Sexually Transmitted Disease (STD) Control Program

Information for Health Care Providers

The STDCP collaborates with many partners to achieve its efforts at STD prevention, intervention, and control. Such collaborations address disparities related to the social determinants of health and pave the way toward fully integrated services, especially in communities disproportionately affected.

• 2010 STD Treatment Guidelines
• Training and Other Resources and Links for Healthcare Professionals
• Centers for Disease Control STD Program
• Communicable Disease Reporting
• Region IX 2009 Chlamydia Clinical Guidelines
• Case Definitions for Sexually Transmitted Diseases
• STDs, Pregnancy and Infertility
• Arizona STD Related Statutes and Administrative Rules
• ADHS Arizona STD Outbreak Response Plan
• Hepatitis Program, ADHS HIV, STD, and Hepatitis Services

Treatment Guidelines for Suspected Cephalosporin Resistant Gonorrhea

To address emerging cephalosporin resistance among isolates of Neisseria gonorrheae, the Centers for Disease Control and Prevention (CDC) and the Arizona STD Control Program recommend the following in cases of suspected cephalosporin treatment failure in patients with a gonorrheal infection. For further information, please consult the CDC 2010 STD Treatment Guidelines.

1. If the patient has not already been treated with ceftriaxone 250 mg, then treat with ceftriaxone 250 mg IM x 1 AND azithromycin 1 gram orally in a single dose.
2. Perform a test of cure with culture and antibiotic susceptibility testing.
3. Inform your local health department.
4. For clinical consultation call the STD Program's Medical Epidemiologist at (602) 372-2544

Emphasize that patients should abstain from oral, vaginal, or anal sex until one week after the patient and all of his/her partners are treated. In patients who have already been treated with the recommended ceftriaxone regimen whose symptoms do not resolve after treatment, please call (602) 372-2544 for clinical consultation.

Expedited Partner Therapy (EPT)

Expedited Partner Therapy (EPT) is also referred to as Patient Delivered Partner Therapy (PDPT). EPT is the practice of providing an extra dose of medication or a prescription to a patient with chlamydia or gonorrhea to deliver to their sexual partner(s). EPT has been shown to be an effective means of treating partners in 3 randomized controlled trials (listed below). In 2005, the Centers for Disease Control and Prevention (CDC) endorsed the use of EPT for partner treatment.

In 2008, EPT became legal in Arizona (ARS 32-1401 § (27)(ss)(v)).

• EPT Postcard | EPT Poster
• EPT Guidelines for Pharmacists
• EPT Guidelines for Physicians
• EPT Fact Sheets for Patient
  • Chlamydia - English | Spanish
  • Gonorrhea - English | Spanish
• EPT Frequently Asked Questions (FAQs) for Medical Professionals
• EPT Public Health Update

References

1. Golden MR, Whittington WLH, Handsfield HH, et al. Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection. N Engl J Med 2005;352:676-85.
2. Kissinger P, Mohammed H, Richardson-Alston G, et al. Patient-delivered partner treatment for male urethritis: A randomized controlled trial. Clin Infect Dis 2005;41:623-9.
3. Schillinger JA, Kissinger P, Calvet H, et al. Patient-delivered partner treatment with azithromycin to prevent repeated Chlamydia trachomatis infection among women. Sex Transm Dis 2003;30:49-56.

New CDC/IHS Standard Screening and Treatment Protocols for Native American Healthcare Providers

The IHS National STD Program has successfully collaborated on a grant from the National Chlamydia Coalition (NCC), with a number of regional and Tribal partners (Project Red Talon, Alaska Native Tribal Health Consortium, Center for Health Training, and the Infertility Prevention Project Regions VIII & X), to develop standardized STD screening and treatment protocols and guidance documents for providers working in Indian Country. These materials are based on CDC STD screening and treatment guidelines and were adapted for IHS, Tribal and Urban Native American healthcare providers to promote and enhance STD services among American Indian/Alaska Native (AI/AN) populations. The referenced documents were piloted in a number of sites and vetted across agencies. The feedback from those efforts have helped inform and guide the final revisions and retooling of the attached materials in an effort to best meet the needs of our provider community. These materials are intended to be a resource to local programs and should be viewed with in your local context. We encourage you to review and evaluate how best these tools, in part or comprehensively, may help to support and enhance STD/HIV prevention activities in your local setting. The tools include:

• Sample Policy - STD and HIV Screening among AI/AN Populations
• Sample Protocols - STD and HIV Screening; STD Treatment
• STD Screening Recommendations
• STD/HIV Treatment Guidelines
• Performing a Risk Assessment Guide
• Patient Delivered Partner Therapy(PDPT) Educational materials for the Client
  • Patient Delivered Partner Therapy Educational Materials for the Chlamydia Partner
  • Patient Delivered Partner Therapy Educational Materials for the Gonorrhea Partner

Note: Information provided in PDF files, unless otherwise noted.