San Antonio obstetrician gynecologist
Medical Director, San Antonio Metropolitan Health District
- Syphilis is back. Rates of this ancient scourge jumped 19 percent from 2014 to 2015, more than any other reportable STD, according to the Centers for Disease Control and Prevention (CDC). Most cases are among men who have sex with men. Men who have sex with men should get tested annually for syphilis, chlamydia, gonorrhea, and HIV.
- Rates of chlamydia rose too — 1.5 million people were diagnosed with this infection in 2015. Since most women with chlamydia show no symptoms, the CDC says all sexually active women should be tested every year until age 25. Yet fewer than half of insured, eligible women under 25 were tested for chlamydia in 2015, according to data collected from U.S. health plans.
- In 2009, Texas made it legal for doctors treating STD patients to provide an extra antibiotic prescription for the patient’s partner. This practice is called Expedited Partner Therapy. While it is better if every partner sees a doctor, that doesn’t always happen. When doctors provide partner prescriptions, re-infections of chlamydia drop 20 percent, and re-infections of gonorrhea drop 50 percent.
- Anyone who is treated for chlamydia, gonorrhea, or trichomoniasis — all easily curable STDs — should be retested in three months to catch re-infections, according to the CDC.
- About 1 in 6 sexually active people have herpes, but only one-tenth of infected people know they are infected. The CDC does not recommend routine blood tests for herpes, in part because the tests are not that accurate, and false positive tests cause emotional distress.
- Everyone between the ages of 13 and 64 should be tested for HIV at least once in their lives.
- There is now a daily pill that prevents HIV. If you are HIV-negative but your partner is HIV-positive, or you are man who has sex with men and you have multiple partners, ask your doctor about pre-exposure prophylaxis (PrEP).
- Patients say they want their doctors to ask about sexual health. Doctors may feel uncomfortable asking intimate questions. The CDC offers this guide: https://www.cdc.gov/std/treatment/sexualhistory.pdf.
- Many people in the LGBT community are reluctant to “come out” to doctors because of previous negative experiences. For free continuing medical education (CME) on LGBT health and tips on creating an LGBT-friendly office, go to LGBThealtheducation.org.
- Doctors can brush up their knowledge about syphilis (“The Great Imitator”) and get free CME with the National STD Training Curriculum: https://www.std.uw.edu/.