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ABC of Sexually Transmitted Infections, 6th Edition



ABC of Sexually Transmitted Infections, 6th Edition

Karen E. Rogstad (Editor)

ISBN: 978-1-118-25118-8 November 2011 BMJ Books 168 Pages

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With sexually transmitted infections (STIs) a major cause of morbidity and mortality throughout the world, the new edition of ABC of Sexually Transmitted Infections is a much-needed introduction and reference guide providing concise and practical information on a range of conditions.

This sixth edition includes the latest guidance on the prevalence, prevention and treatment of STIs, screening programmes and new testing methods. It features new chapters on service modernisation and new care providers, high risk and special needs groups, the use of the internet for information and education, systemic manifestations and sexually transmitted infections in resource-poor settings. Contraception is also covered, reflecting the increasing integration of STI and contraceptive services.

With an international authorship, the ABC of Sexually Transmitted Infections is an authoritative guide and reference for all practitioners, especially those providing community based STI diagnosis and management such as GPs, primary care physicians and contraceptive service providers. Junior doctors, medical students, and nurses working in community or specialist services will also find it a valuable resource as will those working in the fields of obstetrics and gynaecology and public health. This new edition also provides information useful for new STI care providers such as pharmacists, those in the voluntary sector and providers of STI services in resource-poor settings.

Contributors ix

Preface xi

1 Sexually Transmitted Infections: Why are they Important? 1
Kevin A Fenton and Karen E Rogstad

2 STI Control and Prevention 11
Frances Cowan and Gill Bell

3 Provision and Modernisation of Sexual Health Services 16
Christopher K Fairley

4 The Sexual Health Consultation in Primary and Secondary Care 21
Cecilia Priestley

5 Examination Techniques and Clinical Sampling 26
Katrina Perez and Vincent Lee

6 Main Presentations of Sexually Transmitted Infections in Male Patients 29
John Richens

7 Other Conditions Affecting the Male Genitalia 35
Sarah Edwards and Chris Bunker

8 Vaginal Discharge: Causes, Diagnosis, and Treatment 42
Phillip Hay

9 Pelvic Inflammatory Disease and Pelvic Pain 49
Jonathan D C Ross

10 Vulval Diseases 53
Pat Munday

11 Sexually Transmitted Infections and HIV in Pregnancy 59
Janet Wilson

12 Genital Ulcer Disease 64
Raj Patel and Nadi Gupta

13 Syphilis: Clinical Features, Diagnosis, and Management 70
Patrick French

14 Genital Growths and Infestations 78
Clare L N Woodward and Angela J Robinson

15 Viral Hepatitis 84
M Gary Brook

16 Systemic Manifestations of STIs 90
Elizabeth Carlin

17 HIV 95
Ian Williams, David Daniels, Keerti Gedela, Aparna Briggs and Anna Pryce

18 Diagnosis of Sexually Transmitted Infections 110
Sarah Alexander and Monique Andersson

19 Contraception 115
Rak Nandwani and Alison Bigrigg

20 Care of Specific Risk Groups 123
Paul A Fox and Karen E Rogstad

21 Sexual Health Care in Resource Poor Settings 127
David A Lewis

22 Vaccinations, Treatments, and Postexposure Prophylaxis 132
Ashini Jayasuriya

23 The Internet as a Resource for STI Education and Information 141
Claudia Estcourt and John Saunders

Appendices: Proformas for Taking Sexual Histories 145

Appendix 1: Male sexual history proforma 145

Appendix 2: Female sexual history proforma 146

Appendix 3: Assessment proforma for young people attending sexual health services 147

Index 149

"The BMJ do this very well - produce a short, sharp, focussed and generally excellent brief reference work on anything from accident and emergency to X-ray ... The book is almost faultless: failure to achieve ten out of ten is because of the lack of a glossary for the scores of technical terms. Each chapter is superbly, positively, and concisely written, with copious (and often gory) photographs, tables and figures." (British Journal of Cardiology, 2011)

ChapterPageDetailsDatePrint Run

Table 17.4 Recommendations for starting antiretroviral therapy in adults.

Presentation/ clinical condition

BHIVA guidelines, Oct 2008

USDHHS, Dec 2009

Primary HIV infection

Treatment in clinical trial
or neurological involvement
or CD4 <200 cells/mm3
or AIDS-defining illness


Established HIV



CD4 <200 cells/mm3



CD4 201-350

Treat as soon as possible
when patient ready


CD4 351-500

Treat in specific situations
when high risk of clinical
events, e.g. HIVAN,
hepatitis B co-infection
when HBV treatment

Treatment optional

CD4 >500 cells/mm3

Consider enrolment into
‘when to start trial’

Treat if HIVAN or HBV
co-infection when
HBV treatment

AIDS diagnosis

Treat (except for TB when
CD4 >350 cells/mm3)



BHIVA - British HIV Association Guidelines, USDHHS - United States
Department of Health and Human Services