Benefits Of Early Detection And Treatment
The USPSTF reviewed 4 trials and concluded that screening was associated with reduced risk of PID vs no screening.49-52 One recent large, good-quality trial of men and women in primary care clinics found that screening for chlamydia was associated with a reduction in risk of hospital-diagnosed PID compared with usual care , but the absolute difference was small . No differences were seen in rates of PID or epididymitis in clinics.52 No studies reported the association between screening and disease acquisition or transmission or between screening and clinical outcomes other than PID or epididymitis.19
The USPSTF previously found fair-quality evidence that treatment of chlamydial infection during pregnancy is associated with improved outcomes for infants and mothers.53,54 The USPSTF reviewed large cohort studies of screening at the first prenatal visit in pregnant women at increased risk for infection. These studies found that treatment of chlamydial infection was associated with significantly lower rates of preterm delivery, early rupture of membranes, and infants with low birth weight compared with no treatment or treatment failure.53,54 No subsequent studies met inclusion criteria for the current USPSTF review.19,32
The USPSTF found no studies comparing the effectiveness of cotesting for concurrent STIs or using different screening intervals.19,32
Four Curable Sexually Transmitted Infections
Chlamydia, gonorrhoea, trichomoniasis, and syphilis are four potential outcomes of sex that wed all like to avoid. However, according to new global estimates, each day there are more than one million new cases of these sexually transmitted infections.
The worrying thing is, even though we have never known more about how to prevent these infections, rates of infection remain very high worldwide.
The good news is, these 4 infections are curable.
Sti Are Often Asymptomatic Screen For One Sti Screen For All
Screening: Early STI detection in asymptomatic individualsFootnote
Chlamydia trachomatis AND Neisseria gonorrhoeae
Image 1 depicts a flow chart of the different specimens and laboratory tests that may be used for Chlamydia trachomatis and Neisseria gonorrhoeae screening. First void urine samples can be tested for CT and NG using Nucleic Acid Amplification Testing . Urethral, vaginal or cervical swabs can be tested for CT and NG using NAAT and/or culture for NG. Rectal or pharyngeal swabs can be tested for CT and NG using NAAT, if available, and/or culture.
Tips
- Nucleic Acid Amplification Test is highly sensitive and the test of choice when screening asymptomatic individuals for CT and NG
- Preferred specimens for NAAT are first void urine or self-collected vaginal swab
- Collect pharyngeal and rectal specimens from individuals with a history of performing oral sex or having receptive anal intercourse, respectively
- Check with your laboratory for the availability of NAAT for rectal and pharyngeal specimens
Syphilis
Tips
- Testing algorithms may vary by province and territory
Offer HIV testing when screening for other STIFootnote
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How Is Each Condition Transmitted
Both STIs are caused by bacterial infections that are transmitted through unprotected sexual contact, meaning sex without using a condom, dental dam, or another protective barrier between you and your partner during vaginal, anal, or oral sex.
Its also possible to contract the infection through sexual contact that doesnt involve penetration. For example, if your genitals come into contact with the genitals of someone whos contracted the infection, its possible to develop the condition.
Both STIs can also be contracted through protected sex with a condom or other barrier if you dont use protection properly, or if the barrier breaks.
Either STI can be contracted even if you arent showing visible symptoms. Both STIs can also be transmitted to a child at birth if the mother has either condition.
Youre at increased risk for developing these and other STIs if you:
- have multiple sexual partners at one time
- dont properly use protection, such as condoms, female condoms, or dental dams
- regularly use douches which can irritate your vagina, killing healthy vaginal bacteria
- have contracted an STI before
Sexual assault can also increase your risk of both chlamydia or gonorrhea.
Both STIs can be diagnosed using similar diagnostic methods. Your doctor may use one or more of these tests to ensure that the diagnosis is accurate and that the right treatment is given:
What Is The Treatment For Chlamydia
Chlamydia can be easily cured with antibiotics. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV-negative.
Persons with chlamydia should abstain from sexual activity for 7 days after single dose antibiotics or until completion of a 7-day course of antibiotics, to prevent spreading the infection to partners. It is important to take all of the medication prescribed to cure chlamydia. Medication for chlamydia should not be shared with anyone. Although medication will stop the infection, it will not repair any permanent damage done by the disease. If a persons symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated.
Repeat infection with chlamydia is common. Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple chlamydial infections increases a womans risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy. Women and men with chlamydia should be retested about three months after treatment of an initial infection, regardless of whether they believe that their sex partners were successfully treated.
Infants infected with chlamydia may develop ophthalmia neonatorum and/or pneumonia. Chlamydial infection in infants can be treated with antibiotics.
