Sexually Transmitted Diseases (STDs and HIV/AIDS)
Guidelines and Recommendations

Below are selected prevention and treatment guidelines, recommendations, frameworks, approaches, and other documents related to sexually transmitted diseases, including HIV/AIDS. Also see related links on this page.

Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (4/17/07)
These recommendations represent the first statement by the Advisory Committee on Immunization Practices on the use of a quadrivalent human papillomavirus (HPV) vaccine licensed by the U.S. Food and Drug Administration on June 8, 2006. This report summarizes the epidemiology of HPV and associated diseases, describes the licensed HPV vaccine, and provides recommendations for its use for vaccination among females aged 9-26 years in the United States.

Continuing Education- Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (4/17/07)
This activity has been approved for 1.75 contact hours (continuing nursing education); a maximum of 1.75 hours in category 1 credit (continuing medical education credit for non-physicians); a maximum of 1.75 hours in category 1 credit (continuing medical education); and 0.15 continuing education units.

Updated Recommended Treatment Regimens for Gonococcal Infections and Associated Conditions- United States, April 2007 (4/17/07)
This page provides updated treatment regimens for uncomplicated gonococcal infections of the cervix, urethra, and rectum; pelvic inflammatory disease; and more.

HPV Information for Clinicians (12/1/06)
http://www.cdc.gov/std/HPV/hpv-clinicians-brochure.htm
This 36-page brochure discusses the transmission, prevention, detection and clinical management of human papillomavirus.

Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings (11/29/06)http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
These recommendations for HIV testing are intended for all health-care providers in the public and private sectors. The recommendations address HIV testing in health-care settings only.

Dear Colleague Letter on Risk Behaviors and Methamphetamine Use (8/18/06)
http://www.cdc.gov/nchstp/od/Dear_colleague/docs/ DearColleagueRiskBehaviorMetUse8-18-2006.pdf
Review this summary of the science and practice of methamphetamine use and sexual risk, and consider incorporating the suggestions in prevention and intervention planning to reduce sexually transmitted infections (including HIV infection) in your communities.

Social Networks Testing: A Community-Based Strategy for Identifying Persons with Undiagnosed HIV Infection, Interim Guide for HIV Counseling, Testing, and Referral Programs (6/19/06)
http://www.cdc.gov/hiv/resources/guidelines/snt/index.htm
One strategy for reaching and providing HIV CTR to persons with undiagnosed HIV infection is the use of social networks. Enlisting HIV-positive or high-risk HIV-negative persons (i.e., recruiters) to encourage people in their network (i.e., network associates) to be tested for HIV may provide an efficient and effective route to accessing individuals who are infected, or at very high risk for becoming infected, with HIV and linking them to services. The social network approach has proven to be a viable recruitment strategy for reaching people beyond current partners.

Syphilis Elimination Effort (SEE) Toolkit (3/30/05)
http://www.cdc.gov/std/SEE/
This SEE Tool Kit is for public health practitioners responsible for planning, managing, and developing community coalitions to increase the awareness of and garner support for their syphilis elimination or prevention effort. The toolkit includes: a guide that provides advice and instructions on how to mobilize a community; camera-ready print ads; brochures, posters, banners, educational materials specifically developed for health care providers, leaders of the community-based and faith-based organizations, and for elected officials; sexual-history-taking guide; Syphilis - A Physicians Pocket Guide; form letters; radio PSAs; resource guides; tip sheets; and a CD-ROM containing all of the kit materials.

HIV/AIDS and the Flu (11/30/04)
http://www.cdc.gov/hiv/Treatment/hiv-flu.htm
This fact sheet provides questions & answers to guide both the administration of flu shots and antiviral medications in people with HIV/AIDS.

Incorporating HIV Prevention into the Medical Care of Persons Living with HIV (2003)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5212a1.htm
PDF
http://www.cdc.gov/mmwr/PDF/rr/rr5212.pdf
The recommendations apply to incorporating HIV prevention into the medical care of all HIV-infected adolescents and adults, regardless of age, sex, or race/ethnicity. They are intended for all persons who provide medical care to HIV-infected persons (e.g., physicians, nurse practitioners, nurses, physician assistants); they might also be useful to those who deliver prevention messages (e.g., case managers, social workers, health educators). The recommendations were developed by using an evidence-based approach.

