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STI Update
Mimi Secor, MS, M.Ed, FNP-BC, FAANP
GAPA Convention
Sandestin, Florida
July 22, 2010
“A little coitus, never hoitus” is what our patients may think. Ignorance may be bliss or may pose a life threatening risk if a patient is unaware of their risk for acquiring or transmitting a host of STIs, some of which may be lethal or associated with serious sequelae and possibly lifelong problems or implications.
There are an estimated 19 million new sexually transmitted infections reported in the US per year. STIs disproportionately affect young adults with an estimated 1 in 5 teenagers suffering from one or more STIs, and even higher rates affect African American teens with an estimated 1 in 2 infected with one or more STIs. STIs are also increasingly affecting men and women across the lifespan with greater numbers of older patients infected.
The CDC estimates that approximately 50 million Americans are infected with genital herpes, which translates to 1 in 5 Americans. These estimates are even higher among women, affecting an estimated 1 in 4, and 1 in 3 women over 30 years old. With most transmission caused by asymptomatic patients who don’t know they are infected and most infections presenting in a clinically atypical fashion, it can be challenging for the clinician to accurately identify who needs testing and treatment. It is essential that clinicians become familiar with the most accurate diagnostic testing approaches and effective management options. In addition, clinicians must be able to provide appropriate counseling about prevention, transmission and rationale for management of this highly stigmatized infection.
HIV is increasing among heterosexual populations with an estimated 25% of newly infected pts denying high risk behaviors.
HPV is associated with a spectrum of clinical manifestations and potential problems ranging from external genital warts, vulvar cancers, cervical disease/abnormal Paps, anal dysplasia and oropharyngeal cancer just recently discovered to be linked with HPV.
New guidelines for cervical cancer screening and management of abnormal pap smears have been issued, including when to include HPV testing and new screening interval recommendations. The yearly pap is becoming a thing of the past, so clinicians must become familiar with these new recommendations and implications for their practice and patients.
Recent approval of the HPV vaccine for boys and the addition of a second HPV vaccine for girls/women requires clinicians be knowledgeable about these vaccines and how to counsel pts in order to integrate these vaccines into their clinical practices.
Close to a million new chlamydia infections are reported each year in the US, with only 40% of appropriate patients currently being screened. Approximately 2 million more cases of chlamydia are currently not being diagnosed or treated. Various new approaches may be used to facilitate early screening and clinicians must learn about these new diagnostic trends.
New research suggests that pharyngitis may be caused by chlamydia so must be considered in the differential diagnosis and if present treated appropriately according to the CDC recommendations.
Just because you are not paranoid doesn’t mean you shouldn’t be. Come to the GAPA Convention and attend this STI session and learn about “what’s up down there”. Your patient’s lives are in your hands. Are you prepared to deal with these challenges?
Mimi is a national speaker and consultant. She has worked for 33 years as a Nurse Practitioner specializing in women's health and is currently working at Newton Wellesley ObGyn in Newton, Massachusetts. She is also a visiting scholar at Boston College Graduate School of Nursing and guest lecturer at the Massachusetts General Hospital Institute of Health Professions. Not only has Mimi been published extensively, but she also has years of media experience including hosting a new radio show on ReachMD XM 160, Partners in Practice. She has also been a guest on Good Morning America, and interviewed by the Wall Street Journal, Boston Globe and many others. Mimi is a member of the Editorial Advisory Board for the PA and NP online community Clinician 1 and has received several awards in patient care and education.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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