STDs in HIV Clinical Care: New Guidelines on Treatment and Prevention
|
|
- Barnard Lynch
- 5 years ago
- Views:
Transcription
1 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 Clinical Program; Professor of Medicine, Division of Infectious Diseases; University of Colorado School of Medicine
2 Learning Objectives Recognize the importance of STD detection and treatment in HIV-infected patients Utilize a guidelines-based and risk-based approach to STD screening in your HIV clinical practice Through case studies, learn recent changes in STD prevention and management
3 Which of the following best describes your current role in HIV care? A. Prescribing provider (MD, DO, NP, PA) B. Pharmacist C. Nurse D. Dentist E. Other health care provider F. Student G. Not a health care provider Prescribing provider (MD... 0% 0% 0% 0% 0% 0% 0% Pharmacist Nurse Dentist Other health care provider Student Not a health care provider
4 Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the U.S. CDC Fact sheet, February 2013
5 Proportion of MSM* Attending STD Clinics with Primary and Secondary Syphilis, Gonorrhea or Chlamydia by HIV Status, STD Surveillance Network, 2013 *MSM=men who have sex with men. Excludes all persons for whom there was no laboratory documentation or self-report of HIV status. GC urethral and CT urethral include results from both urethral and urine specimens. NOTE: Six jurisdictions (Birmingham, Chicago, Denver, Hartford/New Haven, New Orleans, and Richmond) contributed data from January through June 2013 and the remaining jurisdictions (Baltimore, Los Angeles, New York City, Philadelphia, San Francisco and Seattle) contributed data for all of 2013.
6 The HIV Clinical Program I Work With Has a Screening Program for STDs A. Yes B. No C. I don t know 0% 0% 0% Yes No I don t know
7
8 Screening for MSM, including those with HIV Infection (At least Annually) Syphilis Serology A urethral test for GC and Chlamydia (preferably NAAT) A rectal test for GC and Chlamydia (preferably NAAT) A pharyngeal test for GC (preferably NAAT) CDC. Sexually Transmitted Diseases Guidelines 2015, MMWR 2015;64(No. RR-3):1-140
9
10 STD Screening in HIV+ Individuals Screening Recommendation Comments Chlamydial Infection Gonorrhea Hepatitis C Syphilis Perform annually in patients at risk for STDs Perform annually in patients at risk for STDs Perform annually in patients at risk, e.g. IDU and MSM Perform annually in patients at risk for STDs Trichomoniasis Perform annually in all women More frequent testing may be indicated in patients at high risk for STDs. Repeat in 3 months if +. More frequent testing may be indicated in patients at high risk for STDs. Repeat in 3 months if +. More frequent testing may be indicated in patients at high risk, especially if increases in LFTs. More frequent testing may be indicated in patients at high risk for STDs. Repeat testing 3 months later if positive. Aberg J et al. Clin Infect Dis. (2013) doi: /cid/cit665
11 Syphilis in HIV Infection
12 Treponema pallidum Electron photomicrograph, 36,000 x. Source: CDC/NCHSTP/Division of STD Prevention, STD Clinical Slides
13 Syphilis Sexually transmitted infection caused by the spirochete, Treponema pallidum Categorized into various stages Primary: chancre at site of acquisition Secondary: disseminated illness, often with a skin rash Latent syphilis: serologic evidence without clinical disease, early latent (within a year) and late latent Tertiary syphilis: neurosyphilis, cardiovascular syphilis, gummatous syphilis 17,375 cases of primary and secondary syphilis were reported in the U.S. in 2013
14 Primary and Secondary Syphilis
15 Reported Cases of Syphilis in the U.S., , , ,204 12,171 Primary Secondary Early Latent Late Latent and Late 0 Reported Cases
16 Primary and Secondary Syphilis Reported Cases by Sex and Sexual Behavior, 33 Areas*, *32 states and Washington, DC reported sex of partner data for 70% of cases of P&S syphilis for each year during MSM=men who have sex with men; MSW=men who have sex with women only. STD Surveillance 2013,
17 Source: Sexually Transmitted Infections in Colorado Annual report. CDPHE
18 Cases of Early Syphilis in Denver, 2014 Category Total Number of Cases Cases Among MSM (%) Cases Among HIV+ Persons (%) Primary Syphilis Secondary Syphilis Early Latent Syphilis Total Cases of Early Syphilis (83%) 49 (85%) 75 (87%) 153 (86%) 14 (40%) 26 (45%) 43 (50%) 83 (46%) Patient Reporting Investigating Surveillance Manager (PRISM)
19 Primary and Secondary Syphilis Rates of Reported Cases by State, United States and Outlying Areas, 2013 NOTE: The total rate of primary and secondary syphilis for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was 5.6 per 100,000 population. STD Surveillance 2013,
20 Reported Cases of Primary and Secondary Syphilis, MPAETC/FATC Regions, State Alaska Colorado Idaho Kansas Montana Nebraska New Mexico North Dakota Oregon South Dakota Utah Washington Wyoming
21 How do you screen for syphilis in your clinical program? A. RPR with reflex to a confirmatory test B. Treponemal test with reflex to an RPR C. Other screening algorithm D. We do not have a screening policy 0% 0% 0% 0% RPR with reflex to a conf... Treponemal test with ref... Other screening algorithm We do not have a screeni..
