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A growing shift toward universal screening for infectious diseases is transforming how primary care providers (PCPs) identify and manage conditions such as hepatitis B, hepatitis C, HIV, and sexually transmitted infections (STIs). Recent updates to screening guidelines and new educational resources are making it easier for clinicians to detect these diseases early, improving outcomes for millions of Americans.
From Risk-Based to Universal Screening
Historically, PCPs relied on complex, risk-based screening protocols for infections like hepatitis B and C, HIV, and bacterial STIs. These protocols required providers to ask detailed questions about patient behaviors and risk factors, while patients had to be forthcoming about sensitive information. Conflicting guidelines from agencies such as the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force added to the confusion, often resulting in missed screenings.
However, since 2020, the CDC has recommended universal hepatitis C screening for all adults over 18, and in 2023, it expanded hepatitis B screening to all adults at least once in their lifetime. Universal HIV screening is also now standard practice, as evidence shows it is more effective than risk-based strategies in identifying undiagnosed cases.
Addressing Hepatitis B: An Underused Screening
Hepatitis B remains one of the most underutilized screening tests in the U.S., despite estimates that up to 2.4 million Americans may be living with the infection. Many remain unaware of their status, and misconceptions persist that hepatitis B is not a significant issue domestically. Universal screening aims to change this by simplifying protocols and reducing stigma, making it easier for both providers and patients to participate.
While there is currently no cure for hepatitis B, effective treatments exist, and early detection is crucial. Universal screening also identifies individuals who have been exposed to the virus and are at risk of reactivation, especially if they undergo immune-suppressing treatments such as chemotherapy or long-term steroid use.
Simplifying Hepatitis C and HIV Detection
The CDC’s universal hepatitis C screening recommendation is now supported by new educational tools, such as the University of Washington’s Hepatitis C Online’s HCV Test and Cure Module, which launched in April 2025. This interactive resource helps providers develop proficiency in screening and diagnosing hepatitis C, further supporting early detection and treatment.
Universal HIV screening, meanwhile, has proven more effective than risk-based approaches, as many at-risk individuals may not disclose their risk factors or may not be aware of them. Increased case identification rates suggest that universal protocols are easier for physicians to implement and remember.
Combatting the Rise of STIs
STIs such as gonorrhea, chlamydia, and syphilis continue to rise, with over 2.5 million cases reported to the CDC in 2022. Syphilis, in particular, has resurged as a major public health concern, reaching its highest number of reported cases since 1950 in 2023. Because most people with STIs are asymptomatic, routine screening is essential to prevent long-term health complications, including infertility and chronic pain.
Experts recommend practical strategies to increase screening rates and reduce stigma, such as using brief questionnaires before appointments and exploring at-home testing options. Resources like the STD Clinical Consultation Network and the American Sexual Health Association provide additional support for both providers and patients.
Looking Ahead
Experts emphasize that each case of preventable infection, such as congenital syphilis, is a tragedy that can be avoided through vigilant screening and early intervention. As screening protocols become simpler and more universal, healthcare providers are better equipped to detect and treat infectious diseases before they cause severe complications.
“If we’re more careful about screening, then we can detect people earlier. We could treat them,” said Dr. Matthew Hamill, associate professor of medicine at Johns Hopkins University School of Medicine.
Disclaimer:
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The information presented is based on current guidelines and expert commentary as of June 2025, and recommendations may change as new evidence emerges.
