Skip to main content
SpringerLink
Log in

Office-Based STI Management: A Practical Approach to Sexual History Taking and Syndromic Management of Sexually Transmitted Infections

  • Chapter
  • First Online:
Sexually Transmitted Infections in HIV-Infected Adults and Special Populations

  • 719 Accesses

Abstract

Sexual health is an important facet of comprehensive HIV care delivery. Additionally, patients with sexually transmitted infections (STIs) are commonly encountered in the HIV primary care setting. To better understand the level of patient risk for STI acquisition and HIV transmission, tailor counseling, and implement optimal screening strategies, an understanding of the components of a thorough sexual history is imperative. Given the limited number of point-of-care diagnostic tests for STIs, knowledge of key STI syndromes and the associated etiologies facilitates effective management of symptomatic patients presenting to the HIV primary care setting.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    The “Bachmann Sign”—a finding where a male patient with a urethral discharge has taken measures to contain or “catch” a profuse discharge. The measures may include toilet tissue stuffed into the underwear (most common in the authors’ experience) or something secured to the penis (i.e. an empty M & M® bag, a baby’s sock, a condom).

References

  1. Ashton MR, Cook RL, Wiesenfeld HC, Krohn MA, Zamborsky T, Scholle SH, et al. Primary care physician attitudes regarding sexually transmitted diseases. Sex Transm Dis. 2002;29(4):246–51.

    Article  PubMed  Google Scholar 

  2. Bull SS, Rietmeijer C, Fortenberry JD, Stoner B, Malotte K, VanDevanter N, et al. Practice patterns for the elicitation of sexual history, education, and counseling among providers of STD services: results from the gonorrhea community action project (GCAP). Sex Transm Dis. 1999;26(10):584–9.

    Article  CAS  PubMed  Google Scholar 

  3. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:2015.

    Google Scholar 

  4. McCree DH, Rompalo AM, editors. Biological and behavioral risk factors associated with STDs/HIV in women: implications for behavioral interventions. New York: Springer Science+Business Media, LLC; 2007.

    Google Scholar 

  5. Varghese B, Maher JE, Peterman TA, Branson BM, Steketee RW. Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex Transm Dis. 2002;29(1):38–43.

    Article  PubMed  Google Scholar 

  6. Richardson JL, Milam J, McCutchan A, Stoyanoff S, Bolan R, Weiss J, et al. Effect of brief safer-sex counseling by medical providers to HIV-1 seropositive patients: a multi-clinic assessment. AIDS. 2004;18(8):1179–86.

    Article  PubMed  Google Scholar 

  7. Fisher JD, Fisher WA, Cornman DH, Amico RK, Bryan A, Friedland GH. Clinician-delivered intervention during routine clinical care reduces unprotected sexual behavior among HIV-infected patients. J Acquir Immune Defic Syndr. 2006;41(1):44–52.

    Article  PubMed  Google Scholar 

  8. Gardner LI, Marks G, O’Daniels CM, Wilson TE, Golin C, Wright J, et al. Implementation and evaluation of a clinic-based behavioral intervention: positive steps for patients with HIV. AIDS Patient Care STDS. 2008;22(8):627–35.

    Article  PubMed  Google Scholar 

  9. Kamb ML, Fishbein M, Douglas JM, Rhodes F, Rogers J, Bolan G, et al. Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. Project RESPECT study group. JAMA. 1998;280(13):1161–7.

    Article  CAS  PubMed  Google Scholar 

  10. Bachmann LH, Manhart LE, Martin DH, Seña AC, Dimitrakoff J, Jensen JS, et al. Advances in the understanding and treatment of male urethritis. Clin Infect Dis. 2015;61(Suppl 8):S763–9.

    Article  PubMed  Google Scholar 

  11. Ison CA. Laboratory methods in genitourinary medicine. Methods of diagnosing gonorrhoea. Genitourin Med. 1990;66(6):453–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Kissinger P, Adamski A. Trichomoniasis and HIV interactions: a review. Sex Transm Infect. 2013;89(6):426–33.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Bachmann LH, Hobbs MM, Seña AC, Sobel JD, Schwebke JR, Krieger JN, et al. Trichomonas vaginalis genital infections: progress and challenges. Clin Infect Dis. 2011;53(Suppl 3):S160–72.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Meites E, Gaydos CA, Hobbs MM, Kissinger P, Nyirjesy P, Schwebke JR, et al. A review of evidence-based care of symptomatic trichomoniasis and asymptomatic Trichomonas vaginalis infections. Clin Infect Dis. 2015;61(Suppl 8):S837–48.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Taylor SN, Lensing S, Schwebke J, Lillis R, Mena LA, Nelson AL, et al. Prevalence and treatment outcome of cervicitis of unknown etiology. Sex Transm Dis. 2013;40(5):379–85.

    Article  PubMed  Google Scholar 

  16. Schwebke JR. 282—Trichomonas vaginalis A2—Bennett, John E. In: Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 8th ed. Philadelphia: Elsevier; 2015. p. 3161–3164.e3161.

    Google Scholar 

  17. Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983;74(1):14–22.

    Article  CAS  PubMed  Google Scholar 

  18. Pattullo L, Griffeth S, Ding L, Mortensen J, Reed J, Kahn J, et al. Stepwise diagnosis of Trichomonas vaginalis infection in adolescent women. J Clin Microbiol. 2009;47(1):59–63.

    Article  PubMed  Google Scholar 

  19. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance. Atlanta: Department of Health and Human Services; 2015.

    Google Scholar 

  20. Gupta R, Warren T, Wald A. Genital herpes. Lancet. 2007;370(9605):2127–37.

    Article  PubMed  Google Scholar 

  21. Batteiger BE, Tan M. 182—Chlamydia trachomatis (Trachoma, Genital Infections, Perinatal Infections, and Lymphogranuloma Venereum) A2—Bennett, John E. In: Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 8th ed. Philadelphia: Elsevier; 2015, p. 2154–2170.e2156.

