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Enhanced STD Surveillance Network (eSSuN)
Protocol and Project Implementation Guide
December 2014
12 December 2014
Table of Contents
Page Number
Principal Collaborators
Associate Collaborators
Background
Collaborating Sites
Section 1: Part A
Funded Site Responsibilities
CDC Responsibilities
Memorandum of Agreement
Enhanced Case-based Population Surveillance (Gonorrhea)
Population Component – Methods
Facility Component Sentinel Surveillance
Facility Component – Methods
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Appendix 1: Memorandum of Agreement for Analysis of eSSuN Surveillance Data
Appendix 2: Enhanced SSuN Data Dictionary
Appendix 3: STD/HIV screening recommendations
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Principal Collaborators
Eloisa Llata, MD, MPH
Enhanced STD Surveillance Network Project Officer
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Mark Stenger, MA
Enhanced STD Surveillance Network Project Officer
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Elizabeth Torrone, PhD, MSPH
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Centers for Disease Control and Prevention
Atlanta, GA 30333
Elaine W. Flagg, MS, PhD
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Hillard S. Weinstock, MD, MPH
Chief, Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Heidi Bauer, MD, MS, MPH
STD Control Branch
California Department of Public Health
Richmond, California
C. Patrick Chaulk, MD, MPH
Bureau of STD/HIV/TB Clinical Services
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Baltimore City Health Department
Baltimore, Maryland
Adrian Cooksey, MPH
Bureau of Communicable Disease
Florida Department of Health
Tallahassee, Florida
Krissie Guerard, MS
HIV/STD Section
Minnesota Department of Health
St. Paul, Minnesota
Katherine Hsu, MD, MPH
Sylvie Ratelle STD/HIV Prevention Training Center of New England
Division of STD Prevention & HIV/AIDS Surveillance
Massachusetts Department of Public Health
Jamaica Plain, Massachusetts
Caroline C. Johnson, MD
Division of Disease Control
Philadelphia Department of Public Health
Philadelphia, Pennsylvania
Preeti Pathela, DrPH, MPH
Bureau of STD Control
NYC Department of Health and Mental Hygiene
Queens, New York
Julieann Simon, MSPH
Infectious Disease & Reproductive Health Assessment Unit
Washington State Department of Health
Olympia, Washington
Kim Toevs, MPH
Adolescent Health Promotion and STD/HIV/HCV Programs
Multnomah County Health Department
Portland, Oregon
Associate Collaborators
Greta Anschuetz, MPH
Division of Disease Control
Philadelphia Department of Public Health
Philadelphia, Pennsylvania
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Tomas Aragón, MD, DrPH
STD Prevention and Control Services
San Francisco Department of Public Health
San Francisco, California
Lenore Asbel, MD
Division of Disease Control
Philadelphia Department of Public Health
Philadelphia, Pennsylvania
Susan Blank, MD, MPH
Bureau of STD Control
NYC Department of Health and Mental Hygiene
Queens, New York
Jim Braxton
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Marion Carter, PhD
Health Services Research & Evaluation Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Joan Chow, DrPH, MPH
STD Control Branch
California Department of Public Health
Richmond, California
Darlene Davis
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Aileen Duldulao, PhD
Community Epidemiology Unit
Multnomah County Health Department
Portland, Oregon
Tom Gift, PhD
Health Services Research & Evaluation Branch
Division of STD Prevention
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National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Dawn Ginzl, MPH
HIV/STD Section
Minnesota Department of Health
St. Paul, Minnesota
Gillian Haney, MPH
Division of STD Prevention & HIV/AIDS Surveillance
Massachusetts Department of Public Health
Jamaica Plain, Massachusetts
Jill Huppert, MD, MPH
Program Development & Quality Improvement Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Roxanne Pieper Kerani, PhD
Public Health - Seattle & King Co. STD Program
Harborview Medical Center
Seattle, Washington
Sarah Kidd, MD
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Robert Kirkcaldy, MD, MPH
Surveillance & Data Management Branch
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Ellen Klingler, MPH
Bureau of STD Control
NYC Department of Health and Mental Hygiene
Queens, New York
Alison LaPointe, MPH
HIV/STD Section
Minnesota Department of Health
St. Paul, Minnesota
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Claire LaSee, MPH
Infectious Disease & Reproductive Health Assessment Unit
Washington State Department of Health
Olympia, Washington
Jami Leichliter, PhD
Office of Policy, Planning and External Relations
Division of STD Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Robbie Madera, MPH
Division of Disease Control
Philadelphia Department of Public Health
Philadelphia, Pennsylvania
Hayley Mark, PhD, MPH, RN
Bureau of STD/HIV/TB Clinical Services
Baltimore City Health Department
Baltimore, Maryland
Ninad Mishra, MS, MD
Surveillance & Data Management Branch, DSTDP
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
Ryan Murphy, MPH, PhD
Division of HIV and STD Programs
Los Angeles County Department of Public Health
Los Angeles, California
Trang Nguyen, PhD, MPH
STD Prevention and Control Services
San Francisco Department of Public Health
San Francisco, California
Nicole Olson, MPH
STD Control Branch
California Department of Public Health
Richmond, California
Susan Philip, MD, MPH
STD Prevention and Control Services
San Francisco Department of Public Health
San Francisco, California
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Kathleen Roosevelt, MPH
Division of STD Prevention & HIV/AIDS Surveillance
Massachusetts Department of Public Health
Jamaica Plain, Massachusetts
Michael Samuel, DrPH, MPH
STD Control Branch
California Department of Public Health
Richmond, California
Christina Schumacher, PhD
Bureau of STD/HIV/TB Clinical Services
Baltimore City Health Department
Baltimore, Maryland
Stacy Shiver
Bureau of Communicable Disease
Florida Department of Health
Tallahassee, Florida
Laura Smock, MPH
Division of STD Prevention & HIV/AIDS Surveillance
Massachusetts Department of Public Health
Jamaica Plain, Massachusetts
Sally Stephens, MPH
STD Prevention and Control Services
San Francisco Department of Public Health
San Francisco, California
Jaime Walters, MPH
Community Epidemiology Unit
Multnomah County Health Department
Portland, Oregon
Amy Rock Wohl, PhD, MPH
Division of HIV and STD Programs
Los Angeles County Department of Public Health
Los Angeles, California
Jonathan Zenilman, MD
Bureau of STD/HIV/TB Clinical Services
Baltimore City Health Department
Baltimore, Maryland
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Introduction - Background
Disease surveillance is the systematic, ongoing collection of data, observation and monitoring of the
spread and occurrence of diseases and infectious agents to answer fundamental questions of
epidemiologic importance such as the characteristics of persons and groups affected, increase or
decrease in cases and infections over time and geographic extent of affected populations. The primary
purpose of these activities is to provide information necessary for preventing or limiting the harm to
individuals and populations from diseases and illness. A foundational activity in modern disease
surveillance is case reporting by clinicians, laboratories and healthcare facilities, which ideally provides
basic information on all persons diagnosed with diseases and infections of public health interest. In the
United States, this information is generally reported by providers directly to state and local public health
agencies.
Case-level data are voluntarily reported to CDC by states, territories and independently funded county
and/or city health departments through a framework called the National Notifiable Disease Surveillance
System. These data are the primary source for reporting, analysis and interpretation of trends in the
incidence, prevalence and societal impact of chlamydial infection, gonorrhea and syphilis in the United
States and U.S. Territories. A limited core set of patient demographics is required for national case
reporting including sex, age, race, Hispanic ethnicity, and county of residence. Behavioral information,
such as the gender and number of sex partners, are important to understanding the changing
epidemiology of STDs but these data are not routinely collected. CDC’s ability to interpret trends in
reported case incidence, assess inequalities in the burden of disease by population characteristics and to
respond to issues such as co-morbidities and decreasing antibiotic susceptibility is therefore partly
contingent on data supplied through supplemental sentinel and enhanced surveillance activities.
National case reporting data for STDs lack completeness with respect to critical patient demographics and
are of narrow scope with respect to risk behavior, provider and clinical information, treatment and partner
characteristics. Moreover, case data only provide information on the numerator of interest and are not
optimal for estimating population prevalence of common STDs. Supplemental surveillance data are needed
to refine estimates of the burden of STDs, including incidence and prevalence among at-risk and vulnerable
populations, better monitor STD prevention program impact and STD-related care seeking behaviors.
The STD Surveillance Network (SSuN) was established in 2005 (Cycle 1) to create an ongoing network of
collaborating health departments with the capacity to implement a wide variety of surveillance
activities, the flexibility to modify activities over time as trends dictated, and the ability to use
surveillance data to guide programmatic action.
SSuN Cycle 2 (2008 – 2013) expanded the network to include a greater number of collaborating health
departments and further strengthened the human capacity and IT infrastructure. Activities in Cycle II
included monitoring the prevalence of STDs, HIV, viral hepatitis, and risk behaviors in MSM, assessing
trends in the burden of genital wart disease in patients attending STD clinics, monitoring HIV testing
coverage in patients attending STD clinics, and implementing population-based enhanced gonorrhea
surveillance.
The current cycle (Cycle III, SSuN 2013 - 2018) continues to address these issues through enhanced and
sentinel STD surveillance activities in specific populations (population component) and in expanded
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healthcare facilities (STD Clinics and Family Planning/Reproductive Health settings) serving populations
at risk for STDs. These activities constitute Part A of SSuN and are the core activities of the network; this
document outlines protocols and methods for implementing these enhanced and sentinel surveillance
activities.
Additional information on SSuN may be obtained by contacting the Project Officers:
Eloisa LLata, MD MPH
LCDR, USPHS
Surveillance and Special Studies Team
Surveillance and Data Management Branch
Division of STD Prevention, NCCHSTP, CDC
1600 Clifton Rd NE, MS E-02
Atlanta, GA 30333
email: [email protected]
Enhanced SSuN Cycle 3
Mark Stenger, MA
Epidemiologist
Surveillance and Special Studies Team
Surveillance and Data Management Branch
Division of STD Prevention, NCCHSTP, CDC
1600 Clifton Rd NE, MS E-02
Atlanta, GA 30333
email: [email protected]
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SSuN Cycle III Funded Jurisdictions
The following 10 state, county and/or city health departments successfully competed for funding under
CDC-RFA-PS13-1306, Enhanced STD Surveillance Network and were subsequently awarded funding
under five-year cooperative agreements for Part A activities.
Part A – Sentinel and enhanced surveillance:
Baltimore City Health Department (Award#1H25PS004259-01)
California Department of Public Health (Award#1H25PS004244-01 Revised)
Florida Department of Health (Award#1H25PS004261-01)
Massachusetts Department of Public Health (Award#1H25PS004253-01 Revised)
Minnesota Department of Health (Award#1H25PS004255-01)
Multnomah County Health Department (Award#1H25PS004256-01)
New York City Department of Health & Mental Hygiene (Award#1H25PS004247-01 Revised)
Philadelphia Department of Public Health (Award#1H25PS004248-01 Revised)
San Francisco Department of Public Health (Award#1H25PS004258-01 Revised)
Washington State Department of Health (Award#1H25PS004271-01)
(An additional grantee, Utah Department of Health, was awarded funding for Part B activities not
covered under this protocol)
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Section 1
Part A Core Protocols:
Funded Site Responsibilities
CDC Responsibilities
Memorandum of Agreement
Enhanced Case-Based Population Surveillance (Gonorrhea)
Sentinel Facility Surveillance (Facility Component)
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SSuN Part A – Funded Site Responsibilities
Jurisdictions receiving funding under PS13-1306 are required to participate in the planning,
implementation, maintenance and evaluation of specific sentinel and enhanced activities as
requirements of their cooperative agreement award.
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Awardees will assure sufficient human and technical resources dedicated to SSuN coordination, data
collection, data management, data quality assurance, analysis, interpretation, and dissemination of data
and findings from enhanced case-based and sentinel surveillance and monitoring activities.
Awardees will assure timely and prompt data transmissions of all required datasets to CDC following
collaboratively developed SSuN protocols.
Awardees will participate in regularly scheduled conference calls, virtual meetings and annual face-to-face
awardees meetings as required for developing or revising protocols, developing best practices, reporting
progress toward meeting SSuN objectives, presenting preliminary data and describing status of ongoing
activities.
Awardees will assure that information systems necessary for the collection, management, integration,
analysis, and transmission of SSuN datasets to CDC are available and will be modified as needed to
appropriately collect, manage and transmit SSuN-related data.
Awardees will assure that data management methods and information systems implemented in support
of these activities are designed to provide efficient, sustainable, routine and automated processes to limit
staff burden and minimize the effect of unanticipated staffing changes.
Awardees will provide meaningful funding resources and/or technical assistance to facilities or agencies
providing data as necessary to assure ongoing extraction, appropriate transformation, transmission,
validation, quality assurance and data management of all required data. Meaningful resources may
include direct assistance through staff time and/or financial support to the data-providing entity through
sub-contract.
Where significant information in the SSuN data supply chain depend on external resources (local health
departments, other agency administrative units, commercial and/or non-profit healthcare entities, etc.),
awardees will obtain letters of support (LOS) from these entities demonstrating specific commitment to
providing SSuN data in compliance with collaboratively developed protocols.
Awardees will work collaboratively with CDC and other funded project areas to standardize protocols and
data elements for SSuN activities of national importance.
Awardees will use findings from their SSuN activities to improve and enhance existing core STD (or
STD/HIV, if integrated) surveillance in their jurisdictions. Wherever practical, awardees should incorporate
efficiencies achieved in the course of SSuN implementation, with respect to data systems and electronic
lab/case data, into routine surveillance practice.
Awardees will collaborate with CDC subject matter experts on multi-site analyses of Enhanced SSuN data,
development of presentations and manuscripts for publication. Such collaboration includes awardees
proposing analyses and acting as lead author (where interest and expertise permit), co-authoring and/or
approving use of data for multi-site analyses. Awardees and CDC collaborators will explicitly acknowledge
SSuN funding for all multi and/or single site presentations and publications which include substantial
analyses based on data collected in whole or in part with Enhanced SSuN project funding.
In recognition of the expertise, STD surveillance capacity and specific experience of SSuN collaborators,
awardees may occasionally be called upon to provide broader consultation to DSTDP and CDC on
surveillance or other emergent issues.
Awardees will provide required signatures on the SSuN Memorandum of Agreement (Appendix 1) within
the first SSuN funding year.
Awardees will ensure that all program activities adhere to the security and confidentiality guidelines as
outlined in the “Data Security and Confidentiality Guidelines for HIV, Viral Hepatitis, Sexually Transmitted
Disease, and Tuberculosis Programs: Standards to Facilitate Sharing and Use of Surveillance Data for
Public Health Action” (http://www.cdc.gov/hiv/resources/guidelines/security_confidentiality_hiv.htm.)
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Awardees will provide annual evidence of concurrence with SSuN activities by their jurisdiction’s Overall
Responsible Party (ORP).
