{ "schemaVersion": 2, "eyebrow": "Infectious Diseases", "title": "Sexually Transmitted Infections", "summary": "Use exposure-site testing, syndrome-directed empiric treatment when indicated, pregnancy-specific screening, partner management, and targeted prevention to interrupt transmission while preventing pelvic inflammatory disease, adverse pregnancy outcomes, and neonatal infection.", "seoDescription": "Point-of-care approach to STI testing, syndrome evaluation, treatment principles, pregnancy screening, partner management, and doxycycline PEP.", "clinicalQuestion": "How should clinicians test, triage, treat, and prevent common sexually transmitted infections across exposure sites and risk groups?", "specialty": "Infectious Diseases", "audience": "U.S. physicians and medical trainees", "tags": [ "STI testing", "chlamydia", "gonorrhea", "syphilis", "HIV testing", "pregnancy screening", "doxycycline PEP", "partner services" ], "keyTakeaways": [ "Obtain nucleic acid amplification testing from every anatomic site of sexual exposure; molecular assays have reported sensitivity and specificity of approximately 95% to 99%. [9]", "Treat symptomatic urethritis, cervicitis, proctitis, pharyngitis, vaginitis, or genital ulcer disease according to the syndrome and likely pathogens while confirming organism-specific diagnoses when laboratory testing is available. [11][24]", "Screen and retest pregnant patients according to age and risk; untreated gonorrhea, chlamydia, and syphilis can cause serious maternal, fetal, and neonatal outcomes. [15][18]", "Offer doxycycline postexposure prophylaxis through shared decision-making to gay, bisexual, and other men who have sex with men and transgender women with a bacterial STI diagnosed within the prior 12 months; use 200 mg within 72 hours after sex and reassess every 3 to 6 months. [4][12]", "At any symptomatic STI encounter, test for HIV and other locally prevalent STIs, address sex partners, and use vaccination and barrier prevention as indicated. [17][24]" ], "sections": [ { "id": "triage-and-initial-workup", "eyebrow": "First encounter", "heading": "Triage urgent syndromes and test the exposed sites", "intro": "Use symptoms and anatomy to select immediate testing and empiric coverage.", "paragraphs": [ "Prioritize same-day evaluation for pelvic or lower-abdominal pain with concern for pelvic inflammatory disease, pregnancy with suspected or confirmed STI, acute proctitis, genital ulceration, ocular symptoms after sexual exposure, sexual assault, and possible disseminated infection. Untreated STIs in women are associated with pelvic inflammatory disease, infertility, chronic pelvic pain, ectopic pregnancy, pregnancy loss, stillbirth, and neonatal transmission. [15][17]", "Take a site-specific sexual exposure history rather than inferring exposure from identity: urethral/penile, vaginal/cervical, rectal, pharyngeal, ocular, and skin-to-skin exposure. Obtain NAAT specimens from each exposed mucosal site for gonorrhea and chlamydia when testing is indicated; NAATs are the diagnostic standard and have reported sensitivity and specificity of 95% to 99%. Extragenital infection is frequently asymptomatic, so urine-only testing can miss rectal or pharyngeal infection. [9][11]", "For symptomatic patients, add HIV testing and testing for other prevalent STIs at the same encounter. In patients with urethritis, cervicitis, proctitis, pharyngitis, vaginitis, or genital lesions, interpret a positive organism-specific test in an anatomic and syndromic context because concurrent infection with more than one pathogen is common. [11][17]" ], "bullets": [ "Urethritis: test for gonorrhea and chlamydia; consider other sexually transmitted causes when symptoms persist despite initial management. [11][15]", "Cervicitis or vaginal symptoms: distinguish cervicitis from vaginitis and test for gonorrhea and chlamydia; include trichomoniasis and other causes when indicated by the clinical syndrome. [11][15]", "Proctitis: obtain rectal gonorrhea and chlamydia testing and assess for syphilis, herpes simplex virus, and lymphogranuloma venereum when the clinical pattern suggests these diagnoses. [11]", "Pharyngitis after oral exposure: obtain pharyngeal gonorrhea and chlamydia testing when exposure history supports testing; many extragenital infections are asymptomatic. [11]", "Genital