Dr Linh Medical Service

27/04/2019

SUMMARY AND RECOMMENDATIONS FOR MANAGEMENT OF GONORRHEA

● Gonococcal infections, including urethritis, cervicitis, epididymitis, and proctitis, are a significant cause of morbidity among s*xually active men and women.

● Since treatment failure for gonococcal eradication has significant public health implications, it is desirable for therapeutic regimens to have efficacy rates of greater than 95 percent. The selection of the treatment regimen must also include consideration of drug resistance and potential copathogens, such as Chlamydia trachomatis and Mycoplasma ge***alium.

● High microbiologic cure rates of gonococcal infection had been documented for multiple classes of drugs in the past. However, surveillance of resistance patterns in N. gonorrhoeae worldwide have demonstrated increasing resistance to multiple classes of antibiotics including penicillins, tetracyclines, macrolides, and fluoroquinolones. Of the cephalosporin class of drugs, ceftriaxone has the lowest rates of gonococcal drug resistance in epidemiologic surveys.

● A low but increasing proportion of isolates with decreased susceptibility to ceftriaxone are being reported worldwide. Because of this trend and the lack of new, effective antimicrobials in advanced product development, we suggest dual rather than monotherapy for the treatment of gonococcal infections (Grade 2C).

● For the treatment of suspected or confirmed uncomplicated uroge***al gonococcal infection, we recommend ceftriaxone as the first agent (Grade 1B). For the second agent, we suggest azithromycin (Grade 2C). Ceftriaxone is administered as a single injection of a 250 mg dose at the point of care. Azithromycin is given orally as a single dose (1 g) and also has activity against chlamydia, which is a common copathogen.

● Pharyngeal infections may be somewhat more difficult to cure and may serve as an important reservoir of asymptomatic and resistant infections.

● Pregnant women with uncomplicated gonorrheal infection should be treated with dual therapy with ceftriaxone plus azithromycin since doxycycline should be avoided during pregnancy. In addition to retesting three months following therapy, pregnant women at continued high risk for gonococcal infection should be retested during the third trimester.

● The management of the penicillin allergic patient depends upon the clinical suspicion of true allergy and the type of the allergy (eg, morbilliform rash versus IgE-mediated reactions, such as urticaria).

● Persons diagnosed with a s*xually transmitted infection are at high risk for HIV infection and should be offered testing.

● Patients who finish a recommended regimen for treatment of uncomplicated gonorrheal infections do not need to return for a test of cure. A test of cure is performed with culture (at seven days following therapy) or nucleic acid amplification tests (NAATs; at 14 days following therapy) for any patient who receives an alternate regimen (eg, a cefixime-based regimen) for oropharyngeal gonococcal infection. Patients who continue to be symptomatic should be reevaluated for treatment failure or other s*xually transmitted infections. All patients with documented gonococcal infection should be retested three months following treatment to evaluate for reinfection.

● Treatment failure is suspected in individuals with persistent or recurrent symptoms soon (eg, three to five days) after completing therapy for a documented gonococcal infection. If reinfection is unlikely, relevant specimens (eg, urethral, oropharyngeal, and/or re**al samples depending on exposure) should be submitted for culture and NAAT for N. gonorrhoeae and isolates sent for susceptibility testing. These cases should also be reported to governmental public health agencies.

● Treatment of s*xual partners is essential for preventing reinfection and controlling the spread of N. gonorrhoeae. For s*x partners of patients with documented gonococcal infection, we suggest not routinely employing expedited partner therapy (Grade 2C). Instead, we prefer evaluation and management through traditional strategies of public health or patient notification. However, if a heteros*xual partner cannot be evaluated and managed in this manner, delivery of oral cefixime and azithromycin through expedited partner therapy is a reasonable approach.

REFERENCES

Workowski KA, Bolan GA, Centers for Disease Control and Prevention. S*xually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015; 64:1.

Workowski KA, Berman SM, Douglas JM Jr. Emerging antimicrobial resistance in Neisseria gonorrhoeae: urgent need to strengthen prevention strategies. Ann Intern Med 2008; 148:606.

