Answers to those burning questions -

Size: px
Start display at page:

Download "Answers to those burning questions -"

Transcription

1 Answers to those burning questions - Ann Avery MD Infectious Diseases Physician-MetroHealth Medical Center Assistant Professor- Case Western Reserve University SOM Medical Director -Cleveland Department of Public Health Basic concepts Transmission dynamics of STDs STDs occur at the intersection of the other epidemics esp drugs and poverty Condoms work when used consistently Prevention education and behavior change is challenging (to both the provider and the patient) When there s one, look for others 1

2 HIV and STDs Synergy between STDs and HIV ALL clients seeking STD screening should be offered HIV testing at the same time. All patients between 13 and 64 recommended to have HIV test at least once. ( CDC Oct 2006) Risk of an STD Is dependent on: Personal behaviors Background Community prevalence Transmission dynamics of a given STD 2

3 Estimates of Risk and Duration Disease risk of acquistion Duration of infectivity Gonorrhea days Chlamydia mos. HSV lifelong Chancroid days HIV lifelong The Five Ps: Partners Practices Past History of STDs Protection from STDs Prevention of Pregnancy 3

4 Urethritis and mucopurulent cervicitis 4

5 Causative organisms for Urethritis and cervicitis N. gonorrhea Chlamydia trachomatis Trichomonas Mycoplasma genitalium Herpes simplex virus Adenovirus Gram negative Anaerobes 5

6 Gram stain Diagnostic tests Microscopy of the vaginal/ cervical fluid Nucleic acid amplification Culture DNA probes 6

7 Complications of Untreated genital infections result of spread of pathogen, inflammatory response and subsequent healing (scarring) Pelvic inflammatory disease / epididymitis Infertility Chronic pelvic pain Ectopic pregnancy prostatitis urethral stricture Disseminated gonorrhea/ reactive arthritis post Chlamydia (Reiter s syndrome) Joint involvement, ocular, and skin 7

8 Does this cervix have Chlamydia? 8

9 CDC 2004 surveillance report Chlamydia rates per 100,000, Cleveland Group Overall 1,029 Black female teens 15-19y 10,341 (1 in 10) Black male teens 15-19y 3,414 (1 in 29) Black females 20-24y 7,985 (1 in 12) Black males 20-24y 4,486 (1 in 22) CDPH Dept of Biostatistics 9

10 Why screen and treat an asymptomatic infection? Subtle symptoms Long duration of infectivity Prevent Complications PID Chronic Pelvic Pain Infertility Ectopic Pregnancy 10

11 25% of women with gonorrhea or Chlamydia have endometritis histologically Organisms PID Gonorrhea, Chlamydia, anaerobes Treatment Ceftriaxone 250 mg IM + Doxycycline 100 mg po BID x 14 +/- metronidazole 11

12 Normal female genitalia How does the diagnosis of Chlamydia affect future fertility? Evaluated time to pregnancy and rates of ectopic pregnancy in relation to CT diagnosis among ALL women 31% CT + and 29.5% CT- became pregnant Time to birth comparable No effect on fertility or ectopic pregnancy noted retrospectively among clients diagnosed with CT Andersen et al. Sex Trans Dis June (6)

13 Recurrent Chlamydia infections in young women Prospectively recruited women diagnosed with CT to return for f/u eval at 1 and 4 months ( all treated) Among women negative at first f/u --7.1% positivity at 4 mo f/u Re-screening in 3-4 months recommended for all patients with infection. Whittington et al. Sex Trans Dis Feb (2) Gonorrhea rates by ethnicity CDC 2007 GISP report 13

14 Gonorrhea screening Screening in areas of with at least 1% prevalence high incidence tend to concentrated in urban areas. NAATs screening Cultures Probes Gonorrhea Can also live in oral pharynx Usually without symptoms Easily passed through oral sex to cause urethritis Can live in rectal environment may cause proctitis or no symptoms 14

15 Pharyngeal Gonorrhea Pharyngeal Gonorrhea Symptoms: >90% of infections are asymptomatic Sore throat, when symptoms present Lymphadenopathy may be present Most infections will self-resolve Diagnosis: GC culture or NAATs 15

16 Screening for Rectal and Pharyngeal CT and GC in MSM CDC recommends screening of atrisk men who have sex with men (MSM) at least annually for urethral and rectal GC and CT, and for pharyngeal GC. MMWR, July 9, 2009 STIs in MSM Screened men attending STD clinic and gay men s health clinic with rectal, pharyngeal and urethral swabs 53% of Chlamydia infections not in urethra 64% of gonococcal infections were not in urethra Kent et al. CID 2005;41:

17 It s Everywhere! Kent et al. CID 2005;41:67-74 Asymptomatic infection in Men 86% asymptomatic rectal infections 42% asymptomatic urethral infections Kent et al. CID 2005;41:

18 Screening for Rectal and Pharyngeal CT and GC The rectum and pharynx are the most common sites of GC and CT infection among MSM. Infections are usually asymptomatic and typically occur without concomitant urethral infection Only a minority of MSM at risk for STDs are screened for GC and CT at the recommended frequency. - treatment same as for urethral infections CDC Recommendations Yearly screening for rectal GC and CT for MSM who had receptive anal intercourse during the preceding year Yearly screening for pharyngeal GC for MSM who have had receptive oral intercourse during the preceding year. Screening is recommended regardless of history of condom use during exposure. 18

19 CDC Recommendations Also screen: at three to sex month intervals for MSM who have multiple or anonymous partners MSM who have sex in conjunction with illicit drug use, use methamphetamine or whose sex partners have participate in those activities. NAAT Testing Nucleic acid amplification testing (NAAT) is generally more sensitive than culture for the detection of both GC and CT. NAAT tests have not been cleared by the FDA for the diagnosis of extra-genital CT or GC. Under U.S. law, labs may offer NAAT testing for diagnosis of extra-genital CT or GC after internal validation of the method by verification study. 19

