Abstract
SummaryThis report (hereafter referred to as STD QCS) provides CDC recommendations to U.S. health care providers regarding quality clinical services for sexually transmitted diseases (STDs) for primary care and STD specialty care settings. These recommendations complement CDC’s Sexually Transmitted Diseases Treatment Guidelines, 2015 (hereafter referred to as the STD Guidelines), a comprehensive, evidence-based reference for prevention, diagnosis, and treatment of STDs. STD QCS differs from the STD Guidelines by specifying operational determinants of quality services in different types of clinical settings, describing on-site treatment and partner services, and indicating when STD-related conditions should be managed through consultation with or referral to a specialist. These recommendations might also help in the development of clinic-level policies (e.g., standing orders, express visits, specimen panels, and reflex testing) that can facilitate implementation of the STD Guidelines. CDC organized the recommendations for STD QCS into eight sections: 1) sexual history and physical examination, 2) prevention, 3) screening, 4) partner services, 5) evaluation of STD-related conditions, 6) laboratory, 7) treatment, and 8) referral to a specialist for complex STD or STD-related conditions.CDC developed the recommendations by synthesizing relevant, evidence-based guidelines and recommendations issued by other experts; reviewing current practice in the United States; soliciting Delphi ratings by subject matter experts on STD care in primary care and STD specialty care settings; discussing the scientific evidence supporting the proposed recommendations at a consultation meeting of experts and institutional stakeholders held November 20, 2015, in Atlanta, Georgia; conducting peer reviews of draft recommendations and supporting evidence; and discussing draft recommendations and supporting evidence during meetings of the CDC/Health Resources and Services Administration Advisory Committee on HIV, Viral Hepatitis, and STD Prevention and Treatment STD Work Group. These recommendations are intended to help health care providers in primary care or STD specialty care settings offer STD services at their clinical settings and to help the persons seeking care live safer, healthier lives by preventing and treating STDs and related complications.
Highlights
BackgroundApproximately 20 million new cases of sexually transmitted diseases (STDs) occur every year in the United States, with approximately half occurring among persons aged 15–24 years [1]
CDC took into account existing national guidelines and recommendations, current practice in the United States, Delphi ratings by subject matter experts (SMEs) on STD care in primary care and STD specialty care settings followed by discussion at a consultation meeting, input of external private providers, and feedback from the CDC/Health Resources and Services Administration (HRSA) Advisory Committee on human immunodeficiency virus (HIV), Viral Hepatitis, and STD Prevention and Treatment (CHAC)
expedited partner therapy (EPT) typically is recommended for sex partners of patients who have received a diagnosis of chlamydia or gonorrhea, or both, and who are unlikely to access timely care
Summary
BackgroundApproximately 20 million new cases of sexually transmitted diseases (STDs) occur every year in the United States, with approximately half occurring among persons aged 15–24 years [1]. STDs were diagnosed in public health clinics for reasons of anonymity, confidentiality, and specialized care. In the United States, clinics dedicated to caring for patients with STDs, such as the first STD clinic in Baltimore, Maryland, which opened in 1922, offered confidential care to counteract the stigma of syphilis [7]. These types of clinics increased in number during the 1930s and 1940s, and clinics have remained a large component of public health services [8]. The framework for these STD clinics included timely diagnosis, testing with on-site treatment, and partner services
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