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Sexually Transmitted Infections Treatment Guidelines, 2021


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Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources										Related Pages
					By DiseaseBy PopulationChlamydia
**Women**
Sexually active women under 25 years of age1
Sexually active women 25 years of age and older if at increased risk*1
Retest approximately 3 months after treatment2
Rectal chlamydial testing can be considered in females based on reported sexual behaviors and exposure, through shared clinical decision between the patient and the provider2,3,4**Pregnant Women**
All pregnant women under 25 years of age1
Pregnant women 25 years of age and older if at increased risk*1
Retest during the 3rd trimester for women under 25 years of age or at risk2
Pregnant women with chlamydial infection should have a test of cure 4 weeks after treatment and be retested within 3 months2**Men Who Have Sex with Women**
There is insufficient evidence for screening among heterosexual men who are at low risk for infection, however, screening young men can be considered in high prevalence clinical settings (adolescent clinics, correctional facilities, STI/sexual health clinic)1,5**Men Who Have Sex With Men**
At least annually for sexually active MSM at sites of contact (urethra, rectum) regardless of condom use2
Every 3 to 6 months if at increased risk (i.e., MSM on PrEP, with HIV infection, or if they or their sex partners have multiple partners)2**Transgender and Gender Diverse Persons**
Screening recommendations should be adapted based on anatomy, (i.e., annual, routine screening for chlamydia in cisgender women < 25 years old should be extended to all transgender men and gender diverse people with a cervix. If over 25 years old, persons with a cervix should be screened if at increased risk.)2
Consider screening at the rectal site based on reported sexual behaviors and exposure2**Persons with HIV**
For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter2,6
More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology2
Top of Page
Gonorrhea
**Women**
Sexually active women under 25 years of age1
Sexually active women 25 years of age and older if at increased risk*1
Retest 3 months after treatment2
Pharyngeal and rectal gonorrhea screening can be considered in females based on reported sexual behaviors and exposure, through shared clinical decision between the patient and the provider2,3,4**Pregnant Women**
All pregnant women under 25 years of age, and those 25 and older if at increased risk*1
Retest during the 3rd trimester for women under 25 years of age or at risk2
Pregnant women with gonorrhea should be retested within 3 months2**Men Who Have Sex with Women**
There is insufficient evidence for screening among heterosexual men who are at low risk for infection1**Men Who Have Sex With Men**
At least annually for sexually active MSM at sites of contact (urethra, rectum, pharynx) regardless of condom use2
Every 3 to 6 months if at increased risk2**Transgender and Gender Diverse Persons**
Screening recommendations should be adapted based on anatomy (i.e., annual, routine screening for gonorrhea in cisgender women <25 years old should be extended to all transgender men and gender diverse people with a cervix. If over 25 years old, screen if at increased risk.)2
Consider screening at the pharyngeal and rectal site based on reported sexual behaviors and exposure2**Persons with HIV**
For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter2,6
More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology2
Top of Page
Syphilis
**Women**
Screen asymptomatic women at increased risk (history of incarceration or transactional sex work, geography, race/ethnicity) for syphilis infection2,7**Pregnant Women**
All pregnant women at the first prenatal visit8
Retest at 28 weeks gestation and at delivery if at high risk (lives in a community with high syphilis morbidity or is at risk for syphilis acquisition during pregnancy [drug misuse, STIs during pregnancy, multiple partners, a new partner, partner with STIs])2**Men Who Have Sex With Women**
Screen asymptomatic adults at increased risk (history of incarceration or transactional sex work, geography, race/ethnicity, and being a male younger than 29 years) for syphilis infection2,7**Men Who Have Sex With Men**
At least annually for sexually active MSM2
Every 3 to 6 months if at increased risk2
Screen asymptomatic adults at increased risk (history of incarceration or transactional sex work, geography, race/ethnicity, and being a male younger than 29 years) for syphilis infection2,7**Transgender and Gender Diverse People**
Consider screening at least annually based on reported sexual behaviors and exposure2**Persons with HIV**
For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter2,6
More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology2
Top of Page
Herpes**†**