22 Diagnostic Tests The organism cannot be grown in vitro. The organism can be seen in tissues using darkfield microscopy or with special stains. A PCR is not typically available but has been used in research studies. Most diagnoses are made clinically and with serologic testing. No single serologic test of syphilis is sufficient as tests can be falsely positive, falsely negative, or unreliable as a measure of disease activity.
23 Clement M et al. JAMA 2014;312:
24 The Paradigm Shift in Syphilis Testing Old: screen with a non-treponemal test (RPR or VDRL) and confirm with a treponemal test Issue: the false positive RPR New: screen with a treponemal test, reflexing to RPR or VDRL if positive Issue: false positive treponemal test Issue: the reactive treponemal test with a non-reactive RPR Sena et al, Clinical Infectious Diseases 2010;51:
25 Newer Serologic Tests for Syphilis Newer Treponemal Tests: Enzyme immunoassays and immunochemiluminescent assays Automated with high throughput Excellent sensitivities and specificities Can t distinguish remote from active infection Sena et al, Clinical Infectious Diseases 2010;51:
26 Case Study 1 A 49 year old male with HIV infection, well controlled on ART, presents for routine clinic follow up. Asymptomatic but reports multiple sexual contacts. One year prior, a palpable rectal nodule was detected and was removed by flexible sigmoidoscopy. Pathology revealed condyloma accuminatum. Physical exam today reveals a new rectal nodule. 7/27/15: CD4 480 cells mm 3, HIV viral load TND Syphilis screening 7/27/15: Treponema antibody reactive, RPR non-reactive 3/16/15: Treponema antibody non-reactive (RPR not done)
27 What is the most likely explanation for these clinical and laboratory findings? A. Falsely positive Treponema antibody B. Prior treated syphilis C. Early latent syphilis D. Condyloma lata Falsely positive Trepon... 0% 0% 0% 0% Prior treated syphilis Early latent syphilis Condyloma lata
28 Sensitivity of Serological Tests in Untreated Syphilis Stage of Disease (Percent Positive [Range]) Test Primary Secondary Latent Tertiary VDRL 78 (74 87) (88 100) 71 (37 94) RPR 86 (77 99) (95 100) 73 FTA-ABS* 84 (70 100) Treponemal Agglutination* 76 (69 90) (97 100) 94 EIA *FTA-ABS and TP-PA are generally considered equally sensitive in the primary stage of disease.
29 Sensitivity and Specificity of Syphilis Tests Clement M and Hicks C. JAMA 2014;312:
30 Case Study 1: Conclusion The patient had reported recent high risk sexual contacts. The non-reactive RPR was concerning for early syphilis. The RPR should be highly sensitive in patients with secondary syphilis, including C. lata. The patient was treated for early latent syphilis with benzathine penicillin 2.4 million units IM. He has been referred for flexible sigmoidoscopy with biopsy of the rectal lesion.
31 Case Study 2 A 42 year old female with HIV infection, initially diagnosed in 2001, comes to the clinic to establish care. She is currently on ART with a CD4 count of 545 cells/mm 3 with an undetectable HIV viral load. She reports a prior history of chlamydial infection but no history of syphilis. Laboratory testing reveals a reactive Treponema antibody screen but the RPR is non-reactive. Repeat testing 3 months later reveals the same pattern. She reports no symptoms.
32 What is the most likely explanation for these laboratory findings? A. Falsely positive Treponema antibody B. Prior treated syphilis (perhaps inadvertently) C. Early latent syphilis D. Tertiary syphilis Falsely positive Trepone.. 0% 0% 0% 0% Prior treated syphilis (p... Early latent syphilis Tertiary syphilis
33 Clinical Questions 1. Do these results represent prior syphilis exposure that she does not recall or has not disclosed? 2. Could she have active syphilis? 3. Does she need treatment for syphilis? 4. Does she need additional evaluation? 5. If you elect to treat her, what regimen would you use?
