Sexually Transmitted Infections

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We have a lot of STI’s in the Delta region.

Due to high levels of STIs, it is recommended that we aggressively screen all females AND males => 12 years of age.

When someone asks for a STI check, please do urine, self vaginal or anal swab, or cervical GC/CT, RPR, and HIV tests. Ask if they are interested in Hep B, C and Herpes (HSV1/HSV2) testing as well. When doing the urine STI test, it needs to be done with dirty urine without wiping beforehand. Use the AMB STI PowerPlan which has all testing, treatments, etc.

All positive STI tests will go to the Community Case Manager (CCM) to fill out the required Partner Information forms and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the CCM.

We use Expedited Partner Therapy on anyone who is positive for GC or CT screening. They will either come to the hospital, or go to the village clinic to receive their treatment. They will also get the number of bags of medications for the number of partners they have. A Partner Notification Sheet needs to be filled out so public health knows who was treated.

Frequently Asked Questions

What if the patient is allergic to Cefixime or azithromycin?
Contact Dr. Compton, Dr. Bowerman or an infectious disease specialist at ANMC. Be absolutely sure that the patient is truly allergic. If they are TRULY allergic to all penicillins and cephalosporins, give Azithromycin 2gm orally. It is very important to treat with 2 drugs if possible. If you are not sure, call one of the above for guidance.
What if the patient is only a contact?
Get the appropriate testing for STIs. Do a pharyngeal, genital and anal test as needed. Treat for the appropriate STI as a contact. DO NOT treat their partners.
Has the patient been previously treated? How can I tell?
Please check the MAR, medications and notes for evidence of treatment. Make sure that you set the filter on your medications for All Medications All Statuses. Make sure that you set the MAR dates to include the dates in questions.
When do you recommend an HIV or RPR?
If the patient has a negative HIV and RPR within the past 6 months they do not need a repeat. We want to strongly encourage those without a recent test to get tested.
What if the patient answers yes to anal or oral sex? Do I change the treatment?
If the patient answers yes to having anal or oral sex, perform the appropriate swabs or find a provider to help. They will need to be state lab tests. Treat with the azithromycin and/or Cefixime. Wait for a positive test to treat with different medications.

Anal and Oral GC/CT goes to State Lab