STIcking Points

Reflections on STD Engage 2018

Kees Rietmeijer

November 22, 2018

Last week I attended the STD Engage 2018conference in Orlando, Fl. The annual conference of the National Coalition of STD Directors is increasingly popular (close to 700 attendants this year) and has also become the most diverse conference in the STD field. This diversity reflects the STD workforce in the U.S. and also creates a very special energy in the room. As a non-profit organization, NCSD has the freedom to include speakers that might be considered too controversial to be included in other conferences, such as the CDC-sponsored National STD Conference. Thus, advocates for family planning and GLBTQ health held center stage at STD Engageto enthusiastic acclaim from an audience that is increasingly embracing the concept of sexual healthover sexual diseaseyet is imperative in the public health response to the rising STD rates in this country. 

There were two other things that stood out for me at the Engage 2018 conference, both reflective of new directions NCSD is taking. First, the increasing level of interest by industry partners; both diagnostics and pharmaceutical companies. Coming from academia and public health practice, the relationship with the industry is not necessarily an easy one. However, to the extent that we rely on the evolution of diagnostics, especially point of care tests, and new pharmaceuticals in the era of drug resistance, our relationship with the industry is increasingly important. It is encouraging that NCSD
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STIcking Points

Calling Dr. Darkfield!

Kees Rietmeijer

November 18, 2018

When I started working for one of the Amsterdam STD clinics in 1982, attending physicians were seated in the clinic laboratory and, when not consulting on patients, read Gram stains and wet preps along with clinic laboratorians. Nurses were the primary care providers in the clinic, but attending physicians consulted on all patients with genital ulcers and collected and read specimens for dark field microscopy to diagnose primary syphilis. The nurses seeing the patients would call the attending doctor in the lab on the intercom with a conversation that went something like this: nurse: “Doctor??”; me: “Yes”; nurse: “could you come to do a dark field exam?” When things got busy, this “dialogue” was often abbreviated to: nurse: “Doctor????!!!” and without awaiting the answer: “Darkfield!!!”…. and we were on our way. 

One day, I saw a patient for a follow up visit and while we shook hands, he said: “How are you doing Dr. Darkfield?” Needless to say, as my STD career developed over the
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STIcking Points

The Road Beyond Dean Street

Kees Rietmeijer

October 10, 2018

Over a decade ago, Heijman and colleaguesfrom the Amsterdam Health Department published an article in the journal Sexually Transmitted Diseasesdetailing the implementation and evaluation of a risk-based, short screening protocol for asymptomatic patients visiting their STD clinic. The short protocol included a minimal sexual and medical history followed by phlebotomy for HIV and syphilis testing and self-obtained urine or vaginal sampling for gonorrhea and chlamydia testing - without physical examination.¹

In the Denver STD clinic, we had implemented a similar protocol we referred to as “Express Visits” in 2003 and published our results in STDin 2008. Our paper suggested that about a quarter
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