Consenso de expertos sobre la prevención de infecciones de transmision sexual en Colombia
Contenido principal del artículo
Resumen
Las infecciones de transmisión sexual es una de las causas mas frecuentes de consulta médica. A nivel mundial se ha visto un aumento en el número de casos, por lo que se hace necesario realizar guías y consensos para la prevención y el tratamiento de estas enfermedades. En el siguiente trabajo, se realiza el conceso sobre prevención de infecciones de transmisión que abarca desde la prevención primaria, la realización de la consulta médica, los tipos de pruebas y el manejo ante una potencial exposición. Se ha desarrollado una adaptación de guías internacionales y nacionales, de manera que sean de fácil aplicabilidad en nuestro territorio nacional, y que faciliten la consulta para los médicos en cualquier nivel de atención.
Detalles del artículo
Citas
Abara, W. E., Kirkcaldy, R. D., Bernstein, K. T., Galloway, E., & Learner, E. R. (2025). Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis. The Journal of Infectious Diseases, 231(1), 61-70. https://doi.org/10.1093/infdis/jiae383
Bachmann, L. H., Barbee, L. A., Chan, P., Reno, H., Workowski, K. A., Hoover, K., Mermin, J., & Mena, L. (2024). CDC Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial Sexually Transmitted Infection Prevention, United States, 2024. MMWR. Recommendations and Reports, 73(2), 1-8. https://doi.org/10.15585/mmwr.rr7302a1
Baeten, J. M., Palanee-Phillips, T., Brown, E. R., Schwartz, K., Soto-Torres, L. E., Govender, V., Mgodi, N. M., Matovu Kiweewa, F., Nair, G., Mhlanga, F., Siva, S., Bekker, L.-G., Jeenarain, N., Gaffoor, Z., Martinson, F., Makanani, B., Pather, A., Naidoo, L., Husnik, M., … Hillier, S. (2016). Use of a Vaginal Ring Containing Dapivirine for HIV-1 Prevention in Women. New England Journal of Medicine, 375(22), 2121-2132. https://doi.org/10.1056/NEJMoa1506110
Barbee, L. A., & St Cyr, S. B. (2022). Management of Neisseria gonorrhoeae in the United States: Summary of Evidence From the Development of the 2020 Gonorrhea Treatment Recommendations and the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infection Treatment Guidelines. Clinical Infectious Diseases, 74(Suppl_2), S95-S111. https://doi.org/10.1093/cid/ciac043
Bell, S. F. E., Sweeney, E. L., Kong, F. Y. S., Whiley, D. M., Bradshaw, C. S., & Tickner, J. A. (2024). Response to the ASHM 2023 statement on the use of doxy-PEP in Australia: considerations and recommendations. Medical Journal of Australia, 220(7), 356-360. https://doi.org/10.5694/mja2.52255
Berry, K. R., Gliske, K., Schmidt, C., Cray, L. D. E., Killian, M., & Fenkel, C. (2023). Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, and Other Minoritized Gender and Sexual Identities-Adapted Telehealth Intensive Outpatient Program for Youth and Young Adults: Subgroup Analysis of Acuity and Improvement Following Treatment. JMIR Formative Research, 7, e45796. https://doi.org/10.2196/45796
Bhandari, P., Brett, C., Batool, A., & Sapra, A. (2023). Hepatitis A Vaccine. Pediatric Vaccines and Vaccinations: A European Textbook: Second Edition, 115-125. https://doi.org/10.1007/978-3-030-77173-7_12
Chou, R., Spencer, H., Bougatsos, C., Blazina, I., Ahmed, A., & Selph, S. (2023). Preexposure Prophylaxis for the Prevention of HIV: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA, 330(8), 746-763. https://doi.org/10.1001/jama.2023.9865
Clinical Guidance for PrEP | HIV Nexus | CDC. (n.d.). Retrieved May 18, 2025, from https://www.cdc.gov/hivnexus/hcp/prep/index.html
CROI 2024: Global Epidemiology and Prevention of HIV and Other Sexually Transmitted Diseases - PubMed. (n.d.). Retrieved May 18, 2025, from https://pubmed.ncbi.nlm.nih.gov/39142289/
Flores, J., Davis, A. M., & Hazra, A. (2025). Doxycycline Postexposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infection. JAMA, 333(3), 248-249. https://doi.org/10.1001/jama.2024.24540
Freeland, C., & Cohen, C. (2018). Public Health Response to Hepatitis B Exposure: A Case Study on Gaps and Opportunities to Improve Postexposure Care. Infectious Diseases in Clinical Practice, 26(4), 185-186. https://doi.org/10.1097/IPC.0000000000000656