**Women**
Type-specific HSV serologic testing can be considered for women presenting for an STI evaluation (especially for women with multiple sex partners)2**Pregnant Women**
Routine HSV-2 serologic screening among asymptomatic pregnant women is not recommended. However, type-specific serologic tests might be useful for identifying pregnant women at risk for HSV infection and guiding counseling regarding the risk for acquiring genital herpes during pregnancy2**Men Who Have Sex with Women**
Type-specific HSV serologic testing can be considered for men presenting for an STI evaluation (especially for men with multiple sex partners)2**Men Who Have Sex With Men**
Type-specific serologic tests can be considered if infection status is unknown in MSM with previously undiagnosed genital tract infection2**Persons with HIV**
Type-specific HSV serologic testing should be considered for persons presenting for an STI evaluation (especially for those persons with multiple sex partners)2
Top of Page
Trichomonas
**Women**
Consider screening for women receiving care in high-prevalence settings (e.g., STI clinics and correctional facilities) and for asymptomatic women at high risk for infection (e.g., women with multiple sex partners, transactional sex, drug misuse, or a history of STI or incarceration)2**Persons with HIV**
Recommended for sexually active women at entry to care and at least annually thereafter2,6
Top of Page
HIV
**Women**
All women aged 13-64 years (opt-out)‡9,10
All women who seek evaluation and treatment for STIs2,10**Pregnant Women**
All pregnant women should be screened at first prenatal visit (opt-out)9, 10
Retest in the 3rd trimester if at high risk (people who use drugs, have STIs during pregnancy, have multiple sex partners during pregnancy, have a new sex partner during pregnancy, live in areas with high HIV prevalence, or have partners with HIV)11
Rapid testing should be performed at delivery if not previously screened during pregnancy10**Men Who Have Sex with Women**
All men aged 13-64 years (opt-out)‡9
All men who seek evaluation and treatment for STIs2**Men Who Have Sex With Men**
At least annually for sexually active MSM if HIV status is unknown or negative and the patient or their sex partner(s) have had more than one sex partner since most recent HIV test2,10,12
Consider the benefits of offering more frequent HIV screening (e.g., every 3–6 months) to MSM at increased risk for acquiring HIV infection.2**Transgender and Gender Diverse Persons**
HIV screening should be discussed and offered to all transgender persons. Frequency of repeat screenings should be based on level of risk2,12
Top of Page
HPV, Cervical Cancer, Anal Cancer**§**
**Women**
Women 21-29 years of age every 3 years with cytology13,14,15
Women 30-65 years of age every 3 years with cytology, or every 5 years with a combination of cytology and HPV testing13,14,15**Pregnant Women**
Pregnant women should be screened at same intervals as nonpregnant women13,14,15**Men Who Have Sex with Men**
Digital anorectal rectal exam2
Data is insufficient to recommend routine anal cancer screening with anal cytology2**Transgender and Gender Diverse People**
Screening for people with a cervix should follow current screening guidelines for cervical cancer2**Persons with HIV**
Providers should defer to existing *Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV* for guidance on cervical cancer screening and management of results in persons with HIV16
Top of Page
Hepatitis B Screening
**Women**
Women at increased risk (having had more than one sex partner in the previous 6 months, evaluation or treatment for an STI, past or current injection-drug use, and an HBsAg-positive sex partner)17**Pregnant Women**
Test for HBsAg at first prenatal visit of each pregnancy regardless of prior testing; retest at delivery if at high risk18**Men Who Have Sex with Women**
Men at increased risk (i.e., by sexual or percutaneous exposure)17**Men Who Have Sex With Men**
All MSM should be tested for HBsAg, anti-HBc, and anti-HBs17**Persons with HIV**
Test for HBsAg, anti-HBc, and anti-HBs17
Top of Page
Hepatitis C Screening
**Women**
All adults over age 18 years should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%19**Pregnant Women**
Pregnant women should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%19**Men Who Have Sex with Women**
All adults over age 18 years should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%19**Men Who Have Sex With Men**
All adults over age 18 years should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%19**Persons with HIV**
Serologic testing at initial evaluation2,19
Annual HCV testing in MSM with HIV infection2,19
Top of Page
References
*Per USPSTF, women 25 years or older are at increased risk for chlamydial and gonococcal infections if they have a new partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI; practice inconsistent condom use when not in a mutually monogamous relationship; have a previous or coexisting STI; have a history of exchanging sex for money or drugs; or have a history of incarceration.
