Primary prevention

Primary prevention includes sexual abstinence, barrier contraception, and avoidance of chemical irritants such as vaginal douches or spermicides. Access to sexual health services is key, as is ensuring that the needs of groups with greater sexual health or access needs are met; interventions and services aimed at reducing sexually transmitted infections (STIs) should be relevant to the groups they are targeting.[16] ​Screening programmes for asymptomatic cervicitis due to Chlamydia trachomatis may reduce incident pelvic inflammatory disease by more than 50%.[17] Screening could have more impact if implemented in all preventative care visits.[18]

In clinical trials, post-exposure prophylaxis (PEP) with doxycycline has shown benefit in reducing the incidence of subsequent STIs (syphilis, chlamydia, and gonorrhoea) in high-risk men who have sex with men (MSM) and transgender women (TGW).[19][20][21]​​​​​​ On the basis of the observed efficacy of PEP with doxycycline for reducing the risk of STIs, Centers for Disease Control and Prevention (CDC) recommends that MSM and TGW who have had a syphilis, chlamydia, or gonorrhea infection within the previous 12 months should receive counselling that PEP with doxycycline can be used to prevent these infections.[22]​ PEP with doxycycline could also be discussed with men who have sex with men and transgender women who have not had a bacterial STI within the previous 12 months but who are likely to participate in sexual activities that are known to be high risk for exposure to STIs.[22] PEP with doxycycline can be self-administered within 72 hours of sexual intercourse. Individuals prescribed PEP with doxycycline should undergo STI testing every 3-6 months.

Secondary prevention

Secondary prevention measures include screening and treating sexual partners for sexually transmitted infections and avoiding any known chemical irritants, such as vaginal douches or spermicide.

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