Recommendations for Public Health Surveillance of Syphilis in the United States (2003)
http://www.cdc.gov/std/SyphSurvReco.pdf
The recommendations were developed for state and local public health programs. The intention of this report is to make the collection and reporting of syphilis surveillance data more uniform so that data from a variety of sources are comparable.

Advancing HIV Prevention: New Strategies for a Changing Epidemic-United States (2003)
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5215a1.htm
PDF
http://www.cdc.gov/mmwr/PDF/wk/mm5215.pdf
Press Release
http://www.cdc.gov/media/pressrel/r030417.htm
Telebriefing
http://www.cdc.gov/media/transcripts/t030417.htm
A new initiative was launched in 2003 to reduce barriers to early diagnosis of HIV infection and increase access to quality medical care, treatment, and ongoing prevention services. The initiative consists of four key strategies: make HIV testing a routine part of medical care; implement new models for diagnosing HIV infections outside medical settings; prevent new infections by working with persons diagnosed with HIV and their partners; and further decrease perinatal HIV transmission. CDC will promote recommendations for routine HIV testing of all pregnant women, and, as a safety net, for the routine screening of any infant whose mother was not screened. This initiative emphasizes the use of proven public health approaches to reducing the incidence and spread of disease.

HIV Testing Among Pregnant Women - United States and Canada, 1998-2001 (2002)
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5145a1.htm
PDF
http://www.cdc.gov/mmwr/PDF/wk/mm5145.pdf
To assess the effectiveness of three different prenatal HIV-testing approaches, CDC reviewed prenatal HIV-antibody testing rates associated with these approaches. Medical record data suggest that the "opt-in" voluntary testing approach is associated with lower testing rates than either the "opt-out" voluntary testing approach or the mandatory newborn HIV testing approach. Prenatal HIV testing affords the best opportunity for the prevention of perinatal HIV transmission. On the basis of clinical trial data, perinatal HIV-transmission rates among HIV-infected women who begin antiretroviral treatment during pregnancy are as low as <2%, compared with 12%-13% early transmission rates among women who do not begin preventive treatment until labor and delivery or after birth and 25% among women who receive no preventive treatment.

Screening Tests To Detect Chlamydia trachomatis and Neisseria gonorrhoeae Infections (2002)
http://www.cdc.gov/mmwr/PDF/rr/rr5115.pdf
This report updates the 1993 guidelines for selecting laboratory tests for C. trachomatis with an emphasis on screening men and women in the United States. In this report, screening refers to testing persons in the absence of symptoms or signs indicating C. trachomatis or N. gonorrhoeae infection. In addition, these guidelines consider tests from an economic perspective and expand the previous guidelines to address detection of N. gonorrhoeae as well as C. trachomatis infections. This report also addresses the need for additional testing after a positive screening test to improve the specificity of a final diagnosis. These guidelines are intended for laboratorians, clinicians, and managers who must choose among the multiple available tests, establish standard operating procedures for collecting and processing specimens, interpret test results for laboratory reporting, and counsel and treat patients. Both infections are often asymptomatic among females; and, if untreated, both can lead to pelvic inflammatory disease, infertility, ectopic pregnancy, and chronic pelvic pain.

Screening Tests
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5115a1.htm
Appendix A
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5115a2.htm
Appendix B
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5115a3.htm
Appendix C
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5115a4.htm
Appendix D
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5115a5.htm
Appendix E
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5115a6.htm
Appendix F
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5115a7.htm

Revised Guidelines for HIV Counseling, Testing, and Referral (CTR) (2001)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5019a1.htm
PDF (p. 1)
http://www.cdc.gov/mmwr/PDF/rr/rr5019.pdf
These Guidelines and Recommendations replace guidelines previously issued by CDC and the Public Health Service. The new Counseling, Testing and Referral guidelines include the following significant revisions: providing guidance to all providers of voluntary HIV counseling, testing and referral (CTR), both in the public and private sectors; underscoring the importance of early knowledge of HIV status by making testing more accessible and available; acknowledging providers' need for flexibility in implementing the guidelines, given their particular client base, setting, HIV prevalence level, and available resources; recommending that CTR be targeted efficiently through risk screening and other strategies; and addressing ways to improve the quality and provision of HIV CTR.

