Screening for sexually transmitted infections
- Heidi Swygard, MD, MPH
Heidi Swygard, MD, MPH
- Associate Clinical Professor of Medicine
- University of North Carolina at Chapel Hill
- Myron S Cohen, MD
Myron S Cohen, MD
- Professor of Medicine, Microbiology, Immunology and Public Health
- University of North Carolina at Chapel Hill
- Section Editors
- Noreen A Hynes, MD, MPH, DTM&H
Noreen A Hynes, MD, MPH, DTM&H
- Section Editor — Sexually Transmitted Diseases
- Associate Professor of Infectious Diseases; International Health; and Population, Family, and Reproductive Health
- Johns Hopkins University Schools of Medicine and Public Health
- Robert H Fletcher, MD, MSc
Robert H Fletcher, MD, MSc
- Editor-in-Chief — Adult Primary Care
- Section Editor — General Medicine
- Professor Emeritus of Population Medicine
- Harvard Medical School
Sexually transmitted infections (STIs) are a major public health problem in developed and developing countries. Complications of untreated STIs include upper genital tract infections, infertility, cervical cancer, and enhanced transmission and acquisition of herpesviruses, hepatitis viruses, and the human immunodeficiency virus (HIV).
The approach to STI diagnosis and management is based upon disease or symptom-specific syndromes, including vaginal discharge, urethral discharge, ulcerative genital disease, nonulcerative genital disease, and pelvic pain. However, many patients have asymptomatic disease, which increases the risk of complications and sustained transmission in the community. Unfortunately, routine screening for all potential STIs in all patients is cost-prohibitive, particularly in resource-poor countries . Targeted screening of asymptomatic patients in specified risk groups is important and has been shown to be effective.
STI screening, including targeted screening and prevention, will be discussed here. In its 2010 guidelines on the treatment of sexually transmitted infections, the United States Centers for Disease Control and Prevention (CDC) also made recommendations on screening . The recommendations in this topic are largely consistent with those guidelines.
The approaches to patients with specific genitourinary symptoms and signs are discussed elsewhere (see "Approach to women with symptoms of vaginitis" and "Clinical features and diagnosis of pelvic inflammatory disease" and "Approach to the patient with genital ulcers" and "Acute uncomplicated cystitis and pyelonephritis in women"). The prevention of STIs is discussed elsewhere. (See "Prevention of sexually transmitted infections".)
Information on the clinical presentation, diagnosis, and treatment of specific STIs are reviewed in detail separately. (See related topics). Sexually transmitted infections and HIV infection in adolescents are also discussed separately. (See "Sexually transmitted diseases: Overview of issues specific to adolescents" and "The adolescent with HIV infection".)
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- TAKING A SEXUAL HISTORY
- RISK FACTORS
- GENERAL PRINCIPLES
- Human immunodeficiency virus (HIV)
- Herpes simplex virus type 1 and type 2
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Human papillomavirus
- SCREENING SEXUALLY ACTIVE PATIENTS
- SCREENING SPECIAL POPULATIONS
- Pregnant women
- Men who have sex with men
- Women who have sex with women
- HIV-infected patients
- HEALTH DEPARTMENT NOTIFICATION
- PARTNER NOTIFICATION
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS