STI screening and management for the gynaecologist: the panel, the doses, and the partner notification framework (ASHM / CDC 2021)

A 22-year-old woman walks into your gynaecology clinic with postcoital bleeding and a new partner. She is embarrassed, half-apologetic — "I'm sure it's nothing, doctor." Your job over the next twenty minutes is to take a sexual history without judgement, run the right panel, send the right swabs, treat what you find with the correct dose, and start a partner notification conversation that complies with the Public Health Act. STI screening is not an add-on to the gynaecology consult — it is the consult.^[1][2][3]

^{[1] [2]}

Overview and definition

A sexually transmissible infection (STI) is any infection acquired through sexual contact — vaginal, anal or oral. The gynaecologist's job is to split them into bacterial and protozoal (curable) — chlamydia, gonorrhoea, syphilis, trichomoniasis, mycoplasma — and viral (incurable, modifiable) — HIV, hepatitis B, hepatitis C, HPV, HSV — because that split drives the consultation, the partner conversation and the follow-up plan.^[1]

The Australian framework the gynaecologist anchors to is the ASHM Australian STI Management Guidelines for Use in Primary Care (endorsed by the Blood Borne Viruses and Sexually Transmitted Infections Standing Committee, funded by the Australian Centre for Disease Control).^[1] The global comparator is the CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (Workowski et al., MMWR 70(RR-4)).^[1] Both are convergent on most points; they diverge on gonorrhoea dual therapy, where Australia maintains ceftriaxone plus azithromycin to slow resistance, while the 2021 CDC update moved to ceftriaxone monotherapy — covered in the regional deltas section.^[1][6]

References18ShowHide

1. [1]Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep, 2021.PMID 34292926
2. [2]Cantor A, Dana T, Griffin JC, Nelson HD, Weeks C Screening for Chlamydial and Gonococcal Infections: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 2021.PMID 34519797
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9. [9]American College of Obstetricians and Gynecologists ACOG Committee Opinion No. 651: Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign. Obstet Gynecol, 2015.PMID 26595586
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15. [15]Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine Chlamydia — Australian STI Management Guidelines STI Guidelines Australia, 2025.Source
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18. [18]Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine Syphilis — Australian STI Management Guidelines STI Guidelines Australia, 2025.Source