20 NAAT Testing CDC encourages labs to do their own studies to establish performance and initiate testing. For more information about the process: Carol Farshy NAAT Testing A list of labs that have completed the studies to establish performance is available on the American Public Health Laboratories website: 20

21 21

22 FIGURE 2. Percentage of gonorrhea isolates with cefixime MICs 0.25 µg/ml and ceftriaxone MICs µg/ml, by sex of sex partner --- Gonococcal Isolate Surveillance Project, United States, MMWR July 8, 2011 / 60(26); Gonorrhea treatment Ceftriaxone 250 mg or Cefixime 400 mg po (not for MSM) Plus treatment for Chlamydia Azithromycin 1 gm po once or Doxycycline 100mg po BID x 7 days 22

23 Partner Management Maintain abstinence for 7 days while completing treatment regimen and until all partners are treated All sexual contacts within past 60 days should be evaluated and treated Expedited Partner Therapy (e.g. Field delivered Therapy, Patient Delivered Partner Therapy) should be offered if legal Case screnario- NGU 33 y/o heterosexual male presents to clinic with dysuria- NGU by gram stain. Treated with doxy 100 BID. Returns in 2 wks and states no relief 23

24 NGU Mycoplasma genitalium getting some attention Occurs about 10% of NGU but much higher in pts with persistent NGU as relatively resistant to Doxycycline Pearl- responds best to Azithromycin or Moxifloxacin but not Cipro or Levo NGU persistent 24

25 Trichomonas Diagnostic options Wet mount Culture Pcr/ naat Treatment issues Trichomonas Single dose Metronidazole is NOT recommended for Bacterial vaginosis due to lower efficacy. 25

26 Challenge question Allergy to Metronidazole? Epidemiological Synergy Co-infection with HIV prolongs the infectiousness on STDs STDs facilitate HIV transmission by increasing genital HIV-RNA/DNA levels STDs facilitate HIV acquisition by disrupting epithelial barriers and attracting inflammatory cells GUD increases risk of HIV 8 fold 26

27 Urine-Based Tests Nucleic Acid Amplification Tests (NAATs) for gonorrhea and chlamydia Highly accurate Non-invasive collection High patient acceptability Appropriate for screening asymptomatic persons Allows screening in nontraditional settings Community settings Correctional settings Schools Urethritis/ cervicitis, proctitis Vaginitis Genital ulcers Genital warts Gonorrhea Chlamydia Trichomonas Mycoplasma, Herpes Simplex Virus adenovirus Trichomonas Bacterial vaginosis Candida Syphilis Herpes Simplex Virus Chancroid (h. ducrei) HPV syphilis 27

28 Contact info: Ann Avery MD office pager 28

5/1/2017. Sexually Transmitted Diseases Burning Questions

5/1/2017. Sexually Transmitted Diseases Burning Questions Sexually Transmitted Diseases Burning Questions Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health University of California Los Angeles Los Angeles, California FORMATTED: 04-03-17 Financial

More information

Genital Chlamydia and Gonorrhea Epidemiology, Diagnosis, and Management. William M. Geisler M.D., M.P.H. University of Alabama at Birmingham

Genital Chlamydia and Gonorrhea Epidemiology, Diagnosis, and Management. William M. Geisler M.D., M.P.H. University of Alabama at Birmingham Genital Chlamydia and Gonorrhea Epidemiology, Diagnosis, and Management William M. Geisler M.D., M.P.H. University of Alabama at Birmingham Chlamydia and Gonorrhea Current Epidemiology Chlamydia Epidemiology

More information

Nothing to disclose.

Nothing to disclose. Update on Diagnosis and Treatment Lisa Winston, MD University of California, San Francisco/ Zuckerberg San Francisco General Nothing to disclose. 1 This talk will be a little depressing Rising incidence

More information

GAY MEN/MSM AND STD S IN NJ: TAKE BETTER CARE OF YOUR PATIENTS! STEVEN DUNAGAN SPECIAL PROJECTS COORDINATOR NJ DOH STD PROGRAM SEPTEMBER 27, 2016

GAY MEN/MSM AND STD S IN NJ: TAKE BETTER CARE OF YOUR PATIENTS! STEVEN DUNAGAN SPECIAL PROJECTS COORDINATOR NJ DOH STD PROGRAM SEPTEMBER 27, 2016 GAY MEN/MSM AND STD S IN NJ: TAKE BETTER CARE OF YOUR PATIENTS! STEVEN DUNAGAN SPECIAL PROJECTS COORDINATOR NJ DOH STD PROGRAM SEPTEMBER 27, 2016 TOPICS FOR DISCUSSION What medical providers should know

More information

Sexually transmitted infections (in women)

Sexually transmitted infections (in women) Sexually transmitted infections (in women) Timothy Kremer, MD Assistant Professor, Department of Obstetrics and Gynecology University of North Texas Health Science Center Last official CDC guidelines:

More information

Update on Sexually Transmitted Infections among Persons Living with HIV

Update on Sexually Transmitted Infections among Persons Living with HIV Update on Sexually Transmitted Infections among Persons Living with HIV Stephen A. Berry, MD PhD Assistant Professor of Medicine Johns Hopkins University Division of Infectious Diseases Abbreviations and

More information

Sexually Transmitted Diseases

Sexually Transmitted Diseases Sexually Transmitted Diseases Ina Park, MD, MS California Prevention Training Center University of California San Francisco Dept of Family and Community Medicine Disclosures/Disclaimers No disclosures

