Sexual Health Care for Transgender and Gender Diverse People
Med Clin North Am. 2024 Mar;108(2):393-402. doi: 10.1016/j.mcna.2023.10.002. Epub 2023 Oct 29.ABSTRACTThe proportion of people who identify as transgender and gender diverse (TGD) is increasing. Health care for TGD people, including sexual health care, must affirm and respect patients' gender identities and expressions. Here, the authors outline strategies to make health care settings more welcoming to and inclusive of TGD people and describe concrete steps to improve sexual health care for TGD populations.PMID:38331487 | DOI:10.1016/j.mcna.2023.10.002 (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Kevin L Ard Andrew MacDonald-Ly A C Demidont Source Type: research

On The Horizon: Novel Approaches to Sexually Transmitted Infection Prevention
Med Clin North Am. 2024 Mar;108(2):403-418. doi: 10.1016/j.mcna.2023.10.003. Epub 2023 Nov 1.ABSTRACTRates of sexually transmitted infections (STIs), especially cases of infectious and congenital syphilis, are increasing in the United States. Novel strategies for STI prevention are being explored and include doxycycline post-exposure prophylaxis and the potential utility of vaccines against gonorrhea. Self-collection of samples and point of care testing for STI are increasingly being employed in a variety of settings. Both can improve uptake of screening and lead to earlier detection and treatment of incident STI in target...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Chase A Cannon Stephanie E McLaughlin Meena S Ramchandani Source Type: research

Sexually Transmitted Infections: Medicine in Its Fullest
Med Clin North Am. 2024 Mar;108(2):xv-xvi. doi: 10.1016/j.mcna.2023.10.005. Epub 2023 Nov 3.NO ABSTRACTPMID:38331489 | DOI:10.1016/j.mcna.2023.10.005 (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Jack Ende Source Type: research

Sexually Transmitted Infections
Med Clin North Am. 2024 Mar;108(2):xvii-xix. doi: 10.1016/j.mcna.2023.10.004. Epub 2023 Oct 30.NO ABSTRACTPMID:38331490 | DOI:10.1016/j.mcna.2023.10.004 (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Susan Tuddenham Source Type: research

Sexual Health and Well-Being: A Framework to Guide Care
Med Clin North Am. 2024 Mar;108(2):241-255. doi: 10.1016/j.mcna.2023.10.001. Epub 2023 Oct 30.ABSTRACTAlthough the acceptance of sex positivity centering pleasure and justice has grown, clinical and public health strategies for sexually transmitted infection management have remained focused on risk and adverse outcomes. To promote sex-positive health care practice in clinical settings and beyond, health care practitioners should use an integrated, patient-centered approach to sexual health. These strategies include initiating discussions, continued sexual health education, providing informative material for patients, and k...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Keosha T Bond Asa E Radix Source Type: research

Taking a Sexual History: Best Practices
Med Clin North Am. 2024 Mar;108(2):257-266. doi: 10.1016/j.mcna.2023.09.004. Epub 2023 Oct 30.ABSTRACTRecognizing the holistic definitions of sexual health, health-care providers must approach sexual health history taking with sensitivity, inclusivity, and a trauma-informed perspective. Many versions of what a sexual history should look like exist but certain principles are commonly found. Education of health-care providers on sexual history taking can involve reviewing the components of the sexual history but should also include the importance of using nonstigmatizing language, having a patient-centered approach, and prac...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Donald Hong Joseph Cherabie Hilary E Reno Source Type: research

A Practical Approach to Sexually Transmitted Infection Screening for the Primary Care Clinician
Med Clin North Am. 2024 Mar;108(2):267-278. doi: 10.1016/j.mcna.2023.08.014. Epub 2023 Sep 14.ABSTRACTSexually transmitted infections (STIs) are commonly encountered in primary care. The Centers for Disease Control and Prevention and the US Preventive Services Task Force have both issued guidelines about screening for chlamydia, gonorrhea, syphilis, and HIV. By eliciting a sexual history, understanding their patients' anatomy, and considering factors which may increase the likelihood of STIs and their sequelae, clinicians can implement a practical, evidence-based approach to STI screening.PMID:38331479 | DOI:10.1016/j.mcna...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Kevin L Ard Kenneth H Mayer Source Type: research

The Management of Gonorrhea in the Era of Emerging Antimicrobial Resistance: What Primary Care Clinicians Should Know
Med Clin North Am. 2024 Mar;108(2):279-296. doi: 10.1016/j.mcna.2023.08.015. Epub 2023 Sep 14.ABSTRACTGonorrhea rates continue to rise in the United States and Neisseria gonorrhoeae's propensity to develop resistance to all therapies used for treatment has complicated the management of gonorrhea. Ceftriaxone is the only remaining highly effective recommended regimen for gonococcal treatment and few new anti-gonococcal antimicrobials are being developed. The 2021 CDC STI Treatment Guidelines increased the dose of ceftriaxone to 500 mg (1 g if ≥ 150 kg) for uncomplicated infections. It is recommended that all clinicians sh...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Laura A S Quilter Sancta B St Cyr Lindley A Barbee Source Type: research

