Latest STD treatment guidelines recommend these screening questions
Latest STD treatment guidelines recommend these screening questions
Use normalizing language with patients
The Centers for Disease Control and Prevention (CDC) of Atlanta, GA, published in August 2006 its latest STD treatment guidelines update, which includes changes in prevention and treatment involving HIV patients and men who have sex with men.
The recommendations serve as clinical guidance, and focus on five major strategies for prevention and control of STDs, including the following:
- Education and counseling of persons at risk on ways to avoid STDs through changes in sexual behaviors;1
- identification of asymptomatically infected persons and of symptomatic persons unlikely to seek diagnostic and treatment services;1
- effective diagnosis and treatment of infected persons;1
- evaluation, treatment, and counseling of sex partners of persons who are infected with an STD,1
- pre-exposure vaccination of persons at risk for vaccine-preventable STD.1
The latest guidelines also recommend that clinicians become skilled in using techniques that facilitate rapport with patients through the use of open-ended questions, understandable language, and normalizing language, such as the phrase, "Some of my patients have difficulty using a condom with every sex act. How is it for you?"1
The CDC provides these examples of questions, which pertain to the five Ps of partners, prevention of pregnancy, protection from STDs, practices, past history of STDs, for clinicians to ask their at-risk patients:1
1. Partners
- Do you have sex with men, women, or both?
- In the past two months, how many partners have you had sex with?
- In the past 12 months, how many partners have you had sex with?
2. Prevention of pregnancy
- Are you or your partner trying to get pregnant?
If the answer's "No," then ask: What are you doing to prevent pregnancy?
3. Protection from STDs
- What do you do to protect yourself from STDs and HIV?
4. Practices
- To understand your risks for STDs, I need to understand the kind of sex you have had recently.
- Have you had vaginal sex, meaning 'penis in vagina sex'?
- If "Yes," ask: Do you use condoms: never, sometimes, or always?
- Have you had anal sex, meaning 'penis in rectum/anus sex'?
- If "Yes," ask: Do you use condoms: never, sometimes, or always?
- Have you had oral sex, meaning 'mouth on penis/vagina?
For condom answers:
- If "Never," ask: Why don't you use condoms?
- If "Sometimes," ask: In what situations or with whom, do you not use condoms?
5. Past history of STDs
- Have you ever had an STD?
- Have any of your partners had an STD?
Additional questions to identify HIV and hepatitis risk:
- Have you or any of your partners ever injected drugs?
- Have any of your partners exchanged money or drugs for sex?
- Is there anything else about your sexual practices that I need to know about?1
Reference:
- CDC. Sexually Transmitted Diseases Treatment Guidelines, 2006. MMWR Recomm Rep. 2006;55:1-94.
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