34 Case Study 2: Advice from CDC Guidelines Treponemal Test Positive; RPR or VDRL nonreactive Different Treponemal Test Positive If prior history of syphilis and no evidence of recent exposure, don t treat. If no prior history of syphilis and no evidence of recent exposure, treat for late latent syphilis. Different Treponemal Test Negative No further evaluation or treatment is necessary STD Guidelines,
35 Syphilis Treatment by Disease Stage Disease Stage Primary Treatment Alternative Treatment Primary syphilis Secondary syphilis Early latent syphilis Late latent syphilis Cardiovascular and gummatous syphilis Neurosyphilis Benz PCN 2.4 million units IM x 1 dose Benz PCN 2.4 million units IM x 1 dose Benz PCN 2.4 million units IM x 1 dose Benz PCN 2.4 million units IM weekly x 3 doses Benz PCN 2.4 million units IM weekly x 3 doses PCN G million units IV daily x days 2015 STD Guidelines, Doxycycline 100 mg PO BID x 14 days Doxycycline 100 mg PO BID x 14 days Doxycycline 100 mg PO BID x 14 days Doxycycline 100 mg PO BID x 28 days Consult with ID Physician recommended Procaine PCN 2.4 million units daily + probenecid for days
36 Case Study 2: Conclusion A second treponemal test (FTA-ABS) was reactive. Given the lack of symptoms, additional evaluation (e.g. lumbar puncture) was not done. The patient was treated with benzathine penicillin G 2.4 million units IM weekly x 3 doses.
37 Case Study 3 A 46 year old male with HIV infection, well controlled on ART, presents in January of 2014 for routine follow up. He has a history of syphilis a number of years ago that was treated. On presentation, he has a pruritic rash involving his left hand, left elbow, chin, and right buttock. Laboratory: 1/9/14: CD4 840 cells mm3, HIV viral load TND 1/9/14: Treponema antibody reactive, RPR 1:2 4/30/13: Treponema antibody reactive, RPR reactive < 1:2
38 What is the most likely explanation for these laboratory findings? A. Secondary syphilis B. Serofast state with random variation C. Early latent syphilis with another cause for his rash D. False positive RPR Secondary syphilis 0% 0% 0% 0% Serofast state with rand.. Early latent syphilis wit... False positive RPR
39 Case Study 3 He was contacted to return to the clinic for treatment with benzathine penicillin. However, he did not return for treatment. 8 months later, in September of 2014, he saw his PCP and reported an extensive skin rash. Labs were drawn although no additional treatment was provided. He returned for follow up in our clinic in January of An extensive skin rash was again noted. Laboratory: 9/14: RPR 1:64 (shown to me by patient using his cell phone app) 1/22/15: Treponema antibody reactive, RPR 1:128
40 Case Study 3: Continued He was diagnosed with secondary syphilis. Treated with benzathine penicillin 2.4 million units IM x 1 dose. In phone follow up, he reported no side effects of treatment and improvement of rash. He has not yet followed up for care.
41 Once treated, when should he return for repeat syphilis serology? A. Monthly until a 4-fold drop in titer is demonstrated B. Every 3 months until a 4-fold drop in titer is demonstrated C. In 6 months and 12 months until a 4-fold drop in titer is demonstrated D. Given the efficacy of PCN, serologic follow up is not necessary Monthly until a 4-fold dro... 0% 0% 0% 0% Every 3 months until a In 6 months and 12 mont.. Given the efficacy of PCN,...