Mycoplasma genitalium: Key Information for the Primary Care Clinician
Med Clin North Am. 2024 Mar;108(2):297-310. doi: 10.1016/j.mcna.2023.07.004. Epub 2023 Sep 14.ABSTRACTMycoplasma genitalium (MG) is an emerging sexually transmitted infection, which appears to be a cause of urethritis and cervicitis and has been associated with pelvic inflammatory disease (PID), epididymitis, proctitis, infertility, complications during pregnancy, and human immunodeficiency virus (HIV) transmission. Three Food and Drug Administration (FDA) approved tests are available. Testing should be focused to avoid inappropriate antibiotic use. The Center of Disease Control and Prevention (CDC) guidelines recommend te...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Oluyomi A Obafemi Sarah E Rowan Masayo Nishiyama Karen A Wendel Source Type: research

Herpes Simplex Virus: A Practical Guide to Diagnosis, Management, and Patient Counseling for the Primary Care Clinician
Med Clin North Am. 2024 Mar;108(2):311-323. doi: 10.1016/j.mcna.2023.08.016. Epub 2023 Oct 8.ABSTRACTGenital herpes is a chronic, lifelong sexually transmitted viral infection, which can cause recurrent, self-limited genital ulcers. It is caused by herpes simplex virus (HSV) type 1 and type 2 viruses. Genital HSV infection is a very prevalent STI, which causes self-limited, recurrent genital ulcers. Treatment decreases duration of symptoms and signs and can be provided as episodic or suppressive therapy. Genital herpes can have a substantial impact during pregnancy and on sexual health in general. Counseling on natural his...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Teresa A Batteiger Cornelis A Rietmeijer Source Type: research

Syphilis Serologies: A Practical Approach for the Primary Care Clinician
This article reviews the staging of syphilis and the principles of syphilis serology testing, the algorithms used in diagnosis, and guidance for their use in monitoring the response to treatment. The authors illustrate these principles through a series of clinical scenarios and describe the rationale behind the management approaches.PMID:38331483 | DOI:10.1016/j.mcna.2023.08.002 (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Elizabeth A Gilliams Zachary Lorenz Matthew M Hamill Source Type: research

Proctitis: An Approach to the Symptomatic Patient
Med Clin North Am. 2024 Mar;108(2):339-354. doi: 10.1016/j.mcna.2023.09.002. Epub 2023 Nov 1.ABSTRACTProctitis is an inflammatory condition of the distal rectum that can be associated with common sexually transmitted infections (STIs), such as gonorrhea, chlamydia, and syphilis. For persons presenting with ulcerative findings on examination, in addition to syphilis, Mpox, lymphogranuloma venereum, and herpes simplex virus should be in the differential. Providers should also be aware that there are evolving data to support a role for Mycoplasma genitalium in proctitis. Performing a comprehensive history, clinical evaluation...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Candice J McNeil Luis F Barroso Kimberly Workowski Source Type: research

Update on Mpox: What the Primary Care Clinician Should Know
Med Clin North Am. 2024 Mar;108(2):355-371. doi: 10.1016/j.mcna.2023.09.005. Epub 2023 Oct 20.ABSTRACTMpox is a viral infection, which primarily caused sporadic outbreaks in West and Central Africa until causing a global epidemic in 2022. The disease has disproportionately affected people with human immunodeficiency virus and men who have sex with men. Transmission is through close physical contact, including sexual contact. Infection presents with a characteristic rash, with frequent anogenital involvement-polymerase chain reaction of skin lesions is diagnostic. Vaccination is available for primary prevention and postexpo...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Jacob McLean Shauna Gunaratne Jason Zucker Source Type: research

Recurrent Infectious Vaginitis: A Practical Approach for the Primary Care Clinician
Med Clin North Am. 2024 Mar;108(2):373-392. doi: 10.1016/j.mcna.2023.08.017. Epub 2023 Sep 14.ABSTRACTRecurrent infectious vaginitis can lead to significant morbidity, patient frustration, and health care costs. The most common causes are bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC); however, other infectious and noninfectious etiologies should be considered in patients with recurrent symptoms. A detailed history and physical examination with appropriate testing at the time of symptoms is critical to establishing a correct diagnosis. Management options for recurrent BV and VVC are limited. Complex cases incl...
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Golsa M Yazdy Caroline Mitchell Jack D Sobel Susan Tuddenham Source Type: research

Sexual Health Care for Transgender and Gender Diverse People
Med Clin North Am. 2024 Mar;108(2):393-402. doi: 10.1016/j.mcna.2023.10.002. Epub 2023 Oct 29.ABSTRACTThe proportion of people who identify as transgender and gender diverse (TGD) is increasing. Health care for TGD people, including sexual health care, must affirm and respect patients' gender identities and expressions. Here, the authors outline strategies to make health care settings more welcoming to and inclusive of TGD people and describe concrete steps to improve sexual health care for TGD populations.PMID:38331487 | DOI:10.1016/j.mcna.2023.10.002 (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - February 8, 2024 Category: General Medicine Authors: Kevin L Ard Andrew MacDonald-Ly A C Demidont Source Type: research