Highlights From the 2002 STD Conference

H. Hunter Handsfield, MD

Disclosures

May 10, 2002

In This Article

Introduction

Over the past decade, the National STD Prevention Conference, a biennial meeting sponsored by the Centers for Disease Control and Prevention (CDC), has evolved into a high-quality venue for presentation of prevention-related research on STDs, including HIV infection. The 2002 conference, cosponsored by the American Social Health Association, was rich in new material. This review summarizes selected papers and symposia of particular relevance to clinicians, epidemiologists, and STD prevention specialists.

Several studies addressed the performance of newer diagnostic tests for STDs, especially for chlamydial infection and genital herpes, and the proper use of such testing for screening, diagnosis, or follow-up. Evidence strongly shows that the biggest risk factor for chlamydial infection is previous infection with chlamydia, implying that those previously infected should undergo follow-up testing ("rescreening"), generally within 6 months after treatment. The nucleic acid amplification tests (NAATs) clearly are emerging as the tests of choice for Chlamydia trachomatis. By contrast, while expanded testing for chlamydial infection is clearly indicated, one study indicated that it may be time to consider cutbacks in screening asymptomatic women for gonorrhea. It is increasingly clear that type-specific serologic tests for antibody to herpes simplex virus (HSV) have important roles in clinical management. Although their use in screening asymptomatic persons remains controversial, studies presented in San Diego indicated that such screening would be accepted and even preferred by most patients attending STD clinics.

Other themes from the meeting include the continued high level of STDs among men who have sex with men (MSM), including transmission of HIV; criteria for cerebrospinal fluid (CSF) examination in neurologically asymptomatic persons with syphilis; treatment of chlamydial infection in pregnant women; the efficacy of condoms in preventing transmission of genital herpes; and new approaches to assure that infected persons' sex partners receive adequate therapy for chlamydial infection or gonorrhea.

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