Prevention and Control of Sexually Transmitted and Blood Borne Infections

In view of the epidemic of HIV, sexually transmitted infections (STIs), and blood borne infections sweeping the globe, the AAFP recognizes the need for intense and ongoing public and professional education. AAFP’s goals for this educational outreach are to: increase awareness of these infections, encourage effective prevention; enable proper diagnosis; ensure proper treatment; and follow public health protocols for prompt reporting and outbreak investigation. All of these pieces are critical in order to stem the tide of these infections.

The AAFP endorses and encourages the following HIV, STIs and blood borne infections prevention strategies:

1. Effective ways to prevent sexual transmission of infections are abstinence and the maintenance of a life-long mutually monogamous relationship with one uninfected partner. For individuals who are sexually active with more than one partner, the following strategies are generally effective for reduced infections transmitted through bodily fluids:

  • Have intercourse with one uninfected partner;
  • Use condoms (or other effective devices such as dental dams) in a suitable manner for the entire episode of sexual activity.

2. Prevent blood-borne infection by:

  • Having appropriate up-to-date immunizations;
  • Monitoring safe blood banking protocols, transfusion services and organ donor services.
  • Deferring donations by persons at risk for or with blood borne infections;
  • Avoiding accidental inoculation and/or exposures by the use of universal precautions
  • Avoiding use of contaminated needles;
  • Reducing the amount of used needles in circulation by the development of regulated needle exchange programs;
  • Providing access to treatment when considered curative or effective in reducing transmission.

3. Reduce the number of of congenital and perinatal infections by appropriate testing, diagnosis, and treatment of infected individuals and their partners.

  • Providers should be aware of local law and community standards regarding expedited partner therapy (EPT) and patient-delivered partner therapy (PDPT) for STIs. With EPT and PDPT, clinicians prescribe treatment to partners of individuals known to be infected without providing direct medical evaluation and counseling to the partner.
  • Providers should be advising against breastfeeding when risk of transmitting and infection to the infant exceeds the benefits of breastfeeding.

4. Pre-exposure Prophylaxis for HIV: Pre-exposure prophylaxis, or PrEP, is an effective method for preventing HIV infection in people who are HIV-negative but at substantial risk of contracting it. PrEP adds prophylactic antiretroviral medication to other prevention strategies including consistent condom/barrier use. Family physicians should counsel and when appropriate prescribe PrEP as a routine part of STI prevention.

The AAFP believes that any program for the diagnosis and treatment of HIV, STIs and blood borne infections should emphasize family medicine and the role of primary care physicians. (1971) (2016 COD)