Sexually transmitted and blood-borne infections: Guides for health professionals
The Public Health Agency of Canada (PHAC) provides public health guidance for the prevention and management of sexually transmitted and blood-borne infections (STBBI). PHAC's STBBI guides for healthcare providers and public health professionals outline national recommendations for:
- the screening and diagnosis of STBBI
- the treatment of sexually transmitted infections (STI) of national public health importance
These guides replace the Canadian Guidelines on Sexually Transmitted Infections. PHAC's STBBI guides do not supersede:
- provincial/territorial legislative, regulatory, policy and practice requirements
- any professional guidelines that govern the practise of health professionals in their respective jurisdictions, whose recommendations may differ due to local epidemiology or context
Treatment recommendations include indications for the level and quality of evidence.
Sexually transmitted and blood-borne infection guides
Find key information and public health guidance for the screening, diagnosis and treatment (if available) of:
- Anogenital warts (caused by human papillomavirus)
- Chlamydia (including lymphogranuloma venereum)
- Genital herpes
- Gonorrhea
- Hepatitis B
- Human immunodeficiency virus (HIV)
- Mycoplasma genitalium
- Syphilis
Information on best practices for the prevention and management of STBBI:
- Sexually transmitted blood borne infections (STBBI) prevention guide
- STI-associated syndromes guide
This guide provides an overview of the management of the following sexually transmitted infection (STI)-associated syndromes: Anogenital ulcers, cervicitis, epididymitis, pelvic inflammatory disease (PID), proctitis, urethritis and vaginitis. Limited information about mpox and extensively drug-resistant Shigella (XDR Shigella) are contained in the Syndromic management tab, the Anogenital ulcers tab and the Proctitis tab.
Updates to the guides
| Guide | Changes/Updates | Date |
|---|---|---|
| Syphilis | In the treatment and follow-up tab, the link to syphilis treatment guidance in the event of a benzathine penicillin G-LA shortage has been updated and a link to Health Canada’s Drug supply notices added. | June 2026 |
| Gonorrhea | Updates to the Key information and resources, Screening and diagnostic testing, and Treatment and follow-up tabs to align with the Interim gonorrhea treatment recommendations, including recommendations for NG culture and test-of-cure. In the Treatment and follow-up tab, restored information about considerations for doxycycline or azithromycin when using alternative treatment regimens and removed outdated treatment recommendations related to complicated infections. | June 2026 |
| STI-associated syndromes guide | Removed information about specific empiric treatment regimens in the Cervicitis and Urethritis tabs and added links to infection-specific STBBI Guides. Added a banner to the top of the Pelvic inflammatory disease and Epididymitis tabs to advise readers to refer to infection-specific tabs for current treatment recommendations for chlamydia and gonorrhea. Updated the dose of ceftriaxone for empiric treatment of NG to align with the Interim gonorrhea treatment recommendations. Removed an outdated PID treatment regimen. |
June 2026 |
| Syphilis, chlamydia and gonorrhea | Links to the Doxy-PEP recommendations have been included in both the key information and resources and prevention and control pages of the guides. | November 2025 |
| STBBI prevention guide | Restructuring of content within this guide to create a new biomedical prevention page that incorporates information about vaccination and pre- and post-exposure prophylaxis for HIV and bacterial STI. | November 2025 |
| Chlamydia and gonorrhea | Update to the screening recommendations for chlamydia and gonorrhea for non-pregnant adults and adolescents to reflect the recently published recommendations. | December 2024 |
| Gonorrhea | Update to the recommendations for preferred treatment, the use of culture, and test of cure to reflect the recently published interim guidance for the treatment of uncomplicated gonococcal infections. Update to epidemiology data to reflect recently published reports. | December 2024 |
| STI-associated syndromes guide | Update to the Syndromic management tab, Anogenital ulcers tab, and the Proctitis tab to include sexual transmission and clinical considerations for mpox, HPV, Shigella and other sexually transmitted enteric infections. | August 2024 |