Enhanced Case-Based Population Surveillance Activities
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Awardee’s STD surveillance or supplemental data systems will support, or be modified to
support random sampling of reported cases of gonorrhea in a timely manner following date of
diagnosis and report to the health department (e.g. weekly or at time of initial data entry into
surveillance system).
Sampling methods will support the ability to modify sample fractions as needed to assure a
representative probability sample of all cases reported in their jurisdictions and to maximize
response/investigation completion rates. Awardees must complete a minimum of 250
enhanced case investigations, including provider and patient interview components, annually if
gonorrhea morbidity (the initial target of the network’s enhanced case-based component) is less
than or equal to 10,000 cases annually, otherwise the number of completed investigations
should equal or exceed 2.5% of all reported cases.
Awardees will work collaboratively with CDC and other funded project areas to standardize
sampling methods, protocols and data elements for enhanced surveillance activities.
Enhanced surveillance case investigations, including health department records searches,
clinical variables of interest obtained from providers and patient interviews and for a
representative sample of STD cases will be implemented in compliance with collaboratively
developed SSuN protocols. Awardees will assure maintenance and continuation of these
activities as required by SSuN protocols.
Documentation of HIV status is required at a minimum for sampled cases, including date of last
HIV test (if known) for HIV-negative cases. Awardees will verify HIV-positive status using their
jurisdiction’s eHARS registry and document that this verification has been done.
All gonorrhea cases will be geocoded to the US Census 2010 census tract level.
Awardees will embed patient demographics, diagnosing facility type and geographic data on all
reported gonorrhea cases in SSuN datasets, including those not sampled for enhanced
investigations.
Awardees will assure that unique patient and provider identifiers are available, providing for
longitudinal monitoring of multiple disease episodes for persons and for calculating providerlevel burden of disease.
Facility-Based and other Sentinel Surveillance Activities
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Awardees will make every effort to obtain required visit-level clinical, diagnosis, treatment and
laboratory data for all patients attending at least one (1) categorical STD clinic in their
jurisdiction, in compliance with these protocols.
Awardees will obtain required visit-level clinical, diagnosis, treatment and laboratory data for all
females over 14 and less than 45 years of age at the time of clinic visit from Family
Planning/Reproductive health clinic(s) in compliance with these protocols.
Awardees will assure that unique patient identifiers, at the facility level, are available to provide
for longitudinal monitoring of multiple visits by unique patients within each facility. Unique
identifiers across facilities are strongly encouraged wherever possible.
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SSuN Part A – CDC Responsibilities
Collaborators in the Enhanced STD Surveillance Network are funded through a Cooperative Agreement
rather than a grant mechanism in recognition of the substantial involvement of the funding agency in
the development of activities, protocols and priorities for the network consistent with the broader goals
of the Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB
Prevention, Division of STD Prevention. Substantial involvement by CDC collaborators includes:
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Coordination of development of methods and protocols for SSuN activities.
Facilitation of routine SSuN communications.
Coordination of routine conference calls and annual collaboration meetings to review and plan
program activities.
Provision of technical assistance facilitating secure electronic transmission of data.
Provision of technical assistance with SAS licensure and SAS coding.
Monitoring of grantee progress toward achieving SSuN objectives, including grantee
implementation of data quality assurance processes.
Management of SSuN data warehouse or other central data store to support data provisioning for
collaborative analyses.
Provision of guidance and technical assistance (where requested or identified by CDC) essential to
implementation of activities in compliance with these protocol.
Ensuring that analyses and dissemination of findings from SSuN surveillance activities are
conducted collaboratively by both CDC and appropriate participating sites.
Providing laboratory services for supplemental surveillance projects.
Facilitating discussions with awardees to identify emerging trends/issues in STDs/HIV and sexual
health, STD surveillance technologies and methods and other issues that merit further
investigation by the Enhanced STD Surveillance Network.
Coordinating the development, dissemination and approval of proposals for SSuN analytic projects
Assisting co-authors and lead authors in the development of manuscripts.
Facilitating CDC clearance for manuscripts and presentations based on SSuN findings.
Working with awardees to assure that SSuN activities, at both the awardee and CDC level, adhere
to NHHSTP data security and confidentiality guidelines.
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SSuN Part A – Memorandum of Agreement
Enhanced STD Surveillance Network sites will review and sign a Memorandum of Agreement (MOA)
between the participating site and CDC (Appendix 1). The purpose of this agreement is to provide a
framework governing the sharing and release of STD surveillance data collected, stored and transmitted
to CDC as part of the Enhanced STD Surveillance Network activities.
Confidentiality
All SSuN participating sites are public health departments, not covered entities under HIPAA regulation:
“Without individual authorization, a covered entity may disclose protected health information to a
public health authority that is legally authorized to collect or receive the information for the purposes of
preventing or controlling disease, injury, disability including, but not limited to reporting of disease...and
conducting public health surveillance…” (MMWR, 2003). Data sent to CDC will contain no personal
identifiers such as name, social security number, date of birth, street address, or medical record
number.
Human Subjects Protections
The Associate Director for Science (ADS) of the NCHHSTP, CDC, will review all final SSuN protocols. A
Determination of Non-Research will be sought for SSuN Cycle III activities and, if approved, SSuN will be
exempted from CDC Institutional Review Board (IRB) review because the project activities constitute
surveillance, a disease control activity, and not research. No incentives are provided to participants or
clinic personnel for SSuN activities. Collaborating health departments should assess their local needs for
similar determinations.
Uses of SSuN Part A Data
Local collaborators retain control of and rights to analysis, research, and publication of their locally
collected data, regardless of whether these data are also provided to CDC as part of SSuN activities. Any
proposed use of multi-site data will be discussed with the SSuN Project Officers and Principal
Collaborators of sites whose data are requested. CDC encourages sites to inform CDC and other SSuN
collaborators of site-specific analyses of SSuN-related data in order to promote and stimulate use of
data. Multi-site analyses are encouraged wherever collaboration is both feasible and the results of
multi-site analyses can be of greater or different public health value than a site-specific analysis. Sitespecific SSuN data maintained by CDC will be shared with non-CDC personnel for analysis only with
documented permission from the site’s Principal Collaborator. Guidelines for analysis of SSuN data are
outlined below.
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I. Analysis and Reporting of Multi-site Data:
The following guidelines apply to analyses using multi-site data generated as part of SSuN, including 1)
proposed analyses, 2) public presentations, or 3) manuscripts to be submitted for publication.
1.
Authorship:
1. In general, the first author will be the individual who took the most responsibility for that
specific analysis, based on genesis of the idea, conduct of analysis, and the actual writing of
the manuscript. Ordering of authors (and number of authors per site) should be based on
active and substantive participation in analysis and preparation of the manuscript.
2. In developing manuscripts for submission to peer-reviewed journals/publications, primary
author will offer collaborating sites contributing data the opportunity to identify co-authors.
Where no restrictions limit the number of co-authors exist, all sites are encouraged to
identify specific individuals to be listed as co-authors and to participate actively in
manuscript development. In cases where there are limitations on the number of co-authors,
sites electing only minimal involvement in analysis and manuscript development should
identify an individual for formal inclusion as co-author under a “SSuN Working Group”
designation. Enhanced STD Surveillance Network Working Group designations are ad hoc
and may be comprised of different site representatives as need for each
manuscript/abstract developed for publication.
3. Sites may also choose to be omitted from the co-author list entirely, in which case the
principal collaborator will be formally acknowledged (along with their agency) as
contributing data. A formal request for sites to identify co-authors for analyses/manuscripts
and abstracts, including preliminary tables or analyses, will be transmitted to sites with the
proposal and should select from the following authorship categories:
1. Lead (will be the lead on analysis, initial drafting of manuscripts)
2. Primary (will take an active role in analysis/reviewing/editing)
3. Contributing (can be listed in workgroup if there are restrictions on number of
authors)
4. Acknowledgement only (acknowledgement for use of data in body of the manuscript
is sufficient)
Collaborators are asked to respond promptly to such requests; non-response under normal
circumstances of several weeks or more will be construed as actively declining coauthorship and granting tacit approval for inclusion of site’s data, with the understanding
that explicit acknowledgement for use of data will be included in any presentations or
manuscripts.
4. Authors are encouraged to include both individual contributing authors, and the SSuN
Project as co-authors (e.g., author1, author2,.. author15, SSuN Project Group). Published
reports for which the SSuN Working Group is listed as an author (or in the title) will include
mention of each Principal Collaborator and agency by name either in the author line, as a
footnote, or as an acknowledgement.
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5. Authors are encouraged to include Associate Collaborators in acknowledgements.
2.
Review: Principal Collaborators will review all proposed multi-site projects, abstracts, and papers
generated from multi-site data.
A. For proposed analysis projects, each Principal Collaborator will be notified of proposed
analyses using the recommended project proposal format (TBD), and all Principal
Collaborators must be provided an opportunity to comment.
B. At the discretion of SSuN Project Officers, exploratory analysis of multi-site data stored at
CDC can be conducted, including sharing data internally with CDC-sponsored fellows or
Epidemic Intelligence Service officers, in consultation with collaborators to assist in
development of analytic proposals.
C. Site collaborators should give feedback to the proposing author and the CDC Project Officer
(or designee) about whether a proposed multi-site project is or is not an appropriate and
acceptable use of their site’s data within a reasonable amount of time.
D. If a project is considered not appropriate or unacceptable by one or more collaborating site,
the project will be discussed on a conference call and consensus regarding initiation of that
analysis or project will be reached.
E. Any Principal Collaborator of a site may elect to exclude their data from the proposed
analysis.
F. A site’s data will not be shared externally and NOT be included in final analysis until the
proposing author has received consent for the proposed activity from that site’s Principal
Collaborator(s).
G. Request for submission of an abstract for oral or poster presentation at a relevant
conference based on a new analysis proposal should be made in a timely manner, whenever
possible, before the abstract deadline and should include a copy of the call for abstracts for
the proposed conference. In some circumstances, timelines may need to be shortened due
to circumstances beyond the control of Project Officers (CDC or local clearance
requirements, etc.).
H. Abstracts/presentations and manuscripts generated from the multi-site data should be
submitted to all authors and Principal Collaborators for review prior to submission for CDC
clearance.
1. The first author should specify a deadline for the receipt of comments, and it will be
the responsibility of secondary authors and Principal Collaborators (or their
designees) to provide comments by that deadline.
2. Non-response by the deadline will be assumed to signify approval of the draft.
3. A reasonable time for review is at least 4 days for abstracts and 2 weeks for
manuscripts.
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3.
Clearance: Abstracts/ presentations and manuscripts using data collected through SSuN or
including a CDC co-author, must be submitted for CDC clearance prior to submission for review by
conference organizers, journals, etc. CDC clearance involves review by the Division of STD
Prevention (DSTDP) and other CDC authorities to ensure that all products are of the highest
quality and are scientifically sound, technically accurate, and useful to the intended audience.
Clearance also ensures compatibility of information with CDC recommendations, so that if
findings have implications for changing recommendations or policies, the appropriate CDC
personnel are made aware of these changes. Cross-clearance of a product may also be required if
a topic is the responsibility of another Division or Center at CDC. Authors should be considerate
of the need for local and CDC clearance requirements.
4.
A.
Abstracts should be submitted to the Project Officer for CDC clearance a minimum of four
weeks prior to the submission deadline, unless other arrangements are made in advance.
For some large conferences (e.g., STD Prevention Conference, ISSTDR, International
HIV/AIDS Conference), the Division or Center will specify an earlier clearance deadline, and
this should be taken into consideration.
B.
Before CDC clearance can be initiated, CDC requires documentation of approval by all coauthors. Co-authors are asked to be sensitive to the time requirements for clearance and to
respond to such requests promptly.
C.
Publication of a manuscript in a journal requires CDC clearance of that manuscript, even if
an abstract was previously cleared.
D.
Authors should be aware that CDC clearance for journal articles may take a month or more.
E.
Authors should be aware that products that are not high quality, scientifically sound,
technically accurate, and useful to the intended audience may not be cleared by CDC.
Authors should also expect to receive requests for revisions or clarifications during the
clearance process.
F.
The first author of an abstract or manuscript should provide all authors with a final edited
copy of the abstract or manuscript as submitted for review by conference organizers,
journals, etc., with the date and place of submission noted.
G.
After publication, the first author should provide all co-authors with a copy of the published
version of the abstract or manuscript, as well as copies of slides and texts for presented
papers.
Additional guidelines:
A. Principal and Associate SSuN Collaborators will be given first opportunity to conduct
analyses using collaborative data. However, individuals (e.g., EIS Officers, fellows, students)
may be allowed to conduct analyses and write abstracts/papers using collaborative data if 1)
sponsored by CDC Project Officer, a Principal or Associate Collaborator, and 2) the proposed
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project is accepted by the Principal Collaborators prior to submission of an abstract.
B. In order to facilitate communication, the SSuN Project Officer (or designee) will maintain a
list of SSuN proposed activities, presentations, and publications, and ensure that this list is
available to all Principal Collaborators.
C. The SSuN Project Officer may present SSuN data within CDC without prior approval by SSuN
Principal Collaborators. These data will not be disseminated externally without prior
approval by SSuN Principal Collaborators. The SSuN Project Officer will request prior
approval by SSuN Principal Collaborators for publications or formal presentations outside
CDC. A copy of any internal or external presentation or publication by the SSuN Project
Officer will be distributed to all SSuN Principal and Associate Collaborators.
D. Enhanced STD Surveillance Network Principal and Associate Collaborators may present
informal analyses of SSuN data locally or internally within their agency without prior
approval from the Principal Collaborators. These data should not be disseminated further
without prior approval by SSuN Principal Collaborators. SSuN should be acknowledged on
all slides presenting SSuN data, and a copy of the presentation should be shared with all
SSuN Principal and Associate Collaborators. Prior approval must be obtained for any local
presentation resulting in a published abstract, or any presentation involving significant or
controversial findings.
E. All public presentations or publications using SSuN data should acknowledge the SSuN
Project and CDC. For example: “This activity was funded by the Division of STD Prevention,
CDC, through the Enhanced STD Surveillance Network (SSuN, CDC-RFA-PS13-1306).”
F. Concerns about use or misuse of data should be brought to the attention of the SSuN
Project Officer and/or the Principal Collaborators immediately.
II. Analysis and Reporting of Site-Specific Data:
The following guidelines apply to analyses using site-specific (single site) data generated as part of SSuN,
including 1) proposed analyses, 2) public presentations, or 3) manuscripts to be submitted for
publication.
A.
Site-specific analyses are appropriate when an individual site (or sites) has collected data
that are unique to that site, or are addressing a question particularly pertinent to that site.
B.
Use of SSuN local data by the respective local Principal Collaborators may be conducted at
any time without review by SSuN as a whole.
C.
In general, the first author should be the individual who took the most responsibility for
that specific report, based on genesis of idea, conduct of analysis, and the actual writing of
the paper.
