All subject matter experts disclosed potential conflicts of interest. CDC staff informed the subject matter experts that they were being consulted to exchange information and observations and to obtain their individual input. CDC staff identified governmental and nongovernmental subject matter experts on the basis of their expertise and assisted them in developing questions to guide individual literature reviews.
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These guidelines were developed by CDC staff who worked with subject matter experts with expertise in STI clinical management from other federal agencies, nongovernmental academic and research institutions, and professional medical organizations. This guidance specifies operational determinants of quality services in various clinical settings, describes on-site treatment and partner services, and indicates when STI-related conditions should be managed through consultation with or referral to a specialist. These STI treatment guidelines complement Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020 ( 2) regarding quality clinical services for STIs in primary care and STD specialty care settings.
These guidelines are focused on treatment and counseling and do not address other community services and interventions that are essential to STI and HIV prevention efforts. These guidelines are applicable to any patient care setting that serves persons at risk for STIs, including family planning clinics, HIV care clinics, correctional health care settings, private physicians’ offices, Federally Qualified Health Centers, clinics for adolescent care, and other primary care facilities. Health care providers should always consider the clinical circumstances of each person in the context of local disease prevalence. This report updates Sexually Transmitted Diseases Treatment Guidelines, 2015 ( 1) and should be regarded as a source of clinical guidance rather than prescriptive standards. Although the guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are discussed.
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These guidelines are intended to assist with that effort. Physicians and other health care providers have a crucial role in preventing and treating STIs. The term “sexually transmitted infection” (STI) refers to a pathogen that causes infection through sexual contact, whereas the term “sexually transmitted disease” (STD) refers to a recognizable disease state that has developed from an infection. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs.
These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease 3) alternative treatment options for bacterial vaginosis 4) management of Mycoplasma genitalium 5) human papillomavirus vaccine recommendations and counseling messages 6) expanded risk factors for syphilis testing among pregnant women 7) one-time testing for hepatitis C infection 8) evaluation of men who have sex with men after sexual assault and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. The information in this report updates the 2015 guidelines. These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11–14, 2019.
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