Key Terms
Course
Public Health in Pharmacy Practice: A Casebook, 2nd Edition
Chapter
4 — Drawing the Line: Preventing Sexually Transmitted
Infections Author
Lindsey M. Childs-Kean, PharmD, MPH, BCPS
Most likely STI
Secondary syphilis
Treatment
Benzathine penicillin G (intramuscular injection). Specific dosing per CDC 2015 STD Treatment Guidelines.
Follow-up
Serologic testing (RPR titer) at 6 and 12 months to confirm treatment response; some guidelines extend to 24 months.
Without treatment
JB is at significantly higher risk of acquiring HIV. Syphilis causes mucosal inflammation and breaks in skin/tissue inte
Two vaccines are relevant here
HPV vaccine and Hepatitis B vaccine. (Hepatitis A vaccine is also relevant for MSM given transmission risk.)
Current formulation
9-valent (Gardasil 9) — protects against 9 HPV strains
Upper age limit for routine recommendation
26 years. FDA approval extends to: 45 years.
MSM-specific note
MSM benefit from HPV vaccination through age 26 due to elevated anal cancer risk. Catch-up vaccination through 26 is rou
WHY THIS MATTERS FOR JB
JB is 20 years old. If unvaccinated, he qualifies for the 3-dose catch-up series.
Protects against
Hepatitis A virus (HAV), which can be transmitted sexually (fecal-oral route; relevant for oral-anal contact).
Congenital syphilis
Transmission of syphilis from mother to infant; caused by rising syphilis rates in women of childbearing age; results in
EPT (expedited partner therapy)
Treating a patient's partner without requiring a clinical visit; limited by state laws; identified as a systemic gap.