ulcer disease: evaluate for syphilis and herpes simplex virus rather than assigning a diagnosis by lesion morphology alone. [15]" ], "subsections": [], "table": { "caption": "Exposure-directed diagnostic framework for common sexually transmitted syndromes. [9][11][15]", "columns": [ "Clinical pattern", "Immediate tests", "Interpretation and next action" ], "rows": [ [ "Urethral discharge or dysuria", "Urethral or urine gonorrhea/chlamydia NAAT; HIV and other prevalent STI testing. [11][17]", "Manage as urethritis while test results identify gonorrhea, chlamydia, or another cause. [11]" ], [ "Cervical inflammation, postcoital bleeding, or mucopurulent discharge", "Vaginal/cervical gonorrhea/chlamydia NAAT; assess for trichomoniasis and other causes based on syndrome. [11][15]", "Do not rely on discharge alone to exclude infection; chlamydial and gonococcal infections are commonly asymptomatic. [21]" ], [ "Rectal pain, discharge, or tenesmus", "Rectal gonorrhea/chlamydia NAAT; assess for syphilis, herpes simplex virus, and lymphogranuloma venereum. [11]", "Use results and severity to direct therapy; evaluate promptly when severe symptoms or systemic illness are present. [11]" ], [ "Pharyngeal exposure or symptoms", "Pharyngeal gonorrhea/chlamydia NAAT when indicated by exposure. [11]", "A negative urine test does not exclude pharyngeal infection. [11]" ], [ "Genital ulcer", "Syphilis and herpes simplex virus evaluation; HIV testing. [15][17]", "Treat based on confirmed or strongly suspected cause and arrange follow-up for serologic and lesion-response assessment. [15]" ] ] } }, { "id": "syndrome-directed-management", "eyebrow": "Cause-directed care", "heading": "Match treatment to the organism and syndrome", "intro": "Avoid a single empiric regimen for all mucosal complaints.", "paragraphs": [ "Gonorrhea, chlamydia, syphilis, trichomoniasis, Mycoplasma genitalium, herpes simplex virus, lymphogranuloma venereum, and noninfectious conditions can produce overlapping urethral, cervical, rectal, pharyngeal, and genital symptoms. When quality-assured molecular testing is available, use laboratory-supported diagnosis to select current evidence-based treatment rather than relying on syndromic management alone. [11][24]", "Use the current CDC STI treatment guideline or its current updates to select organism-specific regimen, dose, route, and follow-up because resistance patterns and recommendations change. This is particularly important for gonorrhea, where antimicrobial susceptibility is a continuing clinical and public-health concern, and for persistent Mycoplasma genitalium infection. [1][2][15][18]", "For patients with genital herpes, routine serologic screening is not recommended, including during pregnancy. Evaluate clinically apparent lesions and use the CDC STI treatment guidance for antiviral treatment and counseling. [15]", "Persistent or recurrent symptoms after treatment should trigger reassessment of adherence, re-exposure from an untreated partner, infection at an untested anatomic site, coinfection, and an alternative infectious or noninfectious diagnosis. Do not assume microbiologic failure solely from ongoing symptoms. [11][15]" ], "bullets": [ "Use organism-directed treatment after NAAT or serologic confirmation whenever the patient is clinically stable and follow-up is reliable. [24]", "Use empiric syndromic treatment when clinical severity, likelihood of loss to follow-up, or a high-probability syndrome makes delayed treatment unsafe; obtain diagnostic specimens before treatment whenever feasible. [11][20]", "At treatment visits, identify and manage sex partners to reduce reinfection and onward transmission. Partner counseling and treatment are core components of STI case management. [16][21]", "Document all exposed sites and ensure testing and treatment have addressed those sites; asymptomatic extragenital infection is common. [11]" ], "subsections": [ { "heading": "Sexual assault", "paragraphs": [ "After sexual assault, use a trauma-informed examination and minimize retraumatization while obtaining indicated baseline testing. Because follow-up adherence is often low, CDC-based guidance recommends presumptive antimicrobial treatment for chlamydia, gonorrhea, and trichomoniasis, plus emergency contraception, hepatitis B and HPV vaccination assessment, and HIV exposure