Background: In recent years, the majority of sexually transmitted disease (STD) care has been provided in primary care settings. However, STD clinics remain a pivotal resource for STD service provision. The quality and types of services available in each of these health care settings can vary greatly. In order to provide guidance to primary care, STD clinics, and other healthcare settings on which STD-related services should be available at their sites, we developed recommendations for providing quality STD clinical services.
Methods: We reviewed the 2015 CDC STD Treatment Guidelines to generate a list of 73 specific STD-related services, and conducted a systematic literature review to collect information on delivery of these services in a variety of U.S. healthcare settings. Using a modified Delphi method, we asked 29 STD experts from various key professional medical organizations about the services they thought should be available in basic and specialized STD care settings. In November 2015, we convened a consultation meeting of these experts and other stakeholders to discuss the proposed services for both settings.
Results: The recommendations outline essential services for the delivery of quality STD care in the United States. These new recommendations define two levels of STD service delivery, “basic” and “specialized” and provide guidance on the optimal services that should be available at each level. The range of STD-related services includes history and physical examination; prevention; screening; partner services; management of STD-related conditions; laboratory tests, including point of care tests; and on-site medications. Examples of pertinent STD services include brief behavioral counseling; HIV counseling; PrEP risk assessment; expedited partner therapy; nPEP medication for HIV and injectable medications for syphilis and gonorrhea.
Conclusions: The recommendations in this guidance contribute to improved STD care by defining what STD-related clinical services should be provided in basic and specialized STD care settings.