STI screening and management

Overview

Sexually transmitted infection (STI) screening in general practice follows exposure, not assumptions. NAAT on first-catch urine covers urethral and cervical infection but misses pharyngeal and anorectal infection, which are common, usually asymptomatic, and sustain transmission. Among 343 gay and bisexual men screened at all three sites, genital-only testing would have missed 71.4% of chlamydia and 67.3% of gonorrhoea infections; among women reporting extragenital exposure, about a quarter of infections would have been missed.^[11]

Syphilis has returned, particularly among MSM; its diagnosis rests on understanding two complementary serologic arms. Gonorrhoea treatment is squeezed by resistance — the reason ceftriaxone dose was raised and why entirely new oral agents (zoliflodacin) are entering practice.^[15]

References19ShowHide

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