| STBBI prevention guide | Update to the Primary and secondary prevention tab to include sexual transmission and clinical considerations for mpox, HPV, Shigella and other sexually transmitted enteric infections. | August 2024 |
| Anogenital warts (caused by human papillomavirus) | Consolidation of previous HPV content in the STBBI guides for health professionals into the anogenital warts guide. Scope of content narrowed to focus on the assessment and management of external anogenital warts caused by human papillomaviruses. Update to the format and layout of the guide to align with the other STBBI guides for health professionals. | February 2024 |
| Syphilis | Update to the syphilis screening recommendations for non-pregnant adults and adolescents to reflect the recently published recommendations. | September 2023 |
| Chlamydia and gonorrhea | Update to the screening recommendation for chlamydia and gonorrhea in pregnancy to reflect the recently published recommendation. | April 2023 |
| Chlamydia, gonorrhea and syphilis | Update to the epidemiology data contained within the guides to reflect recently published reports. | June 2022 |
| Chlamydia, gonorrhea, genital herpes, mycoplasma genitalium and syphilis | Changes to the language around sex/gender in order to be more inclusive. | June 2022 |
National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (NAC-STBBI)
PHAC's STBBI guidelines are developed in collaboration with an expert advisory committee with members from across Canada. Visit the NAC-STBBI webpage to learn more about the committee and its workplan.
NAC-STBBI statements
- NAC-STBBI Recommendations on the use of prophylactic doxycycline for the prevention of bacterial STI (chlamydia, gonorrhea, syphilis) [approved by NAC-STBBI June 2025; executive summary published November 2025]
- NAC-STBBI recommendations on screening for Chlamydia trachomatis and Neisseria gonorrhoeae for non-pregnant adults/adolescents [approved by NAC-STBBI September 2024; executive summary published January 2025; full statement published November 2025]
- Interim guidance for the treatment of uncomplicated gonococcal infections [approved by NAC-STBBI September 2023; executive summary published December 2024; full statement published July 2025]
- NAC-STBBI recommendations on screening for syphilis among sexually active adults and adolescents and high prevalence groups [approved by NAC-STBBI August 2023; executive summary published September 2023; full statement published May 2024]
- NAC-STBBI recommendations on screening for Chlamydia trachomatis and Neisseria gonorrhoeae in pregnancy [approved by NAC-STBBI October 2022; full statement published May 2023]
Additional resources
PHAC also produces awareness resources based on the guidelines. These resources for health professionals include factsheets, infographics and Canada Communicable Disease Report (CCDR) articles.
Awareness resources
- Hepatitis C for health professionals
- HIV and AIDS for health professionals
- Summary: HIV antiretroviral medication coverage in Canada
- Mpox (monkeypox): For health professionals
- For health professionals: Shigellosis (Shigella)
Factsheets and infographics
- Doxy-PEP quick reference for health professionals (infographic)
- Staging a syphilis infection in adolescents and adults: Selected physical exam findings according to stage of disease
- Simplified algorithm for clinical syphilis staging and treatment in adolescents and adults
- Let's talk about syphilis (infographic)
- Screening recommendations for chlamydia and gonorrhea in pregnancy in Canada, 2023
- Chlamydia, gonorrhea and infectious syphilis in Canada: 2021 surveillance data update
- Preventing HIV transmission: Undetectable = Untransmittable (U=U) for health professionals (fact sheet)
- Preventing HIV transmission: Undetectable = Untransmittable (U=U): Communication tips for health professionals
Previous
CCDR articles
- Risk of sexual transmission of HIV in the context of viral load suppression
- Translating evidence into practice with the National Advisory Committee on Sexually Transmitted and Blood-Borne Infections
- Addressing the rising rates of gonorrhea and drug-resistant gonorrhea: There is no time like the present
CDN STBBI Guidelines mobile application
Get the most up-to-date recommendations for the management of sexually transmitted and blood-borne infections on your mobile device.
