While the idea of Talk. Test. Treat. is simple, STI prevention and treatment are not one-size-fits-all. We encourage you, our nation’s healthcare providers, to revisit the many ways that you can empower your patients to take charge of their sexual health.
Make sure your patients are aware of the different ways they may be able to access critical STI care, during STI Awareness Week and beyond. In addition to traditional, in-person visits, other options include:
- Express visits allow walk-in STI testing and treatment appointments without a full clinical exam.
- Partnerships with pharmacies and retail health clinics can provide new access points for STI services, such as on-site testing and treatment.
- Telehealth/telemedicine can close gaps in STI testing and treatment, ensure access to healthcare providers, and support self-testing. This is especially critical in rural areas.
- At-home specimen collection allows patients to collect their own sample and take or mail it to a lab for testing. There is also an FDA-approved HIV self-test. These options could be useful when in-person services are not available or feasible.
Providing the best medical care possible means talking to your patients about sexual health.
Taking a sexual history should be a part of routine care.
Talking about sexual health can be challenging, but studies show that patients want to be asked about sex. 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 their confidentiality is being protected by everyone in your office.
- Help normalize sexual health questions and STI/HIV testing recommendations by letting your patients know you ask these questions and offer these services to all 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 use open-ended questions when taking a sexual history.
- 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.
Counsel your patients on safer sex, and ensure that they know about today’s many prevention options. With condoms, hepatitis B and HPV vaccines, and even a daily medication to prevent HIV infection – there have never been more ways for your patients to protect themselves.
Certain STI diagnoses can cause fear and anxiety in your patient.
- Use CDC counseling messages in the 2021 STI Treatment Guidelines to help alleviate these concerns.
Test your patients for STIs as recommended.
Use the sexual history to determine which STIs you should test for and the anatomical sites to test.
STI screening recommendations for different patient populations are available. Below is a brief overview.
- All adults and adolescents from ages 13 to 64 should be tested at least once for HIV.
- All sexually active women younger than 25 years should be tested for gonorrhea and chlamydia every year. Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STI should also be tested for gonorrhea and chlamydia every year.
- Everyone who is pregnant should be tested for syphilis, HIV, hepatitis B, and hepatitis C starting early in pregnancy. Those at risk for infection should also be tested for chlamydia and gonorrhea starting early in pregnancy. Repeat testing may be needed in some cases.
- All sexually active gay, bisexual, and other men who have sex with men should be tested:
- At least once a year for syphilis, chlamydia, and gonorrhea. Those who have multiple or anonymous partners should be tested more frequently (e.g., every 3 to 6 months).
- At least once a year for HIV and may benefit from more frequent HIV testing (e.g., every 3 to 6 months).
- At least once a year for hepatitis C, if living with HIV.
- Anyone who engages in sexual behaviors that could place them at risk for infection or shares injection drug equipment should get tested for HIV at least once a year.
Keep in mind that screening recommendations are sources of clinical guidance, not prescriptive standards. Always consider a patient’s sexual history and the burden of disease in their community.
Once a patient has been tested, make sure they know how they will get their test results.
Follow CDC’s STI Treatment Guidelines to ensure appropriate treatment and care.
The 2021 STI Treatment Guidelines are the most current recommendations for treating patients who have, or who are at risk for infection.
Important treatment topics to be aware of:
Expedited Partner Therapy (EPT) may be an option in cases where a patient’s partner is unwilling or unable to access care.
- Learn about EPT on CDC’s website or contact your state or territorial health department to obtain jurisdiction-specific information.
Reinfection is common for some STIs. Encourage your patients to return for follow-up testing in three months.
Drug-resistant gonorrhea is an immediate public health threat requiring urgent and aggressive action.
Preserve our last treatment option by only treating your patients with the recommended treatment (ceftriaxone 500mg intramuscularly in a single dose).