evaluation. [20]" ], "bullets": [ "Offer HIV postexposure evaluation promptly when the exposure could confer HIV risk. [20]", "Address hepatitis B and HPV immunization status at the initial visit rather than deferring prevention to follow-up. [20]" ] } ], "table": { "caption": "Clinical branches that should change diagnostic and management actions. [11][15][20]", "columns": [ "Branch", "What changes the plan", "Action" ], "rows": [ [ "Symptomatic mucosal syndrome", "Site-specific inflammation or discharge with relevant exposure. [11]", "Collect site-specific NAATs and treat empirically only when syndrome severity or follow-up limitations justify it. [11][20]" ], [ "Genital ulcer syndrome", "Ulcerative lesion rather than isolated discharge syndrome. [15]", "Test for syphilis and herpes simplex virus and include HIV testing. [15][17]" ], [ "Persistent symptoms", "Symptoms after treatment or after renewed sexual exposure. [11][15]", "Check reinfection, untreated partners, untested sites, coinfection, adherence, and alternative diagnoses before changing therapy. [11][15]" ], [ "Sexual assault", "High probability of missed follow-up. [20]", "Provide indicated presumptive antimicrobial prophylaxis, emergency contraception, immunization assessment, and HIV evaluation at the initial encounter. [20]" ] ] } }, { "id": "screening-and-pregnancy", "eyebrow": "Asymptomatic infection", "heading": "Screen by pregnancy status, age, risk, and exposure anatomy", "intro": "Screening finds infection that symptom-based care routinely misses.", "paragraphs": [ "Routine laboratory screening is indicated for sexually active adolescents, and screening strategies should account for age, pregnancy, sexual practices, community prevalence, and disease-specific sequelae. An opt-out approach can reduce dependence on sexual-history disclosure and may improve case detection among adolescents and young adults. [18][16]", "During pregnancy, screen at the first prenatal visit according to CDC recommendations. For gonorrhea, screen pregnant patients at risk, including those younger than 25 years and those 25 years or older with a new sex partner, multiple partners, a partner with concurrent partners, a partner with an STI, or residence in a community with high gonorrhea rates. Treat identified infection during pregnancy and retest in 3 months, in the third trimester, or at delivery as indicated. [18]", "Do not use routine serologic screening for genital herpes in pregnancy. CDC-based pregnancy screening guidance does not recommend routine testing for bacterial vaginosis, herpes, HPV, or trichomoniasis in pregnancy. [15][17]", "For persons with ongoing exposure risk, align repeat STI screening with the risk pattern and anatomic exposure sites. In people using doxycycline postexposure prophylaxis, perform syphilis and gonorrhea/chlamydia screening at all sites of exposure every 3 to 6 months. [12]" ], "bullets": [ "At prenatal intake, identify age-based and behavioral risk factors that require gonorrhea screening. [18]", "When infection is diagnosed in pregnancy, ensure partner testing and treatment to reduce reinfection before delivery. [18]", "Use opt-out screening as a workflow strategy where sexual-history-based testing leaves a substantial testing gap. [16]" ], "subsections": [], "table": { "caption": "Pregnancy-focused STI screening and follow-up decisions. [15][17][18]", "columns": [ "Situation", "Action", "Follow-up" ], "rows": [ [ "Pregnant patient younger than 25 years", "Screen for gonorrhea at the first prenatal visit. [18]", "Treat infection during pregnancy; retest in 3 months, in the third trimester, or at delivery as indicated. [18]" ], [ "Pregnant patient 25 years or older with gonorrhea risk factors", "Screen for gonorrhea at the first prenatal visit. [18]", "Treat infection and test/treat sex partners; repeat testing as indicated. [18]" ], [ "Pregnant patient without symptoms requesting herpes screening", "Do not perform routine genital herpes serologic screening. [15]", "Evaluate and manage clinically suspected herpes according to current STI guidance. [15]" ], [ "Pregnant patient without symptoms requesting routine BV, HPV, or trichomonas testing", "Routine testing is not recommended. [17]", "Test when symptoms or another clinical indication is present. [17]" ] ] } }, { "id": "prevention-and-partner-services", "eyebrow": "Transmission