To prevent STD transmission, guidelines for expedited partner therapy (EPT) have been created by the Centers for Disease Control and Prevention (2006a) and are endorsed by the American College of Obstetricians and Gynecologists (2015). With EPT, a prescription is provided to the diagnosed patient for their partner. It is delivered by the patient to their partner without medical assessment of the partner or professional counseling. EPT ideally does not replace traditional strategies, such as standard patient referral with screening for other STDs.
EPT is acceptable for treatment of sexual contacts with chlamydial infection. In light of new guidelines that recommend injectable ceftriaxone, EPT for gonorrhea is less desirable unless the partner will otherwise not seek treatment (Centers for Disease Control and Prevention, 2016a). Fewer data are available to assess this strategy for trichomoniasis (Kissinger, 2006; Schwebke, 2010). EPT is not recommended for syphilis (Workowski,r2015).
Although sanctioned by the CDC, EPT is not legal in several states. \{oreover, the risk of litigation in the event of adverse outcomes may be elevated when a practice has uncertain legal status or is outside formally accepted community practice standards (Centers for Disease Control and Prevention, 2006a). The legal status of EPT in each of the 50 states can be found at: http://ww.cdc.gov/std/ept/legal!default.htm.
L], L2, and L3 serovars of C trachomatis cause ymphogranuloma venereum (LG). he primary genital infection is transient, is seldom recognized, and is not linked with vertical transmission to the fetus. It can be confused with chancroid. Classically, matted inguinal adenitis may develop on either side of the inguinal ligament to give rise to the "groove sign." At times, these nodes may suppurate. Ultimately, the lymphatics of the lower genital tract and perirectal tissues may be involved. Here, sclerosis and fibrosis can cause vulvar elephantiasis and severe rectal stricture. Fistula formation involving the rectum, perineum, and vulva may also evolve.
For treatment during pregnancy, erythromycin base, 500 mg orally four times daily, is given for 21 days (Workowski, 2015). Some authorities instead use szithromycin, 1 g orally weekly for 21 days, although data regarding eicacy are scarce.
his virus poses a disproportionately higher risk to the newborn than to the mother. hus, strategies in pregnancy aim to curb rates of vertical transmission.
Two types of herpes simplex viruses are distinguished based on immunological diferences. Yet, the two viruses have signiicant DNA sequence homology, and thereby, prior infection with one type attenuates a primary infection with the other. Type 2 HSV is recovered almost exclusively from the genital tract and is usually transmitted by sexual contact. Type 1 is responsible for most nongenital infections and typically is acquired in childhood. However, more than half of new cases of genital herpes in adolescents and young adults are now caused by HSV-1 infection (Bernstein, 2013). his rise in the prevalence of HSV-1 genital disease is thought to stem from an increase in oral-genital sexual practices. Another explanation is that HSV-1 acquisition has declined in childhood as a result of improved living conditions and hygiene (Bradley, 2014; Xu, 2007). Without prior exposure, this renders young people without HSV-l antibodies susceptible to genital acquisition of HSV-l or -2.