† Type-specific HSV-2 serologic assays for diagnosing HSV-2 are useful in the following scenarios: recurrent or atypical genital symptoms or lesions with a negative HSV PCR or culture result, clinical diagnosis of genital herpes without laboratory confirmation, and a patient’s partner has genital herpes. HSV-2 serologic screening among the general population is not recommended. Patients who are at higher risk for infection (e.g., those presenting for an STI evaluation, especially for persons with ≥10 lifetime sex partners, and persons with HIV infection) might need to be assessed for a history of genital herpes symptoms, followed by type-specific HSV serologic assays to diagnose genital herpes for those with genital symptoms.
‡ USPSTF recommends screening in adults and adolescents ages 15-65.
§ Data are insufficient to recommend routine anal cancer screening with anal cytology among populations at risk for anal cancer. Certain clinical centers perform anal cytology to screen for anal cancer among populations at high risk (e.g., persons with HIV infection, MSM, and those having receptive anal intercourse), followed by high-resolution anoscopy (HRA) for those with abnormal cytologic results (e.g., ASC-US, LSIL, or HSIL).

U.S. Preventive Services Task Force. Screening for Chlamydia and Gonorrhea: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2021 Sept 14;326(10).949-956.
Workowski KA, Bachmann L, Chan P, Johnston C, Muzny C, Park I, Reno H, Zenilman J, Bolan G. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70(No. RR-04):1-187.
Bamberger, DM, et al. Extragenital Gonorrhea and Chlamydia Among Men and Women According to Type of Sexual Exposure. Sex Transm Dis, 2019. 46(5): p. 329-334.
Chan PA, Robinette A, Montgomery M, et al. Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature. Infect Dis Obstet Gynecol. 2016.
Rietmeijer CA, Hopkins E, Geisler WM, Orr DP, Kent CK. *Chlamydia trachomatis*Positivity Rates Among Men Tested in Selected Venues in the United States: A Review of the Recent Literature. Sex Transm Dis 2008;35(Suppl):S8–18. PMID:18449072 https://doi.org/10.1097/ OLQ.0b013e31816938ba.
Thompson MA, Horberg MA, Agwu AL, et al. Primary Care Guidelines for Persons With HIV: 2020 Update by the HIV Medicine Association of the Infectious Diseases Society of America.  CID. Nov 6 2020.
Kirsten Bibbins-Domingo. USPSTF Recommendation Statement, Screening for Syphilis Infection in Nonpregnant Adults and Adolescents U.S. Preventive Services Task Force Recommendation Statement. JAMA June 7, 2016 Volume 315, Number 21: 2321-2327.
Screening for Syphilis Infection in Pregnant Women U.S. Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA September 4, 2018 Volume 320, Number 9.
Branson BM, et al. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Healthcare Settings. MMWR. 2006;55(No. RR-14):1-17.
Owens DK. U.S. Preventive Services Task Force. Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2019 321(23): 2326-2336.
Committee on Obstetric Practice HIV Expert Work Group. ACOG Committee opinion no. 752: prenatal and perinatal human immunodeficiency virus testing. Obstet Gynecol 2018;132:e138–42. PMID:30134428 https://doi.org/10.1097/AOG.0000000000002825
DiNenno EA, et al. Recommendations for HIV Screening of Gay, Bisexual, and Other Men Who Have Sex with Men – United States, 2017. MMWR Morb Mortal Wkly Rep, 2017. 66(31): p. 830-832.
