Sexually Transmitted Infections Treatment Guidelines, 2021

The Centers for Disease Control and Prevention (CDC) has released Sexually Transmitted Infections Treatment Guidelines, 2021. This document provides current evidence-based diagnostic, management, and treatment recommendations, and serves as a source of clinical guidance for managing sexually transmitted infections (STIs).

The new guidelines include notable updates from the previous 2015 guidance, including:

• Updated treatment recommendations for chlamydia, trichomoniasis, and pelvic inflammatory disease.
• Updated treatment recommendations for uncomplicated gonorrhea in neonates, children, and other specific clinical situations (e.g., proctitis, epididymitis, sexual assault), which builds on broader treatment changes published in Morbidity and Mortality Weekly Report late last year.
• Information on FDA-cleared diagnostic tests for Mycoplasma genitalium and rectal and pharyngeal chlamydia and gonorrhea.
• Expanded risk factors for syphilis testing among pregnant patients.
• Recommended two-step serologic testing for diagnosing genital herpes simplex virus.
• Harmonized recommendations for human papillomavirus vaccination with the Advisory Committee on Immunization Practices.
• Recommended universal hepatitis C testing in alignment with CDC’s 2020 hepatitis C testing recommendations.

STIs are common and costly to the nation’s health and economy. With 26 million new STIs occurring each year, totaling nearly $16 billion in medical costs, evidence-based prevention, diagnostic, and treatment recommendations are critical to halting continued increases.

The new recommendations come at a pivotal moment in our field’s history. As many of you know all too well, the COVID-19 pandemic caused decreased clinic capacity, as well as drug and diagnostic test kit shortages. Along the way, CDC provided guidance for the disruption of STD clinical services, focusing on syndromic management and STI screening approaches to maximize the number of people with STIs identified and treated, while prioritizing those most likely to experience complications. However, most drug and testing kit shortages have since resolved and many health care providers are returning to normal clinical practices, which includes conducting STI evaluation and management in accordance with CDC Sexually Transmitted Infections Treatment Guidelines, 2021.