Newman LM, Moran JS, Workowski KA. Update on the management of gonorrhea in adults in the United States. Clin Infect Dis 2007; 44 Suppl 3:S84.

Moran JS, Levine WC. Drugs of choice for the treatment of uncomplicated gonococcal infections. Clin Infect Dis 1995; 20 Suppl 1:S47.

Weston EJ, Workowski K, Torrone E, et al. Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea - STD Surveillance Network, United States, 2016. MMWR Morb Mortal Wkly Rep 2018; 67:473.

Fifer H, Natarajan U, Jones L, et al. Failure of Dual Antimicrobial Therapy in Treatment of Gonorrhea. N Engl J Med 2016; 374:2504.

Datta SD, Sternberg M, Johnson RE, et al. Gonorrhea and chlamydia in the United States among persons 14 to 39 years of age, 1999 to 2002. Ann Intern Med 2007; 147:89.

Gottlieb SL, Berman SM, Low N. Screening and treatment to prevent sequelae in women with Chlamydia trachomatis ge***al infection: how much do we know? J Infect Dis 2010; 201 Suppl 2:S156.

Manhart LE, Broad JM, Golden MR. Mycoplasma ge***alium: should we treat and how? Clin Infect Dis 2011; 53 Suppl 3:S129.

Ross JD, Lewis DA. Cephalosporin resistant Neisseria gonorrhoeae: time to consider gentamicin? S*x Transm Infect 2012; 88:6.

European Centre for Disease Prevention and Control. Gonococcal antimicrobial susceptibility surveillance in Europe, 2013. Stockholm: ECDC; 2015.

Australian Gonococcal Surveillance Programme annual reports. http://www.health.gov.au/internet/main/publishing.nsf/content/cda-pubs-annlrpt-gonoanrep.htm (Accessed on November 01, 2014).

World Health Organization. The Gonococcal Antimicrobial Surveillance Programme (GASP) http://www.who.int/reproductivehealth/topics/rtis/gonococcal_resistance/en/ (Accessed on July 10, 2017).

Centers for Disease Control and Prevention (CDC). Update to CDC's s*xually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep 2007; 56:332.

Sparling PF. Antibiotic resistance in Neisseria gonorrhoeae. Med Clin North Am 1972; 56:1133.

Unemo M, Nicholas RA. Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea. Future Microbiol 2012; 7:1401.

Kirkcaldy RD, Zaidi A, Hook EW 3rd, et al. Neisseria gonorrhoeae antimicrobial resistance among men who have s*x with men and men who have s*x exclusively with women: the Gonococcal Isolate Surveillance Project, 2005-2010. Ann Intern Med 2013; 158:321.

Unemo M, Bradshaw CS, Hocking JS, et al. S*xually transmitted infections: challenges ahead. Lancet Infect Dis 2017; 17:e235.

Brittain C, Childs M, Duley L, et al. Gentamicin versus ceftriaxone for the treatment of gonorrhoea (G-TOG trial): study protocol for a randomised trial. Trials 2016; 17:558.

Quaye N, Cole MJ, Ison CA. Evaluation of the activity of ertapenem against gonococcal isolates exhibiting a range of susceptibilities to cefixime. J Antimicrob Chemother 2014; 69:1568.

Eyre DW, Sanderson ND, Lord E, et al. Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018. Euro Surveill 2018; 23.

Schwarcz SK, Zenilman JM, Schnell D, et al. National surveillance of antimicrobial resistance in Neisseria gonorrhoeae. The Gonococcal Isolate Surveillance Project. JAMA 1990; 264:1413.

Centers for Disease Control and Prevention. S*xually Transmitted Disease Surveillance 2015: Gonococcal Isolate Surveillance Project (GISP) Supplement and Profiles. Atlanta: U.S. Department of Health and Human Services; 2017.https://www.cdc.gov/std/stats15/gisp2015/GISP-Supplement-AggrFigs_AggrTables_Clinic-Profiles_2015.pdf (Accessed on July 10, 2017).

Wi T, Lahra MM, Ndowa F, et al. Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action. PLoS Med 2017; 14:e1002344.

