d Females who have two or more sex partners in the last year; a sex partner with multiple sexual contacts; exchanged sex for money or drugs; or a history of repeated episodes of gonorrhea. Clinicians should also consider local epidemiology.

e Males who had sex with males after 1975; past or present injection drug use; persons who exchange sex for money or drugs and their sex partners; injection-drug using, bisexual, or HIV-positive sex partner currently or in the past; blood transfusion during 1978-1985; persons seeking treatment for STDs. Clinicians should also consider local epidemiology.

f The ability of clinician counseling to influence this behavior is unproven.

g Sexually active females with multiple risk factors including history of STD; new or multiple sex partners; age under 25; nonuse or inconsistent use of barrier contraceptives; cervical ectopy. Clinicians should also consider local epidemiology of the disease in identifying other high-risk groups.

h Persons living in, traveling to, or working in areas where the disease is endemic and where periodic outbreaks occur (e.g., countries with high or intermediate endemicity; certain Alaska Native, Pacific Island, Native American, and religious communities); men who have sex with men; injection or street drug users. Vaccine may be considered for institutionalized persons and workers in these institutions, military personnel, and day care, hospital, and laboratory workers. Clinicians should also consider local epidemiology.

i Women who exchange sex for money or drugs or who have had repeated episodes of gonorrhea. Clinicians should also consider local epidemiology.

j Sexually active women with multiple risk factors including history of STD; new or multiple sex partners; nonuse or inconsistent use of barrier contraceptives; cervical ectopy. Clinicians should also consider local epidemiology.

k Blood product recipients (including hemodialysis patients), persons with frequent occupational exposure to blood or blood products, men who have sex with men, injection drug users and their sex partners, persons with multiple recent sex partners, persons with other STDs (including HIV), travelers to countries with endemic hepatitis B.

l Persons living in, traveling to, or working in areas where the disease is endemic and where periodic outbreaks occur (e.g., countries with high or intermediate endemicity; certain Alaska Native, Pacific Island, Native American, and religious communities); men who have sex with men; injection or street drug users. Consider for institutionalized persons and workers in these institutions, military personnel, and day-care, hospital, and laboratory workers. Clinicians should also consider local epidemiology.

m Persons living in, traveling to, or working in areas where the disease is endemic and where periodic outbreaks occur (e.g., countries with high or intermediate endemicity; certain Alaska Native, Pacific Island, Native American, and religious communities); men who have sex with men; injection or street drug users. Consider for institutionalized persons and workers in these institutions, and day-care, hospital, and laboratory workers. Clinicians should also consider local epidemiology.



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