More information

Sexually Transmitted Infections in the Adolescent Population. Abraham Lichtmacher MD FACOG Chief of Women s Services Lovelace Health System

Sexually Transmitted Infections in the Adolescent Population. Abraham Lichtmacher MD FACOG Chief of Women s Services Lovelace Health System Sexually Transmitted Infections in the Adolescent Population Abraham Lichtmacher MD FACOG Chief of Women s Services Lovelace Health System STI in the Adolescent High school students nationwide, 34.2% were

More information

STIs- REVISION. Prof A A Hoosen

STIs- REVISION. Prof A A Hoosen STIs- REVISION Prof A A Hoosen Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria and the NHLS Microbiology Tertiary Laboratory at the Pretoria Academic Hospital Complex

More information

Khalil G. Ghanem, MD, PhD Associate Professor of Medicine Johns Hopkins University School of Medicine. April 2, 2014

Khalil G. Ghanem, MD, PhD Associate Professor of Medicine Johns Hopkins University School of Medicine. April 2, 2014 Khalil G. Ghanem, MD, PhD Associate Professor of Medicine Johns Hopkins University School of Medicine April 2, 2014 E-mail your questions for the presenter to: maphtc@jhsph.edu DISCLOSURES OFF- LABEL USES

More information

Index. Infect Dis Clin N Am 19 (2005) Note: Page numbers of article titles are in boldface type.

Index. Infect Dis Clin N Am 19 (2005) Note: Page numbers of article titles are in boldface type. Infect Dis Clin N Am 19 (2005) 563 568 Index Note: Page numbers of article titles are in boldface type. A Abstinence in genital herpes management, 436 Abuse sexual childhood sexual behavior effects of,

More information

6/11/15. BACTERIAL STDs IN A POST- HIV WORLD. Learning Objectives. How big a problem are STIs in the U.S.?

6/11/15. BACTERIAL STDs IN A POST- HIV WORLD. Learning Objectives. How big a problem are STIs in the U.S.? BACTERIAL STDs IN A POST- HIV WORLD Tracey Graney, PhD, MT(ASCP) Monroe Community College Learning Objectives Describe the epidemiology and incidence of bacterial STDs in the U.S. Describe current detection

More information

Services for GLBTQ Youth

Services for GLBTQ Youth Sexual Health Care Services for GLBTQ Youth Gale R Burstein, MD, MPH, FAAP, FSAHM Erie County Commissioner of Health Buffalo, NY Agenda Introduction Epidemiology Sexual health care services for YMSM Sexual

More information

Advances in STI diagnostics. Dr Paddy Horner Consultant Senior Lecturer University of Bristol

Advances in STI diagnostics. Dr Paddy Horner Consultant Senior Lecturer University of Bristol Advances in STI diagnostics Dr Paddy Horner Consultant Senior Lecturer University of Bristol Advances in STI diagnostics Rapid expansion in on-line STI testing Outstripping NHS expert advice Increasing

More information

S403- Update on STIs for the Generalists

S403- Update on STIs for the Generalists S403- Update on STIs for the Generalists Mobeen H. Rathore, MD Professor and Director University of Florida Center for HIV/AIDS Research Education and Service (UF CARES) Chief, Pediatric Infectious Diseases

More information

STIs: Practical Aspects of Management

STIs: Practical Aspects of Management STIs: Practical Aspects of Management Dr Heather Young FAChSHM DipPH Christchurch Sexual Health heathery@xtra.co.nz 027 343 4963 Sexually Transmitted Infections BACTERIAL STIs: CHLAMYDIA GONORRHOEA SYPHILIS

More information

CLINICAL MANAGEMENT OF STDS

CLINICAL MANAGEMENT OF STDS CLINICAL MANAGEMENT OF STDS Diana Torres-Burgos MD, MPH NYC STD/HIV Prevention Training Center STD/HIV Update Conference Grand Rapids, MI 3/11/2014 Outline Essential components of STD care management Sexual

More information

WHAT DO U KNOW ABOUT STIS?

WHAT DO U KNOW ABOUT STIS? WHAT DO U KNOW ABOUT STIS? Rattiya Techakajornkeart MD. Bangrak STIs Cluster, Bureau of AIDS, TB and STIs, Department of Disease Control, MOPH, Thailand SEXUALLY TRANSMITTED INFECTIONS? STIs Infections

More information

Sexually transmitted infections (in women)

Sexually transmitted infections (in women) Sexually transmitted infections (in women) Timothy Kremer, MD Assistant Professor, Department of Obstetrics and Gynecology University of North Texas Health Science Center Last official CDC guidelines:

More information

Chapter 11. Sexually Transmitted Diseases

Chapter 11. Sexually Transmitted Diseases Chapter 11. Sexually Transmitted Diseases General Guidelines Persons identified as having one sexually transmitted disease (STD) are at risk for others and should be screened as appropriate. Partners of

More information

Sexually Transmitted Diseases. Summary of CDC Treatment Guidelines

Sexually Transmitted Diseases. Summary of CDC Treatment Guidelines DC 2015 Sexually Transmitted Diseases Summary of CDC Treatment Guidelines These summary guidelines reflect the June 2015 update to the 2010 CDC Guidelines for Treatment of Sexually Transmitted Diseases.

