CME: Updated Guidance for STDs

CME: Updated Guidance for STDs

The CDC recently published an update to its 2010 sexually transmitted disease (STD) treatment guidelines in order to address key questions regarding the treatment and clinical management of these diseases. Published in the Morbidity and Mortality Weekly Report (MMWR), the guideline addresses several key updates, including: Alternative treatment regimens for Neisseria gonorrhoeae. The use of nucleic acid amplification tests for the diagnosis of trichomoniasis. Alternative treatment options for genital warts. The role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications. Updated HPV vaccine recommendations and counseling messages. The management persons who are transgender. Annual testing for hepatitis C in individuals with HIV infection. Updated recommendations for diagnosing urethritis. Retesting for chlamydia, gonorrhea, and trichomoniasis to detect repeat infections. A Focus on Risk Assessment As the guideline indicates, primary prevention of STDs should include behavioral and biologic risk assessment. As part of the clinical encounter, the CDC recommends that clinicians routinely obtain sexual histories and address risk reduction using the “Five Ps” approach (Table). “Regarding partners, clinicians should ask patients if they have sex with men, women, or both,” explains Kimberly A. Workowski, MD, FACP, FIDSA, lead author of the guideline update. “They should also ask about how many partners they’ve had in the last 2 and 12 months and whether it’s possible that their partners have other partners.” In terms of practices, Dr. Workowski says it is important to know if patients are engaging in vaginal, oral, or anal sex because certain infections can reside in certain anatomic sites of exposure and, in many instances, may infect patients without symptoms. Additional questions pertain to past history of sexually transmitted...
Updated Guidance for STDs

Updated Guidance for STDs

The CDC recently published an update to its 2010 sexually transmitted disease (STD) treatment guidelines in order to address key questions regarding the treatment and clinical management of these diseases. Published in the Morbidity and Mortality Weekly Report (MMWR), the guideline addresses several key updates, including: Alternative treatment regimens for Neisseria gonorrhoeae. The use of nucleic acid amplification tests for the diagnosis of trichomoniasis. Alternative treatment options for genital warts. The role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications. Updated HPV vaccine recommendations and counseling messages. The management persons who are transgender. Annual testing for hepatitis C in individuals with HIV infection. Updated recommendations for diagnosing urethritis. Retesting for chlamydia, gonorrhea, and trichomoniasis to detect repeat infections. A Focus on Risk Assessment As the guideline indicates, primary prevention of STDs should include behavioral and biologic risk assessment. As part of the clinical encounter, the CDC recommends that clinicians routinely obtain sexual histories and address risk reduction using the “Five Ps” approach (Table). “Regarding partners, clinicians should ask patients if they have sex with men, women, or both,” explains Kimberly A. Workowski, MD, FACP, FIDSA, lead author of the guideline update. “They should also ask about how many partners they’ve had in the last 2 and 12 months and whether it’s possible that their partners have other partners.” In terms of practices, Dr. Workowski says it is important to know if patients are engaging in vaginal, oral, or anal sex because certain infections can reside in certain anatomic sites of exposure and, in many instances, may infect patients without symptoms. Additional questions pertain to past history of sexually transmitted...