Remain vigilant
Actively screen patients (from preteen years onward) for STIs.4-7,10 Screening may range from questions that assess risk to formal STI testing. According to The National Health and Social Life Survey, 71% of individuals with STIs were diagnosed and treated in a private clinic or emergency room.16 Only 29% of sexually active individuals sought care at an STI clinic. Thus, most patients present to the primary care office.4-6 It is crucial that we become as familiar with the guidelines for reporting and partner testing and treatment as with knowing how to treat index patients for STIs.
Reporting specifics. Syphilis, gonorrhea, Chlamydia, chancroid, HIV infection, and AIDS are reportable in every state.17 Hospital and commercial laboratories report all abnormal findings of reportable diseases; however, it is ultimately the physician’s responsibility to report the STI to the local health department. Each state has a complete list of reportable conditions and the time frame for reporting, accessible through its Department of Health Services. Once reported, information becomes confidential, and public health officials may contact you to verify the diagnosis before initiating a follow-up protocol.
Consider notifying patients directly regarding negative and positive results so you can answer any questions they may have and discuss treatment for themselves—and their partners. (See “Getting treatment to partners: The expedited partner therapy option”.) Directly notifying patients offers another opportunity to further educate teens regarding prevention strategies and to dispel any misconceptions they may have.
Correspondence
Anush S. Pillai, DO, FAAFP, 424 Hahlo, Houston, TX 77020; aspillai@tmhs.org