STI Rates and Sexual Health Needs Remain High During COVID-19
HPEPH continues to receive and respond to higher than normal rates of sexually transmitted infections (STIs). The local gonorrhea (GC) outbreak continues and there is evidence of rising numbers of STIs such as HIV, syphilis and chlamydia. For local and provincial STI rates, please visit our HPEPH Fast Facts Dashboard, Password: fastfactsHPE.
We truly appreciate the assistance of our emergency and community health care providers who continue to provide sexual and reproductive health services for patients and would like to remind our partners of the following recommendations:
Appropriate Treatment and Management of Reportable STI’s
Treat GC with first-line dual therapy due to compelling evidence of efficacy and current antimicrobial susceptibility patterns in Ontario . First-line therapy includes:
- Ceftriaxne 250 mg IM WITH Azithromycin 1 gm po given during the same visit.
- Remind patients treated for STI’s of the importance of abstaining from all sexual contact x 7 days after treatment.
- Inform your patients that if they test positive for a reportable STI. A Public Health Nurse will call to provide education, assess them for treatment tolerance and complete contact tracing.
- Health Care Providers can order publicly funded (no cost) STI medications, including first-line GC treatment, from HPEPH BY using the HPEPH Vaccine/STI form available online a hpePublicHealth.ca
 According to Public Health Ontario, World Health Organization, and CDC, “Treatment of gonorrhea with two antimicrobials is recommended on the theoretical basis that dual therapy may potentially improve treatment effectiveness and thereby reduce the likelihood of transmission of resistant strains and having two antibiotics with different mechanisms of action should in theory hinder the development of resistant strains”. In addition, “dual therapy for pharyngeal gonorrhea is supported by studies demonstrating poor cephalosporin penetration of the pharynx”. Ontario Gonorrhea Testing and Treatment Guide