Sexually Transmitted Disease (STD) Clinic

If you're sexually active, particularly with multiple partners, you've probably heard the following advice many times: use protection and make sure you get tested. This is important because a person can have a sexually transmitted disease without knowing it. In many cases, no signs or symptoms occur. In fact, that's why many experts prefer the term sexually transmitted infections (STIs), because you can have the infection without disease symptoms.

But what types of STI testing do you need? And how often should you be screened? The answers depend on your age, your sexual behaviors and other risk factors. Don't assume that you're receiving STI testing every time you have a gynecologic exam or Pap test.

Gay, bisexual and other MSM are at greater risk for hepatitis A, hepatitis B, hepatitis C, and the human papillomavirus (HPV). For this reason, CDC recommends that you be vaccinated against hepatitis A and hepatitis B. There is no vaccine for hepatitis C. The human papillomavirus (HPV) vaccine is also recommended for sexually active men up to age 26.


We can test and treat you for:

  • Chlamydia and gonorrhea
  • HIV, syphilis and hepatitis
  • Genital herpes
  • Human papillomavirus (HPV)
  • Trichomoniasis

If you have sex, you may also have an STD, with subtle or noticeable STD symptoms. Straight or gay, married or single, you're vulnerable to STD's and STD symptoms, whether you engage in oral, anal or vaginal sex. The symptoms of an initial STD infection can include:

  • Fever and flu-like symptoms
  • Genital itching, burning, or discomfort
  • Vaginal discharge in women
  • Swollen lymph nodes
  • A feeling of pressure in the abdomen

Anal Cancer Screening (MSM)

Anal cancer screening is the process of using a series of tests and procedures to detect and prevent abnormal cells that are not yet cancerous (called dysplasia) from becoming cancerous tumors and potentially spreading to other parts of the body. Simple anal pap tests, similar to cervical pap tests given to screen for cervical cancer in women, are given to detect the presence of abnormal cells. A procedure called high resolution anoscopy (HRA) is used with suspicious tissue requiring a biopsy to confirm or deny the presence of cancer. A procedure called infrared coagulation (IRC) is often used to destroy abnormal cells detected by the pap test. Two or three additional screenings and treatments are usually required after any initial screening and treatment to insure that all abnormal cells have been detected and destroyed.

Anal cancer is an increasing health threat to MSMs, especially those who are HIV+, and there is no professional consensus about whether to vaccinate against it, screen for cell changes or how to treat positive results on an anal pap smear. More research is needed and both the consumer and provider communities need to be educated.


What is an anal PAP test?

An anal pap test is a screening test that can be done on men and women.  It is a test that looks for changes in the cells of the anus that could lead to anal cancer (very much like pap smears of the cervix in women).  The anal pap test does not test for colon or rectal cancer.


What is HRA? (High Resolution Anoscopy)

HRA is a procedure for examining and evaluating the anal canal. The test is performed after an anal pap test shows abnormal cells. A small round tube called an anoscope and a magnifying instrument called a colposcope are used to thoroughly examine the anal canal. A small piece of abnormal tissue may be taken for biopsy. A digital rectal examination is also done at the time of the procedure. HRA is performed in our office and usually takes approximately 15 minutes.

There is no preparation required. Enemas and suppositories are not recommended prior to the procedure. HRA is usually well tolerated with individuals and any discomfort that may be experienced is usually mild with cases of bleeding or infection being extremely rare.


What is Infrared Coagulation (IRC)?

Infrared photocoagulation (also called coagulation therapy) is a medical procedure used to destroy abnormal anal cells while sealing the tiny blood vessels resulting in minimal bleeding. During the procedure, the doctor uses a device that creates an intense beam of infrared light. The procedure is performed in our office. No suppositories or enemas are required with local anesthetic being used as needed.

NOTE: You will need to have periodic anal Pap tests and/or HRA to see if there are any additional areas that may require treatment. Sometimes two or three treatments are required before all the abnormal cells are found and destroyed. This is far easier and less painful than surgery and hospitalization for cancer.


Lower genital track disorders

Our STD Clinic treats lower genital track disorders. Lower genital tract diseases involve the lower portion of the female reproductive system, which includes the vagina, vulva, and lower cervix. Intraepithelial neoplasia, or pre-cancerous lesions, is a common form of lower genital tract disease. Managing these pre-cancerous diseases is important to help prevent cancer.

Cervical Cancer is one of the most preventable cancers. In the past 30 years, the use of the Pap test has successfully reduced cervical cancer deaths by over 50%. Medical advances, such as the HPV vaccine, have and will continue to dramatically decrease rates of cervical cancer.


Colposcopy

Colposcopy (kol-POS-kuh-pee) is a procedure to closely examine your cervix, vagina and vulva for signs of disease. During colposcopy, we use a special instrument called a colposcope. We may recommend colposcopy if your Pap test has shown abnormal results. If we find an unusual area of cells during colposcopy, a sample of tissue can be collected for laboratory testing (biopsy). Many women experience anxiety before their colposcopy exams. Knowing what to expect during your colposcopy may help you feel more comfortable.