Muratani T, Akasaka S, Kobayashi T, et al. Outbreak of cefozopran (penicillin, oral cephems, and aztreonam)-resistant Neisseria gonorrhoeae in Japan. Antimicrob Agents Chemother 2001; 45:3603.

Yokoi S, Deguchi T, Ozawa T, et al. Threat to cefixime treatment for gonorrhea. Emerg Infect Dis 2007; 13:1275.

Barry PM, Klausner JD. The use of cephalosporins for gonorrhea: the impending problem of resistance. Expert Opin Pharmacother 2009; 10:555.

Singh AE, Gratrix J, Martin I, et al. Gonorrhea Treatment Failures With Oral and Injectable Expanded Spectrum Cephalosporin Monotherapy vs Dual Therapy at 4 Canadian S*xually Transmitted Infection Clinics, 2010-2013. S*x Transm Dis 2015; 42:331.

Allen VG, Mitterni L, Seah C, et al. Neisseria gonorrhoeae treatment failure and susceptibility to cefixime in Toronto, Canada. JAMA 2013; 309:163.

Centers for Disease Control and Prevention (CDC). Update to CDC's S*xually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections. MMWR Morb Mortal Wkly Rep 2012; 61:590.

https://youtu.be/iFwlnljV2Go

This animation details the history of drug-resistant gonorrhea in the United States, the dangers of untreatable gonorrhea, and why this issue must remain a t...

22/04/2019

Continuing to discuss s*xually transmitted diseases, today I will talk about urethritis.

⚓What is urethritis?

The urethra is the tube that carries urine from the bladder to the outside of the body. Urethritis is the medical term for when the urethra gets irritated or inflamed.
People who have urethritis can have pain, burning, or stinging when they urinate. They also sometimes have discharge, meaning they leak fluid from the p***s or va**na. Men with urethritis can have redness or swelling at the tip of the p***s.

⚓What causes urethritis?

Urethritis is usually caused by an infection. The most common cause is a s*xually transmitted infection. S*xually transmitted infections, often called STIs, are infections you can catch during s*x.
STIs that can cause urethritis include:
- Chlamydia
- Gonorrhea
- Mycoplasma ge***alium
- Trichomoniasis

⚓Should I see a doctor?

Yes. If you have symptoms of urethritis, see a doctor.

⚓Will I need tests?

Probably. You will probably need to give a urine sample or a sample of fluid from your va**na (if you are a woman) to be tested. If you are a man, the doctor might also take a sample from your p***s. If you are a woman, the doctor might also do a pelvic exam. It's also possible you will have a blood test. These tests can show if you have an infection and what kind.

⚓How is urethritis treated?

Treatment usually involves taking antibiotics. If your doctor or nurse thinks you have urethritis, you will probably get treatment right away. You do not need to wait until your test results come back.

If you are treated for an STI, you should not have s*x with anyone until 7 days after you start antibiotics and until you have no more symptoms.

If you learn that you have an STI, you should tell all the people you have had s*x with recently. They might also be infected (even if they have no symptoms) and need treatment.

⚓Can urethritis be prevented?

Since urethritis is usually caused by an STI, you can reduce your chances of getting urethritis again by:
- Using a latex condom every time you have s*x
- Avoiding s*x when you or your partner has any symptoms that could be caused by an infection (such as itching, discharge, or pain with urination)
- Not having s*x

If you had an STI at any time, your doctor might also check you for other STIs now or in the future. People can get more than one STI at the same time. Plus, STIs do not always cause symptoms, so it helps to check.

05/04/2019

As some gentlemen complained to me about their fatigue and reduced s*xual desire, I created a slide show about Low testosterone in men. Please enjoy and don't hesitate to send me your questions.

01/04/2019

What is syphilis?

Syphilis is an infection that you can catch during s*x. Infections that you can catch during s*x are called "s*xually transmitted infections." It is also possible for a pregnant woman to give syphilis to her baby.
Syphilis has different stages. The stages (in the order that they usually happen) are called:
- Primary syphilis
- Secondary syphilis
- Latent syphilis
- Late-stage syphilis (also called tertiary syphilis)
In some cases, the infection moves to the brain, ears, or eyes. This can happen in any of the stages of syphilis.

What are the symptoms of primary syphilis?

Primary syphilis is the first stage of infection. Symptoms start 2 to 3 weeks after the person becomes infected. At that time, the person usually gets a raised red bump on the spot where the infection first entered the body. This bump is usually painless. Eventually it turns into a small sore (or ulcer) with a raised edge.
The sores caused by syphilis usually form on the p***s or around the va**na or a**s. But they can also form in places that are hard to see, such as the back of the throat or inside the va**na or re**um.
Sores caused by primary syphilis usually heal on their own within a few weeks. Since they don't hurt, many people don't get treatment for them.

What are the symptoms of secondary syphilis?

Secondary syphilis is the second stage of infection. It starts weeks or a few months after primary syphilis and happens in about 25 percent of people who don't get treatment for their primary syphilis.
Symptoms of secondary syphilis include:
- A widespread rash
- Large, raised, gray or white patches on warm, moist areas of the body (such as the mouth and ge***als)
- Fever
- Headache
- Sore throat, muscle aches, and other flu-like symptoms
- Weight loss
- Swollen lymph nodes in the neck, armpit, and groin area (lymph nodes are bean-shaped organs scattered throughout the body that store infection-fighting cells)

What are the symptoms of latent syphilis?

Latent syphilis actually causes no symptoms. People who have this form can have the infection for years without knowing it.

What are the symptoms of late-stage syphilis?

Late-stage syphilis (also called tertiary syphilis) can cause serious damage to the heart, skin, brain, and other organs.

What is neurosyphilis?

"Neurosyphilis" is the term for a syphilis infection that has moved into the brain, the spinal cord, or the tissues that surround both. Neurosyphilis can happen during any of the stages of syphilis. Symptoms of it include:
- Headache
- Confusion
- Nausea and vomiting
- Stiff neck
- Vision loss or trouble seeing clearly
If the doctor suspects you have neurosyphilis, you might need a test called a "lumbar puncture," sometimes called a "spinal tap." For this test, the doctor takes a small sample of fluid from the space around the spinal cord. Then the fluid is tested for the bacteria that cause syphilis.
Some people also have vision problems if syphilis involves the eyes. This can happen in anyone with syphilis, but may be more common in people who also have HIV infection.

Is there a test for syphilis?

Yes. Your doctor can order blood tests to find out if you have syphilis.

Should I see a doctor or nurse?

You should see a doctor or nurse if you have symptoms of syphilis, or if any of your s*xual partners have been diagnosed with syphilis. Doctors also recommend that people who are at high risk for syphilis get tested regularly.
If you see a doctor or nurse to be checked for syphilis, he or she might want to test you for other s*xually transmitted infections, too. That's because people who get one type of s*xually transmitted infection are often at risk for other types.
Even if you have no symptoms, it's still possible that you could be infected. If you are infected, there are treatments to cure syphilis.

How is syphilis treated?

Syphilis is usually treated with an antibiotic called penicillin. The amount of time a person must take penicillin depends on what stage of infection they are in. Most people can get a penicillin shot, but some people need to get the medicine through a thin tube that goes into a vein, called an "IV." People who are allergic to penicillin need to take a different antibiotic.
After finishing treatment, most people need follow-up testing to make sure they are cured. Some people need to get multiple blood tests over a few years.

Can syphilis be prevented?

You can reduce your chances of getting syphilis by:
- Using a latex condom every time you have s*x
- Avoiding s*x when you or your partner has any symptoms that could be caused by an infection
- Not having s*x

01/04/2019

🦓What is epididymitis?

Epididymitis is the term doctors use when the epididymis gets inflamed. The epididymis is a small structure that sits on top of the testicle. The epididymis stores s***m and moves it along the male reproductive tract.
Different infections and conditions can cause epididymitis. In teens and men who are having s*x, epididymitis is commonly caused by chlamydia or gonorrhea. These are 2 different infections that people can catch during s*x.
Epididymitis can also be caused by other conditions or infections that people don't catch during s*x. These things are more likely to cause epididymitis in older men.

