CDC’s Sexually Transmitted Infections Treatment Guidelines

A recent issue of JAMA has published a clinical guidelines synopsis of the 2021 CDC Sexually Transmitted Infections (STI) Treatment Guidelines. The JAMA synopsis was written by Drs. Aniruddha Hazra; Maggie Collison, and Andrew Davis. (The original STI treatment guidelines were written by a group of nine experts).

The two-page JAMA clinical guidelines synopsis is well written, and its brevity is appreciated, as the original CDC guidelines are 192 pages long (!).The JAMA synopsis focuses on major recommendations and changes, evidence base, benefits and harms, and areas in need of future study or ongoing research.

For example, Drs. Hazra, Collison, and Davis talk about the dose of ceftriaxone used for gonorrhea and the first-line treatment for non-gonococcal urethritis and cervicitis (including chlamydia) being doxycycline. Antimicrobial resistance is another topic of concern.

The bottom line is sexually transmitted infections are a major public health issue globally. In America, the number of annual cases continues to increase. Our current approach is failing, because of our broken health care system, COVID-19 disruptions, and stigma. We need a holistic sexual health approach and an investment in public health infrastructure if we are to address this problem.

We will fail to control STIs unless we advocate for real health care reform, such as a single payer / Medicare-for-all. (Disclosure – I am a member of Physicians for a National Health Program, which advocates for universal health care). Federally qualified community health centers (FQHCs) should be much better supported, because they are the safety net of American health care. (Disclosure – I practice at an FQHC in Dorchester, Massachusetts.

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