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sexually transmitted diseases control branch

​A Clinician's Resource for Sexually Transmitted Diseases (STDs) in Gay Men and Other Men Who Have Sex with Men (MSM) - The MSM Toolkit

A PDF version of the toolkit is available: MSM Toolkit (PDF).

Effective communication around STDs is a challenge for many healthcare providers, especially with little time to provide comprehensive health care and social support services for patients.

Why focus on MSM?

  • STDs in communities of MSM, particularly among those with HIV infection, are common medical problems with important public health implications.
  • In 2014, 85% of all reported male primary and secondary syphilis cases in California with data on sexual orientation were MSM. Of interviewed MSM with known HIV status, 45% were co-infected with HIV.
  • Infection with STDs such as syphilis, gonorrhea (GC), and chlamydia (CT) increase by a factor of 2 to 5 the risk of sexual HIV acquisition and transmission.

A Clinician's Resource for Sexually Transmitted Diseases (STDs) in Gay Men and Other Men Who Have Sex with Men (MSM) - The MSM Toolkit  is a resource designed to improve clinicians' knowledge, skills, and comfort in effectively diagnosing and managing STDs in MSM.

Disclaimer for public health clinical guidelines: These guidelines are intended to be used as an educational aid to help clinicians make informed decisions about patient care. The ultimate judgment regarding clinical management should be made by the health care provider in consultation with their patient in light of clinical data presented by the patient and the diagnostic and treatment options available. Further, these guidelines are not intended to be regulatory and not intended to be used as the basis for any disciplinary action against the health care provider.
Acronyms used in MSM Toolkit (PDF)

The following sections provide summaries and resources for the chapters within the MSM Toolkit (PDF).

Asymptomatic Screening – Chapter 1

This chapter discusses how and when to evaluate the sexual health of MSM clients. Important considerations for the screening of chlamydia, gonorrhea, syphilis, and HIV are also included.


Sexual History Taking and Risk Assessment – Chapter 2

This chapter outlines the rationale for and methods of conducting sexual histories and risk assessments and includes some sample questions.

Physical Exam Findings – Chapter 3

This chapter describes examples of clinical signs of an STD to look for during a comprehensive physical exam and recommends related testing.

Bacterial STDs – Chapter 4

This chapter discusses patient evaluation, testing, treatment, and follow-up for chlamydia, gonorrhea, and syphilis. Special considerations for suspected gonorrhea treatment failure are included.


​​HIV – Chapter 5

This chapter identifies basic expectations for healthcare providers of MSM related to the prevention, screening, and diagnosis of HIV in MSM patients.

Viral Hepatitis (A, B, and C) – Chapter 6

This chapter discusses recommended strategies for hepatitis testing, vaccination, and clinical management in MSM.


Enhancing the Care Setting – Chapter 7

This chapter discusses methods for creating a clinical environment that is sensitive to the needs of LGBT patients.


STD/HIV Partner Services – Chapter 8

This chapter defines and describes the Partner Services purpose, process, and benefits.


Public Health Reporting – Chapter 9

This chapter provides an overview of the disease-specific reporting requirements for California. Included are links to related legislation, policies, and forms.


Resources and Selected References – Chapter 10

This chapter provides a categorical list of selected resources discussed in the individual toolkit chapters.

Other Resources

California Department of Public Health STD Control Branch

Clinical Guidelines and Job Aids

Public Health Reporting

California Prevention Training Center

MSM Sexual Health Standards of Care - NCSD

AIDS Education Training Centers National Resource Center

Hepatitis C Online

Gay and Lesbian Medical Association

Center of Excellence for Transgender Health

American Academy of HIV Medicine

National HIV/AIDS Clinical Consultation Center

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