🦓What are the symptoms of epididymitis?

Epididymitis causes pain in the testicles or sc***um. The sc***um is the skin sac around the testicles.
Besides pain, epididymitis can also cause:
● Swelling of the sc***um or testicles
● Redness of the sc***um
● Fever

🦓Should I see my doctor or nurse?

Yes. See your doctor or nurse if you have pain or swelling in your testicles or sc***um.
If your pain is severe, and your doctor or nurse can't see you right away, you should go to the emergency room.

🦓Is there a test for epididymitis?

Yes. Your doctor or nurse will ask about your symptoms and do an exam. He or she will also probably do:
● Urine tests
● An ultrasound of your sc***um – An ultrasound is an imaging test that uses sound waves to create pictures of the inside of the body.
● Lab tests – If you have discharge from your urethra (the opening in your p***s where urine leaves your body), your doctor or nurse will take a sample of the discharge. He or she will send the sample to a lab for tests.

🦓Is there anything I can do on my own to feel better?

Yes. To help with the pain and swelling, you can:
● Put a cold gel pack, bag of ice, or bag of frozen vegetables on the area every few hours, for 15 minutes each time.
● Wear a jock strap to support your sc***um.
● Take an over-the-counter medicine to treat your pain. Over-the-counter medicines include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen(sample brand name: Aleve).

🦓What other treatment might I need?

Other treatment depends on what's causing your epididymitis.
If a bacterial infection is causing your epididymitis, your doctor will prescribe antibiotic medicines. Most men can take antibiotic pills at home, but men with a severe infection might need treatment in the hospital.
If you are treated for chlamydia or gonorrhea, you should tell the person you last had s*x with, and anyone you have had s*x with in the past 2 to 3 months. They might also be infected (even if they have no symptoms) and need treatment.

🦓Can epididymitis be prevented?

You can help prevent epididymitis that is caused by chlamydia or gonorrhea by:
● Using a latex condom every time you have s*x
● Avoiding s*x when you or your partner has ge***al itching, discharge, or other symptoms that could be caused by an infection
● Not having s*x

29/03/2019

Something about my career 🤞

You and Your Endocrinologist
Endocrinology is the study of medicine that relates to the endocrine system, which is the system that controls hormones. Endocrinologists are specially trained physicians who diagnose diseases related to the glands. Because these doctors specialize in these conditions, which can be complex and have hard-to-spot symptoms, an endocrinologist is your best advocate when dealing with hormonal issues.

Most patients begin their journey to the endocrinologist with a trip to their primary care provider or family doctor. This doctor will run a series of tests to see what could be the potential problem the patient is facing. If a problem with the hormones is suspected, the primary care doctor will provide a referral. The endocrinologist's goal is to restore hormonal balance in the body.

What Does an Endocrinologist Do?
The glands in a person's body release hormones. Endocrinologists treat people who suffer from hormonal imbalances, typically from glands in the endocrine system or certain types of cancers. The overall goal of treatment is to restore the normal balance of hormones found in a patient's body. Some of the more common conditions treated by endocrinologists include:

- Adrenal disorders
- Osteoporosis and bone health
- Diabetes
- Endocrine disorders in children (lack of growth, problems with puberty)
- Heart problems (high cholesterol, triglycerides, high blood pressure)
- Men's health (infertility, testosterone levels)
- Pituitary disorders
- Thyroid disorders
- Weight and metabolism
- Women's health (menopause, infertility, some menstrual problems)

Most of the work performed by an endocrinologist serves as the basis for ongoing research. Some endocrinologists work solely as research physicians. The goal of the research is to come up with new ways to better treat hormonal imbalances, including the development of new drugs.

Common courses that will have to be completed to become an endocrinologist include:

- Thyroid imaging and analysis
- Clinical endocrinology
- Endocrinology and genetics
- Molecular endocrinology concepts
- Endocrine tumors

It usually takes at least 10 years for a person to complete all of the necessary coursework, schooling and training to become an endocrinologist. From the year 2010 through 2020, there is an expected growth rate of 24 percent for this position. Before a person starts the educational path to becoming this type of physician, it is highly recommended that he or she carefully consider whether or not it is the right path.

