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should be more widely disseminated. Single-dose therapy for bacterial STDs is important in preventing STDs because it averts the problems of ineffective treatment associated with the failure of infected individuals to return for subsequent treatment or to take multiple doses of drugs.
With respect to the above issues, the committee makes the following recommendations:
All clinicians should follow STD treatment guidelines recommended by the CDC and national medical professional organizations.
Single-dose therapy for bacterial and other curable STDs should be available and reimbursable in all clinical settings where STD-related clinical care is routinely provided to populations in which treatment compliance or follow-up are problems.
Risk reduction counseling and education of patients during routine clinical encounters and during evaluations for potential STDs is an important component of clinical management. Focused counseling in both specialized and general clinical settings has substantial potential for changing STD-related behaviors, particularly for adolescents and other high-risk groups. Major barriers that hinder clinicians from providing counseling that need to be addressed include inadequate training in counseling, lack of time allocated for counseling, and lack of reimbursement for such services.
With respect to the above issues, the committee makes the following recommendation:
All health care professionals should counsel their patients during routine and other appropriate clinical encounters regarding the risk of STDs and methods for preventing high-risk behaviors. Counseling for STDs, including HIV infection, should be reimbursed without copayments or other financial disincentives by Medicaid programs, managed care organizations, and other health plans.
Current methods of partner notification are inefficient and extremely resource-intensive and should be redesigned. The optimal combination of activities that are most effective in reaching partners at risk for STDs will vary depending on the local epidemiology of STDs, available staff and other resources, and the spectrum of local health care professionals providing STD-related care. STD programs need to develop new strategies and techniques for community outreach in partnership with other professionals rather than relying solely on public sector staff.