surveillance data and knowledge of the populations or geographic prevalence of STDs. These expanded programs should utilize diagnostic tests that are appropriate for screening persons in a variety of settings. Family planning clinics, prenatal clinics, facilities that provide pregnancy termination services, and other settings where obstetric or gynecological care is available should screen and treat women and their partners for sexually transmitted infections.
Premarital testing for syphilis, as a requirement for marriage licenses, is unnecessary and contributes little to containing syphilis because persons applying for marriage licenses are generally at lower risk for syphilis compared with the general population. Although these tests represent a source of revenue for some states, studies cited in Chapter 4 indicate that the number of previously undetected cases identified through premarital testing is extremely low; the tests are not cost-effective; and they have little public health impact. In addition, unnecessary testing may undermine public support for more appropriate screening programs, such as syphilis screening of women during early pregnancy.
Therefore, the committee makes the following recommendations:
The CDC's STD Treatment Guidelines are a valuable resource that represent the standard for treatment of STDs. Such treatment guidelines help to promote appropriate therapy for STDs on a national basis. Compliance with treatment guidelines is important because it helps ensure that patients receive the most