prevention", "heading": "Build prevention around barriers, vaccination, HIV prevention, and partner treatment", "intro": "Pair each STI diagnosis with a prevention and reinfection plan.", "paragraphs": [ "Recommend condoms for vaginal, oral, and anal sex; consistent correct use provides effective protection against STIs, including HIV, but does not fully protect against infections transmitted from uncovered ulcerated skin, including syphilis and genital herpes. [24]", "Review hepatitis B and HPV immunization status. Safe and effective vaccines are available for hepatitis B and HPV, and vaccination should be incorporated into STI prevention visits rather than reserved for primary care follow-up. [24]", "Use each bacterial STI diagnosis as a prompt to assess HIV testing needs and HIV prevention, including preexposure prophylaxis when risk warrants. All patients presenting with STI symptoms should be screened for HIV and other prevalent STIs. [17]", "Address sex partners at the same visit: identify recent partners, facilitate notification, arrange testing and treatment, and counsel patients that untreated partners are a major driver of reinfection. Partner notification and partner treatment are established elements of STI case management. [16][21]" ], "bullets": [ "Document a prevention plan that includes barrier use, vaccine status, HIV testing or prevention assessment, and partner management. [17][24]", "For recurrent bacterial STIs, reassess exposure sites and prevention tools rather than limiting the response to repeat antimicrobial treatment. [12][16]", "Use nonjudgmental, inclusive sexual-history questions to identify exposures that determine site-specific testing and prevention needs. [11][16]" ], "subsections": [], "table": { "caption": "Prevention interventions selected by clinical scenario. [12][17][24]", "columns": [ "Scenario", "Intervention", "Key limitation or monitoring step" ], "rows": [ [ "Any patient at risk for STI acquisition", "Recommend condoms for vaginal, oral, and anal sex. [24]", "Condoms do not fully prevent syphilis or genital herpes when lesions occur outside the covered area. [24]" ], [ "Eligible or incompletely immunized patient", "Assess and provide hepatitis B and HPV vaccination as indicated. [20][24]", "Address vaccination during the STI encounter to avoid missed prevention opportunities. [20]" ], [ "Symptomatic STI presentation", "Test for HIV and other prevalent STIs. [17]", "Link HIV prevention needs to the exposure pattern and test results. [17]" ], [ "Confirmed bacterial STI", "Initiate partner notification, testing, and treatment processes. [16][21]", "Partner management reduces reinfection risk and should not be deferred. [16]" ] ] } }, { "id": "doxycycline-pep", "eyebrow": "Selected bacterial STI prevention", "heading": "Use doxycycline PEP selectively and monitor for benefit and resistance concerns", "intro": "Doxycycline PEP is an exposure-linked intervention, not universal prophylaxis.", "paragraphs": [ "CDC guidance released in 2024 recommends counseling gay, bisexual, and other men who have sex with men and transgender women with a bacterial STI diagnosed during the past 12 months about doxycycline postexposure prophylaxis and offering it through shared decision-making. The regimen evaluated in trials is doxycycline 200 mg orally within 72 hours after sex. [4]", "Doxycycline PEP has reduced chlamydia and syphilis incidence in trials among persons assigned male sex at birth who were living with HIV or using HIV PrEP; gonorrhea benefit has been less consistent, plausibly reflecting tetracycline resistance in Neisseria gonorrhoeae. [4][5]", "At initiation and every 3 to 6 months, reassess ongoing use, perform syphilis serology and gonorrhea/chlamydia testing at every exposed anatomic site, and test for HIV in persons without HIV according to current recommendations. Prescribe the number of doses through individualized shared decision-making. [12]", "Discuss antimicrobial-resistance uncertainty explicitly. Wider doxycycline PEP use may increase resistance selection, including concern about co-transmission of gonococcal cephalosporin resistance with tetracycline resistance; this risk must be balanced against prevention of syphilis and chlamydia. [3]" ], "bullets": [ "Eligibility emphasized by CDC: gay, bisexual, and other men