centers for Disease Control and Prevention recommends annual syphilis serologic testing with both nontreponemal (RPR or VDRL) and treponemal tests (EIA or CIA) 1, 3
The US Preventive Services Task Force recommends HIV testing for all individuals aged 13-64 years 4, 5
The Centers for Disease Control and Prevention recommends hepatitis B and C screening based on vaccination status and risk factors 4

The American College of Physicians recommends urogenital testing using urine NAAT for chlamydia and gonorrhea (or vaginal swab for those with vaginas) 1, 3
The Infectious Diseases Society of America recommends rectal swabs for chlamydia and gonorrhea using NAAT (if laboratory has validated testing) for those engaging in receptive anal intercourse 1, 3
The American Sexual Health Association recommends pharyngeal swabs for gonorrhea using NAAT or culture (if laboratory has validated testing) for those engaging in receptive oral sex 1, 3

The Centers for Disease Control and Prevention recommends screening every 3-6 months if any of the following risk factors are present: multiple or anonymous sexual partners, substance use during sexual activity, unprotected sex outside a mutually monogamous relationship, recent diagnosis of any STI, sex work or exchanging sex for money or drugs, or partners who engage in any of these high-risk behaviors 1, 2, 3

The American Academy of Pediatrics recommends rescreening at 3 months after treatment for chlamydia or gonorrhea, regardless of whether sexual partners were treated 7, 2
The Centers for Disease Control and Prevention recommends considering rescreening at 3 months for trichomoniasis in those with vaginas 7, 2

The American College of Obstetricians and Gynecologists recommends annual screening for chlamydia and gonorrhea for bisexual individuals ≤25 years with vaginas, regardless of reported risk behaviors 7, 2
The US Preventive Services Task Force recommends screening annually for bisexual individuals >25 years with vaginas if any risk factors are present (new partner, multiple partners, inconsistent condom use) 7, 4

The American Medical Association recommends not assuming screening needs based on sexual orientation identity alone—bisexual individuals may identify as heterosexual, gay, or bisexual, but their actual sexual practices determine screening sites 7
The Infectious Diseases Society of America recommends not relying solely on urogenital testing—extragenital infections (pharyngeal and rectal) are frequently asymptomatic and account for 6-10% of infections in at-risk populations 1, 3
The American College of Physicians recommends not using inferior testing methods—NAATs are strongly preferred over culture or wet mount for chlamydia, gonorrhea, and trichomoniasis due to superior sensitivity 2, 8