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Upon completion of the chapter, the reader will be able to:

  1. Assess the behavioral considerations and the importance of contraception with regard to the contributing factors of sexually transmitted infections (STIs).

  2. Apply the “patient-delivered partner therapy” method when recommending treatment for STIs.

  3. Describe the patient populations that are typically affected by specific STIs.

  4. Identify causative organisms for STIs.

  5. Devise a list of the clinical signs and symptoms corresponding to each type of STI and classify patients based on recommended criteria.

  6. Select appropriate diagnostic procedures for STIs.

  7. Recommend STI treatment regimens and recommend therapy, when appropriate.

  8. Develop monitoring parameters based on recommended regimen.


Though we have made significant progress in science and medicine, longstanding problems of infectious disease continue to plague us.1 Even with the discovery of newly improved antibiotics, sexually transmitted infections (STIs) have not yet been eradicated. Several have reemerged secondary to modern social trends (eg, number of partners, sex workers, and swingers) of sexual activity, socioeconomic concerns, and the global lack of preventive education. image Since the correlation between risky sexual behavior and STIs is well documented,2 many sexually active individuals may contract an infection at some point in their lives. Community approaches to reducing STIs (eg, access to quality health care, promotion of personal health, and advancement of community wellness) have been proven effective.3 Though inconsistent and incorrect condom use increases the probability of new STIs, counseling patients on the consistent use of condoms, spermicides, or diaphragms is also important component in reducing overall incidence. Additionally, healthcare providers who manage persons at risk for STIs should counsel women concerning the option for emergency contraception, when indicated. Mifepristone, levonorgestrel, ulipristal, ethinyl estradiol, and copper T intrauterine devices have been employed in the United States for the prevention of unintended pregnancy.4

Optimal detection and treatment of sexually transmitted diseases depend on counseling by a patient-friendly and knowledgeable clinician who can effectively establish open communication. Acknowledging the hierarchy of human needs is the cornerstone to establishing open communication. When these needs are met in a safe and collaborative environment, it increases patients’ confidence and gives them a sense of trust, which encourages interpersonal and open communication. Open communication with patients may also be encouraged by (a) incorporating training on effective communication within the organization’s mandatory training program, (b) making communication a part of the organization’s culture, (c) implementing patient satisfaction surveys, (d) utilizing technology when appropriate, and (e) ensuring that continuous quality improvement is incorporated. Additionally, clinicians, healthcare workers, and healthcare facilities should strive to incorporate strategies regarding communication improvement, especially when suggested by patients.

In addition to an increasing number of adolescents and young adults engaging in unsafe sexual practices, there is a high incidence of men who have sex with men (MSM) and women who have sex with women (WSW). In fact, MSM is documented as the risk ...

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