New STD Guidelines Issued by CDC

New sexually transmitted disease treatment guidelines, including Nonoxynol-9 recommendations, were issued in May by the Centers for Disease Control and Prevention.

Sexually active adolescent females, 19 years old and under, and young adult women, 20- to 24 years old, should be screened annually for chlamydia even if symptoms are not present. Older women with a risk factor for chlamydia, such as a new partner or multiple sexual partners, also should be annually screened.

Health care providers also are now advised to rescreen all women who are diagnosed with chlamydia three to four months after they complete initial treatment.

CDC is recommending the use of New Serological Tests that can help providers with diagnosing and managing genital herpes by determining if a patient is infected with herpes simplex type one or type two. The majority of individuals with recurring genital outbreaks is infected with HSV-2 and may benefit from either suppressive antiviral treatment, which may prevent outbreaks, or episodic treatment, which can shorten the duration of outbreaks.

For treatment of gonorrhea in Hawaii and California, CDC now recommends providers use the antibiotics cefixime, which is given orally, or ceftriaxone, which is administered by injections. This change is prompted by the growing incidence of drug-resistant gonorrhea in California.

Spermicides containing N-9 should not be used alone, since studies in Africa have found that Nonoxynol-9 can cause vaginal lesions and may increase the risk of HIV transmission. N-9 lubricants should not be used during anal intercourse because studies have shown that N-9 causes damage to the lining of the rectum, providing an entry point for HIV and other STDs.

While the level of N-9 used as a lubricant in condoms is much lower than the level found to be harmful, condoms lubricated with N-9 spermicide also are not recommended because they have a shorter shelf life, cost more and have been associated with urinary tract infections in women. However, previously purchased condoms with N-9 can be used, provided they have not passed their expiration date, since they provide protection against HIV. Condoms lubricated with N-9 are not suggested, but undoubtedly the use of N-9 lubricated condoms is safer than not using any condom.