2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

STIs are on the rise

Limitationsof case report data

• NotallSTIs arenationally notifiable • Most STIs areasymptomatic,only those diagnosed canbe reported • Trends are influenced by screening coverage and reporting practices

Slide4of47FromKAWorkowski,MDatNewOrleans, LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS  USA.

Proportionof MSM AttendingSTD Clinics withPrimary and Secondary Syphilis * , UrogenitalGonorrhea, or Urogenital Chlamydiaby Known HIV Status,STD Surveillance Network (SSuN), 2018

CDC,2018 Surveillance Report

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STI Screening

Women and Heterosexual Men • Chlamydia, Gonorrhea • Women <25 or older women (increased risk) annually • Self collected vaginal swab • Noextragenital testing • HIV+ (trichomonas, pap smear) • Heterosexual men • Consider chlamydia screening (adolescents, corrections, STD clinics)

Men who Have Sex with Men • HIV An/Ab serology • Syphilis serology (RPR/treponemal) • Chlamydia, Gonorrhea

• Urethral infection (NAAT) • Rectal infection (NAAT) • Pharyngeal infection gonorrhea (NAAT)

• Hepatitis A, B • Hepatitis C (MSM/HIV)

• Population based gonorrhea screening not recommended • Noextragenital testing • Retest 3 mo after treatment

At leastyrly,q3-6mobasedon risk

USPSTF,JAMA 2016; USPSTF 2014,Ann Int Med

CDC,MMWR,STDTreatmentGuidelines2015

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