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Web-Based STD Tool Makes Screening Accessible


 

ESTES PARK, COLO. — The STD Wizard is a patient-friendly Internet tool for determining individual STD screening needs that is a particularly good fit for busy primary care medical practices.

“I would recommend this site to your patients,” Dr. L. Chesney Thompson said at a conference on internal medicine sponsored by the University of Colorado.

The STD Wizard (www.stdwizard.org

The Wizard is not a diagnostic tool; instead it analyzes an individual's answers and produces customized recommendations for STD screening. Patients are encouraged to print out the summary and bring it to their physician for action, explained Dr. Thompson, chief of the section of general ob.gyn. at the university.

The STD Wizard's recommendations are based on the 2006 Sexually Transmitted Diseases Treatment Guidelines of the Centers for Disease Control and Prevention. The Wizard was developed and funded by the Medical Institute for Sexual Health and the CDC. The goal is to help rein in the nation's STD epidemic by reaching out to the public in a novel way to encourage greater use of guideline-recommended screening. The idea is to take the screening guidelines directly to the public in an accessible way.

By CDC estimates, 19 million new cases of STDs occur annually in the United States, nearly half in 15- to 24-year-olds. But that 19 million figure is “a woeful underestimate,” Dr. Thompson said.

“Half of the population—that is, males—aren't screened at all for HPV. Herpes simplex virus isn't screened for or reported, either. And those are probably the two most common STDs; 80% of women in this country will have been exposed to HPV by age 50,” he noted.

Five of the top 10 reportable diseases in the United States are STDs. Chlamydia is the most common, with roughly 3 million new cases a year. The CDC recommends annual screening for chlamydia infection in all sexually active females aged 25 years or less and routine screening of older women with risk factors, such as new or multiple partners.

Routine screening isn't recommended for chlamydia in young men because there is insufficient evidence of benefit. But a low threshold for screening high-risk men is appropriate, Dr. Thompson said.

Similarly, although there are as yet no official guidelines for HPV anal screening in men who have sex with men, “there are compelling reasons for doing so,” he continued.

When a patient is diagnosed with one STD, it's worthwhile to consider casting a broader net and screening for others, Dr. Thompson said. This might involve screening for the major reportable ones—gonorrhea, syphilis, chlamydia, chancroid, and HIV—along with hepatitis B and C and herpes simplex.

The STD Wizard involves a 5-minute online questionnaire with simple multiple-choice questions.

Source Dr. Thompson

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