Sexually Transmitted Infections - Revision history

JenniferH: /* Introduction */

2021-08-16T23:53:50Z

Introduction

← Older revision		Revision as of 23:53, 16 August 2021
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	A daily report generated of any +CT or +GC is sent to the '''Infectious Disease Advanced Practice Provide (IDAPP)''' who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic.		A daily report generated of any +CT or +GC is sent to the '''Infectious Disease Advanced Practice Provide (IDAPP)''' who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic.

	Please direct all reactive treponemal and HIV results to IDAPP by forwarding results. Any person who has a Reactive Syphilis or HIV test will have a State of AK Epidemiology report form filled out by the IDAPP to be sure a person is tracked and ~~completed~~ confirmatory testing. If a person is truly positive (confirmatory testing is positive) for Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications.		Please direct all reactive treponemal and HIV results to IDAPP by forwarding results. Any person who has a Reactive Syphilis or HIV test will have a State of AK Epidemiology report form filled out by the IDAPP to be sure a person is tracked and confirmatory testing completed. If a person is truly positive (confirmatory testing is positive) for Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications.

	Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.		Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.

JenniferH: /* Introduction */

2021-08-16T23:53:22Z

Introduction

← Older revision		Revision as of 23:53, 16 August 2021
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	A daily report generated of any +CT or +GC is sent to the '''Infectious Disease Advanced Practice Provide (IDAPP)''' who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic.		A daily report generated of any +CT or +GC is sent to the '''Infectious Disease Advanced Practice Provide (IDAPP)''' who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic.

	Please direct all reactive treponemal and HIV results to IDAPP by forwarding results. Any person who has a Reactive Syphilis or HIV test will have a State of AK Epidemiology report form filled out by the IDAPP to be sure a person is tracked and ~~Confirmatory~~ testing ~~is completed~~. If a person is truly positive for Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications.		Please direct all reactive treponemal and HIV results to IDAPP by forwarding results. Any person who has a Reactive Syphilis or HIV test will have a State of AK Epidemiology report form filled out by the IDAPP to be sure a person is tracked and completed confirmatory testing. If a person is truly positive (confirmatory testing is positive) for Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications.

	Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.		Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.

JenniferH: /* Introduction */

2021-08-16T23:51:10Z

Introduction

← Older revision		Revision as of 23:51, 16 August 2021
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	When someone asks for a STI check, please do urine, self-vaginal or cervical swab, anal and Oral GC/CT swab, RPR, and HIV tests. If a person specifically requests STI screening, inquire if they have gotten a social media notice or text from a partner notifying them of being a STI contact. Let them know many have NO symptoms with Chlamydia. Ask if they are interested in Hep B, C and Herpes (HSV1/HSV2) testing as well (''FYI: HSV testing generally not offered unless specifically requested or herpetic lesion concern''). When doing the urine STI test, it needs to be done with dirty urine without wiping beforehand. Use the '''AMB STI''' or the '''Village Reproductive''' PowerPlan which has all testing, treatments, etc. ''(Vaginal self swab preferred for any female over age 14, and not heavily menstruating).''		When someone asks for a STI check, please do urine, self-vaginal or cervical swab, anal and Oral GC/CT swab, RPR, and HIV tests. If a person specifically requests STI screening, inquire if they have gotten a social media notice or text from a partner notifying them of being a STI contact. Let them know many have NO symptoms with Chlamydia. Ask if they are interested in Hep B, C and Herpes (HSV1/HSV2) testing as well (''FYI: HSV testing generally not offered unless specifically requested or herpetic lesion concern''). When doing the urine STI test, it needs to be done with dirty urine without wiping beforehand. Use the '''AMB STI''' or the '''Village Reproductive''' PowerPlan which has all testing, treatments, etc. ''(Vaginal self swab preferred for any female over age 14, and not heavily menstruating).''

	~~Daily~~ report generated of any +CT or +GC is sent to the Infectious Disease Advanced Practice Provide (IDAPP) who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic.		A daily report generated of any +CT or +GC is sent to the '''Infectious Disease Advanced Practice Provide (IDAPP)''' who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic.

	Please direct all reactive treponemal and HIV results to IDAPP by forwarding results. Any person who has a Reactive Syphilis or HIV test will have a State of AK Epidemiology report form filled out by the IDAPP to be sure a person is tracked and Confirmatory testing is completed. If a person is truly positive for Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications.		Please direct all reactive treponemal and HIV results to IDAPP by forwarding results. Any person who has a Reactive Syphilis or HIV test will have a State of AK Epidemiology report form filled out by the IDAPP to be sure a person is tracked and Confirmatory testing is completed. If a person is truly positive for Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications.