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When Should I Get Chlamydia Testing
As most people infected with chlamydia do not experience symptoms, doctors rely on screening to detect most cases of chlamydia. Screening guidelines vary based on many factors, including a persons anatomy, health, and sexual practices. Regular screening for chlamydia is recommended for several groups:
Certain factors increase the risk of contracting chlamydia and may affect how often a person should be screened. Risk factors include having:
- Sex with a new partner
- More than one sexual partner or a partner who has sex with mutiple people
- A sex partner diagnosed with an STD
Testing for chlamydia is more frequently conducted in asymptomatic people in settings where infection rates are high, which often includes correctional facilities, adolescent health clinics, the military, and sexual health clinics.
Diagnostic chlamydia testing is recommended for anyone with signs or symptoms of this infection. When symptoms do occur, they may not appear until a few weeks after exposure. Signs and symptoms of chlamydia can vary based on the site of infection but may include:
- Burning during urination
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Complications From Chlamydia And Gonorrhea
Because these two diseases often have no symptoms, some people go untreated.
Even with those who have symptoms, stigma, access, or other reasons get in the way of getting medical attention.
Not receiving prompt and proper treatment can create serious health problems.
For women, chlamydia and gonorrhea that goes untreated can spread through your uterus to your fallopian tubes.
Fallopian tubes connect the ovaries to the uterus and transport fertilized eggs during pregnancy. If untreated bacteria that cause gonorrhea and chlamydia spread to this area, the result is pelvic inflammatory disease , affecting around 5% of women in the US.
Pelvic inflammatory disease, similar to chlamydia and gonorrhea, can have no symptoms or just some pelvic or abdominal pain initially.
Unfortunately, PID can do permanent damage to a womens reproductive system, including:
For men, gonorrhea and chlamydia can also lead to serious health problems.
It is uncommon for either to cause infertility in men, but sometimes the infection can spread past the penis causing fever or pain.
One difference is that chlamydia can also spread to the urethra, causing Non-Gonococcal urethritis, which is an infection of the tube that carries urine resulting in inflammation, pain, and fever.
This cannot be caused by the bacteria that causes gonorrhea. However, for both diseases, it is possible for either to cause:
For both women and men, chlamydia and gonorrhea can develop into a form of arthritis:
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How Is Each Condition Analyzed
Both STIs can be analyzed utilizing comparable analytic strategies. Your PCP may utilize at least one of these tests to guarantee that the analysis is exact and that the correct treatment is given:
- physical assessment to search for side effects of a STI and decide your general wellbeing
- Urine test to test your pee for the microscopic organisms that cause chlamydia or gonorrhea
- blood test to test for indications of bacterial contamination
- swab culture to take an example of release from your penis, vagina, or butt to test for indications of infection
Complications from Chlamydia and Gonorrhea
Since these two maladies regularly have no manifestations, a few people go untreated.
Indeed, even with the individuals who have indications, disgrace, access, or different reasons impede getting clinical consideration.
Not accepting brief and legitimate treatment can make genuine medical issues.
For ladies, chlamydia and gonorrhea that goes untreated can spread through your uterus to your fallopian tubes.
Fallopian tubes interface the ovaries to the uterus and transport prepared eggs during pregnancy. In the event that untreated microbes that cause gonorrhea and chlamydia spread to this region, the outcome is pelvic incendiary ailment , influencing around 5% of ladies in the US.
Pelvic incendiary malady, like chlamydia and gonorrhea, can have no side effects or simply some pelvic or stomach torment at first.
Sadly, PID can harm a ladies conceptive framework, including:
Strengths And Limitations Of This Study
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This study determined the proportional contribution and trend in chlamydia and gonorrhoea diagnoses from general practices relative to other services, and whether these infections were treated appropriately.
-
Some double counting of diagnoses of patients referred to specialist sexually transmitted infection services is likely.
-
Diagnoses of chlamydia and gonorrhoea made outside GP, and made outside community and specialist services that routinely report to national surveillance systems, could not be included in our analysis, but it is likely that the great majority of diagnoses were captured.
-
This study provides more complete estimates of the burden of chlamydia and gonorrhoea diagnoses in England.
-
Most patients diagnosed with chlamydia are managed appropriately however, many diagnosed with gonorrhoea were treated with antimicrobials no longer recommended for use.
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Being Exposed To Another Std
Being successfully treated for chlamydia, gonorrhea, or another STD does not protect you from other STDs In fact, many people become infected with STDs over and over again because they continue to have unprotected sex with partners who have untreated STDs.
