Here Comes the SSuN: Early Experiences with the STD Surveillance Network

Rietmeijer, Cornelis A.; Donnelly, Jennifer A.; Bernstein, Kyle T.; Bissette, Jennifer M.; Martins, Summer L.; Pathela, Preeti; Schillinger, Julia A.; Stenger, Mark; Weinstock, Hillard; Newman, Lori M.

doi:10.1177/00333549091240s211

Cited by 21 publications

(16 citation statements)

References 13 publications

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“…They should be available for low‐threshold referral and consultation. They should also be a resource for sentinel surveillance research, including gonococcal resistance , and for research in the development of new STI diagnostics and treatment, as well as for clinical training and workforce development .…”

Section: Discussion: Improving Sti Servicesmentioning

confidence: 99%

Improving care for sexually transmitted infections

Rietmeijer

2019

J Intern AIDS Soc

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Introduction Rising rates of reported sexually transmitted infections (STIs) in the US and Europe are a public health priority and require a public health response. The diagnosis and treatment of STIs have been the cornerstone of STI control and prevention for many decades and, historically, publicly funded STI clinics have played a central role in the provision of STI care. Innovations in non‐invasive diagnostic techniques, especially nucleic acid amplification tests in the mid‐1990s, have facilitated the expansion of STI testing and treatment outside traditional STI clinics, including primary care, family planning, school‐based health, outreach, corrections, emergency departments and HIV prevention and care settings. As a result, the continued need for categorical STI clinics has been debated. In this Commentary, we discuss how practice can be improved at each level of STI care. Discussion STI practice improvement plans should be tailored to the strengths of each care setting. Thus, in primary care, the focus should be on improving STI screening rates, the provision of hepatitis B and human papillomavirus vaccines and, in jurisdictions where this is legal, expedited partner therapy for gonorrhoea and chlamydia. Extragenital (pharyngeal and rectal) testing for gonorrhoea and chlamydia should be available in settings serving populations more vulnerable to STI acquisition at these anatomical sites, including men who have sex with men. In family planning settings with a mostly female patient population, there are opportunities to serve male partners with both contraceptive and STI services. STI screening rates can also be improved in other settings serving populations at increased risk for STIs, including school‐based clinics, emergency departments, correctional health facilities and providers of HIV care and prevention. These improvements are predominantly logistical in nature and not dependent on extensive STI clinical expertise. While some providers in these settings may have the clinical knowledge and skills to evaluate symptomatic patients, many do not, and STI speciality clinics must be available for consultation and referral and evolve from “safety net” providers of last resort to STI centres of excellence. Conclusions A tailored practice improvement plan can be envisioned to achieve an optimally functioning STI care continuum.

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Section: Discussion: Improving Sti Servicesmentioning

confidence: 99%

Improving care for sexually transmitted infections

Rietmeijer

2019

J Intern AIDS Soc

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“…We examined data from the STD Surveillance Network (SSuN), a sentinel surveillance system comprising 42 STD clinics within 12 collaborating jurisdictions (7 state and 5 local health departments) that follow common protocols for data collection and management [10]. Each jurisdiction has 1–12 STD clinics, which are either operated directly by the jurisdiction or are operated by a separate authority.…”

Section: Methodsmentioning

confidence: 99%

Extragenital Gonorrhea and Chlamydia Testing and Infection Among Men Who Have Sex With Men--STD Surveillance Network, United States, 2010-2012

Patton

Kidd

Llata

et al. 2014

Clinical Infectious Diseases

187

154

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Background Gonorrhea (GC) and chlamydia (CT) are the most commonly reported notifiable diseases in the United States. The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened for urogenital GC/CT, rectal GC/CT, and pharyngeal GC. We describe extragenital GC/CT testing and infections among MSM attending sexually transmitted disease (STD) clinics. Methods The STD Surveillance Network collects patient data from 42 STD clinics. We assessed the proportion of MSM attending these clinics during July 2011–June 2012 who were tested and positive for extragenital GC/CT at their most recent visit or in the preceding 12 months and the number of extragenital infections that would have remained undetected with urethral screening alone. Results Of 21 994 MSM, 83.9% were tested for urogenital GC, 65.9% for pharyngeal GC, 50.4% for rectal GC, 81.4% for urogenital CT, 31.7% for pharyngeal CT, and 45.9% for rectal CT. Of MSM tested, 11.1% tested positive for urogenital GC, 7.9% for pharyngeal GC, 10.2% for rectal GC, 8.4% for urogenital CT, 2.9% for pharyngeal CT, and 14.1% for rectal CT. More than 70% of extragenital GC infections and 85% of extragenital CT infections were associated with negative urethral tests at the same visit and would not have been detected with urethral screening alone. Conclusions Extragenital GC/CT was common among MSM attending STD clinics, but many MSM were not tested. Most extragenital infections would not have been identified, and likely would have remained untreated, with urethral screening alone. Efforts are needed to facilitate implementation of extragenital GC/CT screening recommendations for MSM.

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“…The purpose of SSuN is to improve the capacity of national, state, and local STD programs to detect, monitor, and respond rapidly to trends in STDs. 21 SSuN data collection is a public health surveillance activity. Analysis of de-identified SSuN data does not constitute research involving human subjects, so institutional review board review was not required.…”

Section: Methodsmentioning

confidence: 99%

Trichomonas vaginalis in Selected US Sexually Transmitted Disease Clinics

Meites

Llata

Braxton

et al. 2013

Sexually Transmitted Diseases

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Background Trichomonas vaginalis is the most prevalent nonviral sexually transmitted infection in the United States, affecting 3.1% of women of reproductive age. Infection is associated with HIV acquisition and pelvic inflammatory disease. In the United States, Centers for Disease Control and Prevention guidelines recommend testing all women with vaginal discharge for T. vaginalis, but except for HIV-infected women, there are no national guidelines for screening asymptomatic persons. The objective of this analysis is to assess testing and screening practices for T. vaginalis among symptomatic and asymptomatic women in the sexually transmitted disease (STD) clinic setting. Methods We analyzed data on demographics, clinical presentation, and laboratory testing for all women visiting a clinician in 2010 to 2011 at any of 15 STD clinics participating in the STD Surveillance Network. Prevalence of laboratory-confirmed T. vaginalis infection was calculated among symptomatic women tested and among asymptomatic women screened. Results A total of 59,176 women visited STD clinicians: 39,979 were considered symptomatic and 19,197 were considered asymptomatic for T. vaginalis infection, whereas 211 were HIV-infected. Diagnostic practices varied by jurisdiction: 4.0% to 96.1% of women were tested or screened for T. vaginalis using any laboratory test. Among 17,952 symptomatic women tested, prevalence was 26.2%. Among 3909 asymptomatic women screened, prevalence was 6.5%. Among 92 HIV-infected women tested/screened, prevalence was 29.3%. Conclusions Trichomoniasis is common among STD clinic patients. In this analysis, most STD clinics tested symptomatic women seeking care, in accordance with national guidelines. All HIV-infected women should be screened annually. Additional evidence and national guidance are needed regarding potential benefits of T. vaginalis screening in other asymptomatic women.

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Here Comes the SSuN: Early Experiences with the STD Surveillance Network

Cited by 21 publications

References 13 publications

Improving care for sexually transmitted infections

Improving care for sexually transmitted infections

Extragenital Gonorrhea and Chlamydia Testing and Infection Among Men Who Have Sex With Men--STD Surveillance Network, United States, 2010-2012

Trichomonas vaginalis in Selected US Sexually Transmitted Disease Clinics

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