who have sex with men and transgender women with a bacterial STI in the preceding 12 months. [4]", "Dose: doxycycline 200 mg orally as soon as possible and within 72 hours after sex. [4][5]", "Monitoring: reassess continuation and complete multisite STI screening every 3 to 6 months. [12]", "Do not present doxycycline PEP as a substitute for condoms, HIV prevention assessment, vaccination, or partner management. [12][17][24]" ], "subsections": [], "table": { "caption": "Doxycycline PEP implementation framework. [3][4][12]", "columns": [ "Decision point", "Operational action", "Follow-up" ], "rows": [ [ "Candidate selection", "Counsel gay, bisexual, and other MSM and transgender women with a bacterial STI in the last 12 months; offer through shared decision-making. [4]", "Reassess whether benefit continues to justify use every 3 to 6 months. [12]" ], [ "Dose instruction", "Doxycycline 200 mg orally within 72 hours after sex. [4][5]", "Prescribe doses based on individualized patient-provider assessment. [12]" ], [ "Laboratory surveillance", "Screen for syphilis and gonorrhea/chlamydia at all sites of exposure. [12]", "Repeat every 3 to 6 months; perform HIV testing in persons without HIV according to current guidance. [12]" ], [ "Resistance discussion", "Explain that gonorrhea prevention is less consistent and resistance selection is a concern. [3][5]", "Revisit risks, benefits, incident STIs, and continued preference at follow-up. [3][12]" ] ] } } ], "faq": [], "references": [ { "number": 1, "title": "Diagnosis and Treatment of Sexually Transmitted Infections", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jama/fullarticle/2787903", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 2, "title": "Sexually Transmitted Infections", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/collections/5904/sexually-transmitted-infections", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 3, "title": "Doxycycline Postexposure Prophylaxis Could Accelerate the Emergence of Gonococcal Ceftriaxone Resistance—Reply", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2835081", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 4, "title": "Doxycycline Postexposure Prophylaxis and Bacterial Sexually Transmitted Infections Among Individuals Using HIV", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2828994", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 5, "title": "Does Meningococcal Group B Vaccination in the Setting of DoxyPEP Reduce Incidence of Gonorrhea? | NEJM Clinician", "detail": "clinician.nejm.org", "url": "https://clinician.nejm.org/does-meningococcal-group-b-vaccination-setting-doxypep-reduce-incidence-gonorrhea-nejm-jw.NA57639", "authors": "clinician.nejm.org", "host": "clinician.nejm.org" }, { "number": 6, "title": "Sexually Transmitted Infection Treatment Guidelines for Adolescent Health Providers: What's New in 2021?", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1083318822000213", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 7, "title": "A Scoping Review of Approaches to Extragenital ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S1751485125001515", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 8, "title": "Addressing HIV/Sexually Transmitted Diseases and Pregnancy Prevention Through Schools: An Approach for Strengthening Education, Health Services, and School Environments That Promote Adolescent Sexual Health and Well-Being", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S1054139X21002779", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 9, "title": "Diagnosing sexually transmitted infections in resource", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/pdf/10.1002/jia2.25343", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 10, "title": "Sexually Transmitted Infection Prevalence and ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/ijd.70344?af=", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 11, "title": "Sexually transmitted causes of urethritis, proctitis, pharyngitis, vaginitis and cervicitis - 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Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Diagnosis and Treatment of Sexually Transmitted Infections", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jama/fullarticle/2787903", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "by S