Committee on Practice Bulletins—Gynecology. Practice bulletin no. 157: Cervical Cancer Screening and Prevention. Obstet Gynecol 2016;127:e1–20. PMID:26695583 https://doi.org/10.1097/ AOG.0000000000001263
Fontham ETH, Wolf AMD, Church TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. CA Cancer J Clin 2020;70:321–46. PMID:32729638 https://doi.org/10.3322/caac.21628
Curry SJ, et al. Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement. JAMA, 2018. 320(7): p. 674-686.
Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infections Diseases Society of America. Available at https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/Adult_OI.pdf.
Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2018;67(No. RR-1). PMID:29939980 https://www.cdc.gov/mmwr/volumes/67/rr/rr6701a1.htm.
Henderson JT, Webber EM, Bean SI. Screening for Hepatitis B Infection in Pregnant Women: Updated Evidence Report and Systematic Review for the U.S. Preventive Services Task Force. JAMA. 2019;322(4):360–362.
Screening for Hepatitis C Virus Infection in Adolescents and Adults U.S. Preventive Services Task Force Recommendation Statement S. Preventive Services Task Force Article Information *JAMA.*2020;323(10):970-975. doi:10.1001/jama.2020.1123.Top of PageWomen
**Chlamydia**
Sexually active women under 25 years of age1
Sexually active women 25 years of age and older if at increased risk*1
Retest approximately 3 months after treatment2
Rectal chlamydial testing can be considered in females based on reported sexual behaviors and exposure, through shared clinical decision between the patient and the provider2,3,4**Gonorrhea**
Sexually active women under 25 years of age1
Sexually active women 25 years of age and older if at increased risk*1
Retest 3 months after treatment2
Pharyngeal and rectal gonorrhea screening can be considered in females based on reported sexual behaviors and exposure, through shared clinical decision between the patient and the provider2,3,4**Syphilis**
Screen asymptomatic adults at increased risk (history of incarceration or transactional sex work, geography, race/ethnicity) for syphilis infection2,5**Herpes†**
Type-specific HSV serologic testing can be considered for women presenting for an STI evaluation (especially for women with multiple sex partners)2**Trichomonas**
Consider screening for women receiving care in high-prevalence settings (e.g., STI clinics and correctional facilities) and for asymptomatic women at high risk for infection (e.g., women with multiple sex partners, transactional sex, drug misuse, or a history of STI or incarceration)2**HIV**
All women aged 13-64 years (opt-out)‡6, 7
All women who seek evaluation and treatment for STIs2, 7**HPV, Cervical Cancer**
Women 21-29 years of age every 3 years with cytology8, 9, 10
Women 30-65 years of age every 3 years with cytology, or every 5 years with a combination of cytology and HPV testing8, 9, 10**Hepatitis B Screening**
Women at increased risk (having had more than one sex partner in the previous 6 months, evaluation or treatment for an STI, past or current injection-drug use, and an HBsAg-positive sex partner)11**Hepatitis C Screening**
All adults over age 18 years should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%12
Top of Page
Pregnant Women
**Chlamydia**
All pregnant women under 25 years of age1
Pregnant women 25 years of age and older if at increased risk*1
Retest during the 3rd trimester for women under 25 years of age or at risk2
Pregnant women with chlamydial infection should have a test of cure 4 weeks after treatment and be retested within 3 months2**Gonorrhea**
All pregnant women under 25 years of age, and those 25 and older if at increased risk*1
Retest during the 3rd trimester for women under 25 years of age or at risk2
Pregnant women with gonorrhea should be retested within 3 months2**Syphilis**
All pregnant women at the first prenatal visit13
Retest at 28 weeks gestation and at delivery if at high risk (lives in a community with high syphilis morbidity or is at risk for syphilis acquisition during pregnancy [drug misuse, STIs during pregnancy, multiple partners, a new partner, partner with STIs])2,5**Herpes†**
Routine HSV-2 serologic screening among asymptomatic pregnant women is not recommended. However, type-specific serologic tests might be useful for identifying pregnant women at risk for HSV infection and guiding counseling regarding the risk for acquiring genital herpes during pregnancy.2**HIV**
All pregnant women should be screened at first prenatal visit (opt-out)6, 7