Gandhi, R. T., Landovitz, R. J., Sax, P. E., Smith, D. M., Springer, S. A., Gunthard, H. F., Thompson, M. A., Bedimo, R. J., Benson, C. A., Buchbinder, S. P., Crabtree-Ramirez, B. E., del Rio, C., Eaton, E. F., Eron, J. J., Hoy, J. F., Lehmann, C., Molina, J.-M., Jacobsen, D. M., & Saag, M. S. (2025). Antiretroviral Drugs for Treatment and Prevention of HIV in Adults: 2024 Recommendations of the International Antiviral Society-USA Panel. JAMA, 333(7), 609. https://doi.org/10.1001/jama.2024.24543
Garcia, M. R., Leslie, S. W., & Wray, A. A. (2024). Sexually Transmitted Infections. Essential Paediatric Surgery: A Practical Guide, 213-218. https://doi.org/10.1201/9781003182290-39
Geier, M. R., Geier, D. A., & Zahalsky, A. C. (2003). A review of hepatitis B vaccination. Expert Opinion on Drug Safety, 2(2), 113-122. https://doi.org/10.1517/14740338.2.2.113
Goldstone, S. E. (2023). Human papillomavirus (HPV) vaccines in adults: Learnings from long-term follow-up of quadrivalent HPV vaccine clinical trials. Human Vaccines and Immunotherapeutics, 19(1). https://doi.org/10.1080/21645515.2023.2184760
Grant, R. M., Lama, J. R., Anderson, P. L., McMahan, V., Liu, A. Y., Vargas, L., Goicochea, P., Casapía, M., Guanira-Carranza, J. V., Ramirez-Cardich, M. E., Montoya-Herrera, O., Fernández, T., Veloso, V. G., Buchbinder, S. P., Chariyalertsak, S., Schechter, M., Bekker, L.-G., Mayer, K. H., Kallás, E. G., …Glidden, D. V. (2010). Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men. New England Journal of Medicine, 363(27), 2587-2599. https://doi.org/10.1056/NEJMoa1011205
Herrera-Restrepo, O., Davis, K., Sweeney, C., Davenport, E., Ghaswalla, P., & Buck, P. O. (2022). Hepatitis A and B vaccination in adults at risk: A survey of US healthcare providers' attitudes and practices. Human Vaccines and Immunotherapeutics, 18(6). https://doi.org/10.1080/21645515.2022.2123180
Irvin, M. K., Ellis, M., & Lorenz, T. K. (2025). Caring for the LGBTQIA+ Patient: A Best-Practices Primer on Language, Sexual Function Considerations, and Health Disparities in Gynecologic Care. Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2025.04.013
Irving, G. J., Holden, J., Yang, R., & Pope, D. (2012). Hepatitis A immunization in persons not previously exposed to hepatitis A. Cochrane Database of Systematic Reviews, 2012(7). CD009051.PUB2, https://doi.org/10.1002/14651858
Johnson, W. D., O'Leary, A., & Flores, S. A. (2018). Per-partner condom effectiveness against HIV for men who have sex with men. AIDS, 32(11), 1499-1505. https://doi.org/10.1097/QAD.0000000000001832
Kelley, C. F., Acevedo-Quiñones, M., Agwu, A. L., Avihingsanon, A., Benson, P., Blumenthal, J., Brinson, C., Brites, C., Cahn, P., Cantos, V. D., Clark, J., Clement, M., Creticos, C., Crofoot, G., Diaz, R. S., Doblecki-Lewis, S., Gallardo-Cartagena, J. A., Gaur, A., Grinsztejn, B., … PURPOSE 2 Study Team. (2024). Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons. The New England Journal of Medicine, 392(13). https://doi.org/10.1056/NEJMoa2411858
Liegeon, G., & Ghosn, J. (2023). Long-acting injectable cabotegravir for PrEP: A game-changer in HIV prevention? HIV Medicine, 24(6), 653-663. REQUESTEDJOURNAL: JOURNAL:14681293;WGROUP:STRING:PUBLICATION https://doi.org/10.1111/hiv.13451
Luetkemeyer, A. F., Donnell, D., Dombrowski, J. C., Cohen, S., Grabow, C., Brown, C. E., Malinski, C., Perkins, R., Nasser, M., Lopez, C., Vittinghoff, E., Buchbinder, S. P., Scott, H., Charlebois, E. D., Havlir, D. V., Soge, O. O., & Celum, C. (2023). Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections. New England Journal of Medicine, 388(14), 1296- 1306. https://doi.org/10.1056/NEJMoa2211934
Maldonado, I., Plata, M., Gonzalez, M., Correa, A., Nossa, C., Giuliano, A. R., Joura, E. A., Ferenczy, A., Ronnett, B. M., Stoler, M. H., Jin Zhou, H., Joshi, A., Das, R., Bautista, O., Group, T., Luxembourg, A., Saah, A., & Buchwald, U. K. (2022). Effectiveness, immunogenicity, and safety of the quadrivalent HPV vaccine in women and men aged 27-45 years. Human Vaccines and Immunotherapeutics, 18(5). https://doi.org/10.1080/21645515.2022.2078626