Tuddenham · 2022 · Cited by 400 — This review summarizes current evidence regarding the epidemiology, diagnosis, treatment, and prevention of gonorrhea, chlamydia, syphilis,", "score": 0.45464227 }, { "number": 2, "title": "Sexually Transmitted Infections", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/collections/5904/sexually-transmitted-infections", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "Explore the latest in STIs, including advances in the epidemiology, susceptibility patterns, and treatment of syphilis, gonorrhea, and chlamydia.", "score": 0.32456765 }, { "number": 3, "title": "Doxycycline Postexposure Prophylaxis Could Accelerate the Emergence of Gonococcal Ceftriaxone Resistance—Reply", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2835081", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "Title: Doxycycline Postexposure Prophylaxis Could Accelerate the Emergence of Gonococcal Ceftriaxone Resistance—Reply\n# Doxycycline Postexposure Prophylaxis Could Accelerate the Emergence of Gonococcal Ceftriaxone Resistance—Reply | JAMA Internal Medicine | JAMA Network. Image 2: JAMA Internal Medic", "score": 0.60077465 }, { "number": 4, "title": "Doxycycline Postexposure Prophylaxis and Bacterial Sexually Transmitted Infections Among Individuals Using HIV", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2828994", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "Title: Doxycycline Postexposure Prophylaxis and Bacterial Sexually Transmitted Infections Among Individuals Using HIV\nTrends in Quarterly Sexually Transmitted Infection Positivity From January 1, 2021, to December 31, 2023, Among HIV Preexposure Prophylaxis (PrEP) Users Dispensed and Not Dispensed D", "score": 0.45842203 }, { "number": 5, "title": "Does Meningococcal Group B Vaccination in the Setting of DoxyPEP Reduce Incidence of Gonorrhea? | NEJM Clinician", "detail": "clinician.nejm.org", "url": "https://clinician.nejm.org/does-meningococcal-group-b-vaccination-setting-doxypep-reduce-incidence-gonorrhea-nejm-jw.NA57639", "authors": "clinician.nejm.org", "host": "clinician.nejm.org", "snippet": "###### Topics\n\nDoxycycline postexposure prophylaxis (DoxyPEP) reduces incidence of chlamydia and syphilis among men who have sex with men (MSM) but has shown lower efficacy against gonorrhea (probably due to tetracycline resistance in Neisseria gonorrhoeae). Meningococcal group B (4CMenB) vaccinatio", "score": 0.24326065 }, { "number": 6, "title": "Sexually Transmitted Infection Treatment Guidelines for Adolescent Health Providers: What's New in 2021?", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1083318822000213", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "In July 2021, the Centers for Disease Control and Prevention (CDC) released the long-anticipated _Sexually Transmitted Infections Treatment Guidelines, 2021_, replacing the 2015 guidelines.2 The guidelines can be downloaded free of charge from www.cdc.gov/std/treatment, with wall charts and pocket g", "score": 0.7493996 }, { "number": 7, "title": "A Scoping Review of Approaches to Extragenital ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S1751485125001515", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "The 2021 treatment guidelines from the Centers for Disease Control and Prevention emphasize more invasive screening for sexually transmitted infections at", "score": 0.58721006 }, { "number": 8, "title": "Addressing HIV/Sexually Transmitted Diseases and Pregnancy Prevention Through Schools: An Approach for Strengthening Education, Health Services, and School Environments That Promote Adolescent Sexual Health and Well-Being", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S1054139X21002779", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "2024, Annals of Epidemiology Citation Excerpt : [...] ### Associations between young people’s internet pornography use and psychosexual well-being: a systematic review [...] 