26/03/2019

What are anoge***al warts?

Anoge***al warts are small, skin-colored or pink growths that form on the v***a (the lips of the va**na), va**na, p***s, or a**s. They are caused by a virus called human papillomavirus, or "HPV." You can catch this virus during s*x. Anoge***al warts are often called just "ge***al warts."

Is HPV dangerous?

The type of HPV that causes most forms of ge***al warts is not usually dangerous. But other types of HPV can lead to cancer of the cervix (a part inside the woman's body), p***s, or a**s.

Do warts hurt or itch?

Not usually. Most people with ge***al warts have no symptoms (other than the warts). But some people have itching, burning, or tenderness.

Is there a test for ge***al warts?

No, there is no test. But your doctor or nurse should be able to tell if you have warts just by doing an exam. He or she might also take small samples of tissue (biopsy) if it is not clear what you have. But that is not usually necessary.
How are ge***al warts treated?

There are several medicines that can help get rid of warts. Some work by slowly destroying the warts. Others work by getting your body's own infection-fighting system to attack the warts.
Most medicines are lotions or gels that go on the warts. They have to be applied one or more times a week for many weeks. Some medicines must be applied by a doctor or nurse. Others you can apply yourself.
People who do not get better with medicines or who have a very big wart or a lot of warts can have them removed. This is also an option for people who have warts that could become cancer.
There are different treatments to remove warts:
●Cryotherapy, which uses a chemical to freeze warts
●Electrocautery, which uses electricity to burn away warts
●Traditional surgery, which involves cutting away warts
●Laser surgery, which uses light to destroy warts
●Ultrasound surgery, which uses sound waves to break up and remove warts (this is not available many places)

What if I am pregnant?

If you are pregnant, make sure to tell your doctor before you get treated for ge***al warts. Some of the treatments for ge***al warts are safe to use during pregnancy, but others are not.

What happens after treatment?

After you have been treated for warts, your doctor might ask you to check once in a while to see if they come back. If warts are going to come back, they will probably do so within a few months.
You should know that even if you cannot see any warts, you might still have HPV. That means that warts can come back at any time. If warts do come back, you could spread them to someone else.

Can ge***al warts be prevented?

Yes. There are now vaccines against HPV. They can help prevent infection with most of the forms of HPV that cause warts. But the vaccines can prevent infection only if you get vaccinated before you get warts.
You can also protect yourself by not having s*x with anyone who is infected with HPV. But that is hard, because people do not always know that they have the virus. Condoms can help reduce the risk of infection. But they do not totally protect you. The virus can live on places on the skin not covered by a condom

