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MMWR – Morbidity and Mortality Weekly Report

1. Current Tobacco Use Among Middle and High School Students — United States, 2011

Division of News & Electronic Media

Tobacco use among American middle school and high school students showed a slow decline from 2000 to 2011, but the steep rate of decline from 1997 to 2003 has slowed noticeably with steady funding cuts to state tobacco control programs since 2002. Although tobacco use continued an 11-year downward trend, from 2009 to 2011, no significant changes in the use of any tobacco product are reported among middle school students, and tobacco use remains high among high school students. In 2011, nearly 30 percent of high school males and 18 percent of high school females used some form of tobacco, while more than 8 percent of middle school males and nearly 6 percent of middle school females used some form of tobacco. Cigar use increased from 7.1 percent in 2009 to 11.7 percent in 2011 among black high school students, and cigarette use declined from 19.2 percent in 2009 to 15.8 percent in 2011 among Hispanic high school students.

2. Interim Guidance for Clinicians Considering the Use of Preexposure Prophylaxis for the Prevention of HIV Infection in Heterosexually Active Adults

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
News Media Line

CDC issues interim guidance on use of antiretroviral medication to prevent heterosexually-acquired HIV infection.  CDC today released interim guidance on the use of pre-exposure prophylaxis (PrEP) in the United States as a strategy to help prevent HIV infection through heterosexual sex.  When used consistently and in combination with other prevention methods, it may offer an additional means to prevent infection for some women and men at very high risk.  Physicians considering the use of anti-HIV medication to reduce the risk of acquiring HIV through heterosexual sex should ensure that patients are confirmed to be uninfected prior to use and provided regular HIV testing and other key prevention services.  The guidance, which is based on the results of two large international clinical trials in which PrEP was found to significantly reduce the risk of HIV infection among heterosexually-active women and men, supplements existing CDC PrEP interim guidance for men who have sex with men.  The guidance is designed to provide physicians that may be prescribing PrEP with accurate information and key cautions on its safe and effective use, particularly as it relates to women of reproductive age and to couples in which one partner is HIV-positive and the other is HIV-negative.

3. Update to CDC's Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
News Media Line

In light of recent laboratory data showing the oral antibiotic cefixime is becoming less effective, CDC has updated its STD Treatment Guidelines to no longer recommend the drug as a first-line treatment option for gonorrhea in the United States. This change leaves only one drug proven effective for treating infection, an injectable antibiotic called ceftriaxone. Over time gonorrhea has developed resistance to every antibiotic recommended, leaving the cephalosporins, which include cefixime and ceftriaxone, as the final recommended class of drugs. Because of this history and recent lab data, CDC is concerned that continued use of cefixime may prompt resistance to all cephalosporins. Limiting its use now may help preserve ceftriaxone as a treatment option for a little longer. Today, the most effective treatment for gonorrhea is dual therapy: ceftriaxone with another antibiotic. The guidelines outline alternative treatment options when ceftriaxone cannot be used. To closely monitor for resistant infections, the guidelines advise on follow-up testing using culture-based tests. Treating gonorrhea with the most effective method may help delay the emergence of cephalosporin resistance, but it will not solve the problem. CDC is calling on public and private partners to prioritize preventing gonorrhea and developing new treatment options.


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