42 Guidelines for Serologic Follow up For Primary and Secondary syphilis Clinical and serologic evaluation should be done at 6 and 12 months Failure for titers to decline 4-fold could mean either treatment failure or reinfection Serologic decline may be slower in patients with a prior history of syphilis Optimal management of patients who do not have a 4-fold decline is unclear Lower initial titers are less likely to fall 4-fold than higher titers 2015 STD Guidelines,
43 Evidence for Therapy for Each Syphilis Stage Syphilis Stage Primary and Secondary Early latent Late Latent Neurosyphilis Other forms of tertiary syphilis Grade of Evidence of Primary Therapy A = Data from many large randomized clinical trials B = Data from fewer smaller randomized clinical trials, careful analyses of non-randomized studies, or observational registries C = Expert consensus A A C C C Clement M et al. JAMA 2014;312:
44 Incidence of Genital Ulcer Disease in the U.S. in 2013* 306,000 # Cases 10 5,204 Herpes Syphilis Chancroid * Incidence of reported or estimated cases. LGV and Granuloma inguinale not included. CDC. National Overview of Sexually Transmitted Diseases (STDs),
45 Gonorrhea and Chlamydial Infection in HIV Infection
46 Gonorrhea Rates of Reported Cases by State, United States and Outlying Areas, 2013 NOTE: The total rate of reported cases of gonorrhea for the United States and outlying area (Guam, Puerto Rico, and Virgin Islands) was per 100,000 population. STD Surveillance 2013,
47 Gonorrhea Proportion of STD Clinic Patients* Testing Positive by Age, Sex, and Sexual Behavior, STD Surveillance Network (SSuN), 2013 *Only includes patients tested for gonorrhea. MSM=men who have sex with men; MSW=men who have sex with women only. NOTE: Six jurisdictions (Birmingham, Chicago, Denver, Hartford/New Haven, New Orleans and Richmond) contributed data from January through June 2013 and the remaining jurisdictions (Baltimore, Los Angeles, New York City, Philadelphia, San Francisco and Seattle) contributed data for all of STD Surveillance 2013,
48 Chlamydia Rates of Reported Cases by State, United States and Outlying Areas, 2013 NOTE: The total rate of reported cases of chlamydia for the United States and outlying areas (Guam, Puerto Rico, and Virgin Islands) was per 100,000 population. STD Surveillance 2013,
49 Chlamydia Proportion of STD Clinic Patients* Testing Positive by Age, Sex and Sexual Behavior, STD Surveillance Network (SSuN), 2013 *Only includes patients tested for chlamydia MSM=men who have sex with men; MSW=men who have sex with women only. NOTE: Six jurisdictions (Birmingham, Chicago, Denver, Hartford/New Haven, New Orleans, and Richmond) contributed data from January through June 2013 and the remaining jurisdictions (Baltimore, Los Angeles, New York City, Philadelphia, San Francisco and Seattle) contributed data for all of STD Surveillance 2013,
50 Case Study 4 A 24 year old male with HIV infection returns for routine follow up. He has one primary sexual partner but both he and his partner occasionally have other partners. He reports use of condoms on most occasions but not always. He has no new symptoms today and specifically denies sore throat, skin rash, rectal pain, or urinary symptoms. However, he would like an STD check to be sure. Testing included a Treponemal antibody, Hepatitis C antibody, and screening tests for GC and Chlamydia
51 With regards to GC and Chlamydial infections, how do you screen in your clinical program? A. Urine probe for GC and Chlamydia B. Throat culture or probe for GC and chlamydia C. Rectal culture or probe for GC and Chlamydia D. All of the above E. Other screening algorithm based on risk Urine probe for GC and... Throat culture or probe f.. 0% 0% 0% 0% 0% Rectal culture or probe f.. All of the above Other screening algorith...
52 Does Your Clinic Use Nucleic Acid Amplification (NAAT) Tests for Throat and Rectal Testing? A. Yes B. No 33% 33% 33% C. I don t know Yes No I don t know
53 Gonorrhea screening among men who have sex with men: value of multiple anatomic site testing, San Diego, California, Cultures and NAAT tests from all sites reviewed in MSM attending San Diego STD Clinic, During this 7-year period, 1157/7333 (15.8%) of men had > 1 site positive for GC Of those who had a urine and either a rectal or pharyngeal specimen, 970 were positive, including 369 who had a negative urine test with a positive other site If the clinic had tested only urine, 33% of GC cases among MSM would have been missed Sex Transm Dis Oct;35(10): doi: /OLQ.0b013e318177ec70.
