Current and best practices for testing of sexually transmitted diseases.

NC Med J September/October 2006, Volume 67, Number 5 ffective diagnosis and treatment of infected persons is a critical component of sexually transmitted diseases (STDs) prevention and control. STD diagnostic methods that are sensitive, rapid and inexpensive are ideal for testing of individuals presenting with genitourinary symptoms and screening of asymptomatic individuals in high risk populations. Fortunately, recent advances in STD diagnostics have provided nucleic acid amplification tests (NAATs) with increased sensitivity compared to older tests and rapid “pointof-care” (POC) tests, with quick turn-around time for results. However, despite their ability to improve best practices for STD management, NAATs and POC tests have not been widely adopted into public and privately funded practices. This may in part be due to barriers ranging from the cost and complexity of some of these methods to unfamiliarity with application of these new technologies for the testing and screening of at-risk patients. Although federal resources for the control and prevention of STDs are primarily distributed to state and local health departments, the National Health and Social Life Survey reported that STDs are frequently treated in private practice settings. Therefore, consideration of the ideal STD testing methods to use in the apparently low prevalence populations evaluated in private clinics is as crucial as application of these technologies in high prevalence populations presenting to STD clinics and emergency rooms. New STD Diagnostic Methods