Retest in the 3rd trimester if at high risk (people who use drugs, have STIs during pregnancy, have multiple sex partners during pregnancy, have a new sex partner during pregnancy, live in areas with high HIV prevalence, or have partners with HIV)14
Rapid testing should be performed at delivery if not previously screened during pregnancy7**HPV, Cervical Cancer**
Pregnant women should be screened at same intervals as nonpregnant women**Hepatitis B Screening**
Test for HBsAg at first prenatal visit of each pregnancy regardless of prior testing; retest at delivery if at high risk15**Hepatitis C Screening**
Pregnant women should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%12
Top of Page
Men Who Have Sex with Women
**Chlamydia**
There is insufficient evidence for screening among heterosexual men who are at low risk for infection, however, screening young men can be considered in high prevalence clinical settings (adolescent clinics, correctional facilities, STI/sexual health clinic)1, 16**Gonorrhea**
There is insufficient evidence for screening among heterosexual men who are at low risk for infection1**Syphilis**
Screen asymptomatic adults at increased risk (history of incarceration or commercial sex work, geography, race/ethnicity, and being a male younger than 29 years) for syphilis infection2,5**Herpes†**
Type-specific HSV serologic testing can be considered for men presenting for an STI evaluation (especially for men with multiple sex partners)2**HIV**
All men aged 13-64 years (opt-out)‡6
All men who seek evaluation and treatment for STIs2**Hepatitis B Screening**
Men at increased risk (i.e., by sexual or percutaneous exposure)11**Hepatitis C Screening**
All adults over age 18 years should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%12
Top of Page
Men Who Have Sex with Men
**Chlamydia**
At least annually for sexually active MSM at sites of contact (urethra, rectum) regardless of condom use2
Every 3 to 6 months if at increased risk (i.e., MSM on PrEP, with HIV infection, or if they or their sex partners have multiple partners)2**Gonorrhea**
At least annually for sexually active MSM at sites of contact (urethra, rectum, pharynx) regardless of condom use2
Every 3 to 6 months if at increased risk2**Syphilis**
At least annually for sexually active MSM2,5
Every 3 to 6 months if at increased risk2,5**Herpes†**
Type-specific serologic tests can be considered if infection status is unknown in MSM with previously undiagnosed genital tract infection2**HIV**
At least annually for sexually active MSM if HIV status is unknown or negative and the patient or their sex partner(s) have had more than one sex partner since most recent HIV test2, 7, 17
Consider the benefits of offering more frequent HIV screening (e.g., every 3–6 months) to MSM at increased risk for acquiring HIV infection.2**HPV, Anal Cancer§**
Digital anorectal rectal exam2
Data is insufficient to recommend routine anal cancer screening with anal cytology2**Hepatitis B Screening**
All MSM should be tested for HBsAg, HBV core antibody, and HBV surface antibody11**Hepatitis C Screening**
All adults over age 18 years should be screened for hepatitis C except in settings where the hepatitis C infection (HCV) positivity is < 0.1%12
Top of Page
Transgender and Gender Diverse Persons
**Chlamydia**
Screening recommendations should be adapted based on anatomy (i.e., annual, routine screening in cisgender women < 25 years old should be extended to all transgender men and gender diverse people with a cervix. If over 25 years old, persons with a cervix should be screened if at increased risk).2
Consider screening at the rectal site based on reported sexual behaviors and exposure2**Gonorrhea**
Screening recommendations should be adapted based on anatomy (i.e., annual, routine screening for gonorrhea in cisgender women < 25 years old should be extended to all transgender men and gender diverse people with a cervix. If over 25 years old, screen if at increased risk).2
Consider screening at the pharyngeal and rectal site based on reported sexual behaviors and exposure2**Syphilis**
Consider screening at least annually based on reported sexual behaviors and exposure2**HIV**
HIV screening should be discussed and offered to all transgender persons. Frequency of repeat screenings should be based on level of risk.2, 17**HPV, Cervical Cancer**
Screening for people with a cervix should follow current screening guidelines for cervical cancer2
Top of Page
Persons with HIV