D.
If applicable, the SSuN Project (or other Principal Collaborators) should be recognized as coauthors if data used in the analysis were conducted on site-specific data collected
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specifically for transmission to CDC for SSuN-funded activities.
E.
The nature of the recognition should be based on the degree to which other sites,
collaborators or SSuN funding contributed to collection of the data used in the analysis.
F.
All authors should have the opportunity to review any reports on which they are listed prior
to their presentation or publication.
G.
Any report with CDC staff or the SSuN Project Group as a co-author should go through CDC
clearance (see above).
H.
Presentations (local or otherwise) based on data collected using SSuN funding should
acknowledge CDC support for data collection activities and cite the SSuN Funding
Announcement Number (CDC-RFA-PS13-1306).
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SSuN Part A – Enhanced Case-based Population Surveillance (Gonorrhea)
Cycle 3 of SSuN builds on previous experience in enhanced population surveillance in Cycle 1 and 2, and
focuses on persons being diagnosed and reported to funded health departments with infections due to
Neisseria gonorrhoeae (GC). Data collection activities address the following surveillance objectives
relative to patient, provider, laboratory and surveillance system characteristics. Funded jurisdictions will
use SSuN resources to enhance completeness of information for all reported cases of gonorrhea, but at
a minimum will obtain complete information for a probability sample of cases, allowing for accurate
estimation of case characteristics in the domains described below.
Enhanced Case-based Population Surveillance Objectives
Domain1: Case/Patient demographics and insurance characteristics
The following characteristics of cases/patients are often missing or not otherwise available in NETSS
data streams.
1. Objective: Monitor the distribution of reported gonorrhea cases by demographic characteristics
a. Race
b. Hispanic ethnicity
c. Sex (including transgender)
d. Age
Rationale: Race and Hispanic ethnicity are missing for ~20% of cases reported through NETSS.
Complete ascertainment among a random sample of cases will allow for assessment of potential
bias in reporting of race and ethnicity by other factors such as provider type or region, which may
have implications for how inequalities in disease burden are determined and presented nationally.
Misclassification of race may also be explored by comparing the patient self-reported race with that
in the case/laboratory data reported by providers.
Sources of Information: internal health department records, including laboratory data and patient
report.
2. Objective: Monitor the distribution of reported gonorrhea cases by specific geography (census
tract).
Rationale: the lowest level of geography available in NETSS is Zip Code, which limits potential
geospatial analysis. Census data are available on a broad range of social, economic and
demographic factors at the census tract level that are not routinely available at the Zip Code level.
Homeless and incarcerated populations are also of interest; information on the housing status and
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incarceration are not available from any other source for persons diagnosed and reported with
gonorrhea.
Sources of Information: Internal health department records, including laboratory data, and patient
report. Geocoded street address information matched to 2010 US Census Tracts should be
supplemented with information from provider (Phase 2) and patient (Phase 3) investigations where
necessary to assure accuracy.
3. Objective: Monitor the proportion of reported gonorrhea cases are enrolled in/covered
by/accessing health insurance:
a. Individual insurance
b. employer-provided insurance
c. Medicaid / Medicare or other public-pool insurance
Rationale: Health insurance coverage may be a significant factor affecting care seeking behavior
and decisions. Changes in the proportion of patients covered by insurance may also be useful in
assessing the impact of Affordable Care Act on STD prevention and care services. Meta data about
state-level expansion of Medicaid and other public pool insurance will also be collected to assess
differences between SSuN sites.
Sources of Information: Patient and provider report (Phase 2 & 3) investigations.
4. Objective: Monitor the proportion of reported gonorrhea cases paying any immediate out-of-pocket
expense at visit where initially diagnosed with GC.
Rationale: The Affordable Care Act may change the way preventive services such as STD screenings
are paid for. Information on the proportion of patients paying out-of-pocket expenses for routine
preventive screening that should be covered without any co-pay or out of pocket expenses should
be monitored over time to assess cost as a potential barrier to STD screening and integration of STD
services into primary care. Some patients may choose to pay rather than use insurance for privacy
or other reasons; this may be important to determine for planning safety-net services.
Sources of Information: Patient report (Phase 3) investigations
Domain 2: Case/Patient behavioral characteristics
Analyses of behavioral characteristics is severely handicapped by a lack of enhanced (interview) NETSS
data for gonorrhea cases, in 2010, 81.6% of all cases reported through NETSS were missing any
enhanced behavioral data.
5. Objective: Monitor the proportion of male gonorrhea cases reporting male sex partners (MSM).
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Rationale: The proportion of males reporting MSM behavior is important to the epidemiology of
gonorrhea and allows for analyses addressing inequality in the burden of disease among MSM, a
population of relevance to HIV infection as well.
Sources of Information: Patient investigation (Phase 3)
6. Objective: Monitor characteristics of period (3 months) and most recent sex partner(s) among
reported gonorrhea cases.
Rationale: The characteristics of recent sex partners are largely unknown for the majority of
reported gonorrhea cases. This information is useful for enhancing understanding of sexual network
dynamics and for modeling gonorrhea transmission.
Sources of Information: Phase 3 investigations, possible overall # of partners question for provider
investigation to determine if sexual history was taken.
7. Objective: Monitor the distribution of GC infection by anatomic site.
Rationale: Knowledge of infected anatomic sites is important to assessing the burden of disease and
to the epidemiology of GC. These data can also help assess the appropriateness of provider
screening practices.
Sources of Information: Phase 1 (laboratory data), and Phase 2 investigations
Domain 3: Facility type, clinical care and care-seeking characteristics
While provider type (INFOSRCE) is reasonably complete (13% missing) in NETSS, the provider type
coding may not be as useful as desirable in light of changes in insurance coverage and the healthcare
delivery system anticipated with the ACA. Moreover, the reasons why people seek care at specific
facilities versus others is not well understood. Information about the clinical services provided to the
patient (testing, screening, treatment, partner services, etc.) may be useful in assuring quality of care.
These data will be ascertained both from providers and/or patients as appropriate.
8. Objective: Monitor the proportion of cases being diagnosed and reported by facility type:
Rationale: Knowledge of provider status as FQHC or CHC and primary care versus other specialty
care is currently unknown for gonorrhea cases being diagnosed in the community. Clinics
designated as FQHC, and those providers classified as CHC are important as expanded primary care
providers for newly insured populations under the ACA.
Sources of Information: Phase 1 and Phase 2 investigations
9. Objective: Monitor the proportion of cases that are treated with appropriate/recommended
antimicrobials.
Rationale: Treatment data are currently unknown for the majority of gonorrhea cases being
diagnosed and reported. These data are important for assessing provider compliance with CDC
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recommendations and may be useful for interpreting susceptibility data from other sources (GISP).
Partial funding for SSuN was received from the Office of Antimicrobial Resistance (OAR) and this
activity is required of all Part A grantees.
Sources of Information: Phase 1 and Phase 2 investigations.
10. Objective: Monitor the proportion of gonorrhea cases presenting with signs/symptoms of GC
infection as documented by self-report and duration of symptoms from onset to care seeking.
Rationale: The proportion of reported cases that are symptomatic may change over time and could
indicate whether screening is becoming more or less universal. Delay in care seeking after symptom
onset may differ by insurance status, gender, age, etc. and indicate gap in safety net services.
Sources of Information: Phase 2 and Phase 3 investigations
11. Objective: Monitor the primary reason(s) for care-seeking at visit where GC was diagnosed
Rationale: Reason for healthcare visit is integral to understanding under what circumstances
patients seek care and the extent to which STD care is integrated into primary care.
Sources of Information: Phase 3 investigations
Specific Data Elements: patient reported reason for visit (all that apply approach?), recent contact
to STD (elicited).
12. Objective: Monitor the primary reason(s) for choosing the specific provider where GC was
diagnosed
a. is provider the patient’s medical home/primary care provider for all other medical needs?
Rationale: These data will help assess the degree of integration of STD services into primary health
care settings and the future need for safety-net categorical STD care facilities.
Sources of Information: Phase 3 investigation
13. Objective: Monitoring the pregnancy status of reported female gonorrhea cases:
a. Pregnancy status at time of GC dx
Rationale: These data will help assess the degree of integration of STD services into reproductive
health care settings and the future need for categorical STD care facilities.
Sources of Information: Phase 3 investigation
Domain 4: Partner services & HIV co-morbidity
14. Objective: Monitor the proportion of reported gonorrhea cases that are offered and accept partner
services:
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a. Patient referral
b. Provider referral
c. EPT (meds or Rx for partner)
Rationale: Partner services are a primary programmatic activity to reduce the likelihood of reinfection and interrupt the chain of transmission in the community. These data will also allow for the
evaluation of specific interventions such as EPT.
Sources of Information: Phase 2 & Phase 3 investigations
15. Objective: Monitor the proportion of reported gonorrhea cases (not previously known to be HIV
positive) that have been tested for HIV in previous year and at time of gonorrhea diagnosis?
Rationale: HIV testing is critical to identifying new HIV cases; persons who know their status may be
less likely to engage in ongoing risk.
Sources of Information: Phase 1, Phase 2 and Phase 3
16. Objective: Monitor the proportion of reported gonorrhea cases that are HIV positive and proportion
of HIV positive in HIV care/on ART:
a. HIV status documented through HIV-surveillance match?
i. Date of earliest HIV-positive test
b. In HIV care by self-report?
c. On ART?
Rationale: HIV co-infection among persons diagnosed with gonorrhea is not well documented at the
population level. GC diagnoses among HIV-positive persons indicate ongoing sexual exposure risk
and a significant burden of disease among a vulnerable population. Engagement with HIV primary
care and HIV treatment is important to assessing population risk
Sources of Information: Phase 1, Phase 2 and Phase 3
Domain 5: Surveillance system evaluation
17. Objective: Monitor the proportion of reported gonorrhea case notifications to the health
department that:
a. originate with ELR
b. originate as provider reports
c. are duplicates of previously reported cases
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i. time interval from most recent ‘duplicate’ report
d. are for patients previously reported with prior episodes of disease
i. GC
ii. Syphilis
iii. CT
iv. HIV
e. reported from out of jurisdiction
Rationale: These data are critical for monitoring/assuring the quality, completeness and
representativeness of gonorrhea surveillance. These data support creation and maintenance of ‘STD
Surveillance Centers of Excellence’ by providing system evaluation information.
Sources of Information: Phase 1 investigations
18. Objective: Monitor the median time elapsed between diagnosis (specimen collection date if
available or earliest provider report of case) and receipt of notification by the health
department/entry into surveillance system.
Rationale: These data are essential for monitoring/assuring the quality of STD surveillance.
Sources of Information: Phase 1 investigation
Specific Data Elements: date of report, date of specimen collection, date of provider diagnosis, date
of laboratory report.
Domain 6: Population denominators and other useful metadata
19. Objective: Monitor the completeness of NETSS/STD MMG records for all cases in jurisdiction.
Rationale: These data are essential to calculating appropriate case weights for SSuN population data
and developing estimates representative of the universe of reported cases.
Sources of Information: Internal, CSELS
20. Objective: Obtain census data for the jurisdiction (population, ACS, etc.).
Rationale: These data are useful for analyzing social determinants of GC incidence, calculating rates
and other ecologic analyses.
Sources of Information: External
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PART A Population Component – Methods
A. Generating Random Samples
A random sample of all reports of gonorrhea received by collaborating health departments will be
obtained. Gonorrhea ‘reports’ will be locally defined to include provider case reports, laboratory
reporting or any other original source documents as appropriate given the specific surveillance
infrastructure in the funded jurisdictions. Although sampling methodologies will likely vary across
jurisdictions, several criteria will be adhered to with respect to the quality of the random sample:
A. The sampling ‘universe’ will include ALL cases of laboratory confirmed gonorrhea diagnosed and
reported from ALL public and private sources for patients residing within the geographic
boundaries of the collaborating jurisdiction.
B. Records should be individually sampled at the time they are received into the system (or
batched in a timely manner) such that all gonorrhea records meeting the criteria based on
information contained in the report (patient resident in jurisdiction, laboratory/provider
confirmed diagnosis of gonorrhea) have an equal probability of being sampled. Records sampled
should be referred or assigned for enhanced investigation in the shortest practical timeframe.
Sample may be stratified by county or other useful geography as needed to balance work-load
within collaborating jurisdictions but no stratification based on patient sex, age, race, Hispanic
ethnicity or provider characteristics should be applied.
C. If the sample is obtained through a batch process, the sampled records must be identified in a
timely fashion so that at a maximum, with no more than 15 calendar days elapsing between
receipt of the record at the health department, inclusion in a sample frame and subsequent
referral for enhanced investigation.
D. The overall sample fraction must be adjustable (by the entire site or by specific geographic
strata as locally appropriate) in order to assure that a sufficient volume of records are included
in the random sample to result in enough completed case investigations to fulfil stated project
objectives.
E. Funded jurisdictions will conduct routine and frequent quality assurance activities to assess the
representativeness of their sample, with particular attention to equal probability of sampling by
patient characteristics (race, Hispanic ethnicity, gender, age geographic region within
jurisdictions and source of report).
F. Funded jurisdiction will assure that appropriate data are available on ALL reported cases to
calculate valid stratification and non-response weights for their sampled cases.
B. Internal Case Investigation (Phase 1)
At a minimum, sampled records will be compared with existing disease and laboratory registries to
determine if the patient of record has previously been reported (ever reported) to the department of
health for HIV infection and to document any recent history of STDs. Previous GC, CT, Syphilis, viral
hepatitis and TB diagnoses occurring within 365 days of the specimen collection date/diagnosis date of
current GC diagnosis should be documented and included in the SSuN record. It should also be
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determined at this time whether the record represents a ‘duplicate record’ (defined as a GC diagnosis
within 21 days of the specimen collection date/diagnosis date of a previously reported record for the
same anatomic site); this should also be documented and similarly included in the SSuN record. For
duplicate cases/records, previous report date and specimen collection date (used to determine
duplicate status) should be documented.
All laboratory data associated with the patient and specific episode of disease/infection should be
obtained and documented for SSuN with provisions for multiple tests across multiple anatomic sites.
Wherever available, negative laboratory results should also be included in the SSuN dataset to
demonstrate screening practices. Laboratory data obtained in Phase 1 investigations will be managed as
a relational table, with a one-to-many relationship between primary case records and laboratory results.
Results and status of all Phase 1 investigation should be documented with an appropriate disposition
code.
All SSuN population records should be assigned a phase 1 investigation disposition regardless of
sampled status and appropriate Phase 1 disposition codes used to indicate cases not actively followedup on. Jurisdictions are encouraged to complete phase 1 investigations on all incoming records
including those not in the random sample.
