COLUMBUS COUNTY HEALTH DEPARTMENTS
FAMILY PLANNING STI/HIV SCREENING POLICY
Policy Title:
Program Area:
FAMILY PLANNING STI/HIV SCREENING POLICY
Family Planning
Policy Identifier:
(optional)
Effective Date:
Approval Date:
Revision
Date(s):
4/5/2014
Approved by:
Kim Smith RN, BSN, MSHCA, Health Director
Approved by:
Hilda Memory RN, BS, MSHA, Director of Nursing
Purpose:
Columbus County Health Department (CCHD) will provide screening, treatment,
counseling, and referral for sexually transmitted infections (STI) and human
immunodeficiency virus (HIV) to family planning clients seeking services in Family
Clinic.
Definitions:
CCHD Family Planning Clinic will screen and utilize appropriate screening test for
STSs including but not limited to: Gonorrhea, Chlamydia, Human Papilloma
Virus,(HPV), Hepatitis B, Herpes Simplex, Syphilis, Trichomoniasis, and HIV.
Responsibilities:
Family Planning Clinic Staff
Procedures:
Sexual risk assessment must be done on every person seeking service in the Family
Planning Clinic and will follow the NC Sexually Transmitted Diseases Public Health
Program Manual/Clinical Assessment History and Interview as set forth in this
policy.
See History and Interview Protocol
1. The approach to information gathering should be nonjudgmental, utilizing
open-ended questioning skills.
Reformatted 10/7/2011
Page 1 of 4
COLUMBUS COUNTY HEALTH DEPARTMENTS
FAMILY PLANNING STI/HIV SCREENING POLICY
2. All patients presenting for a new problem should be interviewed for the
following information, which should then be documented in the clinical
record.
a. Gender
b. Presenting problem/reason for visit
c. Description of signs/symptoms that captures the elements of location,
duration, severity, and quality:
 Dysuria (onset, frequency)
 Discharge (onset, color, character, frequency, order)
 Lesions (onset, type, location)
 Sore throat (onset, intensity)
 Fever (how high, onset)
 Pain (onset, location, describe intensity on pain scale)
 Itching (onset, location, intensity on scale)
Males:
 tenderness or swelling in scrotum
 perineal discomfort or pain on sitting down
 rectal discharge
 constipation and/or tenesmus
Females:
 pain with intercourse (including description)
 abnormal bleeding (including description)
 last Pap smear (date and result)
 LMP (normal or abnormal)
 Type of contraception and frequency of use
 Number of pregnancies (live birth, abortion, miscarriage, tubal, molar)
d. Risk assessment
 Partner symptoms
 Individual’s anatomical sites of sexual exposure in last 60 days (rectum,
mouth, vagina, penis)
Reformatted 10/7/2011
Page 2 of 4
COLUMBUS COUNTY HEALTH DEPARTMENTS
FAMILY PLANNING STI/HIV SCREENING POLICY
 Previous sexually transmitted infections (including diagnosis and year of
diagnosis)
 Frequency of condom use
 Number of male or female sex partners in the last 60 days-do not
assume patients are heterosexual
 Date of last sexual exposure
 Use of ETOH and/or drugs (amount and frequency)
e. Other pertinent information
 Medication allergies*
 Current medications (including antibiotics in last two weeks
 Treatment used for symptoms
 Hepatitis B vaccine status**
 Prior HIV test (when results)
 Travel out-of-state (include sex partner travel history)***
*Medication allergies should be flagged in the patient record on the problem list or a
label on the chart. Document a description of the allergic reaction experienced by
patient. True hypersensitivity is contraindicated to treatment with the drug in
question.
**All adults age 18 or older who have not had Hep B vaccine should be offered
combination hepatitis A/hepatitis B vaccine (Twinrix) if they have a history of or
currently present with one or more of the following risk factors.
1. Have multiple sexual partners
2. Have unprotected vaginal or anal sex
3. Share needles or paraphernalia (works) for drug use
4. Have been exposed to an infected person’s blood
5. Live in a household with an HBV- infected person
6. Have been tattooed or pierced with non-sterile equipment
7. Have been incarcerated
8. Are HIV +
9. Are HCV +
10.Are man who has sex with men
*** Travel history is pertinent in light of geographic distribution of antibiotic
resistant strains of gonorrhea.
Reformatted 10/7/2011
Page 3 of 4
COLUMBUS COUNTY HEALTH DEPARTMENTS
FAMILY PLANNING STI/HIV SCREENING POLICY
All positive results of test screening and treatment must be reported to the NC
Communicable Disease Branch and entered in NC EDSS (except for syphilis and
HIV see adult health communicable disease policy on reporting these to state)
As noted above all treatment should reflect CDC treatment guidelines (control click
on link)
Medication provided by the state must be used for STDs only. Those other
medications provided by the state as one-dose therapies should be provided as
directly observed therapy (DOT)
All patients shall receive thorough and accurate counseling (an interactive process in
which the client is assisted in making an informed choice) on STIs and HIV to
include: risk assessment and risk reduction, prevention, and transmission of infection.
If a patient is diagnosed with a positive HIV test family planning staff will refer the
patient to the CCHD STD clinic HIV nurse and /or an Infectious Disease Clinic for
counseling.
Laws and Rules:
Title X section 8.1
Reference(s):
NC Sexually Transmitted Diseases Public Health Program Manual/Clinical Assessment History and
interview.
CDC treatment Guidelines
Reformatted 10/7/2011
Page 4 of 4