**Chlamydia**
For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter2, 18
More frequent screening for might be appropriate depending on individual risk behaviors and the local epidemiology2**Gonorrhea**
For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter2, 18
More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology2**Syphilis**
For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter2, 18
More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology2**Herpes†**
Type-specific HSV serologic testing should be considered for persons presenting for an STI evaluation (especially for those persons with multiple sex partners)2**Trichomonas**
Recommended for sexually active women at entry to care and at least annually thereafter2, 18**HPV, Cervical Cancer**
Providers should defer to existing *Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV* for guidance on cervical cancer screening and management of results in persons with HIV19**Anal Cancer§**
Digital anorectal rectal exam2
Data is insufficient to recommend routine anal cancer screening with anal cytology2**Hepatitis B Screening**
Test for HBsAg and anti-HBc and anti-HBs11**Hepatitis C Screening**
Serologic testing at initial evaluation2, 12
Annual HCV testing in MSM with HIV infection2, 12
Top of Page
* Per USPSTF, sexually active women 25 years or older are at increased risk for chlamydial and gonococcal infections if they have a new partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI; practice inconsistent condom use when not in a mutually monogamous relationship; have a previous or coexisting STI; have a history of exchanging sex for money or drugs; or have a history of incarceration.
† Type-specific HSV-2 serologic assays for diagnosing HSV-2 are useful in the following scenarios: recurrent or atypical genital symptoms or lesions with a negative HSV PCR or culture result, clinical diagnosis of genital herpes without laboratory confirmation, and a patient’s partner has genital herpes. HSV-2 serologic screening among the general population is not recommended. Patients who are at higher risk for infection (e.g., those presenting for an STI evaluation, especially for persons with ≥10 lifetime sex partners, and persons with HIV infection) might need to be assessed for a history of genital herpes symptoms, followed by type-specific HSV serologic assays to diagnose genital herpes for those with genital symptoms.
‡ USPSTF recommends screening in adults and adolescents ages 15-65
§ Data are insufficient to recommend routine anal cancer screening with anal cytology among populations at risk for anal cancer. Certain clinical centers perform anal cytology to screen for anal cancer among populations at high risk (e.g., persons with HIV infection, MSM, and those having receptive anal intercourse), followed by high-resolution anoscopy (HRA) for those with abnormal cytologic results (e.g., ASC-US, LSIL, or HSIL)
U.S. Preventive Services Task Force. Screening for Chlamydia and Gonorrhea: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2021 Sept 14;326(10).949-956.
Workowski KA, Bachmann L, Chan P, Johnston C, Muzny C, Park I, Reno H, Zenilman J, Bolan G. Sexually Transmitted Infections, 2021. MMWR Recomm Rep 2021:70(No. RR-04):1-187.
Bamberger, DM, et al. Extragenital Gonorrhea and Chlamydia Among Men and Women According to Type of Sexual Exposure. Sex Transm Dis, 2019. 46(5): p. 329-334.
Chan PA, Robinette A, Montgomery M, et al. Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature. Infect Dis Obstet Gynecol. 2016.
Kirsten Bibbins-Domingo. USPSTF Recommendation Statement, Screening for Syphilis Infection in Nonpregnant Adults and Adolescents U.S. Preventive Services Task Force Recommendation Statement. JAMA June 7, 2016 Volume 315, Number 21: 2321-2327.
Branson BM, et al. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Healthcare Settings. MMWR. 2006;55(No. RR-14):1-17.
Owens DK. U.S. Preventive Services Task Force. Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement. JAMA. 2019 321(23): 2326-2336.
Committee on Practice Bulletins—Gynecology. Practice bulletin no. 157: Cervical Cancer Screening and Prevention. Obstet Gynecol 2016;127:e1–20. PMID:26695583 https://doi.org/10.1097/ AOG.0000000000001263
Fontham ETH, Wolf AMD, Church TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. CA Cancer J Clin 2020;70:321–46. PMID:32729638 https://doi.org/10.3322/caac.21628external icon
Curry SJ, et al. Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement. JAMA, 2018. 320(7): p. 674-686.
Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2018;67(No. RR-1). PMID:29939980 https://www.cdc.gov/mmwr/volumes/67/rr/rr6701a1.htm.
Screening for Hepatitis C Virus Infection in Adolescents and Adults U.S. Preventive Services Task Force Recommendation Statement U.S. Preventive Services Task Force Article Information *JAMA.*2020;323(10):970-975. doi:10.1001/jama.2020.1123.
Screening for Syphilis Infection in Pregnant Women U.S. Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA September 4, 2018 Volume 320, Number 9.
Committee on Obstetric Practice HIV Expert Work Group. ACOG Committee opinion no. 752: Prenatal and Perinatal Human Immunodeficiency Virus Testing. Obstet Gynecol 2018;132:e138–42. PMID:30134428 https://doi.org/10.1097/AOG.0000000000002825
Henderson JT, Webber EM, Bean SI. Screening for Hepatitis B Infection in Pregnant Women: Updated Evidence Report and Systematic Review for the U.S. Preventive Services Task Force. JAMA. 2019;322(4):360–362.
Rietmeijer CA, Hopkins E, Geisler WM, Orr DP, Kent CK. *Chlamydia trachomatis*Positivity Rates Among Men Tested in Selected Venues in the United States: A Review of the Recent Literature. Sex Transm Dis 2008;35(Suppl):S8–18. PMID:18449072 https://doi.org/10.1097/ OLQ.0b013e31816938ba.
DiNenno EA, et al. Recommendations for HIV Screening of Gay, Bisexual, and Other Men Who Have Sex with Men – United States, 2017. MMWR Morb Mortal Wkly Rep, 2017. 66(31): p. 830-832.
Thompson MA, Horberg MA, Agwu AL, et al. Primary Care Guidelines for Persons With HIV: 2020 Update by the HIV Medicine Association of the Infectious Diseases Society of America.  CID. Nov 6 2020.
Panel on Opportunistic Infections in Adults and Adolescents with HIV. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infections Diseases Society of America. Available at https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/Adult_OI.pdfTop of Page
							
					
						Page last reviewed:  June 6, 2022					Content source: 	Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention homeSTI Treatment Guidelines, 2021
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HIV Infection: Detection, Counseling, and Referral
Diseases Characterized by Genital, Anal, or Perianal Ulcersplus icon
Chancroid
Genital Herpes
Granuloma Inguinale (Donovanosis)
Lymphogranuloma Venereum (LGV)
Syphilisplus icon
Primary and Secondary Syphilis
Latent Syphilis
Tertiary Syphilis
Neurosyphilis, Ocular Syphilis, and Otosyphilis
Syphilis Among Persons with HIV Infection
Syphilis During Pregnancy
Congenital Syphilis
Managing Persons Who Have a History of Penicillin Allergy
Diseases Characterized by Urethritis and Cervicitis
Chlamydial Infections
Gonococcal Infectionsplus icon
Gonococcal Infections Among Adolescents and Adults
Gonococcal Infections Among Neonates
Gonococcal Infections Among Infants and Children
*Mycoplasma genitalium*
Vulvovaginal Itching, Burning, Irritation, Odor or Dischargeplus icon
Bacterial Vaginosis
Trichomoniasis
Vulvovaginal Candidiasis
Pelvic Inflammatory Disease (PID)
Epididymitis
Human Papillomavirus (HPV) Infectionplus icon
Anogenital Warts
HPV-Associated Cancers and Precancers
Viral Hepatitisplus icon
HAV
HBV
HCV
Proctitis, Proctocolitis, and Enteritis
Ectoparasitic Infections
Sexual Assault and Abuse and STIsplus icon
Adolescents and Adults
Sexual Assault or Abuse of Children
References
Terms and Abbreviations Used in This Report
Workgroup Members
Timeline of STI Treatment Guidelines STDs Home Page
 Treatment
 Social_round_twitterSTD on Twitter
Social_round_facebookSTD on Facebook


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