Criteria for referral to phase 2 investigations will include:
o
o
o
Record represents case of confirmed gonorrhea and is not a duplicate of a previously
reported case
Diagnosing provider/facility is ascertained and is within funded jurisdiction
Patient determined to reside within jurisdiction at the time of diagnosis
C. Provider Investigation (Phase 2)
For phase 2 investigations, the diagnosing provider is contacted to provide additional information about
the case’s clinical characteristics, the specific care setting and demographics of the patient not present
in the original case or laboratory report. These investigations can be either by direct contact with
providers (phone) or through other methods such as secure fax, mail or other means as long as
confidentiality of patient information is strictly maintained. Phase 2 also represents an opportunity for
funded jurisdictions to obtain contact information necessary for completing Phase 3 investigations if this
information is missing from initial laboratory or case reports. Funded jurisdiction must institute quality
assurance and follow-up procedures to assure the highest possible completion rate for Phase 2
investigations, including tracking investigation status and periodic re-contact to assure provider
completion.
Criteria for referral to phase 3 investigations (patient interview) will include:
o
o
Record represents case of confirmed gonorrhea and is not a duplicate of a previously
reported case
Patient determined to reside within jurisdiction at the time of diagnosis
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o
Initial case report or notification was received by health department within 60 days of
the diagnosis (or specimen collection) date
D. Patient/Case Investigation (Phase 3)
Patient-level investigations/interviews may be conducted either by phone or in-person with at least 3
documented attempts to contact each patient referred for Phase 3 investigations. Sites are required to
develop local protocol documents and data collection instruments (paper and/or electronic) for
investigators, required to provide adequate training to investigators conducting patient contact and to
address local human subject’s requirements.
All reasonable attempts must be made to obtain contact information for cases eligible for Phase 3
investigations. Methods for obtaining contact information for patients may include vital record searches,
registry searches, provider contact, social media (following local conventions), driver’s license and/or
vehicle registration registries if available.
Funded jurisdictions may also find it productive to integrate SSuN data collection into local partner
management and treatment assurance protocols; this is appropriate as long as SSuN-related data
elements are collected in a manner consistent with SSuN questions and coding conventions.
E. Data Management
Data obtained for the population component will come from numerous sources within the health
department and will need to be locally merged, recoded and appropriately structured to facilitate
merging into the national SSuN datasets. Funded jurisdictions are expected to institute rigorous
procedures to assure the quality and validity of data elements (Appendix 2) before submitting data to
CDC. CDC will provide SAS data structures with variable names, lengths and types defined for all
requested datasets. Local data should be transformed to conform to these data structures and include
only the requested data elements properly coded and in appropriate data formats.
Funded jurisdictions will complete data verification and validity checks on datasets prior to transmission
to CDC, including consistency checks to assure that data in the record is internally rational (e.g. that
there are no records of males with cervical infection or pregnancy indicated for males). In collaboration
with data managers in each jurisdiction, CDC will prepare syntax for data validation that will provide for
appropriate quality assurance. Jurisdictions will apply these validation checks and fix the offending
records prior to transmission. In cases where errors are repeatedly introduced from underlying, primary
data sources that cannot be corrected, an exception file should be maintained locally and applied before
transmission to fix historical errors that recur because of the cumulative data process.
Jurisdictions will provide clean, validated datasets to CDC on a monthly basis, alternating facility and
population component datasets such that each component is updated with new data every two months
with cumulative data back to the beginning of each calendar year. A final, validated annual dataset will
be transmitted each year and archived to become the primary repository of that site’s annual reporting.
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These annual datasets will serve as the basis for calculating analytic weights in the population
component and should be preserved at the local level as ‘frozen’ data for local analytic purposes.
Figure 1: Suggested Site-Level Record Process Flow for Population Component of Enhanced SSuN Part
A
F. Transmission of Data to CDC
Required datasets will be securely transmitted to CDC each month, on the 15th of the month, with
complete data though the last day of the preceding month. When the 15th falls on a holiday or
weekend, datasets will be due the first business day following the holiday.
Record-level data will only be transmitted to CDC following the Secure Access Management Service
(SAMS) protocols. Sites may also be required to encrypt data using at least 128-bit RSA-compliant strong
key-pair encryption (such as PGP).
CDC will formally acknowledge all data transmissions and data validation results. Datasets failing to
comply with pre-determined data structures will be rejected, with notification to sites. Sites must reformat, recode or resolve issues and retransmit corrected datasets within 5 working days whenever
possible.
G. Data Management at CDC
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CDC will formally acknowledge data transmission with a return e-mail. Datasets received at CDC will be
validated and merged to the national SSuN database within two weeks of receipt; the national dataset
will be maintained current as of the end of the previous reporting month for purposes of reporting
process measures to funded jurisdictions. Funded sites will receive an individual summary report
documenting the status of all datasets received to date and identifying any datasets that were due and
have not been received, the on-time status of all transmissions and summary process measures such as
the number/proportion of cases with matching laboratory records, the random sample fraction, the
completed phase 1 – 3 investigations and other information as determined by consensus.
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SSuN PART A – Facility Component
Cycle 3 of SSuN will build on previous experience in enhanced facility-based surveillance in Cycle 1 and 2,
and will focus on capturing information on STD-related clinical and prevention services across a broad
range of practice settings, including STD and family planning and reproductive healthcare clinics. Data
collection activities will address the following surveillance objectives relative to trends in infections and
sequelae as well as compliance with screening guidelines, treatment recommendations and use of
appropriate diagnostic technologies not available at the national level from any source. Monitoring and
surveillance activities in selected clinical settings in diverse geographic areas can provide key insights
into shifting patterns of STD care delivery, patient access and the social determinants of STDs.
Facility-based Surveillance Objectives
Domain1: Trends in infections and sequelae
1. Objective: Monitor positivity trends in lab-confirmed chlamydia and gonorrhea infection by
patient demographics, behavioral and clinical characteristics, and/or facility characteristics.
Rationale: Chlamydia and gonorrhea are usually asymptomatic and trends in case
report data are influenced by screening coverage and changes in population tested.
Additionally, behavioral and clinical characteristics of cases are not routinely collected.
Target population:
Family planning clinics: females of reproductive age (15-44 years);
STD clinics: all clinic attendees
Data elements required: patient id, event id, facility id, date of visit, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), tested (chlamydia, gonorrhea); lab result; anatomic site of test;
diagnostic test type; reason for visit
Additional data elements of interest (in addition to required variables): risk behaviors;
pregnancy status; contraceptive use; co-morbid STD diagnoses; self-reported STD
history; symptoms
2. Objective: Monitor positivity trends in HIV by patient demographics, behavioral and clinical
characteristics, and facility characteristics.
Rationale: Understanding the proportion of HIV cases that are identified in safety net
clinics (e.g., STD and/or family planning clinics) can provide an opportunity to target
public health interventions and provide important information on high risk population
sub groups. In addition, persons who know their status may be less likely to engage in
ongoing risk and prevent further transmission.
Target population:
Family planning clinics: females of reproductive age (15-44 years);
STD clinics: all clinic attendees
Data elements required: patient id, event id, facility id, date of visit, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), tested for HIV; laboratory result; HIV status
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Additional data elements of interest: (in addition to required variables): reason for
visit; risk behaviors; pregnancy status; co-morbid STD diagnoses; self-reported STD
history
3. Objective: Evaluate NAAT test of cure (TOC) at 7 days following treatment for potential
treatment failures as outlined by current STD treatment guidelines
Rationale: Gonorrhea differs from most other bacterial sexually transmitted diseases
(STDs) because of its formidable ability to develop antibiotic resistance, which limits the
options for effective treatment and control of the disease. Current CDC guidelines
recommend dual therapy for uncomplicated gonorrhea (ceftriaxone plus azithromycin
or doxycycline as first-line therapy) at all anatomic sites. If a therapy other than
ceftriaxone is used, a TOC is recommended at 7 days post-treatment. TOC may allow
clinicians to rapidly detect patients for whom treatments were ineffective and may
provide active public health surveillance for resistant gonococcal infections.
Target population:
STD clinic attendees with laboratory-confirmed GC
Data elements required: patientid, eventid, facility_id, visdate, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), lab result for gonorrhea; anatomic site of test; diagnostic test type; risk
behaviors; treatment; assessment of risk exposure and symptoms at initial and return
visit.
4. Objective: Monitor trends in pelvic inflammatory disease (PID) by patient demographics,
behavioral and clinical characteristics, and facility characteristics.
Rationale: PID is not a nationally notifiable disease and sentinel surveillance is necessary
to monitor trends and to increase understanding of the epidemiology of PID.
Target population:
Family planning clinics: females of reproductive age (15-44 years)
STD clinics: all female clinic attendees
Data elements required: patientid, eventid, facility_id, visdate, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), PID diagnosis; physical exam signs (adnexal tenderness; cervical motion
tenderness, etc.)
Additional data elements of interest: reason for visit; risk behaviors; pelvic exam; prior
PID history; contraceptive use; pregnancy status; co-morbid STD diagnoses results; selfreported STD history; symptoms
5. Objective: Monitor trends in HIV-STD co-infection by patient demographics, behavioral and
clinical characteristics, and facility characteristics.
Rationale: HIV/STD co-infection cannot be assessed at the national level through exact
match methods. The heavy burden of co-infection with HIV disease and then a STD is
indicative of continued high risk behavior. Understanding both the incidence of STDs
among persons known to be infected with HIV and the incidence of co-diagnosis can
help inform and evaluate prevention interventions.
Target population:
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Family planning clinics: females of reproductive age (15-44 years);
STD clinics: all clinic attendees
Data elements required: patientid, eventid, facility_id, visdate, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), laboratory result for HIV, gonorrhea, chlamydia; other STD diagnoses;
prior testing history and current HIV status
Additional data elements of interest: reason for visit; risk behaviors and exposure;
pregnancy status; self-reported STD history.
6. Objective: Monitor etiologic trends in STD-related conditions such as non-gonococcal urethritis
(NGU), PID or other non-pathogen specific diagnoses in categorical STD clinics through
supplemental laboratory analysis.
Rationale: Numerous pathogens have been isolated from men and women with STDrelated conditions such as NGU, PID and cervicitis. Little is known about the prevalence
of non-reportable genital-tract bacterial infections in patients presenting for care in
categorical STD clinics. Moreover, the extent of co-infection with multiple pathogens is
unknown for persons diagnosed with chlamydia, gonorrhea and other reportable STDs.
The susceptibility of these co-occurring pathogens to commonly used antibiotics is
unknown.
Data elements required: No additional patient-level data elements are needed.
Additional data elements of interest: Specimen ID (if biologic samples are analyzed at
CDC).
Domain2: Trends in preventive healthcare services
1. Objective: Monitor adherence to STD/HIV screening and re-screening recommendations
(screening and rescreening recommendations listed in Appendix 3).
Rationale: Monitoring adherence to screening and re-screening recommendations can
help inform and evaluate interventions. Currently the CDC recommends:
• annual chlamydia screening for young women and older women at increased
risk
• gonorrhea screening for all persons at increased risk
• annual HIV tests
• annual syphilis and chlamydia/gonorrhea screening at exposed sited (MSM).
• Re-screening at 3 months for persons diagnosed with chlamydia or gonorrhea
Target population:
Family planning clinics: females of reproductive age (15-44 years);
STD clinics: all clinic attendees
Data elements required: patientid, eventid, facility_id, visdate, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), tested chlamydia, gonorrhea, HIV; lab result; HIV status; anatomic site of
exposure for MSM; risk behaviors
Additional data elements of interest (in addition to required variables): reason for visit;
pregnancy status; self-reported STD history
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12 December 2014
2. Objective: Monitor trends in appropriate treatment of diagnosed STDs
Rationale: Treatment information is not routinely reported for most STDs and little is
known about the prevalence of presumptive treatment. Understanding appropriate
treatment of identified infections and sequelae can evaluate implementation of the
treatment guidelines and identify areas for intervention.
Target population:
Family planning clinics: females of reproductive age (15-44 years);
STD clinics: all clinic attendees
Data elements required: patientid, eventid, facility_id, visdate, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), laboratory result for chlamydia, gonorrhea, and PID other STD diagnoses,
medications prescribed on visit
Additional data elements of interest: pregnancy status
3. Objective: Monitor changes in patient clinic population, including demographic in light of ACA
and integration of STDs in primary care
Rationale: In the face of a changing funding and policy landscape, it remains to be seen
whether publicly funded providers will continue to be used as providers of choice for
many clients with health-care coverage and remain a "safety net" for uninsured persons
in need of family planning and STD services. Tracking such trends to monitor the
demand for FP and STD services in SSuN clinics may help inform budget planning and
resource allocation.
Target population:
Family planning clinics: females of reproductive age (15-44 years) ;
STD clinics: all clinic attendees
Data elements required: patientid, eventid, facility_id, visdate, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), and insurance status
4. Objective: Monitor trends in partner treatment for STDs
Rationale: To ensure patients are not re-infected, partner management services is
necessary (including traditional partner management, EPT, provider referral) .
Monitoring whether patients received partner treatment can inform implementation of
the preventive services and identify areas for intervention.
Target population:
Family planning clinics: females of reproductive age (15-44 years) ;
STD clinics: all clinic attendees
Data elements required patientid, eventid, facility_id, visdate, gender, age,
race/ethnicity, gender of sex partner(s), facility characteristics (available from facility
reference file), lab result (chlamydia, gonorrhea); medications prescribed on visit;
provision of partner treatment
Enhanced SSuN Cycle 3
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PART A Facility Component – Methods
A. Clinic selection
STD clinic: Each SSuN site has identified at least one (1) categorical STD clinic in their jurisdiction in
which to conduct enhanced STD surveillance. Where multiple categorical STD clinics exist, awardees
considered the following priorities for inclusion: (1) those with highest patient volume, greatest
representation from at-risk populations, and reporting a meaningful proportion of gonorrhea and
syphilis diagnosed in their jurisdiction, (2) clinics serving most representative population of MSM and
young people relative to other clinic options, (3) clinics serving racial and ethnic minorities, and, (4)
clinics with stable funding streams (billing infrastructure, university/medical school support, etc.) to
maximize likelihood that selected facilities remain operational throughout the project period. Inclusion
of multiple STD clinics where cost efficient, quality surveillance data can be obtained is highly desirable.
Selected STD clinics are expected to maintain line-listed data on all patients and all visits in an electronic
format that allows for extraction of de-identified data for inclusion in the warehouse and analysis.
Family planning and reproductive health clinic: Each SSuN site has identified one or more FP/RH clinics
providing family planning and/or reproductive health (FP/RH) services to 15 – 44 year old females.
Inclusion of multiple clinics where cost efficient, quality surveillance data can be obtained is highly
desirable. FP/RH clinics proposed for inclusion must be representative of the highest risk population(s),
serve at least 2,000 females 15 – 24 years old annually and have current chlamydial infection/gonorrhea
screening coverage of 70% or greater among that population. Selected FP/RH clinics are expected to
maintain line-listed data on all female patients age 15-44 and all visits in an electronic format that allows
for extraction of de-identified data for inclusion in the warehouse and analysis.
