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Providers: What you do matters.

Providers: What you do matters.

 

Healthcare providers, you are the protectors of health across the nation. Right now, millions are threatened by STDs as rates of chlamydia, gonorrhea, and syphilis continue to climb. You can help put a stop to these dangerous trends.

This STD Awareness Month, CDC wants to help you do just that. This year the focus is on the relationship between provider and patient. With the theme of Treat Me Right, we are encouraging patients to take control of their health by asking you for what they need. For providers, we’re arming you with the tools you need to treat them right – from detecting an infection and selecting the correct treatment regimen to engaging with your patients in a way that makes them feel heard and respected.

At the end of the day, patients are people. They come in all sizes and shapes, sexual orientations, and many cultural backgrounds. Delivering care that is aware of – and not biased by – these differences is what takes your care from good to great. Cultural competency trainings are available.

Take a Sexual History

Treating your patients right starts with taking a thorough sexual history. It is an important part of their overall medical history and allows you to make informed clinical decisions.

These conversations also help to normalize and destigmatize discussions around sex. One way to discreetly introduce the topic of sexual health is by incorporating it into your patient questionnaires prior to the visit.

A list of essential sexual health questions is available; however, at the bare minimum you should assess the sex of your patient’s sex partner, if they currently have more than one sexual partner, and their anatomic sites of exposure based on the type of sexual activity they are engaging in.

The following tips can help to ensure the most productive conversations with your patients:

  • Help foster trust with your patient – before their visit even starts – by creating a welcoming and inclusive clinic or office environment. For example, you can use these tips to make your office teen-friendly.
  • Make sure your patients are comfortable and in a private space, especially before asking sensitive questions; this includes assuring patients that their confidentiality is being protected by everyone in your office.
  • Help normalize your sexual health questions and STD/HIV testing recommendations by letting your patients know that you ask these questions and offer these services “to all my patients, as sexual health is a normal part of a person’s overall health and well-being.”
  • Avoid making assumptions about your patients; asking is the only way to know for sure. Standardize sexual orientation/gender identity (SOGI) questions, and during the sexual history, use open-ended questions.
  • If your patient is hesitant to answer a question, try rephrasing it or briefly explain why you are asking it.
  • Ensure that you and your patient share an understanding of the terms being used to avoid confusion.

Test and Treat

Treating your patients right continues with using the sexual history to determine what STDs your patient should be tested for and the anatomical sites to test.

Once a patient has been tested, make sure they know how they will get their test results.

In addition, treat your patients right by following CDC’s STD Treatment Guidelines when they are diagnosed with an STD. Also remember that the only recommended treatment for syphilis is injectable long-acting Benzathine penicillin G.

Dual Therapy for Gonorrhea

CDC recommends dual therapy for gonorrhea

In particular, CDC recommends dual therapy to treat gonorrhea – a single dose of 250mg of intramuscular ceftriaxone AND 1g of oral azithromycin – as drug-resistant gonorrhea is of increasing concern.

Expedited Partner Therapy. Illustration of a woman telling a clinician about her partner and the clinician prescribing treatment for both of them.

Verify that your patient’s partners are tested and treated, too. Expedited Partner Therapy (EPT) may be an option in cases where a patient’s partner is unwilling or unable to access care. EPT is the clinical practice of treating the sex partners of patients diagnosed with chlamydia or gonorrhea by providing prescriptions or medications to the patient to take to their partner if they are unable to seek timely treatment.

Reinfection is common for some STDs. Encourage your patients to return for follow-up testing in 3 months.

Treating your patient right is more than simply testing and treating them. You should also encourage risk reduction by providing prevention counseling. Prevention counseling should be offered to all sexually active adolescents and adults at increased risk for STDs (e.g., patients who have received an STD diagnosis, had an STD in the past year, or have multiple sexual partners).

 

Did you know?
Counseling is typically included in the preventive medicine CPT codes. Medicare covers up to two individual 20-30 minute, face-to-face, high-intensity behavioral counseling sessions per year for sexually active adults at increased risk for STDs.

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