More information

Several of the most common STDs are often asymptomatic. Asymptomatic

Several of the most common STDs are often asymptomatic. Asymptomatic What Are STDs? Several of the most common STDs are often asymptomatic. Asymptomatic Individuals show no symptoms, or the symptoms are mild and disappear after the onset of the infection Common STDs There

More information

STDs and Hepatitis C

STDs and Hepatitis C STDs and Hepatitis C Catherine S. O Neal, MD Assistant Professor of Clinical Medicine, Infectious Diseases Louisiana State University Health Sciences Center March 3, 2018 Objectives Review patient risk

More information

Novos desafios para controlar as infecções sexualmente transmissíveis [New Challenges in Managing Sexually Transmitted Infections]

Novos desafios para controlar as infecções sexualmente transmissíveis [New Challenges in Managing Sexually Transmitted Infections] Novos desafios para controlar as infecções sexualmente transmissíveis [New Challenges in Managing Sexually Transmitted Infections] Khalil Ghanem, MD, PhD Associate Professor of Medicine Directors, STD/HIV/TB

More information

Chlamydia Trachomatis and Neisseria Gonorrhoeae. Khalil G. Ghanem, MD Johns Hopkins University

Chlamydia Trachomatis and Neisseria Gonorrhoeae. Khalil G. Ghanem, MD Johns Hopkins University This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Stephanie. STD Diagnosis and Treatment. STD Screening for Women. Physical Exam. Cervix with discharge from os

Stephanie. STD Diagnosis and Treatment. STD Screening for Women. Physical Exam. Cervix with discharge from os STD Diagnosis and Treatment Ina Park, MD, MS STD Control Branch, California Department of Public Health California STD/HIV Prevention Training Center Stephanie 23 year-old female presents for contraception,

More information

LABORATORY DIAGNOSIS SEXUALLY TRANSMITTED DISEASES

LABORATORY DIAGNOSIS SEXUALLY TRANSMITTED DISEASES LABORATORY DIAGNOSIS SEXUALLY TRANSMITTED DISEASES LABORATORY MEDICINE COURSE 2004 CLINICAL MICROBIOLOGY SERVICE STD EPIDEMIC- USA TIP OF THE ICEBERG INCIDENCE DISCHARGE Chlamydia - 4 million Gonorrhea

More information

Julie Nelson RNC/WHNP-BC Epidemiology NURS 6313

Julie Nelson RNC/WHNP-BC Epidemiology NURS 6313 Julie Nelson RNC/WHNP-BC Epidemiology NURS 6313 Chlamydia Most frequently reported bacterial STI in the US In 2006, In U.S. 1,030,911 cases were reported. Estimated 2,291,000 infections in 14-39 year olds.

More information

Learning Objectives. STI Update. Case 1 6/1/2016

Learning Objectives. STI Update. Case 1 6/1/2016 Learning Objectives STI Update June 16 th, 2016 Madhu Choudhary, MD. FIDSA Assoc. Prof of Medicine Albany Medical College Review screening recommendations for STI in different patient populations Describe

More information

What's the problem? - click where appropriate.

What's the problem? - click where appropriate. STI Tool v 1.9 @ 16/11/2017 What's the problem? - click where appropriate. Male problems: screening urethral symptoms proctitis in gay men lumps or swellings ulcers or sores skin rash and/or itch Female

More information

Emerging Issues in STDs and Resistance

Emerging Issues in STDs and Resistance Emerging Issues in STDs and Resistance Toye H. Brewer, MD Asst. Professor of Clinical Medicine University of Miami School of Medicine Co-Director- Fogarty International Training Program Outline Syphilis-

More information

Clinical Guidelines Update (aka Know Your NAATs)

Clinical Guidelines Update (aka Know Your NAATs) Clinical Guidelines Update (aka Know Your NAATs) WARNING: contains adult themes, sexual references and pictures that may be disturbing! Dr Heather Young Christchurch Sexual Health Centre heather.young@cdhb.health.nz

More information

Disclosures. What s New in the 2015 CDC STD Treatment Guidelines. Outline. None

Disclosures. What s New in the 2015 CDC STD Treatment Guidelines. Outline. None Disclosures None What s New in the 2015 CDC STD Treatment Guidelines Ina Park, MD, MS California STD/HIV Prevention Training Center UCSF Dept of Family and Community Medicine STD Control Branch California

More information

Sexually Transmitted Infections: New Tests, New Guidelines

Sexually Transmitted Infections: New Tests, New Guidelines Sexually Transmitted Infections: New Tests, New Guidelines Michael S. Policar, MD, MPH UCSF Ob, Gyn, and Reproductive Sciences No disclosures for this lecture Value of STI Screening and Testing Benefits

More information

STD Essentials for the Busy Clinician. Stephanie E. Cohen, MD, MPH

STD Essentials for the Busy Clinician. Stephanie E. Cohen, MD, MPH STD Essentials for the Busy Clinician Stephanie E. Cohen, MD, MPH Assistant Professor, Division of Infectious Diseases, UCSF Medical Director, City Clinic San Francisco Department of Public Health Disclosures

More information

Categories of STI Screening and Testing Routine screening Population based risk factors Targeted screening Personal behavioral risk factors Contact te

Categories of STI Screening and Testing Routine screening Population based risk factors Targeted screening Personal behavioral risk factors Contact te Sexually Transmitted Infections: New Tests, New Guidelines Michael S. Policar, MD, MPH UCSF Ob, Gyn, and Reproductive Sciences No disclosures for this lecture Value of STI Screening and Testing Benefits

More information

Sexually Transmi/ed Diseases

Sexually Transmi/ed Diseases Sexually Transmi/ed Diseases Chapter Fourteen 2013 McGraw-Hill Higher Education. All rights reserved. Also known as sexually transmitted infections The Major STDs (STIs) HIV/AIDS Chlamydia Gonorrhea Human

More information

Trends in Reportable Sexually Transmitted Diseases in the United States, 2007

Trends in Reportable Sexually Transmitted Diseases in the United States, 2007 Trends in Reportable Sexually Transmitted Diseases in the United States, 2007 National Surveillance Data for Chlamydia, Gonorrhea, and Syphilis Sexually transmitted diseases (STDs) remain a major public

