Additionally, there is a section on screening for STDs reflecting recommendations of the US Preventive Services Task Force (USPSTF); it also includes recommendations from the American College of Obstetricians and Gynecologists. In at least one instance, though, the USPSTF recommendation on screening for HIV infection contradicts other CDC sources.4,5 Also included is guidance on using vaccines to prevent hepatitis A, hepatitis B, and human papillomavirus (HPV), which follows the recommendations of the Advisory Committee on Immunization Practices. When to use DNA testing to detect HPV is described briefly.
A shortcoming of the CDC guidelines
Although the CDC’s STD guidelines remain the most authoritative source of information on the diagnosis and treatment of STDs, they do not seem to use a consistent method for assessing and describing the strength of the evidence behind the recommendations, which family physicians have come to expect. (However, it is sometimes possible to discern the type and strength of evidence for a particular recommendation from the written discussion.)
The new guidelines state that a series of papers to be published in Clinical Infectious Diseases will describe more fully the evidence behind some of the recommendations and include evidence tables. However, in future guideline updates, it would be helpful if the CDC were to include a brief description of the quantity and strength of evidence alongside each recommended treatment option in the tables.
How best to keep up to date
Although the new guidelines summarize the current status of recommendations on the diagnosis, treatment, and prevention of STDs and are a useful resource for family physicians, we cannot stay current simply by referring to them alone over the next 4 to 5 years until a new edition is published. As new evidence develops, changes in recommendations will be published in the Morbidity and Mortality Weekly Report.
Case in point: new interim HIV recommendations. Interim recommendations were recently released on pre-exposure prophylaxis for men who have sex with men.6 (For more on these recommendations, check out this month’s audiocast at jfponline.com.) Final recommendations are expected later this year. Recommendations for post-exposure prophylaxis to prevent HIV infection are also expected soon.