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Extragenital Screening

Don’t forget to swab! Among men who have sex with men, 84% of gonorrhea and chlamydia infections would be missed with urine-only screening1. Make sure your clients are screened for gonorrhea and chlamydia of the throat and rectum.

What:	Extragenital Screening for Gonorrhea and Chlamydia
Where:	Rectum and throat
Who:	Men who have sex with men (MSM), transgender women, people living with HIV, and people on PrEP who report having receptive anal and/or oral sex
When:	At least annually, or every 3 to 6 months as needed based on exposure
Why:	When urine-only screening is performed, up to 90% of rectal gonorrhea and 77% of rectal chlamydia infections remain untreated¹. HIV-negative men diagnosed with rectal infections are excellent candidates for PrEP, because they have a high risk of HIV infection
How:	Swab specimen (self or clinician-collected swab)

The California Prevention Training Center supports clinics and providers in implementing rectal and pharyngeal STI screening.

For more information, contact us.

Resources for Providers

FDA clears first diagnostic tests for extragenital testing for chlamydia and gonorrhea, FDA New Release
May 23, 2019

Extragenital Chlamydia and Gonorrhea Among Community Venue–Attending MSM, CDC MMWR
April 11, 2019

CA Department of Public Health, Dear Colleague Letter
February 20, 2019

HIV incidence among men with and those without sexually transmitted rectal infections, Clinical Infectious Diseases
October 15, 2013

National Coalition of STD Directors – Extragenital Testing

NYC Department of Health and Mental Hygiene – STI’s Among MSM Protocol Card

Resources for Clinics

Self Swab Instructional Posters:

Rectal, Throat, and Vaginal Self-Swab

Rectal Self-Swab

Throat Self-Swab

Vaginal Self-Swab

CDC Recommendations for Laboratory-Based Detection of Gonorrhea and Chlamydia, March 14, 2014

Verification of Patient Self-Collected Extragenital Nucleic Acid Amplification Tests

Resources for Patients

CDC Just Diagnosed – Gonorrhea and Chlamydia

CDC PrEP Resources

Please PrEP Me – Provider Locator

Building Healthy Online Communities – Sexual Health Information

Marcus JL, Bernstein KT, Kohn RP, Liska S, Philip SS. Infections missed by urethral-only screening for chlamydia or gonorrhea detection among men who have sex with men. Sexually transmitted diseases. 2011 Oct 1;38(10):922-4.

Home Training STD Expert Hour Webinar – Sexual History Taking

STD Expert Hour Webinar – Sexual History Taking

February 6, 2019

Yvonne Piper RN, FNP covers the following learning objectives for this webinar:

Describe 5 key components of a routine sexual history to reduce infectiousness and decrease STD/HIV transmission
Demonstrate respectful, non-judgmental communication skills to discuss sexual practices, sexual risks, and risk reduction strategies with patients
Understand effective methods of dialogue with patients regarding issues of sexual history and sexual behaviors, to improve communication with patients and patient outcomes
Discuss the advantages and disadvantages of open-ended and closed questions to enhance sexual history taking

Congenital Syphilis Algorithm

This algorithm provides recommendations for the evaluation and management of infants <30 days old with in-utero exposure to syphilis

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Extragenital Screening Resources

Extragenital (rectum and throat) gonorrhea and chlamydia screening resources for providers, clinics, and patients.

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Secondary Syphilis Patient Evaluation Algorithm

Algorithm to evaluate patients for secondary syphilis. Includes sexual history taking and physical exam, diagnostic work-up, treatment and follow-up, and reporting and partner management.

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Primary Syphilis Patient Evaluation Algorithm

Algorithm to assist in evaluating patients for primary syphilis.

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Home Training STD Expert Hour Webinar – Genital Herpes

STD Expert Hour Webinar – Genital Herpes

April 10, 2018

Dr. Kim Erlich covers the following learning objectives for this webinar:

Describe common and unusual clinical features seen in patients with genital herpes, to improve diagnosis and management
Discuss effective counseling strategies, to aid in reducing herpes transmission
Describe current and future treatment options, to control symptoms, reduce outbreaks, and help prevent herpes transmission

Home Training The Evolving Well Woman Visit

The Evolving Well Woman Visit

April 26, 2018

The contents of the well-woman visit have changed significantly in the past decade, such that many screening tests are performed in modified age groups and at different screening intervals. This webinar will review the well-woman health screening recommendations published by the California Department of Public Health (CDPH), U.S. Preventive Services Task Force (USPSTF), American College of Obstetrics and Gynecology (ACOG) and other national organizations.