More information

Women s Sexual Health: STI and HIV Screening. Barbara E. Wilgus, MSN, CRNP STD/HIV Prevention Training Center at Johns Hopkins

Women s Sexual Health: STI and HIV Screening. Barbara E. Wilgus, MSN, CRNP STD/HIV Prevention Training Center at Johns Hopkins Women s Sexual Health: STI and HIV Screening Barbara E. Wilgus, MSN, CRNP STD/HIV Prevention Training Center at Johns Hopkins I have no disclosures! Review most recent rates of STIs and HIV across the

More information

Update on Sexually Transmitted Infections Jeanne Marrazzo, MD, MPH

Update on Sexually Transmitted Infections Jeanne Marrazzo, MD, MPH Update on Sexually Transmitted Infections Jeanne Marrazzo, MD, MPH Division of Infectious Diseases University of Alabama at Birmingham School of Medicine Birmingham, Alabama Outline Syphilis in all its

More information

Testing, Treating and Managing STIs Dr Jean Irvine

Testing, Treating and Managing STIs Dr Jean Irvine Testing, Treating and Managing STIs Dr Jean Irvine 1 Chlamydia 2 3 Chlamydia: key facts Intracellular bacterial infection Sexually transmitted: Vaginal sex Anal sex?oral sex Most common bacterial STI in

More information

Disclosures. STD Screening for Women. Chlamydia & Gonorrhea. I have no disclosures or conflicts of interest to report.

Disclosures. STD Screening for Women. Chlamydia & Gonorrhea. I have no disclosures or conflicts of interest to report. Disclosures Management of STIs: Challenges in Practice I have no disclosures or conflicts of interest to report. Alison O. Marshall, MSN, FNP-C Associate Professor of Practice & Director of the Family

More information

Extragenital Gonorrhea and Chlamydia among MSM

Extragenital Gonorrhea and Chlamydia among MSM Extragenital Gonorrhea and Chlamydia among MSM Laura Quilter, MD Infectious Disease and STD PTC Fellow University of Washington Division of Allergy and Infectious Diseases 3/28/2016 uwptc@uw.edu uwptc.org

More information

Clinical Practice Objectives

Clinical Practice Objectives STD Essentials for the Busy Clinician Susan S. Philip, MD, MPH Assistant Professor, Division of Infectious Diseases, UCSF Director, STD Prevention and Control Services San Francisco Department of Public

More information

STI Indicators by STI

STI Indicators by STI STI Indicators by STI Table of Contents pg. 2 Sexual History pg. 3-4 Syphilis pg. 5-6 Gonorrhea pg. 7-9 Chlamydia pg. 10 HIV/PrEP 1 Sexual History Comprehensive Sexual History Elements Percentage of patients

More information

STI 2016: Where We Need to Go

STI 2016: Where We Need to Go STI 2016: Where We Need to Go Gail Bolan, M.D. Director, Division of STD Prevention National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention Sexually

More information

Selassie AW (DBBE) 1. Overview 12 million incident cases per year $10 billion economic impact More than 25 organisms.

Selassie AW (DBBE) 1. Overview 12 million incident cases per year $10 billion economic impact More than 25 organisms. Infectious Disease Epidemiology BMTRY 713 (A. Selassie, DrPH) Lecture 12 Sexually Transmitted Diseases Learning Objectives 1. Review the epidemiology of sexually Transmitted Diseases 2. Assess the personal

More information

Screening & Treating Chlamydia in Primary Care. Wednesday, September 21, 2016

Screening & Treating Chlamydia in Primary Care. Wednesday, September 21, 2016 Screening & Treating Chlamydia in Primary Care Wednesday, September 21, 2016 We Want To Hear From You! Type questions into the Questions Pane at any time during this presentation Patient-Centered Primary

More information

Sexually Transmitted Diseases:

Sexually Transmitted Diseases: Sexually Transmitted Diseases: Diagnosis and Management Department of Internal Medicine, Division of Infectious Diseases University of New Mexico A 21 year old woman comes to your clinic asking to be checked

More information

Sexually Transmitted Disease Treatment Tables

Sexually Transmitted Disease Treatment Tables Sexually Transmitted Disease Treatment Tables Federal Bureau of Prisons Clinical Practice Guidelines June 2011 Clinical guidelines are made available to the public for informational purposes only. The

More information

Disclosure Information Julie Stoltey, MD MPH

Disclosure Information Julie Stoltey, MD MPH Courtesy CDC Public Health Image Library The New Yorker 2012 2016 Update on Testing, Treatment, and Gonorrhea Resistance Julie Stoltey, MD, MPH STD Control Branch-California Dept. of Public Health Assistant

More information

Sexually Transmitted Diseases

Sexually Transmitted Diseases Table of content Sexually Transmitted Diseases Judith A. Lightfoot DO, FACOI Update on the prevalence of STD s in the US Which populations are greatly affected? Should we be alarmed? How does this affect

More information

The objectives of this presentation are; to increase awareness of the issue of antimicrobial resistant gonorrhea, and to inform primary care and

The objectives of this presentation are; to increase awareness of the issue of antimicrobial resistant gonorrhea, and to inform primary care and 1 Antimicrobial resistant gonorrhea is an emerging public health threat that needs to be addressed. Neisseria gonorrhoeae is able to develop resistance to antimicrobials quickly. Effective antibiotic stewardship

More information

Dr Edward Coughlan. Clinical Director Christchurch Sexual Health Christchurch

Dr Edward Coughlan. Clinical Director Christchurch Sexual Health Christchurch Dr Edward Coughlan Clinical Director Christchurch Sexual Health Christchurch 16:30-17:25 WS #48: Mycoplasma Genitalium - The New Black 17:35-18:30 WS #58: Mycoplasma Genitalium - The New Black (Repeated)