22/03/2019

SEXUALLY TRANSMITTED INFECTIONS INFORMATION FOR PATIENTS
PLEASE SHARE THIS IF YOU CARE FOR COMMUNITY
What are s*xually transmitted infections?
S*xually transmitted infections, often called STIs, are infections you can catch during s*x. They are also called s*xually transmitted diseases, or STDs. Some STIs are caused by bacteria, and others are caused by viruses.
The most common STIs include:
● Chlamydia
● Gonorrhea
● Mycoplasma ge***alium
● Ge***al herpes, also called "herpes simplex virus" or "HSV"
● Ge***al warts, also called "human papillomavirus" or "HPV" – Some types of HPV can cause cervical cancer in women.
● Hepatitis A, B, and C
● Syphilis
● Trichomoniasis
● Human immunodeficiency virus, also called "HIV" – This is the virus that causes AIDS.
Many of these infections can be transmitted through any type of s*x. That includes not just p***s-in-va**na or p***s-in-a**s s*x, but also oral s*x and other types of s*x play. HIV and hepatitis can be transmitted in other ways, too, such as exposure to body fluids.
What is STI screening?
STI screening includes a series of tests that doctors use to find out if a person has any STIs. STIs often don't cause any symptoms. People can have STIs and not know it. That's what makes screening so important.
Doctors recommend that people who are at risk for STIs be screened even if they have no symptoms and feel fine. For example, you could be at risk for chlamydia if you had unprotected s*x with a new partner. Screening for chlamydia will alert your doctor that you have this infection. Treatment will prevent the infection from getting worse and keep you from infecting other people.
There are different types of tests that screen for different infections. Many STIs can be found through a blood or urine test. If you decide to be screened for STIs, your doctor or nurse can work with you to figure out which specific tests you need.
Who should be screened for STIs?
Different screening tests are appropriate for different people, depending on their gender and s*x habits.
● All men and women (including teenagers) should get screened for HIV.
● All girls and women younger than 26 years who have had s*x should be screened every year for gonorrhea and chlamydia.
● Older women who have s*x with more than one partner and do not use condoms should be screened every year for gonorrhea and chlamydia.
● All men and women who are having s*x and either do not have a stable partner or are having s*x with more than one partner should get screened for hepatitis B.
● All men and women born between 1945 and 1965 should be screened for hepatitis C. Also, anyone who has had s*x with a person infected with hepatitis C should be screened.
● Pregnant women should be screened for syphilis, chlamydia, HIV, and hepatitis B. Some pregnant women might also need to be screened for other infections depending on their s*x habits.
● Men and women who are infected with HIV should be screened at least once for hepatitis A, B, and C. They should also be screened at least once a year for syphilis, chlamydia, and gonorrhea. Women who are infected with HIV should be screened at least once a year for trichomonas. Men who are infected with HIV, and who have s*x with men with HIV, should be screened at least once a year for hepatitis C.
● Men who have s*x with men should be screened at least once for hepatitis A, B, and C. They should also be screened at least once a year for HIV, syphilis, chlamydia, and gonorrhea.
The list above includes some general guidelines, but some people might need other screening tests depending on their s*x habits and other factors. If you are unsure whether you should be screened and for what, ask your doctor or nurse for advice.
Where can I get screened?
If you have a doctor or nurse you see regularly, he or she should be able to screen you. But if you prefer to have screening done without your regular doctor or nurse, or if you don't have one, you can go to a clinic. Some clinics let you get screened without giving your name (anonymously).
Be careful with any pharmacies or online stores that offer to sell you kits to use at home to screen for STIs. For some of these tests, you turn in or mail away a sample, and then you get the results either by phone or online. For others, you do a test at home and get results within an hour. But it is not always clear which test kits are ones you can trust. If you do use one of these kits and get a positive result, be sure to follow up with a doctor or nurse. And if you get a negative result but think you might have an infection, see a doctor or nurse.
What symptoms should I watch for?
In general, watch out for any ge***al itching, burning, sores, or discharge. But be aware that many STIs do not cause any symptoms. The best way to know for sure if you have an STI is to be screened.
What if I have an STI?
If you have an STI, you will need treatment. The right treatment will depend on the type of STI you have. Treatment might include antibiotics or medicines called antivirals, which fight viruses. Treatment will cure your infection or keep it from getting worse. It will also reduce the chances that you spread your infection to others.
If you do have an infection, you might need to tell the people you could have infected. Your doctor or nurse can help you figure out which partners you need to tell based on when you last had s*x with them.
Can STIs be prevented?
There is no surefire way to prevent all STIs, but there are things you can do to reduce your chances of catching one.
● The most important thing you can do is to wear a condom every time you have s*x. Both male and female condoms can protect against STIs. But be aware that male condoms made out of "natural materials," such as sheep intestine, do not protect against STIs.
● Ask your doctor if there are any vaccines you should have. If you are 26 years old or younger, you can get a vaccine to protect against HPV, the virus that causes ge***al warts. If you do not have hepatitis A or B and have not already gotten the vaccine for hepatitis A or B, you can get those vaccines, too.
● If your partner has herpes, he or she can reduce the chances of infecting you by taking a medicine called valacyclovir (brand name: Valtrex).
● If you are at very high risk of catching HIV, you might be able to take a pill every day to reduce the chances that you will get HIV. This is an option only for very few at-risk people. If you are interested in this, talk to your doctor