54 Guidelines for Screening for Gonorrhea and Chlamydial Infection in HIV Infection Men and women should be screened at initial presentation and then annually if at risk for infection. Nucleic acid amplification tests (NAATs) have the highest sensitivity for detecting gonorrhea and chlamydia. Vaginal swabs in women and urine in men are the preferred specimens for genital testing with NAATs. Aberg J et al. Clin Infect Dis. (2013) doi: /cid/cit665
55 Guidelines for Screening for Gonorrhea and Chlamydial Infection in HIV Infection Anorectal testing for gonorrhea and chlamydia should be done in those who report receptive anal intercourse. Pharyngeal testing for gonorrhea should be considered if the patient reports receptive oral sex. Testing for oropharyngeal chlamydia is not routinely recommended because its prevalence is generally low. Aberg J et al. Clin Infect Dis. (2013) doi: /cid/cit665
56 Neisseria gonorrhoeae Percentage of Isolates, with Penicillin, Tetracycline, and/or Ciprofloxacin Resistance, Gonococcal Isolate Surveillance Project (GISP), 2013 NOTE: PenR=penicillinase-producing Neisseria gonorrhoeae and chromosomally-mediated penicillinresistant N. gonorrhoeae; TetR=chromosomally- and plasmid-mediated tetracycline-resistant N. gonorrhoeae; and QRNG=quinolone-resistant N. gonorrhoeae. STD Surveillance 2013,
57 Primary Antimicrobial Drugs Used to Treat Gonorrhea Among Participants, Gonococcal Isolate Surveillance Project (GISP), Ceftriaxone 125 mg NOTE: For 2013, Other includes no therapy (0.9%), azithromycin 2g (1.7%), and other less frequently used drugs (<0.1%). STD Surveillance 2013,
58 Treatment of Gonococcal and Chlamydial Infections in Adults and Adolescents Infection Uncomplicated gonococcal infection of the cervix, urethra, or rectum Uncomplicated gonococcal infection of the pharynx Recommended Regimen Ceftriaxone 250 mg IM + azithromycin 1 gm orally Ceftriaxone 250 mg IM + azithromycin 1 gm orally Alternative Regimen Cefixime 400 mg PO + azithromycin 1 gm orally or gemifloxacin 320 mg orally + azithromycin 2 gm orally Unclear. Pharyngeal gonorrhea is more difficult to eradicate than other sites of infection. Chlamydial infection Azithromycin 1 mg orally or doxycycline 100 mg PO BID x 1 week Erythromycin 500 mg QID x 7 days Erythromycin ES 800 mg QID x 7 days Levofloxacin 500 mg QD x 7 days Ofloxacin 300 mg BID x 7 days CDC. Sexually Transmitted Diseases Guidelines 2015, MMWR 2015;64(No. RR-3):1-140
59 Summary STDs are very common among persons living with HIV infection. Screening for syphilis should be routine, the frequency based on sexual history. Diagnosis of syphilis typically requires interpretation of both treponemal and non-treponemal tests. Screening for GC and Chlamydia should often include multiple body sites, based at least in part on sexual history. Other important STD screens in HIV infection include Hepatitis C, trichomoniasis, and, in patients who are not immune, Hepatitis B.
60 Questions and Discussion
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 information6/11/15. 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 informationNothing 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 informationThe Great Imitator Revealed: Syphilis
The Great Imitator Revealed: Syphilis Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health University of California Los Angeles David Geffen School of Medicine Los Angeles, California Learning
More informationSexually 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 informationEmerging 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 informationWHAT 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 informationSexually 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 informationSTD 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 informationSyphilis Update: New Presentations of an Old Disease
Syphilis Update: New Presentations of an Old Disease Bradley Stoner, MD, PhD Washington University in St. Louis Disclosure: Bradley Stoner, MD, PhD STDs in the United States Where do we stand right now?
More informationKhalil 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 informationClinical 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 informationChapter 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 informationAnswers to those burning questions -
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
More informationS403- 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 informationSyphilis Treatment Protocol
STD, HIV, AND TB SECTION Syphilis Treatment Protocol CLINICAL GUIDANCE FOR PRIMARY AND SECONDARY SYPHILIS AND LATENT SYPHILIS www.lekarzol.com (4/2016) Page 1 of 8 Table of Contents Description... 3 Stages
More informationGenital 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 informationSyphilis in the 21 st Century: Sex, Sores, Science, and Surveillance. Syphilis in Men
Syphilis in the 21 st Century: Sex, Sores, Science, and Surveillance Syphilis in Men Kenneth A. Katz, MD, MSc, MSCE Kaiser Permanente, San Francisco, CA AAD Annual Meeting Washington, D.C. March 2, 2019
More informationClinical 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 informationDidactic Series. STD Screening & Management: Syphilis. Christian B. Ramers, MD, MPH
Didactic Series STD Screening & Management: Syphilis Christian B. Ramers, MD, MPH Assistant Medical Director Family Health Centers of San Diego Ciaccio Memorial Clinic 3/26/15 ACCREDITATION STATEMENT:
More informationSTDs 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 informationSexually 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 informationLearning 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 information2012 California Clinical Laboratory Survey: STD/HIV/Hepatitis Testing
2012 California Clinical Laboratory Survey: STD/HIV/Hepatitis Testing Joan M. Chow, MPH, DrPH Surveillance, Epidemiology, Assessment & Evaluation Section Sexually Transmitted Disease Control Branch Division
More informationNovos 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 informationServices 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 informationDisclosures. 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 informationUpdate 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 information9/9/2015. Began to see a shift in 2012 Early syphilis cases more than doubled from year before
George Walton, MPH, CPH, MLS(ASCP) CM STD Program Manager Bureau of HIV, STD, and Hepatitis September 15, 2015 1 1) Discuss the changing epidemiology of syphilis in Iowa; 2) Explore key populations affected
More informationLearning Objectives. Syphilis. Lessons. Epidemiology: Disease in the U.S. Syphilis Definition. Transmission. Treponema pallidum
Learning Objectives Syphilis Treponema pallidum 1 Upon completion of this content, the learner will be able to 1. Describe the epidemiology of syphilis in the U.S. 2. Describe the pathogenesis of T. pallidum.