    Google Scholar 

  22. Stoner BP, Cohen SE. Lymphogranuloma venereum 2015: clinical presentation, diagnosis, and treatment. Clin Infect Dis. 2015;61(Suppl 8):S865–73.

    Article  PubMed  Google Scholar 

  23. González-Beiras C, Marks M, Chen CY, Roberts S, Mitjà O. Epidemiology of Haemophilus ducreyi infections. Emerg Infect Dis. 2016;22(1):1–8.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ndinya-Achola JO, Kihara AN, Fisher LD, Krone MR, Plummer FA, Ronald A, et al. Presumptive specific clinical diagnosis of genital ulcer disease (GUD) in a primary health care setting in Nairobi. Int J STD AIDS. 1996;7(3):201–5.

    Article  CAS  PubMed  Google Scholar 

  25. O’Farrell N, Hoosen AA, Coetzee KD, van den Ende J. Genital ulcer disease: accuracy of clinical diagnosis and strategies to improve control in Durban, South Africa. Genitourin Med. 1994;70(1):7–11.

    PubMed  PubMed Central  Google Scholar 

  26. Radolf JD, Tramont EC, Salazar JC. 239—Syphilis (Treponema pallidum) A2—Bennett, John E. In: Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 8th ed. Philadelphia: Elsevier; 2015, p. 2684–2709.e2684.

    Google Scholar 

  27. Centers for Disease Control and Prevention. Discordant results from reverse sequence syphilis screening-five laboratories, United States, 2006–2010. MMWR Morb Mortal Wkly Rep. 2011;60(5):133–7.

    Google Scholar 

  28. Holmes KK, Sparling PF, Stamm WE, et al. Clinical manifestations of syphilis. In: Sexually transmitted diseases, 4th ed. New York: McGraw Hill; 2008.

    Google Scholar 

  29. Brunham RC, Gottlieb SL, Paavonen J. Pelvic inflammatory disease. N Engl J Med. 2015;372(21):2039–48.

    Article  PubMed  Google Scholar 

  30. Chesson HW, Dunne EF, Hariri S, Markowitz LE. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis. 2014;41(11):660–4.

    Article  PubMed  Google Scholar 

  31. Moscicki AB, Schiffman M, Burchell A, Albero G, Giuliano AR, Goodman MT, et al. Updating the natural history of human papillomavirus and anogenital cancers. Vaccine. 2012;30(Suppl 5):F24–33.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Marcus JL, Bernstein KT, Kohn RP, Liska S, Philip SS. Infections missed by urethral-only screening for chlamydia or gonorrhea detection among men who have sex with men. Sex Transm Dis. 2011;38(10):922–4.

    Article  PubMed  Google Scholar 

  33. Aberg JA, Gallant JE, Ghanem KG, Emmanuel P, Zingman BS, Horberg MA, et al. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58(1):1–10.

    Article  PubMed  Google Scholar 

  34. Moncada J, Schachter J, Liska S, Shayevich C, Klausner JD. Evaluation of self-collected glans and rectal swabs from men who have sex with men for detection of Chlamydia trachomatis and Neisseria gonorrhoeae by use of nucleic acid amplification tests. J Clin Microbiol. 2009;47(6):1657–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. van der Helm J, Hoebe C, van Rooijen M, Brouwers EE, Fennema HS, Thiesbrummel HF, et al. High performance and acceptability of self-collected rectal swabs for diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in men who have sex with men and women. Sex Transm Dis. 2009;36(8):493–7.

    Article  PubMed  Google Scholar 

  36. Alexander S, Ison C, Parry J, Llewellyn C, Wayal S, Richardson D, et al. Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men. Sex Transm Infect. 2008;84(6):488–92.

    Article  CAS  PubMed  Google Scholar 

  37. Barbee LA, Tat S, Dhanireddy S, Marrazzo JM. Implementation and operational research: effectiveness and patient acceptability of a sexually transmitted infection self-testing program in an HIV Care setting. J Acquir Immune Defic Syndr. 2016;72(2):e26–31.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Soni S, White JA. Self-screening for Neisseria gonorrhoeae and Chlamydia trachomatis in the human immunodeficiency virus clinic-high yields and high acceptability. Sex Transm Dis. 2011;38(12):1107–9.

    Article  PubMed  Google Scholar 

  39. Peterkin A, Risdon C. Caring for lesbian and gay people: a clinical guide. Canada: University of Toronto Press Incorporated; 2003.

    Book  Google Scholar 

  40. Wolfe D. Complete guide to gay men’s sexual, physical, and emotional well-being: men like us. New York: Ballantine Books; 2000.

    Google Scholar 

  41. Edwards L. Genital dermatology. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Section on Infectious Diseases, Wake Forest University Health Sciences, Medical Center Blvd., Winston-Salem, NC, 27157, USA

    Laura Hinkle Bachmann & Candice Joy McNeil

Authors
  1. Laura Hinkle Bachmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Candice Joy McNeil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laura Hinkle Bachmann .

Editor information

Editors and Affiliations

  1. Division of Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA

    Laura Hinkle Bachmann

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Bachmann, L.H., McNeil, C.J. (2017). Office-Based STI Management: A Practical Approach to Sexual History Taking and Syndromic Management of Sexually Transmitted Infections. In: Bachmann, L. (eds) Sexually Transmitted Infections in HIV-Infected Adults and Special Populations. Springer, Cham. https://doi.org/10.1007/978-3-319-56694-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56694-8_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56692-4

  • Online ISBN: 978-3-319-56694-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation