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Sexually Transmitted Infections Treatment Guidelines, 2021


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					**Chairperson:** Kimberly A. Workowski, MD,  National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC, and Emory University, Atlanta, Georgia.
**Workgroup Members:** Elizabeth Alderman, MD, The Children’s Hospital at Montefiore, The Pediatric Hospital for Albert Einstein College of Medicine, Bronx, New York; Lindley Barbee, MD,  University of Washington and Public Health Seattle and King County STD Clinic, Seattle,; Luis Barroso, MD, Wake Forest Baptist Health, Winston-Salem, North Carolina; Gale Burstein, MD,  Erie County Department of Health, Buffalo, New York; Virginia A. Caine, MD, Marion County Public Health Department, Indiana University, Indianapolis; Carla Chibwesha, MD,  University of North Carolina at Chapel Hill; Stephanie Cohen, MD,  San Francisco Department of Public Health,  California; Susan Cu-Uvin, MD, Brown University, Providence, Rhode Island; Jodie Dionne-Odom, MD, University of Alabama at Birmingham; Julia Dombrowski, MD,  Public Health – Seattle and King County, University of Washington, Seattle; Carolyn Gardella, MD Veterans Affairs Puget Sound University of Washington, Seattle; William M. Geisler, MD, University of Alabama at Birmingham; Khalil G. Ghanem, MD, PhD, Johns Hopkins University, Baltimore, Maryland; Matthew Golden, MD Seattle and King County STD/HIV Program University of Washington; Margaret R. Hammerschlag, MD, SUNY Downstate Medical Center, Brooklyn, New York; H. Hunter Handsfield, MD, University of Washington Center for AIDS and STD, Seattle; King K. Holmes, MD, PhD, University of Washington, Seattle, Washington; Edward W. Hook III, MD, University of Alabama at Birmingham; Katherine Hsu, MD Ratelle STD/HIV Prevention Training Center, Massachusetts Department of Public Health, Boston; Christine Johnston MD University of Washington, Seattle; Patricia Kissinger, PhD  Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Jeffrey D. Klausner, MD,  University of California Los Angeles ; Lisa E. Manhart, PhD University of Washington, Seattle; Jeanne Marrazzo, MD, University of Alabama at Birmingham; David H. Martin, MD, Tulane University, Louisiana State University Health Sciences Center, New Orleans, Louisiana; Leslie Massad, MD, Washington University, St. Louis, Missouri; Kenneth H. Mayer, MD, Fenway Health, The Fenway Institute, Harvard Medical School, Beth Israel Deaconess Hospital, Boston, Massachusetts; Candice McNeil, MD,  Wake Forest Baptist Health, Alabama/North Carolina HIV/STD Prevention Training Center, Forsyth County Department of Public Health, Winston-Salem, North Carolina; Leandro Mena, MD, University of Mississippi Medical Center, Jackson; Caroline Mitchell, MD,  Vincent Center for Reproductive Biology, Boston, Massachusetts; Okeoma Mmeje, MD,  University of Michigan, Ann Arbor; Anna-Barbara Moscicki, MD, University of California Los Angeles, Los Angeles, California; Christina A. Muzny, MD,  University of Alabama at Birmingham; Natalie Neu, MD,  Columbia University, New York, New York; Paul Nyirjesy, MD, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania; Jeff Peipert, MD, PhD, Indiana University, Indianapolis; Rebecca Perkins, MD, Boston University, Boston; Susan Philip, MD San Francisco Department of Public Health, San Francisco; Asa Radix, MD, PhD Callen-Lorde Community Health Center, New York, New York; Anne Rompalo, MD, Johns Hopkins University, Baltimore, Maryland; Sarah Rudman, MD County of Santa Clara Public Health Department, San Jose, California; Pablo J. Sanchez, MD, The Ohio State University Nationwide Children’s Hospital, Columbus; George Sawaya, MD, University of San Francisco, San Francisco; Arlene Seña, MD, University of North Caroline at Chapel Hill and Durham County Department of Public Health, North Carolina; Jeanne Sheffield, MD, Johns Hopkins University, Baltimore, Maryland; Jack Sobel, MD, Wayne State University, Detroit, Michigan; David Soper, MD, Medical University of South Carolina, Charleston ; Anne Spaulding, MD, MPH, Emory University, Atlanta, Georgia; Bradley Stoner, MD, PhD, Washington University, St. Louis, Missouri; Stephanie Taylor, MD, Louisiana State University Crescent Care Sexual Health Center, New Orleans; Susan Tuddenham, MD Johns Hopkins University School of Medicine, Baltimore, Maryland; Karen Wendel, MD, Denver Public Health,  Colorado; Harold C. Wiesenfeld, MD, University of Pittsburgh, Pennsylvania; Jonathan Zenilman, MD, Johns Hopkins University, Baltimore, Maryland.
**Moderators:**Philip Chan, MD, Brown University, Providence, Rhode Island; Edward W. Hook III, MD, University of Alabama at Birmingham; Christine Johnston, MD University of Washington, Seattle; David H. Martin, MD, Tulane University, Louisiana State University Health Sciences Center, New Orleans, Louisiana; Jeanne Marrazzo, MD University of Alabama at Birmingham; Christina A. Muzny, MD University of Alabama at Birmingham; Ina Park, MD, University of California San Francisco; Hilary Reno, MD, PhD, Washington University, St. Louis, Missouri; Jonathan Zenilman, MD, Johns Hopkins University, Baltimore, Maryland
**Rapporteurs:**Philip Chan, MD, Brown University, Providence, Rhode Island; Hilary Reno, MD, PhD, Washington University, St. Louis, Missouri; Christine Johnston, MD,  University of Washington, Seattle; Christina A. Muzny, MD,  University of Alabama at Birmingham,; Ina Park, MD, ; University of California, San Francisco; Jonathan Zenilman, MD, Johns Hopkins University, Baltimore, Maryland
**Liaison Participants**: Jean Anderson, MD, CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention/ Treatment, Johns Hopkins University, Baltimore, Maryland; Kevin Ault, MD,  American College of Obstetrics and Gynecologists, University of Kansas, Lawrences; Himani Bisht, PhD, U.S. Food and Drug Administration; J. Quentin Clemens, MD American Urological Association, University of Michigan, Ann Arbor; Gina Coleman, MD, Public Health Agency of Canada, Ottawa; Carolyn Deal, PhD, National Institute of Allergy and Infectious Diseases; Maeve B. Mello, PhD, Pan American Health Organization/World Health Organization Washington, D.C.; Diane Foley, MD, U.S. Department of Health and Human Services, Washington D.C.; Michael Ganio, PharmD, MS, American Society of Health-System Pharmacists, Bethesda, Maryland; Eric Garges, MD, MPH,  U.S. Department of Defense, Arlington, Virginia, Uniformed Services University, Bethesda, Maryland; Brent Gibson, MD, , National Commission on Correctional Health Care, Chicago, Illinois; William A. Glover II, PhD, Association of Public Health Laboratories, Silver Spring, Maryland; W. David Hardy, MD, HIV Medical Association, Johns Hopkins University, Baltimore, Maryland; David Harvey, National Coalition of STD Directors, Washington, D.C.; Letha Healey, MD, Health Resources and Services Administration (HIV/AIDS Bureau), Rockville, Maryland; Michael Huey, MD, American College Health Association, Silver Spring, Maryland, Emory University, Atlanta, Georgia; Gal Mayer, MD, GLMA: Health Professionals Advancing LGBTQ Equality, Washington, D.C.; Sumathi Nambiar, MD, , U.S. Food and Drug Administration, Silver Spring, Maryland; Seema Nayak, MD, National Institutes of Health, Rockville, Maryland; Lori Newman, MD, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland; Samantha Ritter, MPH, National Association of County and City Health Officials, Washington, D.C.; Elizabeth Ruebush, Association of State and Territorial Health Officials, Arlington, Virginia; Bisan Salhi, MD, PhD, American College of Emergency Physicians, Irving, Texas, Emory University, Atlanta, Georgia; Natasha Travis, MD, National Medical Association, Silver Spring, Maryland, Johns Hopkins University, Baltimore, Maryland; Maria Trent, MD, MPH, Society for Adolescent Health and Medicine, Chicago, Illinois, Johns Hopkins University, Baltimore, Maryland; Julie Vaishampayan, MD, , Infectious Disease Society of America, Arlington, Virginia; Barbara Van Der Pol, PhD, , American Sexually Transmitted Diseases Association, Research Triangle Park, North Carolina, University of Alabama at Birmingham, ,; Teodora Elvira Wi, MD, Department of Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
**CDC Consultants:** Sevgi O. Aral, PhD; Laura H. Bachmann, MD; Kyle Bernstein, PhD; Gail Bolan, MD; John Brooks, MD; Philip Chan, MD, Brown University, Providence, Rhode Island; Aaron Harris, MD, MPH; Matthew Hogben, PhD; Sarah Kidd, MD; Kristen Kreisel, PhD; Lauri Markowitz, MD; Ina Park, MD University of California San Francisco; Laura Quilter, MD; Hilary Reno, MD, PhD, Washington University, St. Louis, Missouri; Sancta St. Cyr MD; Mona Saraiya, MD; Julie Schillinger, MD; Virginia Senkomago, PhD; Philip Spradling, MD; Phoebe Thorpe, MD; Mark Weng, MD
**CDC, Division of Sexually Transmitted Disease Prevention Treatment Guidelines 2021 Project Coordinator:**Kimberly A. Workowski, MD National Center for HIV, Viral Hepatitis, STD, and TB Prevention. CDC, and Emory University, Atlanta, Georgia.
**CDC Support Staff:**Alexandra Coor, MPH; Quinn Haaga; Amber Herald; Patricia Jackson; Brenda Kelly
**Conflicts of Interest:**All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Christina Muzny reports other support from CDC, during the conduct of the study; grants from the National Institutes of Health/National Institute of Allergy and Infectious Diseases and Lupin Pharmaceuticals; personal fees from Lupin Pharmaceuticals, PhagoMed, Cepheid, and Beckton Dickinson; and personal fees and other support from Roche Diagnostics, Abbott Molecular, and BioFire Diagnostics, outside the submitted work. Hilary Reno reports grants from Hologic, outside the submitted work. Christine Johnston reports other support from CDC, during the conduct of the study; received research funding from SanofiPasteur; royalties from UpToDate; and personal fees from MedPace, Gilead, AbbVie, and UpToDate, outside the submitted work.
							
					
						Page last reviewed:  July 22, 2021					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
Provider Resourcesplus icon
Customizable Announcement
Screening Recommendations
Tables of Evidence
Table of Contents
Summary and Introduction
Methods
Clinical Prevention Guidanceplus icon
STI and HIV Infection Risk Assessment
Primary Prevention Methods
Partner Servicesplus icon
Expedited Partner Therapy (EPT)
Reporting and Confidentiality
Retesting After Treatment to Detect Repeat Infections
Detection of STIs in Special Populationsplus icon
Pregnant Women
Adolescents
Children
MSM
WSW and WSWM
Transgender and Gender Diverse Persons
Persons in Correctional Facilities
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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