B. Facility data collection
Visit-level clinical, diagnosis, treatment and laboratory data should be from all clinic attendees either at
the time of registration or during the clinic encounter and documented in the clinic electronic medical
record. Such data is necessary for STD program monitoring and implementation, much of which is
currently routinely collected by the participating clinics. Unique patient identifiers (at the facility level)
must be available in all facility-based data collection and management systems to provide for
longitudinal monitoring of multiple visits by unique patients within each facility providing data for SSuN
activities. This unique patient identifier must be submitted as part of each visit record. Unique identifiers
applicable across facilities are also strongly encouraged wherever possible. Sites will develop and
maintain information management systems sufficiently robust to provide for archival, query-based data
retrieval and comprehensive quality assurance on clinical visit and laboratory data extracted from, or
submitted by, all participating facilities. Required data elements (Appendix 2) will be collaboratively
defined by SSuN Collaborators and transmitted to CDC on all facility clinic patient visits on a TBD basis.
These data elements may be modified by SSuN Collaborators over time in response to changing
objectives. The actual data collection instruments will be designed locally to conform to local clinic data
collection needs. Sites are encouraged to update data collection instruments on a regular basis.
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Information on each participating clinic will be provided to CDC annually in a facility reference file. Each
facility will be given a unique facility ID. These facility IDs will be included in the visit-level dataset so that
patient-level data can be linked to facility data. Required facility-level characteristics reported will be
collaboratively defined by SSuN Collaborators. These data elements may be modified by SSuN
Collaborators over time in response to changing objectives.
C. Data Management
Data obtained for the facility-based components will come from numerous sources and will need to be
locally merged, recoded and appropriately structured prior to submission to CDC. Funded jurisdictions
are also expected to institute rigorous procedures to assure the quality and validity of data before
submitting to CDC. CDC will provide SAS data structures with variable names, lengths and types defined
for all requested datasets. Local data should be transformed to conform to these data structures and
include only the requested data elements properly coded in appropriate data formats.
Funded jurisdictions will complete data verification and validity checks on datasets prior to transmission
to CDC, including consistency checks to assure that data in the record is internally rational (e.g. that
there are no records of males with cervical infection or pregnancy indicated for males). In collaboration
with data managers in each jurisdiction, CDC will prepare syntax for data validation that will provide for
appropriate quality assurance. Jurisdictions will apply these validation checks and fix the offending
records prior to transmission. In cases where errors are repeatedly introduced from underlying, primary
data sources, an exception file should be maintained locally and applied before transmission to fix
historical errors that recur because of the cumulative data process.
Jurisdictions will provide clean, validated datasets to CDC (transmission frequency to TBD), with
cumulative data back to the beginning of each calendar year. The final, validated annual dataset will be
archived and become the primary repository of that site’s annual reporting and should be preserved at
the local level as ‘frozen’ data for local analytic purposes.
Datasets required for the facility component include four files:
1.
2.
3.
4.
5.
D.
Clinic table (Clinic_SITE_MMDDYY.SAS)
Related laboratory table (ClinicLAB_SITE_MMDDYY.SAS)
Related diagnosis table(ClinicDX_SITE_MMDDYY.SAS)
Related treatment table (ClinicTX_SITE_MMDDYY.SAS)
Annual facility reference file (ClinicREF_SITE_MMDDYY.SAS)
Transmission of Data to CDC
Required clinic and population datasets will be securely transmitted to CDC on a staggered schedule. On
the 15th of each month, sites will transmit each of the datasets on an alternating basis. For example, on
March 15th sites would send the population data and then on April 15th, sites would send the clinic data,
on May 15th the population data, etc. Data should be complete through the last day of the preceding 2
Enhanced SSuN Cycle 3
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12 December 2014
months. When the 15th falls on a holiday or weekend, datasets will be due the first business day
following the holiday.
Record-level data will only be transmitted to CDC following SAMS protocols. Sites may also be required
to encrypt data using at least 128-bit RSA-compliant strong key-pair encryption (such as PGP).
CDC will formally acknowledge all data transmissions and the validation results. Datasets failing to
comply with pre-determined data structures will be rejected, with notification to sites. Sites must reformat, recode or resolve issues and retransmit corrected datasets within 5 working days whenever
possible.
E. Data Management at CDC
CDC will formally acknowledge data transmission with a return e-mail. Datasets failing to comply with
pre-determined data structures will be rejected, with e-mail notification. Sites must re-format, recode or
resolve issues and retransmit corrected datasets within 5 working days.
Datasets received at CDC will be validated and merged to the national SSuN database within two weeks
of receipt; the national dataset will be maintained current as of the end of the previous reporting month
for purposes of reporting process measures back to funded jurisdictions. Funded sites will receive an
individual summary report documenting the status of all datasets received to date and identifying any
datasets that were due and have not been received, and the on-time status of all transmissions.
Summary process measures will also be provided and may include:
Facility component:
•
•
•
the proportion of laboratory records without a corresponding clinic record
What proportion of unique eventIDs are duplicative
The proportion of observations which have missing data of key variables (e.g., missing sex of sex
partner for male patients)
Enhanced SSuN Cycle 3
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Appendix 1: Memorandum of Agreement
Memorandum of Agreement for
Analysis of Enhanced STD Surveillance Network (SSuN) Surveillance Data between
The Division of STD Prevention,
National Center for STD, Viral Hepatitis, STD and TB Prevention
and
PURPOSE
The purpose of this agreement is to provide a mutually agreed framework between CDC and
funded entities for the sharing and release of STD surveillance data collected as part of the Enhanced
STD Surveillance Network activities.
BACKGROUND & OBJECTIVES
The Enhanced STD Surveillance Network (hereafter, SSuN) is comprised of state/local and/or city
health departments funded by cooperative agreement (CDC-PS13-1306) to implement common
protocols for enhanced and sentinel STD surveillance. 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
through enhanced collection, reporting, analysis, visualization (e.g., mapping) and interpretation of
disease information. Data are sent by funded jurisdictions following prescribed protocols to CDC and
merged into a national dataset that can be used by Principal Collaborators and CDC subject matter
experts for analysis as provided for in SSuN protocols. This memorandum of agreement is intended to
explicitly demonstrate concurrence between funded sites and CDC with SSuN procedures and guidelines
allowing the use of data collected and contributed by Enhanced SSuN collaborating sites.
STORAGE OF SSuN DATA
The health department identified above agrees to send to CDC de-identified datasets with data
elements (Appendix 2) specified in SSuN protocols on all persons reported with gonorrhoea, all visits to
collaborating STD clinics, other collaborating speciality clinics, and females 15 – 44 years of age seen in
collaborating family planning/reproductive health clinics.
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12 December 2014
Sites will send SSuN data through SAMS using specified encryption methods and biologic specimens (if
required for supplemental projects) through approved carriers per protocols. CDC agrees to accept and
securely store these data, accessible only to SSuN project staff. Data will not be integrated into other
datasets maintained by CDC and will at all times be stored secure servers with fully restricted access.
Biologic specimens (if required for supplemental projects) will be received directly by the Laboratory
Reference and Research Branch.
To protect the confidentiality of persons reported with STDs, state and local surveillance
program staff agree to abide by the Data Security and Confidentiality Guidelines for NCHHSTP.
(http://www.cdc.gov/nchhstp/programintegration/docs/PCSIDataSecurityGuidelines.pdf) and will be
required to document compliance as part of annual project reporting. Full names, street addresses,
social security numbers, telephone numbers, or any other specific identifying information will not be
sent to CDC. Databases will contain geographic information at the census tract level as well as other
demographic, clinical, and behavioral data elements specified in SSuN protocols collaborative developed
by SSuN collaborators. Census tract data collected in the population component will be linked with US
census and all such internal datasets will also be stored on secure servers with fully restricted access.
The Surveillance and Data Management Branch in the Division of STD Prevention is charged with
the responsibility of maintaining the security and confidentiality and the scientific integrity of all SSuN
databases, dataset and subsequent analyses. Appropriate CDC staff will be designated custodians of the
SSuN data and accept full responsibility for observance of all conditions of use and for establishment
and maintenance of CDC-standard security precautions to prevent unauthorized use. Other CDC staff in
the Division of STD Prevention may be granted access to dataset derived from SSuN data as needed for
legitimate data management or analytic purposes.
Enhanced STD Surveillance Network Principal Collaborators will be promptly notified of any CDC
personnel changes that affect access to data collected and managed for this project. All CDC staff with
access to SSuN data will remain current with the annual Health and Human Services Information
Security Awareness Training. A record of the completion of security training for all CDC staff is
maintained by the CDC Information Technology Services Office (ITSO).
CDC may retain Enhanced SSuN data as long as the data are protected as described herein. CDC
will annually review the need for the data with Enhanced SSuN Principal Collaborators, and shall destroy
all copies of the data if it is determined that no further analysis will be conducted.
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DATA RE-RELEASE & USE
Local collaborators retain full control of and rights to analysis, research, and publication of their
locally collected data, regardless of whether these data are also provided to CDC as part of SSuN
activities. However, collaborators agree to acknowledge CDC funding in publications resulting of
analyses of data collected specifically through SSuN funding. Principal Collaborators may request and
receive multi-site SSuN dataset for specific analytic purposes provided the SSuN Project Officer and the
Principal Collaborator (or designated representative) of sites contributing data have reviewed and
approved the analysis proposal. Proposals for such analyses must include all of the information required
in SSuN protocols prior to consideration for approval.
All analyses and dissemination of SSuN multi-site data collected during the project period in the
form of peer and non-peer reviewed manuscripts, technical reports, manuals, and presentations require
the written approval of CDC and every SSuN site that has contributed data for that analysis. All
publications with a CDC author must be cleared through DSTDP/NCHHSTP/CDC clearance.
This agreement may be amended at any time in writing by mutual agreement of CDC and SSuN
Principal Collaborators. Such amendments will not be binding unless and until they are signed by
personnel authorized to bind each of the parties.
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Signatures:
I have read and agree to follow the stipulations in the Memorandum of Agreement for collection,
transmission to CDC and analysis of Enhanced STD Surveillance Network (SSuN) Surveillance data.
_______________________________________________________________________________
Hillard Weinstock, MD, MPH
Chief, Surveillance and Data Management Branch,
Division of STD Prevention,
National Center for STD, Viral Hepatitis, STD and TB Prevention
Centers for Disease Control and Prevention
Date
______________________________________________________________________________
Eloisa Llata, MD MPH
Project Officer – Enhanced STD Surveillance Network (SSuN)
Surveillance and Data Management Branch,
Division of STD Prevention,
National Center for STD, Viral Hepatitis, STD and TB Prevention
Centers for Disease Control and Prevention
Date
______________________________________________________________________________
Mark Stenger, MA
Project Officer – Enhanced STD Surveillance Network (SSuN)
Surveillance and Data Management Branch,
Division of STD Prevention,
National Center for STD, Viral Hepatitis, STD and TB Prevention
Centers for Disease Control and Prevention
Date
______________________________________________________________________________________
Health Department Enhanced SSuN Principal Collaborator
Date
Title:
Health Department:
Enhanced SSuN Cycle 3
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12 December 2014
Appendix 2: Enhanced SSuN Data Dictionary
This appendix provides guidance on coding selected data elements and defines response coding to
assure uniformity of interpretation and provide standard definitions for code sets.
Population Component – Phase 1 – Case Report and Internal Health Department Investigation
1
P1_SiteID
SSuN Site ID
This 2 character code primarily identifies sites funded under SSuN Cycle
3 and may include additional sites as required throughout the grant
period.
BA=Baltimore
CA=California
FL=Florida
MA=Massachusetts
MN=Minnesota
MC=Multnomah County
NY=New York City
PH=Philadelphia
SF=San Francisco
WA=Washington
Supplemental codes – for historical data only:
VA=Virginia (Cycle II)
AL=Alabama (Cycle II)
CO=Colorado (Cycle II)
CH=Chicago (Cycle II)
This data element cannot be ‘null’ or contain missing values.
2
P1_EventID
Site generated unique event identifier
This record ID should be supplied by the site and may be an event or
report identifier from underlying surveillance system. Regardless of
source, this ID must be unique for each confirmed case report. This
data element cannot be ‘null’ or contain missing values.
3
P1_PatientID
Site generated ID allows for longitudinal tracking of unique persons
This ID should be supplied by the site and may be a unique patient
identifier from underlying surveillance systems or may be generated
specifically for SSuN from identifying information provided through
case reporting. Regardless of source, this ID must be unique and allow
for longitudinal tracking of persons reported with multiple episodes of
disease. This data element cannot be ‘null’ or contain missing values.
Enhanced SSuN Cycle 3
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12 December 2014
4
P1_RecRepDte
Earliest date this specific disease event/report received at health
department?
This date should reflect the earliest information available to the health
department regarding the case. This date should include laboratory
records received if lab results were reported prior to receipt of a
provider case report.
5
P1_RandSamp
Is this record/case selected in the random sample?
This data element cannot be ‘null’ or contain missing values.
0=Not in random sample
1=In random sample
6
P1_SampDte
Date record/case sampled by jurisdiction
For jurisdiction deploying a batch process for record sampling, this
should be the actual date that the batch was sampled. For
jurisdictions deploying real-time sampling of cases through their
surveillance system, this date should match the report date (or date
case status was confirmed if appropriate). This data element cannot
be ‘null’ or contain missing values.
7
P1_RecSx
Was lab or provider report how case was initially reported to the health
department?
This data element is intended to capture the source of the initial case
notification to the health department. If the grantee is not able to
reliably capture this information for a specific case, this must be
documented by entering a value of ‘3’ for that case record. This data
element cannot be ‘null’ or contain missing values.
0=Laboratory report, electronic
1=Laboratory report, paper
2=Provider report, electronic or paper
3=Report source not captured by surveillance system
8
P1_PrevPtx
Enhanced SSuN Cycle 3
Is patient previously known to HD from infectious disease reporting
records (TB, HIV, STDs, Hep)?
This data element is designed to capture whether this patient is known
to the HD from a previous case report. This data element cannot be
‘null’ or contain missing values. If a match with previous patients is
not done, please code as a new patient. If a subsequent match is
performed and patient found to be previously reported, the value
should be changed accordingly.
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12 December 2014
0=New Patient, not previously reported
1=Patient previously reported
9
P1_InitSx
If patient previously reported, what is the registry/source of earliest
report for this PATIENT?
0=STD Registry
1=HIV Registry
2=Viral Hepatitis Registry
3=Other Disease Registry
4=Unknown
10
P1_HregMatch
Was eHARS registry match done for this patient?
This data element may be initially coded as ‘2’ if the grantee conducts
a batch match with their HIV registry and the case is reported before
that batch is processed. This information can be updated in the SSuN
record in the next data transmission following the match. This data
element cannot be ‘null’ or contain missing values.
