Kimberly A. Workowski, MD1,2; Laura H. Bachmann, MD1; Philip A. Chan, MD1,3; Christine M. Johnston, MD1,4; Christina A. Muzny, MD1,5;
Ina Park, MD1,6; Hilary Reno, MD1,7; Jonathan M. Zenilman, MD1,8; Gail A. Bolan, MD1
1Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, Georgia; 2Emory University, Atlanta, Georgia;
3Brown University, Providence, Rhode Island; 4University of Washington, Seattle, Washington; 5University of Alabama at Birmingham, Birmingham, Alabama;
6University of California San Francisco, San Francisco, California; 7Washington University, St. Louis, Missouri; 8Johns Hopkins University, Baltimore, Maryland
Summary
These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by
CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11–14, 2019.
The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of
Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended
treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of
Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors
for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with
men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health
care providers can use these guidelines to assist in prevention and treatment of STIs.

Division of
STD Prevention, National Center for HIV/AIDS, Viral Hepatitis,
STD, and TB Prevention, CDC. Telephone: 404-639-1898; Email:
kgw2@cdc.gov.
Introduction
The term “sexually transmitted infection” (STI) refers to
a pathogen that causes infection through sexual contact,
whereas the term “sexually transmitted disease” (STD) refers
to a recognizable disease state that has developed from an
infection. Physicians and other health care providers have a
crucial role in preventing and treating STIs. These guidelines
are intended to assist with that effort. Although the guidelines
emphasize treatment, prevention strategies and diagnostic
recommendations also are discussed.
This report updates Sexually Transmitted Diseases Treatment
Guidelines, 2015 (1) and should be regarded as a source of
clinical guidance rather than prescriptive standards. Health care
providers should always consider the clinical circumstances of
each person in the context of local disease prevalence. These
guidelines are applicable to any patient care setting that serves
persons at risk for STIs, including family planning clinics,
HIV care clinics, correctional health care settings, private
physicians’ offices, Federally Qualified Health Centers, clinics
for adolescent care, and other primary care facilities. These
guidelines are focused on treatment and counseling and do
not address other community services and interventions that
are essential to STI and HIV prevention efforts.