This article includes recommendations for management of most sexually transmitted infections (STIs) other than HIV and viral hepatitis. Some of the indications and dosages recommended here have not been approved by the FDA (see Table 1).

The CDC has issued new recommendations for treatment of gonococcal infection. A single 500-mg IM dose (1000 mg in patients weighing ≥150 kg) of the third-generation cephalosporin ceftriaxone is now the treatment of choice for patients with uncomplicated urogenital, rectal, or pharyngeal gonorrhea.

The CDC has issued a recommendation for use of a single dose of doxycycline for post-exposure prophylaxis (PEP) of bacterial sexually transmitted infections (STIs), specifically syphilis, chlamydia, and gonorrhea, in men who have sex with men (MSM) and transgender women (TGW) who had a bacterial STI within the previous 12 months.

The FDA has approved Phexxi (Evofem), a nonhormonal prescription-only vaginal gel containing lactic acid, citric acid, and potassium bitartrate, for prevention of pregnancy. The gel is intended for on-demand contraception; it is not effective when used after intercourse. It was previously approved for use as a vaginal lubricant (Amphora), but was never marketed.

The FDA has authorized use of the Visby Medical Women's Sexual Health Test (Visby), an at-home test available without a prescription, for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis infections in women with and without symptoms. It is the first test to become available in the US for these sexually transmitted infections (STIs) that can be performed entirely at home. Other at-home tests are available in the US for diagnosis of chlamydia, gonorrhea, and trichomoniaisis, but they require mailing a urine or blood sample to a...

The CDC is recommending that persons at high risk of mpox (see Table 1) receive two doses of the Jynneos vaccine. The recommendation follows reports of a recent cluster of mpox cases in the US and warnings about the risk of a renewed outbreak during the spring and summer as people gather for festivals and other events. The CDC does not recommend routine immunization against mpox for the general population.

The FDA has approved Apretude (ViiV Healthcare), an IM extended-release (ER) formulation of the integrase strand transfer inhibitor (INSTI) cabotegravir, for use every 2 months to prevent sexually acquired HIV-1 infection in at-risk adolescents and adults. Apretude is the first ER formulation to be FDA-approved for pre-exposure prophylaxis (PrEP) of HIV-1 infection.

The FDA has approved ibrexafungerp (Brexafemme – Scynexis), a first-in-class triterpenoid antifungal ("fungerp"), for oral treatment of vulvovaginal candidiasis in postmenarchal females.

The FDA has approved oteseconazole (Vivjoa – Mycovia), a new oral azole antifungal, to reduce the incidence of recurrent vulvovaginal candidiasis (RVVC) in females with a history of RVVC. Oteseconazole is the first drug to be approved in the US specifically for treatment of RVVC.

Intrauterine devices (IUDs) and the etonogestrel implant are the most effective reversible contraceptive methods available. Hormonal oral contraceptives, patches, rings, and injectables are also effective in preventing pregnancy. When used alone, barrier and behavioral methods generally have higher failure rates than other methods (see Table 1). Selection of a contraceptive method is usually based on patient-specific factors and personal preference