1=Yes
2=No
11
P1_HregMatchStat
Did this patient match a registry entry in eHARS?
This data element may be initially coded as ‘3’ if the grantee conducts
a batch match with their HIV registry and the case is reported before
that batch is processed. This information can be updated in the SSuN
record in the next data transmission following the match. This data
element cannot be ‘null’ or contain missing values.
1=Matching Record Found
2=No Matching Record
3=Match Not Performed
12
P1_HDXMOYR
What is this patient's earliest indication of HIV positive result?
This information can be obtained from the eHARS person table
(HIVPMOYR).
13
P1_Othno
Additional registry number
If this patient also has a record in other/ancillary disease registries.
This is primarily for local use in matching patient records to update
missing information.
Enhanced SSuN Cycle 3
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12 December 2014
14
P1_Othsx
Additional registry source
If this patient also has a record in other/ancillary disease registries and
P1_Othno is not blank, this element should be populated with the
source.
0=STD Registry
1=HIV Registry
2=Viral Hepatitis Registry
3=Other Disease Registry
4=Unknown
15
P1_PrevDx
Most recent previous diagnosis (if applicable; could include hep, TB or
HIV)
If this patient also has a record in other/ancillary disease registries as
indicated by #13 & 14 above, what was the initial diagnosis indicated
by that record? Should be ‘Null’ if no previous diagnosis is confirmed.
10311=Syphilis, primary
10312=Syphilis, secondary
10313=Syphilis, early latent
10315=Syphilis, unknown latent
10314=Syphilis, late latent
10318=Syphilis, late with symptoms
10280=Gonorrhea
10274=Chlamydia
10100=Hepatitis B, acute
10105=Hepatitis B, chronic
20001=Hepatitis C
10562=HIV infection (non-AIDS)
10560=AIDS
10307=Nongonococcal Urethritis (NGU)
10308=Muco-purulent cervicitis (MPC)
10309=Pelvic Inflammatory Disease (PID)
10273=Chancroid
10306=Lymphogranuloma venereum (LGV)
10276=Granuloma Inguinale
20002=TB
20003=Other
16
P1_PrevDxDte
Enhanced SSuN Cycle 3
Date of most recent previous diagnosis documented above.
Must not be null if P1_PrevDx is not null.
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16.1 P1_PrevGCDx
Has the patient been previously diagnosed and reported with GC?
1=Yes
2=No
3=Registry records not searched
16.2 P1_PrevGCDxDte
17
P1_CaseDup
Date of most recent previous diagnosis of GC documented above.
Must not be null if P1_PrevGCDx = 1
Is this record/case a duplicate report, new report or was duplicate
status not determined?
The grantee should document if an initial case report was
subsequently found to be a duplicate of an existing case – the record
should be retained in the SSuN dataset and coded as a duplicate (‘1’)?
If the jurisdiction receives a report that they know to be a duplicate at
the time of report, the record can be omitted from the SSuN datasets
and not sampled for enhanced investigation. This data element cannot
be ‘null’ or contain missing values.
0=New Case
1=Duplicate Case (previously reported <15 days)
9=Unknown, site surveillance system does not capture
18
P1_FacilityID
Site generated facility ID. Each reporting provider/facility must have a
unique facility ID and link to a record in the provider table.
This is a primary key for linking the provider type and other provider
information to the case record. Historically, the majority of cases in
any grantee’s jurisdictions will be reported from known providers, but
for cases reported from entirely new providers, this field should be
populated with that facility’s new number and be included in the next
update of the provider reference file.
19
P1_Dispo
What is the status of the internal health department (Phase 1)
investigation for this record?
The investigation referred to for this data element includes the search
of existing health department records, matching and merging with
electronic or other laboratory data, eHARS match and other disease
registries. At initial report, cases may be coded as ‘10’. This should be
updated as appropriate. Cases listed as pending should be updated
within 60 days and this information
updated in the next SSuN data
transmission. This data element cannot be ‘null’ or contain missing
values. Jurisdictions may choose to initiate phase 1
investigations
on all reported cases, regardless of whether they fall into the random
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sample, or may elect to initiate phase 1 investigations on only those
records in the random sample.
0=Investigation complete: record referred to phase 2
1=Investigation complete: no further action, record determined
to be a duplicate of previously reported case
2=Investigation complete: no further action, case determined to
reside outside of jurisdiction based on existing department of
health information
3=Investigation complete: no further action, case not in SSuN
random sample
4=Investigation complete: no further action, case not eligible for
SSuN sample
10=Investigation not complete: P1 investigation pending
11=Investigation not complete: no further action, insufficient
information in originating record to initiate and complete
internal investigation
22=Investigation not complete: record not in random sample
20
P1_Referral1
Is this record/case referred for provider (Phase 2) investigation?
This indicates whether the record has been referred to provider
investigation (methods of which will differ across SSuN sites). If
provider is not contacted, surveyed or otherwise followed up with to
supply any additional case-specific information, code as ‘1’.
0=Referred to P2 Investigation
1=Not Referred to P2 Investigation
2=Referral Pending
21
P1_PtxSex
Sex of the patient as indicated on initial health department report?
This data element cannot be ‘null’ or contain missing values.
1=Male
2=Female
3=Male-to-Female TG
4=Female-to-Male TG
5=TG Unknown or Unspecified
9=Unknown
22
P1_PtxRace_White
Enhanced SSuN Cycle 3
White Race
Information from case/lab reports to the health department only.
Patient self-report from interviews should be captured in #110 – 116.
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12 December 2014
If additional information from any source (other than patient report) is
received, #22 through 27 may be updated as required by underlying
surveillance system.
1=Yes
2=No
3=Unknown
4=Refused
23
P1_PtxRace_Black
Black Race
Information from case/lab reports to the health department only.
Patient self-report from interviews should be captured in #110 – 116.
If additional information from any source (other than patient report) is
received, #22 through 27 may be updated as required by underlying
surveillance system.
1=Yes
2=No
3=Unknown
4=Refused
23
P1_PtxRace_AIAN
American Indian/Alaska Native Race
Information from case/lab reports to the health department only.
Patient self-report from interviews should be captured in #110 – 116.
If additional information from any source (other than patient report) is
received, #22 through 27 may be updated as required by underlying
surveillance system.
1=Yes
2=No
3=Unknown
4=Refused
25
P1_PtxRace_Asian
Asian Race
Information from case/lab reports to the health department only.
Patient self-report from interviews should be captured in #110 – 116.
If additional information from any source (other than patient report) is
received, #22 through 27 may be updated as required by underlying
surveillance system.
1=Yes
2=No
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3=Unknown
4=Refused
26
P1_PtxRace_NHOPI
Native Hawaiian/Other Pacific Islander Race
Information from case/lab reports to the health department only.
Patient self-report from interviews should be captured in #110 – 116.
If additional information from any source (other than patient report) is
received, #22 through 27 may be updated as required by underlying
surveillance system. .
1=Yes
2=No
3=Unknown
4=Refused
27
P1_PtxRace_Other
Other Race
Information from case/lab reports to the health department only.
Patient self-report from interviews should be captured in #110 – 116.
If additional information from any source (other than patient report) is
received, #22 through 27 may be updated as required by underlying
surveillance system.
1=Yes
2=No
3=Unknown
4=Refused
28
P1_PtxRace_UNK
Is all information on race and Hispanic ethnicity missing from initial
reporting record/documents?
If additional/supplemental information is received on race and
ethnicity of patient but this information was missing from the initial
report to the health department, please leave this data element coded
as ‘1’ and capture the source of supplemental information in #29
below.
1=Yes
2=No
29
P1_PtxRaceSource
What is the source of the final race information of record as ascertained
for this patient?
For grantees able to distinguish the source of information for race,
please indicate as appropriate. For grantees NOT able to distinguish
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the source of race data at all, code as ‘6’. If race information is
missing/unknown from all sources, code as ‘5’.
1=Patient Self-Report
2=Provider Case Report
3=Laboratory Report
4=Previous Registry Record
5=No Information Available from Any Source
6=Source not Identifiable
30
P1_PtxHisp
Patient Hispanic ethnicity
Information from case/lab reports to the health department only.
Patient self-report from interviews should be captured in #109. If
additional information from any source (other than patient report) is
received, #30 may be updated as required by underlying surveillance
system.
1=Hispanic
2=Non-Hispanic
3=Unknown
4=Refused
31
P1_PtxHISPSource
What is the source of the final Hispanic ethnicity information
ascertained for this patient?
For grantees able to distinguish the source of information for Hispanic
ethnicity, please indicate as appropriate. For grantees NOT able to
distinguish the source of Hispanic ethnicity data at all, code as ‘6’. If
information is missing/unknown from all sources, code as ‘5’.
1=Patient Self-Report
2=Provider Case Report
3=Laboratory Report
4=Previous Registry Record
5=No Information Available from Any Source
6=Source not Identifiable
32
P1_PtxAGE
Age of patient from initial reporting record/document .
If age information is missing/unknown from all sources, use null value.
33
P1_PtxAgeUnit
Age unit
If #32 is null, use null value for this data element (‘.’)
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1=Years
2=Months
34
P1_PtxCountyres
County of patient residence
If information is missing/unknown, code to null value ( ‘.’)
35
P1_PtxCTract
Census Tract of patient residence
If information is missing/unknown, code to null value (‘.’)
36
P1_PtxAddrStat
Was patient street address present and complete in initial reporting
documents?
This data element cannot be ‘null’ or contain missing values.
1=Street Address Known
2=Street Address Missing
3=Street Address Incomplete
37
P1_GCAccuracy
What is the basis of census tract assignment (XY coordinates, street
segment, place/zip centroid, not geocodable)?
This data element cannot be ‘null’ or contain missing values.
1=Close (based on direct street segment, parcel, or l
ongitude/latitude match)
2=Approximate (modification of address required to match to
street segment)
3=Very approximate (based only on zip or city centroid)
4=Not-geocodable (insufficient data to geocode, PO Box,
General Delivery)
5=Data suppressed by Site policy
9=Missing (no address available)
38
P1_DxDte
What is the diagnosis date for the current episode of disease (may be
date of provider visit, specimen collection date, laboratory report date
or other suitable proxy)
This data element cannot be ‘null’ or contain missing values.
39
P1_DxCode
Diagnosis (for gonorrhea cases, this value = 10280)
This data element cannot be ‘null’ or contain missing values.
10280=Gonorrhea
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40
P1_SiteUrine
Urine 'site' of infection, usually a proxy for urethral infection in men but
not as specific for women.
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown
41
P1_SiteVagCerv
Vaginal or cervical site of infection in women - combined because there
are no clear analytic reasons to separate.
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown
42
P1_SiteUreth
Urethral site of infection - only if this is specifically indicated, if the only
specimen source available is a urine-based NAAT, default to 'Urine'
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown
43
P1_SiteRect
Rectal site of infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown
44
P1_SitePhar
Pharyngeal site of infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown
45
P1_SiteEye
Ocular site of infection
If information is missing/unknown, code as ‘3’
1=Yes
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2=No
3=Unknown
46
P1_SiteSera
Blood or sera infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown
47
P1_SiteJoint
Joint or synovial fluid infection
1=Yes
2=No
3=Unknown
48
P1_SiteOTH
Site of infection, not specified above
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown
49
P1_SiteUNK
All site of infection information missing for this case - use only if no
other information is available.
If the answer to any one of 40-48 above is ‘1’ or ‘2’ then this data
element should be coded ‘2’. If all data elements 40-48 are coded as
‘3’ then code this data element as ‘1’.
1=Yes
2=No
Population Component – Phase 1 – Laboratory Records
50
P1_L1_EventID
Unique identifier for associated surveillance record
Will be a primary key for merging lab and case data; should
correspond to P1_EventID. This data element cannot be ‘null’ or
contain missing values.
51
P1_L1_LabID
Unique identifier for laboratory performing testing
Site assigned; may be ID from other system or specifically created for
SSuN. If performing lab is not known, site should still create a lab
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record with a locally defined ID corresponding to unknown lab that
they will use throughout the SSuN data collection period. This data
element cannot be ‘null’ or contain missing values.
52
P1_L1_Accession
Unique identifier (accession number) for laboratory record
Leave blank (null) if not available/ascertained
53
P1_L1_PatientID
Unique identifier for person (allowing longitudinal tracking of persons)
Will be a secondary key for merging lab and case data; should
correspond to P1_PatientID. This data element cannot be ‘null’ or
contain missing values.
54
P1_L1_CondTested
specific condition/pathogen tested
This data element cannot be ‘null’ or contain missing values.
1=Syphilis
2=Gonorrhea
3=Chlamydia
4=Genital Herpes
5=Trichomoniasis
6=HIV
7=Hep A
8=Hep B
9=Hep C
10=BV
11=Other
55
P1_L1_SpecColDte
Specimen collection date - this is often used as a proxy for diagnosis
date and is important to obtain
This data element cannot be ‘null’ or contain missing values.
56
P1_L1_LabRepDte
This is the date that the performing lab reported the results to the
health department
57
P1_L1_SecType
Type of specimen
This data element cannot be ‘null’ or contain missing values.
1=Exudate
2=Blood/sera
3=Synovial fluid
4=Urine
5=CSF
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6=Tissue
7=Saliva
8=Other
9=Unknown
58
P1_L1_AnatSite
This is the anatomic site from which the specimen was obtained and is
important in determining the anatomic site of infection
This data element cannot be ‘null’ or contain missing values.
1=Urethra
2=Vagina/cervix
3=Urine
4=Rectum
5=Pharynx
6=Eye
7=Sera/Blood
8=Joint
9=Other Anatomic Site
10=Unknown Anatomic Site
59
P1_L1_TestType
As test technology advances, it is important to obtain the type of test
performed
This data element cannot be ‘null’ or contain missing values.
1=Culture,
2=NAAT
3=Non-amplified nucleic acid test/DNA probe
4=Gram Stain
5=DFA
6=Rapid HIV
7=ELISA
8=Western blot
9=Pooled RNA
10=RPR
11=VDRL
12=FTA
13=TP-PA
14=MHA
15=Wet Mount/Clue Cell
16=PH
17=Other
18=Unknown
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60
P1_L1_QualRes
Qualitative result: For most pathogens/tests, positive, negative,
equivocal and unknown
This data element cannot be ‘null’ or contain missing values.
1=Positive
2=Negative
3=Reactive
4=Weakly Reactive
5=Non-Reactive
6=Equivocal/Indeterminate
7=Specimen Inadequate/Contaminated
8=Other
9=Unknown
61
P1_L1_Quantres
Not relevant to GC/CT but may become relevant in the future or for
other pathogens of interest (default to ‘null’ value)
Population Component – Phase 2 – Provider Investigation
62
P2_ProvID
Unique facility/provider ID
This data element cannot be ‘null’ or contain missing values.