More informationTimby/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 informationSTI 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 informationPublic/Private Partnerships: Intervening in the Spread of Syphilis
Public/Private Partnerships: Intervening in the Spread of Diana Torres-Burgos MD, MPH Gerard Castaneda, BSN Alana Thomas, BS STD/HIV Update Conference Grand Rapids, MI 3/11/2014 Outline overview Stages
More information4/6/17 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 informationUse of Treponemal Immunoassays for Screening and Diagnosis of Syphilis
Use of Treponemal Immunoassays for Screening and Diagnosis of Syphilis Guidance for Medical Providers and Laboratories in California These guidelines were developed by the California Department of Public
More informationSYPHILIS. The Great Pretender K. Amen Eguakun, MSN, APRN, AAHIVS
SYPHILIS The Great Pretender K. Amen Eguakun, MSN, APRN, AAHIVS Learning Objectives At the end of this presentation, the participants will be able to 1. Describe the epidemiology of syphilis in the United
More informationALASKA NATIVE MEDICAL CENTER SEXUALLY TRANSMITTED DISEASE SCREENING AND TREATMENT GUIDELINES
ALASKA NATIVE MEDICAL CENTER SEXUALLY TRANSMITTED DISEASE SCREENING AND TREATMENT GUIDELINES A. Screening Page Chlamydia and Gonorrhea 1 HIV 1 Syphilis 1 Genital Herpes 2 Hepatitis A 2 Hepatitis B 2 Hepatitis
More informationTrends 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 informationSex, Sores, Science, and Surveillance: Syphilis in the 21 st Century (U046)
Sex, Sores, Science, and Surveillance: Syphilis in the 21 st Century (U046) Kenneth A. Katz, MD, MSc, MSCE Dermatologist, Kaiser Permanente, San Francisco, CA AAD Annual Meeting, San Diego, CA February
More informationWomen 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 informationLymphogranuloma Venereum (LGV) Surveillance Project
Lymphogranuloma Venereum (LGV) Surveillance Project Lymphogranuloma venereum (LGV) is a systemic, sexually transmitted disease (STD) caused by a type of Chlamydia trachomatis (serovars L1, L2, L3) that
More informationSexually 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 informationReplaces: 04/13/17. / Formulated: 7/05 SYPHLIS
Effective Date: 81017 Replaces: 041317 Page 1 of 7 POLICY: The Texas Department of Criminal Justice (TDCJ) will identify, test, and manage all offenders with suspected or confirmed syphilis with a uniform
More informationGuidelines for the Laboratory Detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum Testing
Guidelines for the Laboratory Detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum Testing Recommendations from the an expert consultation meeting held at CDC January 13-15,
More informationSTD 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 informationSexually 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 informationUpdate 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 informationSTI Update Including PrEP
STI Update Including PrEP Gordon Liu, M.D, AAHIVS HIV/Hep C Director Latterman Family Health Center UPMC McKeesport Family Medicine Clinical Assistant Professor Department of Family Medicine University
More informationSexually 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 informationRETURN 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 informationClinical 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 informationSyphilis among MSM: Clinical Care and Public Health Reporting
Massachusetts Department of Public Health Bureau of Infectious Disease and Laboratory Sciences Syphilis among MSM: Clinical Care and Public Health Reporting Kevin Ard, MD, MPH, Medical Director, National
More informationExtragenital 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 informationThe Use of a Rapid Syphilis Test with Specimens from an HIV Cluster Investigation in Rural West Virginia
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention The Use of a Rapid Syphilis Test with Specimens from an HIV Cluster Investigation in Rural West Virginia Lara E. Pereira, Ph.D. Centers
More informationDermatologist 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 informationSTD UPDATE Patrick Loose, Chief HIV, STD & Hepatitis Branch February 15, 2018
Patrick Loose, Chief HIV, STD & Hepatitis Branch February 15, 2018 MISSION Improve health outcomes in communities disproportionately impacted by HIV and STDs Collect, study and publish data Diagnose and
More informationWhat'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 informationSexually Transmitted Diseases Treatment Guidelines, 2015
Morbidity and Mortality Weekly Report Recommendations and Reports / Vol. 64 / No. 3 June 5, 2015 Sexually Transmitted Diseases Treatment Guidelines, 2015 U.S. Department of Health and Human Services Centers
More informationOverview. 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 informationSexually 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 informationSerological screening for syphilis in HIV-infected individuals: is a non-treponemal test adequate in the era of increasing of new syphilis infections?