More information

Professor Jonathan Ross

Professor Jonathan Ross SECOND JOINT CONFERENCE OF BHIVA AND BASHH 2010 Professor Jonathan Ross Whittall Street Clinic, Birmingham COMPETING INTEREST OF FINANCIAL VALUE > 1,000: Speaker Name Statement Professor Ross has received

More information

STD Prevention Among Youth

STD Prevention Among Youth STD Prevention Among Youth Jody Pierce Glover New Beginnings Emer S. Smith, MPH Maine Center for Disease Control & Prevention In Today s Talk... Maine Learning Results: Education Content Areas Health Behaviors

More information

Outline. HIV and Other Sexually Transmitted Infections. Gonorrhea Epidemiology. Epidemiology 11/2/2012

Outline. HIV and Other Sexually Transmitted Infections. Gonorrhea Epidemiology. Epidemiology 11/2/2012 HIV and Other Sexually Transmitted Infections Tanya Kowalczyk Mullins, MD, MS Division of Adolescent Medicine Cincinnati Children s Hospital Medical Center Outline Epidemiology of select STIs and HIV STIs

More information

Sexually Transmitted Infection surveillance in Northern Ireland An analysis of data for the calendar year 2011

Sexually Transmitted Infection surveillance in Northern Ireland An analysis of data for the calendar year 2011 Sexually Transmitted Infection surveillance in Northern Ireland 2012 An analysis of data for the calendar year 2011 Contents Page Summary points. 3 Surveillance arrangements and sources of data.. 4 1:

More information

Trends in Sexually Transmitted Infections (STIs) C. Junda Woo, MD, MPH, Medical Director San Antonio Metropolitan Health District June 3, 2017

Trends in Sexually Transmitted Infections (STIs) C. Junda Woo, MD, MPH, Medical Director San Antonio Metropolitan Health District June 3, 2017 Trends in Sexually Transmitted Infections (STIs) C. Junda Woo, MD, MPH, Medical Director San Antonio Metropolitan Health District June 3, 2017 1 Speaker Disclosure Dr. Woo has disclosed that she has no

More information

MYCOPLASMA GENITALIUM A PRACTICAL GUIDE

MYCOPLASMA GENITALIUM A PRACTICAL GUIDE MYCOPLASMA GENITALIUM A PRACTICAL GUIDE DR JENNY HAYWARD FRANZCOG FACHSHM NEW ZEALAND SEXUAL HEALTH CONFERENCE SATURDAY 9 TH SEPTEMBER 1 ACKNOWLEDGE FRUSTRATIONS AWARENESS EVOLVING AREA TESTING OFTEN MULTIPLE

More information

STD UPDATE 2017 FSACOFP CONVENTION

STD UPDATE 2017 FSACOFP CONVENTION STD UPDATE 2017 FSACOFP CONVENTION L. Michael Waters, Jr, DO Adjunct Clinical Assistant Professor of Family Medicine LECOM-Bradenton Clinical Assistant Professor of Family Medicine PCOM- Georgia DISCLOSURES

More information

Chlamydia Curriculum. Chlamydia. Chlamydia trachomatis

Chlamydia Curriculum. Chlamydia. Chlamydia trachomatis Chlamydia Chlamydia trachomatis 1 Learning Objectives Upon completion of this content, the learner will be able to: 1. Describe the epidemiology of chlamydial infection in the U.S. 2. Describe the pathogenesis

More information

Sexually transmitted infections

Sexually transmitted infections Sexually transmitted infections Dr Caroline CHARLIER-WOERTHER Université Paris Descartes Paris, France Learning objectives Counsel patients about the risk of STD Know how to diagnose and treat a sexuallytransmitted

More information

Sexually Transmitted Infections Angela Farrell MD Dept of Family Medicine University of Iowa

Sexually Transmitted Infections Angela Farrell MD Dept of Family Medicine University of Iowa Sexually Transmitted Infections Angela Farrell MD Dept of Family Medicine University of Iowa Objectives Review taking a sexual history Discuss screening, diagnosis, and management of chlamydia, gonorrhea,

More information

RETURN OF THE CLAP: Emerging Issues in Gonorrhea Management and Antibiotic Resistance

RETURN OF THE CLAP: Emerging Issues in Gonorrhea Management and Antibiotic Resistance RETURN OF THE CLAP: Emerging Issues in Gonorrhea Management and Antibiotic Resistance Ina Park, MD, MS University of California San Francisco California Prevention Training Center DISCLOSURE No Relevant

More information

Emergency, Community and Health Outreach

Emergency, Community and Health Outreach ECHO Q&A Emergency, Community and Health Outreach Draft 4 FINAL DRAFT June 16, 2009 ECHO Questions and Answers 10 Minute Conversation STD Prevention and Treatment GUEST: Please modify question #2 for your

More information

Chapter 20: Risks of Adolescent Sexual Activity

Chapter 20: Risks of Adolescent Sexual Activity Unit 7 Lesson 7.1 Notes Introductory Video Video STIs: Running the Risk Chapter 20: Risks of Adolescent Sexual Activity Section 1: What Are the Risks? Key Terms: Sexually Transmitted Disease (STD) an infectious

More information

Update on Sexual Health: Screening, Diagnosing and Treating STIs

Update on Sexual Health: Screening, Diagnosing and Treating STIs Update on Sexual Health: Screening, Diagnosing and Treating STIs Dr Gila Metz Medical Director, Health Sexuality and Risk Reduction Unit Ottawa Public Health November 28, 2013 Objectives To review current

More information

The Impact of Sexually Transmitted Diseases(STD) on Women

The Impact of Sexually Transmitted Diseases(STD) on Women The Impact of Sexually Transmitted Diseases(STD) on Women GAL Community Symposium AUM September 2, 2011 Agnes Oberkor, MPH, MSN, CRNP, Nurse Practitioner Senior Alabama Department of Public Health STD

More information

STIs in Primary Care. Dr Eleanor Draeger 19 th January 2016

STIs in Primary Care. Dr Eleanor Draeger 19 th January 2016 STIs in Primary Care Dr Eleanor Draeger 19 th January 2016 Poli=cs! 2012! Health and Social Care act! Sexual Health commissioning moved to local authority! 2015! 200 million cuts to public health! 40%

More information

Overview. Disclosures. Sexually Transmitted Diseases: What s New in the Guidelines and Beyond?

