STI Diagnosis and TX

Question 1

Who should be screened for STIs?

Answer 1

• sexually active women younger than 25 years old
• new sexual partner in previous 3 months
• ALL pregnant women (concern for neonate)
• sexually active gay and bisexual men
• anyone participating in unprotected sex or IV drug use
• residing in an area of high STD prevelance
• adults and adolescents from ages 13-64 tested once for HIV

Question 2

sexually active women < 25 should be screened for?

Answer 2

• gonorrhea and chlamydia annually
• HIV (at least once)
• syphilis, trichomoniasis, HBV and HCV if increased ris k

Question 3

MSM should be screened for what STIs?

Answer 3

• gonorrhea, chlamydia, HIV and syphillis at least annually
• HBV, HAV at first visit
• HCV at least once
• Rectal gonrrhea/chlamydia and pharyngeal gonorrhea if exposed

Question 4

pregnant women should be screened for?

Answer 4

• 1st trimester: chlamydia, gonorrhea, syphillis, HIV, and HBV
• repeat in 3rd trimester if new partner

Question 5

which STDs require expedited partner therapy?

Answer 5

chlamydia, gonorrhea, and trichomonas infections

Question 6

• most common reportable bacterial STD with peak incidence in females 15-24

Symptoms in women

• odorless mucopurulent vaginal discharge (no pruritis)
• 85% asymptomatic
• exam- cervical dishcharge, friable
• cervicitis
• ascending infection» PID
• urethritis

Men

• asymptomtic or urethral discharge/dysuria
• “milking hte urethra”
• epididymitis (unilateral testicular pain and tenderness)

can lead to reactive arthritis (gonorrhea and other too)

Answer 6

chlamydia

Question 7

screening test for chlamydia trachomatis?

Answer 7

• nucleic acid amplification test (NAAT)
• Urine samples
• rectal, throat, endocervical, vaginal, male urethra