63
P2_ProvCO
County FIPS code for provider/facility physical location
64
P2_ProvZIP
Facility/provider physical location 5-digit ZIP
65
P2_ProvCHC
Is facility/provider a Community Health Center (CHC)?
Community Health Centers are not-for-profit primary care
organizations governed by a community board and whose primary
mission is to provide medical services to traditionally under-served
populations. The primary way of determining CHC status is by selfidentification (though some put it in their name). The National
Association of Community Health Centers (NACHC) does maintain
member lists as well. Non-profit and community board governance
are the key features.
1=Yes
2=No
3=Unknown/Missing
66
P2_ProvFQHC
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Is facility/provider a Federally Qualified Health Center (FQHC)?
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Federally qualified health centers (FQHCs) include all organizations
receiving grants under Section 330 of the Public Health Service Act
(PHS). These are a matter of public record and lists are available from
HRSA
1=Yes
2=No
3=Unknown/Missing
67
P2_ProvPTXvisitDte
Date of patient initial visit for this issue, can be supplied/filled in from
case or laboratory report information
68
P2_ProvClinType
What was the category of provider examining/treating this patient (e.g.
MD, RN, ARNP, etc.?)
1=MD
2=RN
3=PA
4=ARNP
5=LPN
6=Other
7=Unknown/Not Ascertained
69
P2_ProvPTX_GenderSP
Provider documented gender of sex partners
1=Males only
2=Females only
3=Both Males and Females
4=Not Documented
70
P2_ProvPTX_Insure
Insurance status of patient from provider's records
1=Yes, Insured
2=No, Not Insured
3=Unknown/Missing
71
P2_Urethritis
Was urethritis found on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No
72
P2_Proctitis
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Was proctitis found on exam
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Missing/unknown information code as null (‘.’).
1=Yes
2=No
73
P2_Epididymitis
Was epididymitis found on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No
74
P2_PID
Was PID diagnosed.
Missing/unknown information code as null (‘.’).
1=Yes
2=No
75
P2_Discharge
Was discharge found on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No
76
P2_OtherFinding
Were there other STD-related findings on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No
77
P2_NoFinding
Were there no findings on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No
78
P2_ProvScrnUreth
Was patient screened/tested for infection at urethral site
1=Yes
2=No
3=Unknown
4=Refused
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79
P2_ProvScrnVagCerv
Was patient screened/tested for infection at vaginal/cervical site
1=Yes
2=No
3=Unknown
4=Refused
80
P2_ProvScrnAnal
Was patient screened/tested for infection at anorectal site
1=Yes
2=No
3=Unknown
4=Refused
81
P2_ProvScrnPhar
Was patient screened/tested for infection at pharyngeal site
1=Yes
2=No
3=Unknown
4=Refused
82
P2_ProvScrnHIV
Was patient screened/tested for HIV infection at time of visit
1=Yes
2=No
3=Unknown
4=Refused
83
P2_ProvPTX_TxDte
Treatment date
84
P2_ProvPTX_CFTRI
Was patient treated with ceftriaxone?
Missing/unknown information code as null (‘.’).
1=Yes
2=No
85
P2_ProvPTX_CFTRI_DS
Ceftriaxone dosage
Missing/unknown information code as null (‘.’).
1=125mg
2=250mg
3=500mg
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86
P2_ProvPTX_Azit
Was patient treated with azithromycin
Missing/unknown information code as null (‘.’).
1=Yes
2=No
87
P2_ProvPTX_Azit_DS
Azithromycin dosage
Missing/unknown information code as null (‘.’).
1=1 gram
2=2 grams
88
P2_ProvPTX_Doxy
Was patient treated with doxycycline?
Missing/unknown information code as null (‘.’).
1=Yes
2=No
89
P2_ProvPTX_Cefx
Was patient treated with cefixime?
Missing/unknown information code as null (‘.’).
1=Yes
2=No
90
P2_ProvPTX_Oth
Were other medications prescribed/provided for treating GC
Missing/unknown information code as null (‘.’).
1=Yes
2=No
91
P2_ProvPTX_OtherTXT
Specific other medications prescribed/provided for treating GC (text)
92
P2_ProvPTX_PDPT
Were any medications/prescriptions provided for patient's partner(s)?
Missing/unknown information code as null (‘.’).
1=Yes
2=No
93
P2_ProvPTX_HIBC
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Was patient counseled to prevent transmission/reinfection?
Missing/unknown information code as null (‘.’).
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1=Yes
2=No
94
P2_ProvPTX_Refer
Was patient referred to HD (or other) for partner services?
Missing/unknown information code as null (‘.’).
1=Yes
2=No
Population Component – Phase 3 – Patient Interview
95
1P3_IDX_ID
Interviewer/Investigator ID
This is a locally assigned ID to uniquely identify the person conducting
patient interview. This data element cannot be ‘null’ or contain
missing values for interviewed cases.
96
P3_PatientID
Unique identifier for person (allowing longitudinal tracking of persons)
Will be a secondary key for merging data; should correspond to
P1_PatientID. This data element cannot be ‘null’ or contain missing
values for interviewed cases.
97
P3_EventID
Unique identifier for record
Will be a primary key for merging data; should correspond to
P1_EventID. This data element cannot be ‘null’ or contain missing
values for interviewed cases.
98
P3_IDX_CADate1
Contact attempt date 1
This data element cannot be ‘null’ or contain missing values for
interviewed cases.
99
P3_IDX_CAout1
Contact attempt outcome 1
This data element cannot be ‘null’ or contain missing values for
interviewed cases.
0=Answer/Partial or Complete Interview Obtained
1=No Answer/No Message
2=No Answer/Message Left
3=Answer/Hang up
4=Answer/Refusal
5=Answer/Reschedule DIS call-back
6=Answer/Reschedule Patient Callback
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7=Number out of service
8=Other
100 P3_IDX_CADate2
Contact attempt date 2
101 P3_IDX_CAout2
Contact attempt outcome 2
0=Answer/Partial or Complete Interview Obtained
1=No Answer/No Message
2=No Answer/Message Left
3=Answer/Hang up
4=Answer/Refusal
5=Answer/Reschedule DIS call-back
6=Answer/Reschedule Patient Callback
7=Number out of service
8=Other
102 P3_IDX_CADate3
Contact attempt date 3
103 P3_IDX_CAout3
Contact attempt outcome 3
0=Answer/Partial or Complete Interview Obtained
1=No Answer/No Message
2=No Answer/Message Left
3=Answer/Hang up
4=Answer/Refusal
5=Answer/Reschedule DIS call-back
6=Answer/Reschedule Patient Callback
7=Number out of service
8=Other
104 P3_IDX_CADate4
Contact attempt date 4
105 P3_IDX_CAout4
Contact attempt outcome 4
0=Answer/Partial or Complete Interview Obtained
1=No Answer/No Message
2=No Answer/Message Left
3=Answer/Hang up
4=Answer/Refusal
5=Answer/Reschedule DIS call-back
6=Answer/Reschedule Patient Callback
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7=Number out of service
8=Other
106 P3_IDX_Ixdate
Interview/Disposition Date
107 P3_IDX_Dispo
Phase 3 investigation/Interview Disposition
Cannot be ‘null’ for cases included in random sample.
0=Investigation complete: patient contacted, interview
completed
1=Investigation complete: patient contacted, partial interview
completed
10=Investigation not complete: P3 investigation pending
(Default)
11=Investigation not complete: patient contacted, refused
interview
12=Investigation not complete: patient contacted, unable to
complete interview because of language barrier
22=Investigation not complete: patient did not respond to at
least 3 interview contact attempts
33=Investigation not complete: patient contact not initiated
because patient determined to be resident in correctional,
mental health or substance abuse facility.
44=Investigation not complete: patient contact not initiated
because patient determined to be active military on foreign
deployment.
55=Investigation not complete: >60 days from diagnosis
66=Investigation not complete: case determined to be OOJ
77=Investigation not complete: insufficient contact information
88=Investigation not complete: provider refused patient contact
99=Investigation not complete: administrative closure/other
reason
108 P3_PTX_age
What is your age?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
888=Refused
108.1 P3_PTX_sex
What gender or sex do you consider yourself to be?
1=Male
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2=Female
3=Male-to-Female TG
4=Female-to-Male TG
5=TG Unknown or Unspecified
8=Refused
109 P3_PTX_HispEthnic
Do you consider yourself to be Hispanic or Latino/a?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Unknown
4=Refused
110 P3_PTX_White
patient reported White race
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Unknown
4=Refused
111 P3_PTX_Black
patient reported Black race
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Unknown
4=Refused
112 P3_PTX_AIAN
patient reported AIAN race
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
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2=No
3=Unknown
4=Refused
113 P3_PTX_Asian
patient reported Asian race
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Unknown
4=Refused
114 P3_PTX_NHOPI
patient reported NHOPI race
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Unknown
4=Refused
115 P3_PTX_OTHrace
patient reported other race
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview. Code as 1 if anything specified in by patient that is not
otherwise captured above.
1=Yes
2=No
116 P3_PTX_RefRace
patient refuses provision of all race information
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
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117 P3_PTX_Insure
Do you have any kind of health care coverage, including health
insurance, prepaid plans such as HMOs, or government plans such as
Medicare, Indian Health Services, the V.A. or Military?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
118 P3_PTX_InsType
What kind of healthcare insurance do you have?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Private healthcare insurance provided by my employer
2=Private healthcare insurance I pay for myself
3=Public healthcare insurance like Medicaid, Medicare, or a
plan from my state
4=Active or retired military or dependent plan like the V.A. or
military
5=Bureau of Indian Affairs/IHS/Urban Indian Health
7=Other
8=Don‘t know / Not sure
9=Refused
119 P3_PTX_OthInsSpecify
Other type of insurance (text)
120 P3_PTX_PriCareDoc
Do you have one person you think of as your personal doctor or health
care provider?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes, only one
2=More than one or facility
3=No
4=Don't Know /Not Sure
5=Refused
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121 P3_PTX_Hccost
Was there a time in the past 12 months when you needed to see a
doctor but could not because of cost?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
122 P3_PTX_OOPE
When you went to see _______________ (mention reporting provider,
clinic or facility name) when you were diagnosed with gonorrhea, did
you need to pay anything out-of-pocket at the time of your visit?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
123 P3_PTX_SYMP
Did you go to the doctor that time because you were having symptoms
or pains you thought might be from an STD?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
124 P3_PTX_Delay
How long did you have these symptoms or pains before you were able
to see the doctor?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=1 Day
2=2 - 6 Days
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3=1 - 2 weeks
4=More than 2 weeks
5=Don‘t know / Not sure / Don’t remember
6=Refused
125 P3_PTX_ExpSTD
Before you went to the doctor that time, did any of your sex partners
tell you that you might have been exposed to an STD?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
126 P3_PTX_reasA
Reason for going to specific doctor: regular doctor: Because this is your
usual/regular doctor.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
127 P3_PTX_reasB
Reason for going to specific doctor: Because you could get seen for free.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
128 P3_PTX_reasC
Reason for going to specific doctor: Because they take your insurance.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
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129 P3_PTX_reasD
Reason for going to specific doctor: Because you felt more comfortable
about your privacy there.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
130 P3_PTX_reasE
Reason for going to specific doctor: Because you could get seen right
away.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
131 P3_PTX_reasF
Reason for going to specific doctor: Because you wanted to see an
expert specializing in STDs.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
132 P3_PTX_reasI
Reason for going to specific doctor: Because this doctor is close to your
house and easy to get to.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
133 P3_PTX_reasG
Enhanced SSuN Cycle 3
Reason for going to specific doctor: Because you were embarrassed and
didn’t want to go to your regular doctor.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
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1=Yes
2=No
134 P3_PTX_reasH
Reason for going to specific doctor: Because I didn’t want the insurance
papers/info sent to my home/parents.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
135 P3_PTX_reasJ
Reason for going to specific doctor: Any other reason?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
136 P3_PTX_othReasonText Other reason text.
137 P3_PTX_refusreason
Refused all reasons
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
138 P3_PTX_PartnerTest
Did the doctor, nurse or anyone else during that visit talk to you about
the importance of getting your sex partners examined and tested for
STDs?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
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139 P3_PTX_TellParts
In the time since your visit, did you tell any of your sex partners they
may need to tested or treated for STDs?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
140 P3_PTX_EPToffer
Did a doctor, nurse or someone at the health department offer to give
you medications or a prescription for you to give to any of your sex
partner(s)?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
141 P3_PTX_EPTWHO
Who was it that offered you the additional medications or
prescriptions? Was it someone from your doctor’s office or someone
from the health department?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=My doctor’s office
2=The health department
3=Someone else
4=Don‘t know / Not sure
5=Refused
142 P3_PTX_EPTGET
Enhanced SSuN Cycle 3
Did you actually get the additional medications or prescriptions for your
sex partners?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
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1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
143 P3_PTX_EPTMEDORRX
Did you get medicine to give to your partner? Or did you get
prescriptions that your partners needed to have filled at a pharmacy?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=I got additional medications
2=I got prescription(s)
3=Don‘t know / Not sure
144 P3_PTX_EPTGAVE
Did you give the additional medications or prescriptions to at least one
of your sex partners?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
9=Refused
145 P3_PTX_HIVtested
Did you get tested for HIV at that visit?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
146 P3_PTX_HIVresult
What was the result of your HIV test at that visit?
This data element cannot be ‘null’ or contain missing values if #146=1.
1=Positive
2=Negative
3=Don't Know / Not Sure / did not get results
4=Refused
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147 P3_PTX_everHIVtst
Have you ever been tested for HIV?
May be ‘Null’ if #143=1. This data element cannot be ‘null’ or contain
missing values for cases responding with 2, 3 or 4 to #146.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
148 P3_PTX_whenHIVtest
When was your last HIV test? Just month and year is ok? (IF PATIENT
UNABLE TO RECALL, PROBE UNTIL APPROXIMATE RESPONSE ELICITED)
May be ‘Null’ if #148=2, 3 or 4.
149 P3_PTX_HIVeverResult
What was the result of that HIV test?
This data element cannot be ‘null’ or contain missing values for cases
responding to #148=1.
1=Positive
2=Negative
3=Don't Know / Not Sure / did not get results
4=Refused
150 P3_PTX_inHIVcare
When was your most recent visit to a doctor, nurse or other health care
worker for HIV medical care? (IF PATIENT UNABLE TO RECALL, PROBE
UNTIL APPROXIMATE RESPONSE ELICITED)
This data element cannot be ‘null’ or contain missing values for cases
identifying as HIV positive (150=1 or 147=1).
151 P3_PTX_ART
Are you taking antiretroviral medicines to treat your HIV infection?
This data element cannot be ‘null’ or contain missing values for cases
identifying as HIV positive (150=1 or 147=1).
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
152 P3_PTX_PrEP
Enhanced SSuN Cycle 3
Has your health care provider prescribed medications to help you
prevent getting HIV?
