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Feature Article

The who, what and from where of STIs: selective testing in asymptomatic patients

Deborah Bateson, Ellie Freedman, Mary Stewart, Phillip Read
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Abstract

As most sexually transmissible infections (STIs) are asymptomatic, it is important to offer opportunistic testing to people identified as being at risk. Appropriate testing, treatment and contact tracing in the primary care setting will help reduce the burden of STIs in our community.

Key Points

  • Most sexually transmissible infections (STIs) are asymptomatic.
  • It is important to offer appropriate opportunistic testing to people at risk of STIs.
  • A full sexual history and examination is not necessary in most asymptomatic patients and may present an unnecessary barrier to testing.
  • Testing and treatment of chlamydia and gonorrhoea is usually straightforward.
  • First-void urine samples are appropriate for chlamydia or gonorrhoea testing in asymptomatic women and men.
  • Retesting for chlamydia three months after treatment is important to diagnose reinfection.
  • Contact tracing is important to reduce the spread of asymptomatic infection in the community.

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