Abstract no. WEPE 494 Serological screening for syphilis in HIV-infected individuals: is a non-treponemal test adequate in the era of increasing of new syphilis infections? G.Chrysos 1, D.Karageorgopoulos
More informationCLINICAL 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 informationSyphilis: Screening (USPSFT) Syphilis: Screening. Sexually Transmitted Diseases. Family Medicine Board Review Course. Reference
Sexually Transmitted Diseases Family Medicine Board Review Course March 26, 2012 Ronald H. Goldschmidt, MD Reference Centers for Disease Control and Prevention Guidelines for Treatment of Sexually Transmitted
More informationChallenging 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 informationSTI Treatment Guidelines. Teodora Wi. Training Course in Sexual and Reproductive Health Research
Teodora Wi Geneva, 28 August 2017 STI Treatment Guidelines Teodora Wi Training Course in Sexual and Reproductive Health Research 2017 Twitter @HRPresearch 1 STI treatment guidelines Neisseria gonorrhoeae
More informationMSM&TGpopulations. Management in. Sex. Sex. Outline. STIs/HIV. Sex. Sexual fluidity and HIV. Risk behavior. Recreational drugs
Outline MSM = (at least) 9 patients /day Management in MSM&TGpopulations OPASSPUTCHAROEN M.D. CHULALONGKORNUNIVERSITY BANGKOK, TH /HIV Recreational drugs ual fluidity and HIV Risk behavior AIDS Patient
More informationChlamydia 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 informationChancroid Table of Contents
Subsection: Chancroid Page 1 of 8 Chancroid Table of Contents Chancroid Fact Sheet Subsection: Chancroid Page 2 of 8 Chancroid (Haemophilus ducreyi) Overview (1,2) For a more complete description of chancroid,
More informationLearning Objectives. Epidemiology 5/3/2013. Treponema pallidum Diagnosis, Treatment and Prevention. Anne Rompalo, MD, ScM Professor of Medicine
Treponema pallidum Diagnosis, Treatment and Prevention Anne Rompalo, MD, ScM Professor of Medicine Learning Objectives Describe the epidemiology of syphilis in the U.S.Describe the pathogenesis of Treponema
More informationPodcast Transcript. Title: The STD Crisis in America: Where We Are and What Can Be Done Speaker Name: Bradley Stoner, MD, PhD Duration: 00:30:43
Podcast Transcript Title: The STD Crisis in America: Where We Are and What Can Be Done Speaker Name: Bradley Stoner, MD, PhD Duration: 00:30:43 NCTCFP: Welcome to this podcast sponsored by the National
More informationClinical 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 information10/29/2018 PROPHYLAXIS AND TREATMENT: CURBING THE ALARMING SPREAD OF SEXUALLY TRANSMITTED DISEASES DISCLOSURE OBJECTIVES FOR PHARMACISTS GOAL
DISCLOSURE PROPHYLAXIS AND TREATMENT: CURBING THE ALARMING SPREAD OF SEXUALLY TRANSMITTED DISEASES Dr. Feller does not have any actual or potential conflicts of interest to disclose and will not be discussing
More information2/13/ Graphic photographs or cartoons used during this presentation might be offensive to some; for this I apologize in advance.
