| General STI Guidance |
- General STI Guidance to review with adolescent:
- STI Health and Prevention
- HIV testing should be performed for all youth diagnosed with STI
- Complete all doses of antibiotics
- Avoid sex until treatment course of is completed and symptoms are resolved
- For single dose therapy, avoid sexual intercourse for at least 7 days
- Avoid sex until sexual partner(s) are treated, and if symptoms, if present,
are resolved
- Call PCP if unable to tolerate medications
- Repeat testing in 3 mos for gonorrhea and chlamydia
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| Follow-up |
- Call PCP if symptoms worsen or if symptoms are not improving after 3-5 days
- Recommend follow-up in 3-5 days for adolescents treated for PID
- Gonorrhea (rectal or urogenital), chlamydia, or trichomonas:
- Aptima testing to assess for reinfection 3 mos after treatment
- Oropharyngeal gonorrhea:
- Aptima test of cure 3-4 weeks after infection
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| Pregnancy Prophylaxis |
- All post-pubertal females presenting within 120 hrs of intercourse are eligible
- Preferred Regimen
- Plan B: 1.5 mg Levonorgestrel once in ED or provide prescription
- Note:
- Package label recommends one dose with second dose 12 hrs later
- Efficacy of both 1 or 2 doses are equivalent
- Prescribe Ondansetron along with EC
- Provide written and verbal information to adolescent offered pregnancy prophylaxis
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| Partner Treatment |
- Inform partners in the last 60 days to notify need for evaluation and treatment
- Partners of adolescents with syphilis (primary, secondary or early latent) should be referred for evaluation and treatment
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| Prevention |
- Use condoms consistently
- See your PCP annually for STI screening
- Make an appointment for STI screening if you have been exposed or are having symptoms that could be associated with STI
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PrEP
Pre-exposure prophylaxis |
- PrEP
-
PrEP Facts: Introduction & FAQ
-
Preventing HIV with PrEP
- If adolescent is interested in PrEP:
- Scan QR code to get educational information sent directly to them via text message and get linked to the CHOP PrEP navigator
- or
- Contact PreP navigator directly at 215-292-6390 during business hours or Adolescent medicine on call provider
- If navigation not available:
- Inform adolescent of need for ongoing routine visits to maintain script
- Help adolescent develop adherence plan for daily use (or 2-1-1 if applicable)
- If prescribing PrEP, utilize order set for necessary labs and prescription support
- Explicitly consent patient to allow adolescent team to contact them
- Confirm whose phone number is provided
- Review process for obtaining prescription
- Refer for repeat STI testing in 3 mos
- Order HIV testing and counsel on importance of completion
- National HIV, STD, and Hepatitis Testing (CDC)
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