The Centers for Disease Control and Prevention on Monday issued a "Dear Colleague" letter to U.S. health care providers, calling on them to offer "comprehensive sexually transmitted disease prevention services" for gay and bisexual men. The letter, signed by several top federal health officials, calls for "integrated services" at all public and private health care settings to prevent and treat all STDs. The letter was issued based on data showing STD infections, particularly syphilis, to be rising dramatically among gay and bisexual men. The CDC urges all sexually active gay and bisexual men to be screened annually for HIV infection, syphilis, gonorrhea, and chlamydia, and for unvaccinated men to receive hepatitis A and B inoculations. According to the letter, health care providers should also instruct gay and bisexual men on how to avoid STDs--for example, by using condoms--and provide referrals to community-based prevention programs. "The letter comes at a critical time for state and local public health officials battling increases in HIV and STD infections among gay men," said Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, in a press release.