The Sexually Transmitted Infections Guidelines Committee of the New York State Department of Health AIDS Institute has released two new guidelines: Management of Syphilis in Patients with HIV and Management of Gonorrhea and Chlamydia in Patients with HIV. The 2018 editions of these guidelines provide clinical practice recommendations based on the most up-to-date published evidence.
Highlights of each include the following:
- New screening recommendations: All patients with HIV should be screened at least annually, and those at greatest risk of syphilis infection should be screened every 3 months. See the Screening section of the guideline.
- New tables: Screening and Diagnostic Tests for Syphilis and Interpretation of Results of Reverse-Sequence Testing for Syphilis.
- New figures: Standard Protocol for Syphilis Screening and Diagnosis and Alternative, Reverse Algorithm for Syphilis Screening and Diagnosis.
- Expanded discussion: NYS disease reporting requirements for syphilis and HIV; see Syphilis and Neurosyphilis: Presentation, Diagnosis, and Reporting and Sex and Needle-Sharing Partner Exposure to Syphilis and HIV.
- Revised follow-up intervals: See Recommended Treatment and Follow-Up of Syphilis in Patients with HIV.
- New screening recommendations: Three-site screening is recommended for MSM and transgender women who have HIV at first visit, at least annually, and every 3 months if an individual is at high risk of STI acquisition (see the Screening section of the guideline).
- New tables: Sample Collection and Testing Methods for Laboratory Detection of Gonococcal and Chlamydial Infection.
- Expanded discussion: NYS disease reporting requirements for gonorrhea and chlamydia and HIV; see Presentation, Diagnosis, and Reporting and Sex Partner Exposure to HIV and Gonorrhea and Chlamydia.
Treatment regimens: See the Treatment section for recommendations for treatment of uncomplicated gonococcal infection, uncomplicated chlamydial and LGV infections, and for treatment of patients with penicillin allergy.