Overview. Disclosures. Sexually Transmitted Diseases: What s New in the Guidelines and Beyond? Sexually Transmitted Diseases: What s New in the Guidelines and Beyond? Susan S. Philip, MD, MPH Director, Disease Prevention and Control Branch Population Health Division San Francisco Department of Public

More information

Timby/Smith: Introductory Medical-Surgical Nursing, 9/e

Timby/Smith: Introductory Medical-Surgical Nursing, 9/e Timby/Smith: Introductory Medical-Surgical Nursing, 9/e Chapter 62: Caring for Clients With Sexually Transmitted Diseases Slide 1 Epidemiology Introduction Study of the occurrence, distribution, and causes

More information

Chapter 25 Notes Lesson 1

Chapter 25 Notes Lesson 1 Chapter 25 Notes Lesson 1 The Risk of STIs 1) What is a sexually transmitted disease (STD)? Referred to as a sexually transmitted infection (STI) infectious diseases spread from person to person through

More information

New Guidelines for Detection and Treatment of Sexually Transmitted Infections

New Guidelines for Detection and Treatment of Sexually Transmitted Infections UCSF Controversies in Women s health December 8, 2016 San Francisco, CA New Guidelines for Detection and Treatment of Sexually Transmitted Infections Disclosure I am a litigation consultant to a law firm

More information

Challenging STD Cases. Chris Davis, PA-C University of Utah Clinic 1A

Challenging STD Cases. Chris Davis, PA-C University of Utah Clinic 1A Challenging STD Cases Chris Davis, PA-C University of Utah Clinic 1A Case #1 28 year old HIV + MSM presents for first HIV visit with lesion on glans of penis CD4 count of 3 and viral load of 610,000 Multiple

More information

Trends in STDs among Young People in New York State

Trends in STDs among Young People in New York State Trends in STDs among Young People in New York State Kris Mesler, Bureau of Child and Adolescent Health Alison Muse, Bureau of Sexually Transmitted Disease Control New York State Department of Health Figure

More information

Dr Raymond Ofori Microbiologist, Imperial College Health Care Trust, London

Dr Raymond Ofori Microbiologist, Imperial College Health Care Trust, London Dr Raymond Ofori Microbiologist, Imperial College Health Care Trust, London Bacterial diseases Chlamydia (CT) Gonorrhoea (GC) Syphilis Trichomoniasis (Trich) Viral diseases Human Papillomavirus (HPV) Genital

More information

4/6/17 UNPRECEDENTED HIGH. Shelagh Larson, RNC, WHNP, NCMP

4/6/17 UNPRECEDENTED HIGH. Shelagh Larson, RNC, WHNP, NCMP Shelagh Larson, RNC, WHNP, NCMP UNPRECEDENTED HIGH Total combined cases of chlamydia, gonorrhea, and syphilis reported in 2015 reached the highest number ever, according to the annualmore than 1.5 million

More information

LTASEX.INFO STI SUMMARY SHEETS FOR EDUCATIONAL USE ONLY. COMMERCIAL USE RIGHTS RESERVED. COPYRIGHT 2013, JEROME STUART NICHOLS

LTASEX.INFO STI SUMMARY SHEETS FOR EDUCATIONAL USE ONLY. COMMERCIAL USE RIGHTS RESERVED. COPYRIGHT 2013, JEROME STUART NICHOLS LTASEX.INFO STI SUMMARY SHEETS FOR EDUCATIONAL USE ONLY. COMMERCIAL USE RIGHTS RESERVED. COPYRIGHT 2013, JEROME STUART NICHOLS LTASEX.INFO! IN AIDS is a treatable complication of advanced HIV infection.

More information

STD Epidemiology. Jonathan Zenilman, MD Johns Hopkins University

STD Epidemiology. Jonathan Zenilman, MD Johns Hopkins University This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Updated Guidelines for Post-Assault Testing and Treatment

Updated Guidelines for Post-Assault Testing and Treatment Updated Guidelines for Post-Assault Testing and Treatment Ann S. Botash, MD Professor of Pediatrics October 5, 2016!" Disclosure Statement Ann S. Botash, MD, has no financial relationships with any commercial

More information

Management of Gonorrhea in Adolescents and Adults in the United States

Management of Gonorrhea in Adolescents and Adults in the United States SUPPLEMENT ARTICLE Management of Gonorrhea in Adolescents and Adults in the United States Sarah Kidd 1 and Kimberly A. Workowski 1,2 1 Division of STD Prevention, Centers for Disease Control and Prevention,

More information

Clinical Education Initiative TITLE: UPDATE ON MSM SEXUAL HEALTH. Speaker: Maureen Scahill, MS NP

Clinical Education Initiative TITLE: UPDATE ON MSM SEXUAL HEALTH. Speaker: Maureen Scahill, MS NP Clinical Education Initiative Support@ceitraining.org TITLE: UPDATE ON MSM SEXUAL HEALTH Speaker: Maureen Scahill, MS NP 1/25/2017 2/10/2017 Update on MSM Sexual Health [video transcript] 00:00:08 - [Maureen]

