Chlamydia
Disease Specific Information
Testing and Treatment
- Universal annual screening is recommended in all sexually active adults and adolescents under the age of 30 years. For persons with multiple sexual partners or a new partner since last tested, offer screening every three to six months.
- Nucleic acid amplification tests (NAAT) are the most sensitive tests for detecting C. trachomatis.
- Several treatment options are recommended.
Resources
Gonorrhea
Disease Specific Information
Testing and Treatment
Gonorrhea is the second most commonly reported sexually transmitted infection in Canada.1 In January 2025, PHAC’s revised treatment guidelines, key information, and resources for Neisseria gonorrhoeae (gonorrhea) in the Canadian Guidelines on Sexually Transmitted Infections.
- Preferred treatment for uncomplicated gonococcal infections in adults and adolescents 10 years or older (including pregnant people):
- Ceftriaxone 500 mg IM as a single dose.
- Since 500 mg vials of ceftriaxone are not available in Canada, clinicians should continue to use 250 mg vials to be administered in two separate injections.
- The 1 g of azithromycin PO is no longer routinely required.
However, for patients for whom chlamydia infection has not been ruled out with a negative test, concurrent treatment for chlamydia should also be offered as per PHAC’s Chlamydia and LGV Guidance.
- Consult the guidelines for alternative treatment options if required.
Specimen Collection:
- To assess drug sensitivity, the guidelines recommend specimen collection for culture (when feasible), in addition to specimens for nucleic acid amplification testing (NAAT) for greater sensitivity in cases of:
- suspected treatment failure,
- infection acquired in areas with high rates of antimicrobial resistance,
- symptomatic patients,
- pelvic inflammatory disease (PID),
- pregnancy,
- sexual abuse/sexual assault, or
- an asymptomatic individual notified as a contact of a gonorrhea case.
The guidelines recommend a test of cure for all positive sites in all cases. Refer to the test of cure guidelines as recommendations depend on timing after treatment completion and the patient’s symptom status.
Resources
Herpes
- Genital herpes, particularly recently-acquired infection, increases the risk of HIV acquisition and transmission.
- Herpes is not a reportable disease.
Testing and Treatment
- Not everyone will experience symptoms.
- Swabs can be taken from sites of suspected infection.
- Anti-viral medications are effective in decreasing the duration and severity of herpes in the absence of contraindications.
- Consult the Genital herpes guide for treatment and follow-up.
Resources
Hepatitis B
Disease Specific Information
Resources
Hepatitis C
Disease Specific Information
Testing and Treatment
- The diagnosis of hepatitis C requires 2 types of tests:
- hepatitis C antibody (anti-HCV) test
- hepatitis C ribonucleic acid (RNA) test2
Resources
HIV& AIDS (Human Immunodeficiency Virus & Acquired immune deficiency syndrome)
Disease Specific Information
- Ontario Public Health Standards – Infectious Disease Protocol – A - Appendix 1: Case Definitions and Disease Specific Information Disease: Acquired Immunodeficiency Syndrome (AIDS).
- HIV& AIDS is a reportable disease.
Testing and Treatment
Consider and discuss HIV testing as part of routine care with all patients. Refer to the Sexually transmitted and blood-borne infections: Guides for Health Professionals for Human immunodeficiency virus.
Resources
Resources for your Patients
Human Papilloma Virus (HPV)
- HPV is not a reportable disease.
Resources
Molluscum Contagiosum
Molluscum contagiosum is contagious until the bumps have disappeared. Anyone who has skin-to-skin contact with an infected person is at risk of getting infected.
- Molluscum Contagiosum is not a reportable disease.
- It is most common among children under 10 years of age but can affect anyone.
- In adults it is primarily a sexually transmitted infection.
- Lesions can be present on any part of the body.
- For adults, it is most common to find them on the abdomen, genitals and inner thighs.
- Unless irritated or scratched, there is no inflammation, redness or pain.
Testing and Treatment
- Molluscum Contagiosum is not a reportable disease.
- Diagnosed by observing lesion.
- Lesions are usually benign and resolve without scarring if left alone.
- Most common complication of molluscum is a bacterial secondary infection.
- Government of Canada Molecular Detection of Molluscum contagiosum virus.
Syphilis
Disease Specific Information
Testing and Treatment
Congenital Syphilis
The number of cases of congenital syphilis has risen sharply in recent years. A Public Health Ontario surveillance report states that “between 2013 and 2018, a total of six cases of early congenital syphilis were reported provincially (i.e., an average of one case per year); however, from 2019 to 2022 a total of 41 cases were reported. In March 2024, the Canadian Paediatric Society released a position statement on Diagnosis and management of congenital syphilis – Avoiding missed opportunities.
- In pregnancy, universal screening is recommended in the first trimester or at the first prenatal visit.
- Repeat screening at 28-32 weeks and again at delivery for pregnant women at ongoing risk of infection or reinfection, and in areas experiencing outbreaks.
- Consider screening pregnant individuals more frequently who are at ongoing risk of infection.
- All individuals who deliver a stillborn infant after 20 weeks of gestation.
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