JenniferH: /* Introduction */

2021-08-16T23:48:34Z

Introduction

← Older revision		Revision as of 23:48, 16 August 2021
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	When someone asks for a STI check, please do urine, self-vaginal or cervical swab, anal and Oral GC/CT swab, RPR, and HIV tests. If a person specifically requests STI screening, inquire if they have gotten a social media notice or text from a partner notifying them of being a STI contact. Let them know many have NO symptoms with Chlamydia. Ask if they are interested in Hep B, C and Herpes (HSV1/HSV2) testing as well (''FYI: HSV testing generally not offered unless specifically requested or herpetic lesion concern''). When doing the urine STI test, it needs to be done with dirty urine without wiping beforehand. Use the '''AMB STI''' or the '''Village Reproductive''' PowerPlan which has all testing, treatments, etc. ''(Vaginal self swab preferred for any female over age 14, and not heavily menstruating).''		When someone asks for a STI check, please do urine, self-vaginal or cervical swab, anal and Oral GC/CT swab, RPR, and HIV tests. If a person specifically requests STI screening, inquire if they have gotten a social media notice or text from a partner notifying them of being a STI contact. Let them know many have NO symptoms with Chlamydia. Ask if they are interested in Hep B, C and Herpes (HSV1/HSV2) testing as well (''FYI: HSV testing generally not offered unless specifically requested or herpetic lesion concern''). When doing the urine STI test, it needs to be done with dirty urine without wiping beforehand. Use the '''AMB STI''' or the '''Village Reproductive''' PowerPlan which has all testing, treatments, etc. ''(Vaginal self swab preferred for any female over age 14, and not heavily menstruating).''

	Daily report generated of any +CT or +GC sent to the Infectious Disease Advanced Practice Provide (IDAPP) who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. ~~Please direct all reactive treponemal and HIV results to IDAPP by forwarding results~~.		Daily report generated of any +CT or +GC is sent to the Infectious Disease Advanced Practice Provide (IDAPP) who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic.

	~~We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic~~. Any person who has a Reactive Syphilis, HIV test will have a State of AK Epidemiology report form filled out by the IDAPP, to be sure a person is tracked and Confirmatory testing is completed. If a person is truly +Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications. Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.		Please direct all reactive treponemal and HIV results to IDAPP by forwarding results. Any person who has a Reactive Syphilis or HIV test will have a State of AK Epidemiology report form filled out by the IDAPP to be sure a person is tracked and Confirmatory testing is completed. If a person is truly positive for Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications.

			Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.

	==Treatment Recommendations==		==Treatment Recommendations==

JenniferH: /* Resources/References */

2021-08-16T23:40:43Z

Resources/References

← Older revision		Revision as of 23:40, 16 August 2021
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	* [[media:YK HIV-STD Update 6-25-19.pdf\|HIV-STD Update 2019]]		* [[media:YK HIV-STD Update 6-25-19.pdf\|HIV-STD Update 2019]]
	* [[media:STI_guideline.pdf\|Sexually Transmitted Infections, Screening YKHC Clinical Guideline]]		* [[media:STI_guideline.pdf\|Sexually Transmitted Infections, Screening YKHC Clinical Guideline]]


			''Please direct any comments or questions to the IDAPP or STI designated Provider via email or TigerText.''

JenniferH: /* Treatment Recommendations */

2021-08-16T23:40:24Z

Treatment Recommendations

← Older revision		Revision as of 23:40, 16 August 2021
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	#There is no effective therapy for pharyngeal gonorrhea beside ceftriaxone, thus we recommend you contact HROB, IDAPP, or an ID specialist. Contacting the experts in Seattle for a recommendation for therapy is highly recommended.		#There is no effective therapy for pharyngeal gonorrhea beside ceftriaxone, thus we recommend you contact HROB, IDAPP, or an ID specialist. Contacting the experts in Seattle for a recommendation for therapy is highly recommended.
	#The recommended medications are on formulary at all of the village clinics and SRCs. They are also in the Pyxis in the ED, Outpatient Clinic, Inpatient and OB.		#The recommended medications are on formulary at all of the village clinics and SRCs. They are also in the Pyxis in the ED, Outpatient Clinic, Inpatient and OB.

	~~''Please direct any comments or questions to the IDAPP or STI designated Provider via email or TigerText.''~~

	==Treatment of chlamydia Workflow in the outpatient clinic (OPC)==		==Treatment of chlamydia Workflow in the outpatient clinic (OPC)==

JenniferH: /* Resources/References */

2021-08-16T23:38:56Z

Resources/References

← Older revision		Revision as of 23:38, 16 August 2021
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	==Resources/References==		==Resources/References==
	* [https://www.std.uw.edu/ University of Washington National STD Curriculum]		* [https://www.std.uw.edu/ University of Washington National STD Curriculum]
	* Health care providers with STI consultation requests can contact the [https://www.stdccn.org\|STD Clinical Consultation Network (STDCCN)], a free service.		* Health care providers with STI consultation requests can contact the [https://www.stdccn.org STD Clinical Consultation Network (STDCCN)], a free service.
	* [[media:YK HIV-STD Update 6-25-19.pdf\|HIV-STD Update 2019]]		* [[media:YK HIV-STD Update 6-25-19.pdf\|HIV-STD Update 2019]]
	* [[media:STI_guideline.pdf\|Sexually Transmitted Infections, Screening YKHC Clinical Guideline]]		* [[media:STI_guideline.pdf\|Sexually Transmitted Infections, Screening YKHC Clinical Guideline]]

