THIS CHAPTER is based on practical clinical experience of the author in the management of sexually transmitted diseases since 1969 in the United Kingdom (UK). In the UK, genitourinary medicine (sexually transmitted infections [STI] covers human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS) as well as does sexually transmitted diseases (STDs). It is a separate specialty and requires very considerable postgraduate study in all aspects of sexual health. Although emergencies in the acute internal or medical sense are rare, rapid and astute clinical management of many of the conditions encountered is necessary.

Patients are usually concerned when they think that they might have contracted an STD. Accurate diagnosis is needed so that necessary medication (whether it be antimicrobial, antifungal, or antiviral) may be given. Fast diagnosis is needed to abort infection, wherever possible, and to prevent immediate and long-term consequences to the patient. When an STI has been contracted, it is imperative that an easily understood explanation and education also be given to the patient with the reasons given why contact tracing (partner notification) must be pursued for sexual contacts. Follow-up is necessary not only to make sure that any immediate infection or infections are cured, but also to make sure that adequate care is taken to test for infections such as syphilis and HIV, which may well require testing not only on immediate presentation but also 1 month and 3 months after initial presentation.