The following topics are covered in detail:

Reproductive goals counseling
Use of newer cervical cancer screening technologies
Utility of screening clinical breast exams and screening pelvic exams
Coding for well-woman visits

Presenter:

Michael Policar, MD, MPH

Resources:

Webinar Q & A

S3 E14: Monkeypox: Where are We Now? with Dr. Peter Chin-Hong

Listen now

Host Tammy Kremer chats with UCSF Infectious Disease Specialist Dr. Peter Chin-Hong about the current state of the Mpox outbreak: how it reflects contemporary health inequities, how stigma can be a barrier to people accessing treatment, and how lessons learned from past public health crises shaped the clinical and community response. Dr. Chin-Hong speaks about his experience caring for Mpox patients over the course of the outbreak, and how the stigma surrounding the virus has discouraged individuals from seeking out the necessary care, creating invisible populations of patients who are disconnected from diagnosis and treatment. Finally, he breaks down the social and behavioral interventions that have been effective in slowing the spread of the virus over the past months. They explore the role of public health education and messaging in the Mpox outbreak and how Dr. Chin-Hong anticipates the outbreak may proceed.

Read the transcript of the episode here.

CAPTC-Related Training and Resources:

S3 E8: Monkeypox in California: A Personal Story and Public Health Perspective

S3 E3: Monkeypox, What’s the Hype?

CAPTC Monkeypox FAQ’s

CDC Monkeypox Resource Center

Turn on notifications to never miss an episode of Coming Together for Sexual Health.

Follow Coming Together for Sexual Health on Instagram and Twitter.

Peter Chin-Hong, MD, is a professor of medicine and associate dean at UCSF. He specializes in treating infectious diseases, especially in immunosuppressed patients such as recipients of organ and stem cell transplants and HIV-positive recipients of organ transplants. He is regularly featured in the media discussing COVID-19 and Mpox.

S3 E12: Four Decades of Sexual Health: History of the CAPTC

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Director of the CAPTC Dana Cropper sits down with Gail Bolan, MD, and Alice Gandelman to discuss the founding of the CAPTC and its work in supporting sexual healthcare providers over the last 33 years. We learn about the forces that shaped the sexual healthcare field. Our guests unpack how the CAPTC developed alongside the HIV/AIDS epidemic in the late 1980s, the surprising relationship between HIV work and STI response, strategies to meet sexual healthcare needs both within and outside of sexual health clinics, and the ever-present need for greater training for providers around testing and treatment of STIs. We learn about how behavioral interventions were centered in response to the HIV/AIDS epidemic, and the importance of centering social determinants of health and larger structural forces in prevention and treatment efforts. They also discuss their hopes for opening up discussions about sexual health and de-stigmatizing the topic in the greater community.

Read the transcript of the episode here.

Resources:

HHS/Viral Hepatitis Action Plan

Ending the HIV Epidemic in the US (EHE)

Provision of Quality of STD Services (CDC) 2020

San Francisco City Clinic

Health HIV

National Coalition for Sexual Health

Turn on notifications to never miss an episode of Coming Together for Sexual Health.

Follow Coming Together for Sexual Health on Instagram and Twitter.

Gail Bolan, MD, was the Director of the Division of STD Prevention at the Centers for Disease Control and Prevention (CDC) from 2011 through 2020. Prior to joining CDC, she directed the California Prevention Training Center for 23 years. She served as the Chief of the STD Control Branch at the California Department of Public Health and the Director of the San Francisco City and County STD Prevention and Control Program from 1997 to 2011 as well as Medical Director of the San Francisco City Clinic from 1987 to 1997. 

Alice Gandelman was the Director of the CAPTC from 1994 through 2021. She oversaw growth and development of CAPTC in numerous training and capacity-building programs in STD, HIV, sexual, and reproductive health.