STD care in primary care settings At the time of the patient visit The following general services, equipment, or tests should be available as basic STD care services at the time of the patient visit: º Thermometer º pH paper The following general services, equipment, or tests could be available as basic STD services with test results available during the patient visit: º Phlebotomy º Test for trichomoniasis† º Test for bacterial vaginosis§ º Test for vulvovaginal candidiasis¶ º Urine dipstick º Urinalysis with microscopy º Test for pregnancy º Test for HIV Clinical laboratory The following tests should be available through a clinical laboratory as basic STD care services: º Urogenital NAAT for gonorrhea and chlamydia º Extragenital (pharynx and rectum) NAAT for gonorrhea and chlamydia º Quantitative nontreponemal serologic test for syphilis º Treponemal serologic test for syphilis º HSV viral culture or PCR º HSV serology º Fourth-generation antigen/antibody HIV test º Oncogenic HPV NAATs with Pap smear º nPEP and PrEP º Serologic tests for hepatitis A, B, and C º Test for pregnancy The following tests could be available through a clinical laboratory as basic STD care services: º Gram stain, methylene blue, or gentian violet stain for urethritis º Gonorrhea culture º Gonorrhea antimicrobial susceptibility testing** º NAAT for trichomoniasis

STD care in STD specialty care settings At the time of the patient visit The following general services, equipment, or tests should be available as specialized STD care services at the time of the patient visit: º Thermometer º pH paper º Phlebotomy º Test for trichomoniasis† º Test for bacterial vaginosis§ º Test for vulvovaginal candidiasis¶ º Urine dipstick º Urinalysis with microscopy º Test for pregnancy º Gram stain, methylene blue, or gentian violet stain for urethritis º On-site qualitative nontreponemal serologic test for syphilis The following general services, equipment, or tests could be available as specialized STD care services with test results available during the patient visit: º Dark-field microscopy for syphilis º Test for HIV Clinical laboratory The following tests should be available through a clinical laboratory as specialized STD care services: º Urogenital NAAT for gonorrhea and chlamydia º Extragenital (pharynx and rectum) NAAT for gonorrhea and chlamydia º Quantitative nontreponemal serologic test for syphilis º Treponemal serologic test for syphilis º HSV viral culture or PCR º HSV serology º Fourth-generation antigen/antibody HIV test º Oncogenic HPV NAATs with Pap smear º nPEP and PrEP º Serologic tests for hepatitis A, B, and C º Gonorrhea culture º Gonorrhea antimicrobial susceptibility testing** º NAAT for trichomoniasis

Abbreviations: HIV = human immunodeficiency virus; HPV = human papillomavirus; HSV = herpes simplex virus; NAAT = nucleic acid amplification test; nPEP = nonoccupational postexposure prophylaxis; Pap = Papanicolaou; PCR = polymerase chain reaction; PrEP = preexposure prophylaxis; STD = sexually transmitted disease.

* Primary care setting is defined as a place where patients are evaluated for various health conditions. STD specialty care setting is defined as a place where the focus is on providing patients with timely, comprehensive, confidential, and culturally sensitive STD care. STD care delivered in STD specialty care settings includes all care delivered in primary care settings.

^† On-site test for trichomoniasis can include wet mount microscopy and OSOM Trichomonas.

^§ On-site test for bacterial vaginosis can include wet mount microscopy, OSOM BVBlue, and Affirm.

^¶ On-site test for vulvovaginal candidiasis can include wet mount microscopy.

** Access needs to be established for transport medium that adequately maintains the viability of Neisseria gonorrhoeae until the specimen reaches a laboratory (e.g., transport medium in transport container, transport system, or transport swab). Providers should contact their state or local health department if they have concerns about resistant N. gonorrhoeae infection or if assistance is required for culture and antimicrobial susceptibility testing.