{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T01:18:22Z","timestamp":1778635102309,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"S6","license":[{"start":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T00:00:00Z","timestamp":1567123200000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Rising rates of reported sexually transmitted infections (<jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content>s) in the <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> and Europe are a public health priority and require a public health response. The diagnosis and treatment of <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content>s have been the cornerstone of <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> control and prevention for many decades and, historically, publicly funded <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> clinics have played a central role in the provision of <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> care. Innovations in non\u2010invasive diagnostic techniques, especially nucleic acid amplification tests in the mid\u20101990s, have facilitated the expansion of <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> testing and treatment outside traditional <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> clinics, including primary care, family planning, school\u2010based health, outreach, corrections, emergency departments and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention and care settings. As a result, the continued need for categorical <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> clinics has been debated. In this Commentary, we discuss how practice can be improved at each level of <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> practice improvement plans should be tailored to the strengths of each care setting. Thus, in primary care, the focus should be on improving <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> screening rates, the provision of hepatitis B and human papillomavirus vaccines and, in jurisdictions where this is legal, expedited partner therapy for gonorrhoea and chlamydia. Extragenital (pharyngeal and rectal) testing for gonorrhoea and chlamydia should be available in settings serving populations more vulnerable to <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> acquisition at these anatomical sites, including men who have sex with men. In family planning settings with a mostly female patient population, there are opportunities to serve male partners with both contraceptive and <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> services. <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> screening rates can also be improved in other settings serving populations at increased risk for <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content>s, including school\u2010based clinics, emergency departments, correctional health facilities and providers of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> care and prevention. These improvements are predominantly logistical in nature and not dependent on extensive <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> clinical expertise. While some providers in these settings may have the clinical knowledge and skills to evaluate symptomatic patients, many do not, and <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> speciality clinics must be available for consultation and referral and evolve from \u201csafety net\u201d providers of last resort to <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> centres of excellence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A tailored practice improvement plan can be envisioned to achieve an optimally functioning <jats:styled-content style=\"fixed-case\">STI<\/jats:styled-content> care continuum.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25349","type":"journal-article","created":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T07:02:27Z","timestamp":1567148547000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Improving care for sexually transmitted infections"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1837-2286","authenticated-orcid":false,"given":"Cornelis A","family":"Rietmeijer","sequence":"first","affiliation":[{"name":"Rietmeijer Consulting Denver CO USA"},{"name":"Colorado School of Public Health University of Colorado Denver CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,30]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Sexually transmitted disease surveillance 2017","author":"Centers for Disease Control and Prevention","year":"2018"},{"key":"e_1_2_7_3_1","unstructured":"European Centre for Disease Prevention and Control.Gonorrhea Annual Report for 2017.2019[cited 2019 May 29] Available from:https:\/\/ecdc.europa.eu\/sites\/portal\/files\/documents\/gonorrhoea-annual-epidemiological-report-2017.pdf"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1071\/SH16104"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053377"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001976"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-053029"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0216732"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052994"},{"issue":"3","key":"e_1_2_7_10_1","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines","volume":"64","author":"Workowski KA","year":"2015","journal-title":"MMWR Rcomm Rep"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/430704"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"issue":"5","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1128\/jcm.31.5.1209-1212.1993","article-title":"Direct detection of Chlamydia trachomatis in urine specimens from symptomatic and asymptomatic men by using a rapid polymerase chain reaction assay","volume":"31","author":"Jaschek G","year":"1993","journal-title":"J Clin Microbiol"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199708000-00008"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.olq.0000200497.14326.fb"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000427"},{"key":"e_1_2_7_17_1","unstructured":"National Committee for Quality Assurance.Chlamydia screening in women.2018[cited 2019 Jan 2]. 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