Mayer, K. H., Molina, J. M., Thompson, M. A., Anderson, P. L., Mounzer, K. C., De Wet, J. J., DeJesus, E., Jessen, H., Grant, R. M., Ruane, P. J., Wong, P., Ebrahimi, R., Zhong, L., Mathias, A., Callebaut, C., Collins, S. E., Das, M., McCallister, S., Brainard, D. M., … Hare, C. B. (2020). Emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis (DISCOVER): primary results from a randomised, double-blind, multicentre, active-controlled, phase 3, noninferiority trial. The Lancet, 396(10246), 239-254. https://doi.org/10.1016/S0140-6736(20)31065-5
Molina, J.-M., Capitant, C., Spire, B., Pialoux, G., Cotte, L., Charreau, I., Tremblay, C., Le Gall, J.-M., Cua, E., Pasquet, A., Raffi, F., Pintado, C., Chidiac, C., Chas, J., Charbonneau, P., Delaugerre, C., Suzan-Monti, M., Loze, B., Fonsart, J., … Delfraissy, J.-F. (2015). On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. New England Journal of Medicine, 373(23), 2237-2246. https://doi.org/10.1056/NEJMoa1506273
Nelson, N. P., Weng, M. K., Hofmeister, M. G., Moore, K. L., Doshani, M., Kamili, S., Koneru, A., Haber, P., Hagan, L., Romero, J. R., Schillie, S., & Harris, A. M. (2020). Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recommendations and Reports, 69(5), 1. https://doi.org/10.15585/mmwr.rr6905a1
Papp, J. R., Park, I. U., Fakile, Y., Pereira, L., Pillay, A., & Bolan, G. A. (2024). CDC Laboratory Recommendations for Syphilis Testing, United States, 2024. MMWR. Recommendations and Reports, 73(1), 1-32. https://doi.org/10.15585/mmwr.rr7301a1
Paschen-Wolff, M. M., DeSousa, A., Paine, E. A., Hughes, T. L., & Campbell, A. N. C. (2024). Experiences of and recommendations for LGBTQ+- affirming substance use services: an exploratory qualitative descriptive study with LGBTQ+ people who use opioids and other drugs. Substance Abuse: Treatment, Prevention, and Policy, 19(1). https://doi.org/10.1186/s13011-023-00581-8
Peyriere, H., Makinson, A., Marchandin, H., & Reynes, J. (2018). Doxycycline in the management of sexually transmitted infections. Journal of Antimicrobial Chemotherapy, 73(3), 553-563. https://doi.org/10.1093/jac/dkx420
Pinkerton, S. D., & Abramson, P. R. (1997). Effectiveness of condoms in preventing HIV transmission. Social Science and Medicine, 44(9), 1303-1312. https://doi.org/10.1016/S0277-9536(96)00258-4
Recommended schedule of testing and follow-up for individuals on PrEP- PrEP Guidelines. (n.d.). Retrieved September 4, 2025, from https://prepguidelines.com.au/clinical-follow-up-and-monitoring-of-patientson-prep/
Van der Ende, M. E., Regez, R. M., Schreij, G., Van der Meer, J. T. M., & Danner, S. A. (2002). Post-exposure prophylaxis. International Journal of STD and AIDS, 13(SUPPL. 2), 30-34. https://doi.org/10.1258/095646202762226137
Weller, S. C. (1993). A meta-analysis of condom effectiveness in reducing sexually transmitted HIV. Social Science and Medicine, 36(12), 1635-1644. https://doi.org/10.1016/0277-9536(93)90352-5
Weller, S. C., & Davis-Beaty, K. (2002). Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database of Systematic Reviews, 2012(3). https://doi.org/10.1002/14651858.CD003255
White, J. A., Dukers-Muijrers, N. H. T. M., Hoebe, C. J. P. A., Kenyon, C. R., DC Ross, J., & Unemo, M. (2025). 2025 European guideline on the management of Chlamydia trachomatis infections. International Journal of STD and AIDS, 36(6), 434-449. https://doi.org/10.1177/09564624251323678
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recommendations and Reports, 70(4), 1-187. https://doi.org/10.15585/mmwr.rr7004a1
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2023). Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1-187. https://doi.org/10.15585/mmwr.rr7004a1
World Health Organization. (2021). Consolidated guidelines on HIV prevention, testing, service delivery and monitoring: recommendations for a public health approach. World Health Organization, 592.
Young, T. N., Arens, F. J., Kennedy, G. E., Laurie, J. W., & Rutherford, G. W. (2007). Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure. Cochrane Database of Systematic Reviews, 2007(1). https://doi.org/10.1002/14651858.CD002835.pub3
Zhang, L. (2020). Hepatitis A vaccination. Human Vaccines and Immunotherapeutics, 16(7), 1565-1573. https://doi.org/10.1080/21645515.2020.1769389