If youve been treated for an STD and dont want to get another one, the best thing that you can do is change your behaviors to decrease your risk. That means consistently practicing safe sex and always talking to new partners about STD risk before having sex.
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Taking The Incorrect Medication
Keep in mind that your treatment can fail if you’re taking the wrong medication. You might be prescribed the wrong drugs due to syndromatic treatment, an efficient, but sometimes inaccurate treatment method in which patients are prescribed STD treatment based on symptoms, rather than testing. This is sometimes done in STD clinics when there is a concern that the patient might not come back for their test results.
And you could be taking the wrong medication if you’ve acquired it on your own and chose the wrong onessuch as taking medication that was prescribed for a past STD you had, or for your partner, or for a friend.
Not all STDs are caused by the same pathogens . Different illnesses require different treatments.
That’s why it’s so important for your healthcare provider to correctly identify what’s causing your infection. That’s also why you can’t just take any random antibiotic and hope it’s going to work.
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Treatment For Chlamydia Is Quick And Easy
Two antibiotics are most often used for treating chlamydia:
- Azithromycin The main treatment for chlamydia is one gram of azithromycin, taken one time, says , deputy director of clinical services for public health with the Seattle and King County HIV and STD Program in Washington. That one gram comes as either two pills or four pills. It is not expensive.
- Doxycycline If your doctor prescribes doxycycline, you will take two pills daily for one week. It costs somewhat more than azithromycin.
Antibiotics can also cure chlamydia in infants, who can get the infection from their mothers, and treatment is essential for them. Without treatment, infants infected with chlamydia can develop conjunctivitis, which can cause blindness, or pneumonia, which can be fatal.
What Measures Can I Take To Prevent These Conditions
The only way that you can completely prevent yourself from catching chlamydia, gonorrhea, or another STI is by abstaining from sexual activity.
But there are also plenty of ways you can reduce your risk of contracting or transmitting these infections:
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How Do I Know If I Have An Sti
Dont wait until you show symptoms, as you might never get any. If youve had unprotected sex then its important to get tested to make sure that you dont have an STI. Especially because infections like chlamydia and gonorrhea can be symptomless, you run the risk of infecting your partner, or any future partner.
You can visit a sexual health clinic to get tested where they will ask you questions about your sexual history before examining you. The tests for chlamydia and gonorrhea involve giving a urine sample and possibly a swab test from the vagina. If you prefer, you can order a test kit online to do at home.
If you test positive for one, or think that you have symptoms of one, then its advisable to get tested for all common STIs. It is possible to have multiple sexually transmitted infections.
Patient Referrals From Gp
In CPRD, information on patient referrals can be stored as Read codes in medical and investigation/test records, in specific referral to specialty records, or in unstructured format in the free text field. A patient was defined as having been referred for further management if any structured record indicating a referral was found within the 42-day period of the STI episode. We did not have access to the free text records, and assumed that most episodes without a treatment or referral code had likely been informally referred.
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Harms Of Screening And Treatment
The USPSTF reviewed several studies, including 4 recent studies , assessing harms of site-specific chlamydia and gonorrhea testing as well as harms of collection methods in women. The false- positive, false-negative, false alarm, and false reassurance rates varied by anatomical site but were overall generally low across all NAATs and specimen types.19,32
No studies of psychosocial harms, such as anxiety, related to testing met inclusion criteria for this or prior reviews.19,32
Gonorrhea: Symptoms & Treatment Options
Symptoms: Most people dont have any symptoms when they have gonorrhea. However, those who do have reported the following issues: burning sensation when peeing a white, yellow, or green discharge when peeing or spotting between periods.
If you had anal sex, you might get anal itching or painful bowel movements.
Treatment: The really great news is that gonorrhea can be cured with antibiotics. Its crucial to take every single prescribed dose. Otherwise, youll continue having the infection.
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Syphilis: Symptoms & Treatment Options
Symptoms: The symptoms of syphilis will vary depending on the stage the disease is in: Primary, secondary, latent, or tertiary.
During its primary stage, you may get painless sores in the affected area: genitals, anus, or mouth. They usually will go away within a couple of weeks. However, the person will still be infected with the virus unless they receive treatment.
During the secondary stage, you may get flu-like symptoms, such as a sore throat, fever, headaches, and being tired all the time.
During the latent stage, the person wont have any symptoms. If left untreated, the illness will reach its tertiary stage.
During the tertiary stage, the disease will start to affect internal organs, including your central nervous system and your brain.
Treatment: Syphilis can be treated with Penicillin. The dosage and length of treatment will depend on the stage of the disease. You should also follow up within 6 to 12 months after treatment has ended to make sure youre cured.
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Copyright 2021 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOGs complete disclaimer.
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