Centers for Disease Control and Prevention Sexually Transmitted Disease Treatment Guidelines.

Sexually transmitted diseases (STDs) constitute an epidemic of tremendous magnitude, with an estimated 18.9 million persons acquiring a new STD each year [1]. Reported disease rates underestimate the true burden of infection because the majority of STDs are asymptomatic and therefore go undetected, and also because of underreporting. STDs have far-reaching public health consequences on the sexual and reproductive health of individuals as well as the long-term health and health care costs of the community. The accurate identification and effective clinical management of STDs represents a critical strategy for improving reproductive and sexual health and strengthening human immunodeficiency virus (HIV) prevention efforts. This is especially relevant to women, adolescents, and infants, as untreated infections frequently result in severe, long-term complications, including tubal infertility, adverse pregnancy outcomes, cancer, and facilitation of HIV infection. For more than 20 years, the Centers for Disease Control and Prevention’s (CDC) national guidelines for managing STDs has helped clinicians deliver optimal STD care. The CDC STD treatment guidelines are the most widely referenced and authoritative source of information on STD treatment and prevention strategies for clinicians who evaluate persons with STDs or those at risk for STDs. The 2010 Guidelines for the Treatment of Sexually Transmitted Diseases were developed in consultation with publicand private-sector professionals knowledgeable in the management of STDs [2]. Evidence-based systematic reviews were performed on peer-reviewed journal articles and abstracts that had became available since publication of the 2006 CDC STD treatment guidelines. Evidence tables developed from the systematic reviews summarized the study type, population, and setting; treatment regimens or other interventions; outcome measures; and potential limitations to the reported findings. This report contains 11 background papers that describe the available evidence in several topic areas included in the 2010 CDC STD greatment guidelines. Current advances and controversies described in this supplement include discussion regarding the prevention, evaluation, and management of various sexually transmitted infections (STIs) and syndromes that have important implications for clinical practice. A variety of prevention interventions are available to reduce the risk of acquiring STIs. Effective prevention may involve a combination of approaches including risk reduction counseling, appropriate use of $1 available prevention methods (male latex condoms, diaphragms, topical microbicides, male circumcision), evaluation and treatment of infected persons and their sex partners, and vaccination of persons at risk for vaccine-preventable infections. Vaccination is one of the most effective methods for preventing transmission of some STIs including human papillomavirus (HPV). Vaccination with either a quadrivalent or bivalent HPV vaccine is recommended for females aged 11–12 years to prevent cervical precancer and cancer, with catch-up vaccination for females aged 13–26 years [3, 4]. The quadrivalent vaccine is also recommended for prevention of genital warts [5] and was recently licensed for the prevention of anal cancer in males and females. In addition, HBV vaccination is Correspondence: Kimberly A. Workowski, MD, FACP, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E02, Atlanta, GA 30333 ([email protected]). Clinical Infectious Diseases 2011;53(S3):S59–63 Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2011. 1058-4838/2011/53S3-0001$14.00 DOI: 10.1093/cid/cir694