Leon Bullard, MD, MA Medical Consultant, DHEC, DADE The 23 rd Annual APRN Conference Charleston, SC February 24, 2017 1. Provide a brief (very) review of the syphilis story. 2. Define and discuss the stages
More informationSexually 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 informationSYPHILIS (Treponema pallidum) IMMEDIATE NOTIFICATION STD PROGRAM
SYPHILIS (Treponema pallidum) IMMEDIATE NOTIFICATION STD PROGRAM Event Name: Event Time Period: Clinical Description (CDC 2014) Syphilis 180 days Syphilis is a complex sexually transmitted disease that
More informationSTI 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 informationSusanne Norris Zanto, MPH, MLS (ASCP) CM, SM Montana Public Health Laboratory
Susanne Norris Zanto, MPH, MLS (ASCP) CM, SM Montana Public Health Laboratory Describe the challenges in syphilis diagnostics Present two testing algorithms Non-treponemal test as initial screen Treponemal
More informationThe 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 informationSTIs- 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 informationDisclosure 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 informationWhat s Going On Down There? Prevalent Sexually Transmitted Infections in Adolescents & Young Adults with HIV
What s Going On Down There? Prevalent Sexually Transmitted Infections in Adolescents & Young Adults with HIV Carla London, DNP, CFNP St Jude Children s Research Hospital November 7, 2018 Conflicts and
More informationExtragenital Chlamydia and Gonorrhea. Angel Stachnik, MPH Sr. Epidemiologist Office of Epidemiology and Disease Surveillance
Extragenital Chlamydia and Gonorrhea Angel Stachnik, MPH Sr. Epidemiologist Office of Epidemiology and Disease Surveillance Rate of Chlamydia (CT) and Gonorrhea (GC), Clark County, 2012-2016 600 Rate per
More informationSex, Sores, Science, and Surveillance: Syphilis in the 21 st Century (U046)
Sex, Sores, Science, and Surveillance: Syphilis in the 21 st Century (U046) Kenneth A. Katz, MD, MSc, MSCE Dermatologist, Kaiser Permanente, San Francisco, CA AAD Annual Meeting, Orlando, FL March 4, 2017
More informationShelagh 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 annual more than 1.5 million
More informationLABORATORY 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 informationSexually Transmitted Infection Treatment and HIV Prevention
Sexually Transmitted Infection Treatment and HIV Prevention Toye Brewer, MD Co-Director, Fogarty International Training Program University of Miami Miller School of Medicine STI Treatment and HIV Prevention.
More informationTo view an archived recording of this presentation please click the following link:
To view an archived recording of this presentation please click the following link: http://pho.adobeconnect.com/p16lj8z0qm3/ Please scroll down this file to view a copy of the slides from the session.
More information10/29/2018 PROPHYLAXIS AND TREATMENT: CURBING THE ALARMING SPREAD OF SEXUALLY TRANSMITTED DISEASES DISCLOSURE GOAL
PROPHYLAXIS AND TREATMENT: CURBING THE ALARMING SPREAD OF SEXUALLY TRANSMITTED DISEASES Jade Feller, PharmD PGY-1 Pharmacy Resident Iowa City Veterans Affairs Health Care System November 13, 2018 DISCLOSURE
More informationThe 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 informationDirect Comparison of the Traditional and Reverse Syphilis Screening Algorithms
JCM Accepts, published online ahead of print on 16 November 2011 J. Clin. Microbiol. doi:10.1128/jcm.05636-11 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions. All
More informationChlamydia 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 informationSEXUALLY TRANSMITED DISEASES SYPHILIS ( LUES ) Dr D. Tenea Department of Dermatology University of Pretoria
SEXUALLY TRANSMITED DISEASES SYPHILIS ( LUES ) Dr D. Tenea Department of Dermatology University of Pretoria INTRODUCTION Venereal disease = old term STD infections transmitted by sexual contact Sexually
More informationSexually Transmitted Disease Surveillance 1998 Supplement
Sexually Transmitted Disease Surveillance 1998 Supplement Division of STD Prevention November 1999 Gonococcal Isolate Surveillance Project (GISP) Annual Report - 1998 DEPARTMENT OF HEALTH AND HUMAN SERVICES
More informationEdward W. Hook, III, M.D.
Challenging Cases Edward W. Hook III M.D. Professor and Director Division of Infectious Diseases University of Alabama at Birmingham And PI, Alabama/North Carolina STD PTC Edward W. Hook, III, M.D. Grant/Research
More information12/8/12. Overview. Optimizing STD Management in HIVinfected Individuals: What s new in 2012
Optimizing STD Management in HIVinfected Individuals: What s new in 2012 Gail Bolan, M.D. Director, Division of STD Prevention National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention Centers
More informationDISCLOSURES LEARNING OBJECTIVES 10/17/2018. NPA Conference Saratoga Srings NY, October Sexually Transmitted Infections: New and Not so New Bugs
Sexually Transmitted Infections: New and Not so New Bugs Melinda S Godfrey MBA, MS, NP University of Rochester Infectious Disease Division Monroe County STD Clinic New York State, STD Center of Excellence
More informationRevisions to the Syphilis Surveillance Case Definitions, 2018
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Revisions to the Syphilis Surveillance Case Definitions, 2018 Sarah Kidd, MD, MPH Medical Epidemiologist Division of STD Prevention
More informationSTD 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 informationTrends in STDs: US Perspective. Michael Towns, M.D. WW Vice President, Medical Affairs BD Diagnostic Systems
Trends in STDs: US Perspective Michael Towns, M.D. WW Vice President, Medical Affairs BD Diagnostic Systems Outline Overview of STD Epidemiology and Current Situation in US Overview of Chlamydia infections
More informationGAY 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