Colposcopy uses a dissecting microscope with various magnification lenses to provide an illuminated, magnified view of the cervix, vagina, and vulva. Colposcopic evaluation of the cervix and vagina is based on the finding that malignant and premalignant epithelium have specific macroscopic characteristics relating to contour, color, and vascular pattern that are recognizable by colposcopy. The improved visualization of epithelial surfaces enhances the colposcopist's ability to distinguish normal from abnormal areas and to obtain directed biopsies from suspicious tissue. Colposcopy of the vulva, a keratinized epithelium, provides a magnified bright light examination. The primary goal of colposcopy is to identify precancerous and cancerous lesions so that they may be treated early.

More information about Colposcopy here.


Types of Intraepithelial Neoplasia

Vaginal intraepithelial neoplasia is a condition in which the skin of the vagina changes. This type of intraepithelial neoplasia can disappear without treatment, but if the abnormal skin cell growth becomes severe, it can change into cancer. Often there are no indications of vaginal intraepithelial neoplasia and it is found during other medical tests, including the Pap smear. A colposcopy, which helps magnify the area, may be used to fully diagnose the condition.

Vulvar intraepithelial neoplasia is a condition in which there is abnormal cell growth on the vulvar skin. Often it can disappear without treatment. Although it is not cancer, vulvar intraepithelial neoplasia has the ability to change into cancer, which can develop slowly.


Cervical intraepithelial neoplasia (CIN)

Known as cervical dysplasia and cervical interstitial neoplasia, is the potentially premalignant transformation and abnormal growth (dysplasia) of squamous cells on the surface of the cervix. CIN is not cancer, and is usually curable.Most cases of CIN remain stable, or are eliminated by the host's immune system without intervention. However a small percentage of cases progress to become cervical cancer, usually cervical squamous cell carcinoma (SCC), if left untreated. The major cause of CIN is chronic infection of the cervix with the sexually transmitted human papillomavirus (HPV), especially the high-risk HPV types 16 or 18. Over 100 types of HPV have been identified. About a dozen of these types appear to cause cervical dysplasia and may lead to the development of cervical cancer. Other types cause warts.

More information here.

Sexually Transmitted Diseases (STD's)

Sexually Transmitted Diseases (STD) are serious business. With several varieties of STD's, each having serious health ramifications, you simply cannot take the possibility of an STD too seriously. If you are concerned that you have an STD, one simple phone call to our STD Clinic can ease your mind and, if necessary, put you on the road to healing.


Chlamydia DNA (Urine)

Chlamydia is a sexually transmitted disease (STD) caused by a bacterium that can damage a woman's reproductive organs (infertility) if left untreated. It's a serious disease that often has minimal or no symptoms. Chlamydia and Gonorrhea have similar symptoms such as discharge and painful urination.


Chlamydia/Gonorrhea by Nucleic Acid Amplification

Chlamydia and Gonorrhea are both sexually transmitted diseases (STDs) that are caused by a bacterium and have similar symptoms such as discharge and painful urination.


Comprehensive STD Panel

The Comprehensive STD Panel (urine and blood) tests for several sexually transmitted diseases at the same time at one low price, including HIV, Syphilis, Herpes I and II, Gonorrhea, Chlamydia, Hepatitis B and C.


Gonorrhea DNA, Urine

Gonorrhea is a sexually transmitted disease (STD) caused by a bacterium that can cause numerous reproductive and health issues if left untreated. It's a serious disease that often has minimal or no symptoms. If you do have symptoms, some include a discharge and painful urination. These symptoms are very similar to Chlamydia, so you might want to consider the Comprehensive STD Panel. It tests for both Gonorrhea and Chlamydia, as well as several others.


Hepatitis A Antibody (Total)

There are several types of hepatitis — each caused by a different hepatitis virus. The Hepatitis A Antibody (Total) Test will determine a prior Hepatitis A infection or an acute Hepatitis A infection.


Hepatitis B Surface Antigen

There are several types of hepatitis — each caused by a different hepatitis virus. Viral hepatitis can be contracted through unprotected sex, using contaminated needles, or other causes.


Hepatitis C Virus (HCV) Antibody

There are several types of hepatitis — each caused by a different hepatitis virus. Viral hepatitis can be contracted through unprotected sex, using contaminated needles, or other causes. The Hepatitis C Virus (HCV) Test only tests for Hepatitis C.


Hepatitis Panel

Hepatitis is an inflammation of the liver that can be contracted through unprotected sex, using contaminated needles, or other causes. There are several types of hepatitis — each caused by a different hepatitis virus.


Herpes Simplex Virus (I/II, IgG)

There are two types of herpes — Simplex Virus–1 (HSV–1) and Simplex Virus–2 (HSV–2). HSV–1 is very common among people (70%) and they usually come into contact with the virus from an oral infection as a child.


HIV

Human Immunodeficiency Virus (HIV) is most commonly transmitted sexually, but can also be contracted through IV drug use and less likely, blood transfusions. It is the virus that causes AIDS. This condition damages your immune system and can lead to serious illness, infections and many other symptoms.


Syphilis

The Syphilis Test detects antibodies to the bacterium that cause the disease in blood, body fluid or tissue. It will tell you if you're infected or not.