JenniferH: /* Frequently Asked Questions */

2021-08-16T23:38:09Z

Frequently Asked Questions

← Older revision		Revision as of 23:38, 16 August 2021
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	#*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.		#*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?		#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/Oral +STI results will not clear unless correct RX is prescribed and taken)		#*If the patient answers yes to having anal or oral sex, perform the extra-genital swab as appropriate or find a provider to help. Treat per Sexually Transmitted Infection YKHC Clinical Guideline. Wait for a positive test to treat with different medications. (Anal/Oral +STI results will not clear unless correct RX is prescribed and taken)
	#Are you asking the 5 P’s: Partners (who and how many and gender); Practices (This includes behavior making them at risk for HIV, such as ETOH/Drugs); Protection for STI (Condom use with all routes of sex); Past Hx of +STI; Prevention of Pregnancy.		#Are you asking the 5 P’s: Partners (who and how many and gender); Practices (This includes behavior making them at risk for HIV, such as ETOH/Drugs); Protection for STI (Condom use with all routes of sex); Past Hx of +STI; Prevention of Pregnancy.

JenniferH: /* Frequently Asked Questions */

2021-08-16T23:30:52Z

Frequently Asked Questions

← Older revision		Revision as of 23:30, 16 August 2021
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	==Frequently Asked Questions==		==Frequently Asked Questions==
	#What if the patient is allergic to a recommended antibiotic choice?		#What if the patient is allergic to a recommended antibiotic choice?
	#*~~Contact Dr. Compton 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~~.		#*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, consult IDAPP or ID specialist.
	#What if the patient is only a contact?		#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.		#*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.

JenniferH: /* Introduction */

2021-08-16T23:28:32Z

Introduction

← Older revision		Revision as of 23:28, 16 August 2021
Line 6:		Line 6:
	When someone asks for a STI check, please do urine, self-vaginal or cervical swab, anal and Oral GC/CT swab, RPR, and HIV tests. If a person specifically requests STI screening, inquire if they have gotten a social media notice or text from a partner notifying them of being a STI contact. Let them know many have NO symptoms with Chlamydia. Ask if they are interested in Hep B, C and Herpes (HSV1/HSV2) testing as well (''FYI: HSV testing generally not offered unless specifically requested or herpetic lesion concern''). When doing the urine STI test, it needs to be done with dirty urine without wiping beforehand. Use the '''AMB STI''' or the '''Village Reproductive''' PowerPlan which has all testing, treatments, etc. ''(Vaginal self swab preferred for any female over age 14, and not heavily menstruating).''		When someone asks for a STI check, please do urine, self-vaginal or cervical swab, anal and Oral GC/CT swab, RPR, and HIV tests. If a person specifically requests STI screening, inquire if they have gotten a social media notice or text from a partner notifying them of being a STI contact. Let them know many have NO symptoms with Chlamydia. Ask if they are interested in Hep B, C and Herpes (HSV1/HSV2) testing as well (''FYI: HSV testing generally not offered unless specifically requested or herpetic lesion concern''). When doing the urine STI test, it needs to be done with dirty urine without wiping beforehand. Use the '''AMB STI''' or the '''Village Reproductive''' PowerPlan which has all testing, treatments, etc. ''(Vaginal self swab preferred for any female over age 14, and not heavily menstruating).''

	Daily report generated of any +CT or +GC sent to the Infectious Disease Advanced Practice Provide (IDAPP) who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP.		Daily report generated of any +CT or +GC sent to the Infectious Disease Advanced Practice Provide (IDAPP) who will complete the required AK State Epidemiology report form and follow-up with the patient regarding treatment. The provider should order any required medications and send a message to the IDAPP. Please direct all reactive treponemal and HIV results to IDAPP by forwarding results.

	We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic. Any person who has a Reactive Syphilis, HIV test will have a State of AK Epidemiology report form filled out by the IDAPP, to be sure a person is tracked and Confirmatory testing is completed. If a person is truly +Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications. Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.		We use '''Expedited Partner Therapy''' for anyone who is positive for GC or CT screening. The EPT kits can be given out at the hospital or the village clinic. Any person who has a Reactive Syphilis, HIV test will have a State of AK Epidemiology report form filled out by the IDAPP, to be sure a person is tracked and Confirmatory testing is completed. If a person is truly +Syphilis or HIV, the IDAPP will coordinate needed follow up care and initiation of medications. Ideally, a Partner Notification Sheet is filled out so public health knows who was treated, but the patient does not need to provide the names of partners. The IDAPP is usually able to elicit the partner’s names, even if you are not.