2025, Sexual Health \n ### Prevalence of late HIV diagnosis and its impact on mortality: A comprehensive systematic revie", "score": 0.3634441 }, { "number": 9, "title": "Diagnosing sexually transmitted infections in resource", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/pdf/10.1002/jia2.25343", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "by TEC Wi · 2019 · Cited by 233 — Nucleic acid amplification tests (NAATs) are the gold standard for the diagnosis of STIs most have a sensitivity and specificity ranging from 95% to 99% [6].", "score": 0.49523994 }, { "number": 10, "title": "Sexually Transmitted Infection Prevalence and ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/ijd.70344?af=", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Despite high overall knowledge (85.3%), STI prevalence was substantial: active syphilis 17.7%, HIV 11.5%, and Chlamydia trachomatis 8.6%, while", "score": 0.2030118 }, { "number": 11, "title": "Sexually transmitted causes of urethritis, proctitis, pharyngitis, vaginitis and cervicitis - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1357303922000457#!", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: Sexually transmitted causes of urethritis, proctitis, pharyngitis, vaginitis and cervicitis - ScienceDirect\n# Management of infective and non-infective genital conditions Sexually transmitted causes of urethritis, proctitis, pharyngitis, vaginitis and cervicitis. https://doi.org/10.1016/j.mpm", "score": 0.6191726 }, { "number": 12, "title": "Utilization of Doxycycline Postexposure Prophylaxis at a Midwestern United States HIV/PrEP Clinic | Open Forum Infectious Diseases | Oxford Academic", "detail": "academic.oup.com", "url": "https://academic.oup.com/ofid/article/12/2/ofaf062/7990430", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "Doxycycline postexposure prophylaxis (doxy PEP) has been demonstrated to decrease the incidence of sexually transmitted infections (STIs) caused by *Neisseria gonorrhoeae* (GC), *Chlamydia trachomatis* (CT), and *Treponema pallidum* (syphilis), prompting the Centers for Disease Control and Preventio", "score": 0.43223172 }, { "number": 13, "title": "January 2026 - Volume 53 - Issue 1 : Sexually Transmitted Diseases", "detail": "journals.lww.com", "url": "https://journals.lww.com/stdjournal/toc/2026/01000", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Image\n\n### January 2026 - Volume 53 - Issue 1\n\n### Intimate Partner Violence Victimization and Sexually Transmitted Infections Among Sexual Minority Men: A Rapid Systematic Review and Meta-Analysis\n\n### Preexposure Prophylaxis Use Among Men Who Have Sex With Men With a History of Rectal Gonorrhea, R", "score": 0.36772484 }, { "number": 14, "title": "Filling in the Gaps: Updates on Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections | Clinical Infectious Diseases | Oxford Academic", "detail": "academic.oup.com", "url": "https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciae062/7601780", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "Abbreviations: aHR, adjusted hazard ratio; ANRS IPERGAY, France Recherche Nord & sud Sida-hiv hépatites Intervention Préventive de l’Exposition auxRisques avec et pour les Gays; CI, confidence interval; CT, *Chlamydia trachomatis*; DaDHS, DailyDoxycycline in HIV+ for Syphilis PrEP Study; DoxyPEP, Do", "score": 0.35878035 }, { "number": 15, "title": "Clinical Updates in Sexually Transmitted Infections, 2024", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11270754", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "## continue to increase in the United States with more than 2.5 million cases of gonorrhea, chlamydia, and syphilis reported to the Centers for Disease Control and Prevention in 2022. Untreated STIs in women can lead to adverse outcomes, including pelvic inflammatory disease, infertility, chronic p", "score": 0.78413767 }, { "number": 16, "title": "Updates on Testing, Treatment, and Prevention of Sexually Transmitted Infections in the United States, 2025", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12755409", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Consideration of opt-out screening, particularly for adolescent and young adult females, was introduced in the 2021 CDC guidelines. Opt-out STI screening involves clinicians notifying patients that testing will be performed unless the patient declines. This is more effective in identifying infection", "score": 0.67988104 }, { "number": 17, "title": "Sexually Transmitted Infections - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK560808", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "## Treatment / Management\n\nThe Centers for Disease Control and Prevention published an update to their