Revised Recommendations for HIV Screening of Pregnant Women (2001)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5019a2.htm
PDF (p. 59)
http://www.cdc.gov/mmwr/PDF/rr/rr5019.pdf
These Guidelines and Recommendations replace guidelines previously issued by CDC and the Public Health Service. Major revisions to the 1995 Screening of Pregnant Women recommendations include: emphasizing HIV testing as a routine part of prenatal care; strengthening the recommendation that all pregnant women be tested for HIV; recommending simplification of the testing process and making the consent process more flexible; recommending that providers explore and address reasons for refusal of testing; and emphasizing HIV testing and treatment at the time of delivery for women who have neither received prenatal testing nor antiretroviral drugs, if HIV-positive.

Bright Ideas 2001: Innovative or Promising Practices in HIV Prevention & Planning (2001)
http://www.cdc.gov/hiv/pubs/brightideas.pdf
Bright Ideas 2001 follows the huge success of Bright Ideas 2000, shared for the first time one year ago at the Community Planning Leadership Summit for HIV Prevention in Los Angeles. Presented are another set of practices identified as noteworthy or promising, to better share and network about strategies to increase the effectiveness of community planning and HIV prevention in the nation.

Compendium of HIV Prevention Interventions with Evidence of Effectiveness (2001-Revision)
http://www.cdc.gov/hiv/pubs/hivcompendium/hivcompendium.htm
PDF
http://www.cdc.gov/hiv/pubs/hivcompendium/HIVcompendium.pdf
CDC developed this Compendium to respond to prevention service providers, planners, and others who request science-based interventions that work. All interventions selected for this Compendium came from behavioral or social studies that had both intervention and control/comparison groups and positive results for behavioral or health outcomes. The Compendium provides state-of-the-science information about interventions with evidence of reducing sex-and/or drug-related risks, and the rate of HIV/STD infections. These interventions have been effective with a variety of populations, e.g., clinic patients, heterosexual men and women, high-risk youth, incarcerated populations, injection drug users, and men who have sex with men. They have been delivered to individuals, groups, and communities in settings such as storefronts, gay bars, health centers, housing communities, and schools. (November, 1999; Revised 2001)

Appendix: Revised Surveillance Case Definition for HIV Infection (1999)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4813a2.htm
This revised definition of HIV infection, which applies to any HIV (e.g., HIV-1 or HIV-2), is intended for public health surveillance only. It incorporates the reporting criteria for HIV infection and AIDS into a single case definition.

Guidelines for National HIV Case Surveillance, Including Monitoring for HIV Infection and AIDS (1999)
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4813a1.htm
PDF
http://www.cdc.gov/mmwr/PDF/rr/rr4813.pdf
CDC and CSTE recommend that all states require reporting to public health surveillance of all cases of perinatal HIV exposure in infants, the earliest diagnosis of HIV infection (exclusive of anonymous tests) and the earliest diagnosis of AIDS in persons of all ages, and deaths among these persons (4,33). Such reporting should constitute the core minimum performance standard for HIV/AIDS surveillance in all states and territories. CDC provides federal funds and technical assistance to states to establish and conduct active HIV/AIDS surveillance programs. On the basis of feasibility, needs, and resources, areas may be funded to implement additional surveillance activities (e.g., supplemental research and evaluation studies and serologic surveys), but these approaches might not be necessary in all areas. The following recommended practices update and revise the CDC Guidelines for HIV/AIDS Surveillance released in 1996 and updated in 1998 as a technical guide for state and local HIV/AIDS surveillance programs (34,73-75). Recommended practices represent CDC's guidance for best public health practice based on available scientific data. Programmatic standards set minimum requirements for states to receive support from CDC for HIV/AIDS surveillance activities.

Related Links

STDs and HIV/AIDS: Women’s Health Topics A-Z
http://www.cdc.gov/women/az/std.htm

Guide to Community Preventive Services
http://www.cdc.gov/epo/communityguide.htm

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This page last reviewed April 17, 2007
This page last updated January 4, 2008
URL: http://www.cdc.gov/women/gderecom/std.htm

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Office of Women's Health