More information

Clinical Education Initiative ADOLESCENTS AND STDS: CASE STUDIES. Tara Babu, MD

Clinical Education Initiative ADOLESCENTS AND STDS: CASE STUDIES. Tara Babu, MD Clinical Education Initiative Support@ceitraining.org ADOLESCENTS AND STDS: CASE STUDIES Tara Babu, MD 2/16/2017 Adolescents and STDs: Case Studies [video transcript] 00:00:08 - Hello, my name is Tia Babu

More information

toe... Chlamydia - CDC Fact Sheet Appendix K - Part 2

toe... Chlamydia - CDC Fact Sheet Appendix K - Part 2 Appendix K - Part 2 Chlamydia - CDC Fact Sheet What is chlamydia? Chlamydia is a common STD that can infect both men and women. It can cause serious, permanent damage to a woman's reproductive system,

More information

What You Need to Know. Sexually Transmitted Infections (STIs)

What You Need to Know. Sexually Transmitted Infections (STIs) What You Need to Know Sexually Transmitted Infections (STIs) What You Need to Know About STIs What are STIs? Sexually transmitted infections (STIs) are diseases that spread through sexual contact. If you

More information

Clinical Cases from the STD Clinical Consultation Network

Clinical Cases from the STD Clinical Consultation Network Clinical Cases from the STD Clinical Consultation Network Christine Johnston STD TCG April 24, 2017 Last Updated: uwptc@uw.edu uwptc.org 206-685-9850 STD Clinical Consultation Network (STDCCN) Developed

More information

CDC Laboratory Update

CDC Laboratory Update CDC Laboratory Update Chlamydia and Gonorrhea Laboratory Guidelines Overview of the APHL / CDC STD Steering Committee Laboratory Recommendations for the Detection of Chlamydia trachomatis, Neisseria gonorrhoeae

More information

GONORRHEA; ACUTE Does Not Include Chronic Gonorrhea

GONORRHEA; ACUTE Does Not Include Chronic Gonorrhea 1 ID 13 GONORRHEA; ACUTE Does Not Include Chronic Gonorrhea Background This case definition was developed in 2013 by the Armed Forces Health Surveillance Center (AFHSC) for the purpose of epidemiological

More information

TO DECREASE THE CHANCE OF GETTING

TO DECREASE THE CHANCE OF GETTING POST ASSAULT MEDICATIONS Terri Stewart RN Naomi Sugar MD TO DECREASE THE CHANCE OF GETTING Pregnant STDs Chlamydia Gonorrhea Trichomonas Hep B HIV EMERGENCY CONTRACEPTION Plan B Levonorgestrel PLAN B Plan

More information

STDs in HIV Clinical Care: New Guidelines on Treatment and Prevention

STDs in HIV Clinical Care: New Guidelines on Treatment and Prevention STDs in HIV Clinical Care: New Guidelines on Treatment and Prevention Palliative Care Conference Faculty Development Conference August 13, 2015 Steven C. Johnson M.D. Director, University of Colorado HIV/AIDS

More information

Sexually Transmitted Infections

Sexually Transmitted Infections Sexually Transmitted Infections Introduction Sexually transmitted diseases, or STDs, are some of the most common infectious diseases. Sexually transmitted diseases are also called sexually transmitted

More information

Family Planning Title X Chlamydia Screening Quality Improvement Project

Family Planning Title X Chlamydia Screening Quality Improvement Project Family Planning Title X Chlamydia Screening Quality Improvement Project Illinois Department of Public Health STD Section Staff March 22, 2017 Objectives Discuss current STD trends and epidemiology of chlamydia

More information

Best Practices in STD Partner Management

Best Practices in STD Partner Management Best Practices in STD Partner Management An Overview of Patient-Delivered Partner Therapy (PDPT) and Counseling for Partner Notification and Treatment Amber Eisenmann, MS Director of Learning Exchange

More information

Sexually Transmitted Diseases This publication was made possible by Grant Number TP1AH from the Department of Health and Human Services,

Sexually Transmitted Diseases This publication was made possible by Grant Number TP1AH from the Department of Health and Human Services, Sexually Transmitted Diseases This publication was made possible by Grant Number TP1AH000081-01-01 from the Department of Health and Human Services, Office of Adolescent Health; its contents are solely

More information

Partner Counseling and Referral Services

Partner Counseling and Referral Services Partner Counseling and Referral Services Presented at the Sexually Transmitted Disease (STD) Intensive Course Cleveland, OH June 22, 2012 Rhiannon Richman, MPH Infertility Prevention Project Coordinator

More information

STI in British Columbia: Annual Surveillance Report

STI in British Columbia: Annual Surveillance Report STI in British Columbia: Annual Surveillance Report 212 Contact Information BC Centre for Disease Control Clinical Prevention Services 655 West 12th Avenue Vancouver BC V5Z 4R4 Phone: 64-77-5621 Fax: 66-77-564

More information

How is it transferred?

How is it transferred? STI s What is a STI? It is a contagious infection that is transferred from one person to another through sexual intercourse or other sexually- related behaviors. How is it transferred? The organisms live

More information

Ron Gray, MBBS, MFCM, MSc Johns Hopkins University. STIs in an International Setting

Ron Gray, MBBS, MFCM, MSc Johns Hopkins University. STIs in an International Setting This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Dermatologist Venereologist MD, PhD

Dermatologist Venereologist MD, PhD Vassiliki Mousatou Dermatologist Venereologist MD, PhD Genital warts Genital herpes Syphilis Gonococcal and no gonococcal urethritis HIV Hepatitis B and C Also: Lymphogranuloma venereum and Granuloma

More information