Sexually Transmitted Diseases Treatment Guidelines in 2021. There are sections in this treatment guideline that direct specific care for select populations such as pregnant women, adolescents, pers", "score": 0.65966886 }, { "number": 18, "title": "Sexually Transmitted Infections Treatment Guidelines, 2021", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8344968", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "and comments on the draft recommendations. The peer review comments, webinar, questions, and responses were considered by CDC staff in developing the final recommendations for the updated STI treatment guidelines. Recommendations for HIV, hepatitis C, cervical cancer screening, STI screening in preg", "score": 0.65835214 }, { "number": 19, "title": "WHO expands guidance on sexually transmitted infections and reviews country progress on policy implementation", "detail": "www.who.int", "url": "https://www.who.int/news/item/26-07-2025-who-expands-guidance-on-sexually-transmitted-infections-and-reviews-country-progress-on-policy-implementation", "authors": "www.who.int", "host": "www.who.int", "snippet": "These evidence-based guidelines aim to strengthen STI prevention, screening, diagnosis and treatment, especially in high-burden, resource-limited settings. They complement existing guidance covering syndromic management, management of specific STIs: such as gonorrhoea, chlamydia, syphilis, trichomon", "score": 0.61779 }, { "number": 20, "title": "Sexual Assault Infectious Disease Prophylaxis - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK482239", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "In summary, interprofessional collaboration is paramount in sexual assault infectious disease prophylaxis, enabling the delivery of comprehensive and patient-centered care that considers survivors' physical and psychological needs while addressing legal aspects as well. This multidisciplinary approa", "score": 0.5954225 }, { "number": 21, "title": "Sexually Transmitted Infections - IRIS", "detail": "iris.who.int", "url": "https://iris.who.int/server/api/core/bitstreams/159eddb4-1021-4455-8990-85f6d9564ddc/content", "authors": "iris.who.int", "host": "iris.who.int", "snippet": "The current review looks specifically at data that address various aspects of sexually transmitted infections (STIs) in adolescents. STIs – including infection with the human immunodeficiency virus (HIV) – represent a major health risk to all sexually active adolescents.\nCarefully planned strategies", "score": 0.58123237 }, { "number": 22, "title": "STIs guidelines", "detail": "www.who.int", "url": "https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/guidelines/stis-guidelines", "authors": "www.who.int", "host": "www.who.int", "snippet": "These\nguidelines outline a public health approach to strengthening and\nexpanding HIV testing services (HTS). They present and discuss key\nupdates...\n\nUpdated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (‎syphilis)‎ and new recommendations", "score": 0.54594 }, { "number": 23, "title": "SEXUALLY TRANSMITTED INFECTIONS AMONG ... - IRIS", "detail": "iris.who.int", "url": "https://iris.who.int/server/api/core/bitstreams/6c6a4c56-feeb-4214-b1ed-42c5d014404d/content", "authors": "iris.who.int", "host": "iris.who.int", "snippet": "QUALITY OF STI CASE MANAGEMENT Hardly any assessments of the clinical aspects of STI care for adolescents have been carried out. Nor, with the exception of a few private sector clinics, have case management guidelines been reviewed or adherence to guidelines been assessed. A few evaluations have com", "score": 0.41108778 }, { "number": 24, "title": "Sexually transmitted infections (STIs)", "detail": "www.who.int", "url": "https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)", "authors": "www.who.int", "host": "www.who.int", "snippet": "the majority of STIs are asymptomatic. Thus, WHO recommends countries to enhance syndromic management by gradually incorporating laboratory testing to support diagnosis. In settings where quality assured molecular assays are available, it is recommended to treat STIs such as gonorrhoea, chlamydia, s", "score": 0.40387306 } ], "publishedAt": "2026-08-24T16:17:30.852398+00:00", "updatedAt": "2026-08-24T16:17:30.852398+00:00", "readingMinutes": 7, "slug": "sexually-transmitted-infections" }