This data element should be ‘null’ for patients reporting being HIV
positive. This data element cannot be ‘null’ or contain missing values
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for patients identifying as HIV negative or unknown HIV status (150=2,
3 or 4; 147=2, 3 or 4).
1=Yes
2=No
3= Don‘t know / Not sure
4=Refused
153 P3_PTX_Pregnant
Were you pregnant at the time you were told that you had gonorrhea?
This data element cannot be ‘null’ or contain missing value for female
cases interviewed. May be null for partial interviews, must be null for
male cases.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
154 P3_PTX_GenderSP
During the past 12 months, have you had sex with only males, only
females, or with both males and females?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Males only
2=Females only
3=Both Males and Females
4=Unknown
9=refused
155 P3_PTX_Sxorient
Do you consider yourself to be…
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Heterosexual/Straight
2=Gay/Lesbian/Homosexual
3=Bisexual
4=Other
9=Refused
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156 P3_PTX_MaleSPL3MO
Thinking back to the 3 months before you were diagnosed with
gonorrhea, how many MEN did you have sex with during that time?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview. Probe for approximate response or ‘best’ guess. Enter 0 to
indicate ‘None’.
157 P3_PTX_FemaleSPL3MO Thinking back to the 3 months before you were diagnosed with
gonorrhea, how many WOMEN did you have sex with during that time?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview. Probe for approximate response or ‘best’ guess. Enter 0 to
indicate ‘None’.
157.1 P3_PTX_SPtreatOne
To the best of your knowledge, was your sex partner treated?
This data element is for patient reporting only a single sex partner.
1=Yes, definitely
2=Yes, probably
3=Don‘t know / Not sure
4=No, probably not
5=Refused
157.2 P3_PTX_SPtreatMult
To the best of your knowledge, would you say that all of your sex
partners were definitely treated, at least one of your partners was
definitely treated, or that none were treated?
This data element is for patients reporting multiple sex partners.
1=All definitely treated
2=At least one definitely treated
3=At least one probably treated
4=Not sure
5=Probably none treated
6=Refused
158 P3_PTX_SexExch
Enhanced SSuN Cycle 3
During the past 12 months, have you given drugs or money in exchange
for sex or received drugs or money in exchange for sex? By sex we
mean vaginal, oral, or anal sex.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
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1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
159 P3_PTX_LastSex
When was the last time you had sex?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=In last week
2=> 1 week but within last month
3=> 1 month, but within 2 months
4=> 2 months ago
5=Don't Know / Not sure
9=Refused
160 P3_PTX_GenderMRSP
Thinking back to the last time you had sex, was the person you had sex
with…(male/female)?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Male
2=Female
3=Male-to-Female TG
4=Female-to-Male TG
5=TG Unknown or Unspecified
9=Unknown
161 P3_PTX_AgeMRSP
Thinking back to the last person you had sex with, how old do you think
that person is? If you don’t know for sure, it’s OK to make your best
guess.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview. If patient refuses, please enter 888.
162 P3_PTX_HISPMRSP
Would you say that person is Hispanic/Latino/a? If you don’t know for
sure, it’s OK to make your best guess.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
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1=Yes, Hispanic
2=No, Not Hispanic
8=Unknown/Can't guess
9=Refused
163 P3_PTX_RaceMRSP
Thinking back to the last person you had sex with, what race(s) would
you say that person is? If you don’t know for sure, it’s OK to make your
best guess.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=White
2=Black
3=AI/AN
4=ASIAN
5=NH/OPI
7=Other race
8=Unknown/Can't guess
9=Refused
164 P3_PTX_MRSPHIV
Thinking back to the last person you had sex with, do you know if that
person HIV positive?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes, I know that person is HIV positive
2=No, I know that person is HIV negative
3=Don't Know /Don't Remember/ Not Sure
4=Refused
165 P3_PTX_SexAgainMRSP
Thinking back to the last person you had sex with; do you think you will
have sex with this person again?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
3=Don't Know /Maybe/ Not Sure
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4=Refused
166 P3_PTX_GEOMRSP
Thinking back to the last person you had sex with, about how far away
does that person live from you. If you don’t know for sure, it’s OK to
make your best guess.
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
0=Partner lives with me
1=less than 5 minutes
2=5 to 15 minutes
3=15 to 30 minutes
4=30 minutes to 1 hour
5=> 1 hour
6=They live in another state
7=They live in another country
8=Don't know / Not sure
9=Refused
167 P3_PTX_DIS_EPT
Did the interviewer/DIS provide EPT/PDPT to patient?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
168 P3_PTX_DIS_EPTnum
Number of partners EPT provided for
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
169 P3_PTX_DIS_OtherPS
Did interviewer/DIS provide other partner services to patient (DIS
referral)?
This data element cannot be ‘null’ or contain missing values for
interviewed cases. May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial
interview.
1=Yes
2=No
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Population Component – Provider/Facility Metadata File (Annual)
170 P4_ProvID
Unique identifier for provider/facility
This data element cannot be ‘null’ or contain missing values.
171 P4_ProvName
Name of provider or facility
172 P4_ProvCO
FIPS code for provider/facility physical location
173 P4_ProvZIP
Facility/provider physical location 5-digit ZIP
This data element cannot be ‘null’ or contain missing values.
174 P4_UpdateDate
Date provider information last updated/verified
This data element cannot be ‘null’ or contain missing values.
175 P4_LocationLon
Provider physical location longitude
176 P4_LocationLat
Provider physical location latitude
177 P4_CensusTract
Census tract of provider physical location
178 P4_Prov_Fac_Type
Facility or provider type code (PHINVAD compatible)
This data element cannot be ‘null’ or contain missing values.
1=Blood Bank
Includes for-profit sera collection centers
2=Correctional Facilities
Includes jails, prisons, juvenile detention, etc.
3=Day care center (environment)
4=Dentist
5=Drug Treatment Facility
6=Emergency Room/Emergency Department
Include HMO/other urgent care in this category
7=Family Planning Facility
Includes reproductive health clinics
8=Other Federal Agencies
Do not include bureau of prisons in this category (should be 2,
above)
9=HIV Care Facility
Includes and care facility whose primary service is HIV care
regardless of funding source, categorical HIV clinics associated
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with hospitals or provider networks should be included in this
category.
10=HIV Counseling and Testing Site
Include HIV outreach & street testing in this category
11=Hospital - Not ED/ER
This should include in-patient facilities where the patient was
admitted for care. Ambulatory Care Clinics associated with
HMO or HMC plans should be coded as 14
12=Labor and Delivery
13=Laboratory
14=Managed Care/HMOs
15=Mental Health Provider
16=Military
17=National Job Training Program
18=Other, not otherwise specified
19=Other Health Department Clinic
Do not include health department clinics whose primary
function is STD services or reproductive health (code as 28 and
7, respectively)
20=Other State and Local Agencies
21=Other Treatment Center
22=Pharmacy
23=Prenatal/Obstetrics Facility
24=Private physicians' group office
25=Public Health Clinic
Include ONLY public clinics not otherwise categorized
26=Data/Disease Registries
27=Rural Health Clinic
Includes clinics specifically designated as RHCs on the Centers
for Medicare & Medicaid Services (CMS) website
28=Categorical STD Clinic
29=School-Based Clinic
30=TB Clinic
31=Tribal Government Clinic
Do not include IHS hospitals (those are coded as 32)
32=Indian Health Service
33=Veterinary Sources
34=Vital Statistics
99=unknown
179 P4_ProvCHC
Enhanced SSuN Cycle 3
Is facility/provider a Community Health Center (CHC)?
This data element cannot be ‘null’ or contain missing values.
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1=Yes
2=No
3=Unknown/Missing
180 P4_ProvFQHC
Enhanced SSuN Cycle 3
Is facility/provider a Federally Qualified Health Center (FQHC)?
This data element cannot be ‘null’ or contain missing values.
1=Yes
2=No
3=Unknown/Missing
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Facility Component – Patient Visit Records
181 F1_FacilityID
Unique facility identifier
This ID should be supplied by the site and is a unique facility identifier
from underlying surveillance systems or may be generated specifically
for SSuN. Regardless of source, this ID must be unique and allow for
longitudinal tracking of the facility. This data element cannot be ‘null’
or contain missing values.
182 F1_SiteID
Unique site code
BA=Baltimore
CA=California
FL=Florida
MA=Massachusetts
MN=Minnesota
MC=Multnomah county
NY=New York City
PH=Philadelphia
SF=San Francisco
WA= Washington
This 2 character code primarily identifies sites funded under SSuN Cycle
3 and may include additional sites as required throughout the grant
period. Supplemental codes – for SSuN cycle II historical data only:
VA=Virginia (Cycle II)
AL=Alabama (Cycle II)
CO=Colorado (Cycle II)
CH=Chicago (Cycle II)
This data element cannot be ‘null’ or contain missing values.
183 F1_PatientID
Unique patient identification number assigned by site
This ID should be supplied by the site and may be a unique patient
identifier from underlying surveillance systems or may be generated
specifically for SSuN. Regardless of source, this ID must be unique and
allow for longitudinal tracking of patients within facilities. This data
element cannot be ‘null’ or contain missing values.
184 F1_Visdate
Date of clinic visit
This data element cannot be ‘null’ or contain missing values.
185 F1_EventID
Unique visit identification
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This record ID should be supplied by the site and may be an event or
report identifier from underlying surveillance system. Regardless of
source, this ID must be unique for each clinic visit. This
data element cannot be ‘null’ or contain missing values.
186 F1_GISP_yrmo
What is the Year/Month isolate was collected?
This data element pertains only to facilities participating in GISP and
refers to the year and the month the GISP specimen was collected. This
data element cannot be ‘null’ or contain missing values for GISP
patients.
187 F1_GISP_number
What is the patient's GISP number?
This data element pertains only to facilities participating in GISP and
refers to the GISP ID supplied by the site. This data element cannot be
‘null’ or contain missing values for GISP patients.
188 F1_Gender
What is the patient's gender?
1= Male
2= Female
3=Transgender M to F
4=Transgender F to M
5=Transgender unspecified
6= Other
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the information is collected by the facility but is unknown for this
record.
189 F1_Age
How old is the patient? (Age in years).
If age is unknown or missing, use null value.
190 F1_Hisp
Is the patient of Hispanic ethnicity?
1= Yes
2= No
9= Not captured
191 F1_AI/AN
Is the patient of American Indian or Alaska Native?
1= Yes
2= No
9= Not captured
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192 F1_Asian
193 F1_PIH
Is the patient of Asian?
1= Yes
2= No
9= Not captured
Is the patient of Pacific Islander or Hawaiian?
1= Yes
2= No
9= Not captured
194 F1_Black
Is the patient Black?
1= Yes
2= No
9= Not captured
195 F1_White
Is the patient White?
1= Yes
2= No
9= Not captured
Is the patient Multirace?
1= Yes
2= No
9= Not captured
196 F1_Multirace
197 F1_Otherrace
Is the patient another race not listed above?
1= Yes
2= No
9= Not captured
For #190-197 indicate yes for all of the race/ethnic questions that
apply. A response of 9 indicates the information is not captured/
collected by the facility or is not provided to SSuN. Response should be
null if (1) race is collected by the facility but is unknown for this record,
or (2) a response of “no” is not collected separately.
198 F1_Insurance
What is the primary health insurance status of the patient?
1= Insured, Public only
2= Insured, Private only
3= Insured, Multiple types
4= Insured, unknown type
5= Uninsured
9= Insurance status not captured
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A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the information is collected but is unknown for this record.
199 F1_Visit_type
Type of clinic visit
1 = Clinician
2= express/fast track
8= Other
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or not provided to SSuN. A response of null indicates
that the information is collected but is unknown for this record.
200 F1_Reason_visit
What was the primary purpose of the visit?
1= Symptomatic/new problem
2= Treatment only
3= Follow-up
4= Family planning
5= STD/HIV screening only
6= Prenatal care
8= Other
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the information is collected but is unknown for this record.
201 F1_Pregnant
Is the patient pregnant today?
1= Yes
2= No
3= Patient does not know/ not sure
9= Not captured
If information is collected but patient is not sure, then appropriate
response is 3. A response of 9 indicates the information is not captured
or collected by the facility or is not provided to SSuN. Null values
allowed for men or if information is collected by the facility but
unknown for this record.
202 F1_Contraception
What is the patient's primary method of contraception at the end of her
visit?
1= hormonal
2= IUD
3= Barrier
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4= None
5= Natural
8= Other
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values allowed for men
or if information is collected by the facility but unknown for this
record.
203 F1_Sympt
Does the patient have STI symptoms?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the information is collected by the facility but is unknown for this
record.
204 F1_Contact_STD
Was the patient a contact or exposed to STD?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the information is collected by the facility but is unknown for this
record.
205 F1_Pelvic_exam
Was a pelvic exam performed?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values allowed for men
or if information is collected by the facility but unknown for this
record.
206 F1_MENSEX
How many male sex partners has the patient had in the last 3 months?
If number of male sex partners is unknown, missing, or not captured,
use null value.
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207 F1_FEMSEX
How many female sex partners has the patient had in the last 3
months?
If number of female sex partners is unknown, missing, or not captured,
use null value.
208 F1_SEXOR3
Has the patient had sex with men, women, or both over the past 3
months?
1= Men
2= Women
3= Both
4= No sexual partners in the last 3 months
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the information is collected by the facility but is unknown for this
record.
209 F1_NUMSEX3
How many sex partners has the patient had in the past 3 months?
If number of sex partners is unknown, missing, or not captured, use
null value.
210 F1_SEXUALITY
Does the patient consider him/herself gay (homosexual), straight
(heterosexual), or bisexual?
1 = gay/homosexual
2= straight/heterosexual
3= bisexual
4= Other
9 = Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the information is collected by the facility but is unknown for this
record.
211 F1_NewSex
Did the patient have a new sex partner in last 3 months?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the (1) information is collected by the facility but is unknown for
this record or (2) that there was not an opportunity for a “no”
response (radio button).
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212 F1_Rectal_exposure
Did the patient engage in receptive anal sex in last 3 months?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the (1) information is collected by the facility but is unknown for
this record or (2) that there was not an opportunity for a “no”
response (radio button).
213 F1_Pharynx_exposure
Did the patient engage in receptive oral sex in last 3 months days?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. A response of null indicates
that the (1) information is collected by the facility but is unknown for
this record or (2) that there was not an opportunity for a “no”
response (radio button).
214 F1_Partner_tx
Did the patient accept expedited partner therapy?
1= Yes
2= No
9= Not captured
A response of 9 indicates that EPT is provided by the facility, but
information is not captured or collected or is not provided to SSuN. A
response of null indicates that the (1) information is collected by the
facility but is unknown for this record, (2) facility does not provide EPT,
or (3) information is collected by the facility but there is not an
opportunity for a “no” response (radio button).
215 F1_GISP_Travel
Has the patient traveled outside of the United States (50 US states)
during the previous 60 days?
1= Yes
2= No
9= Not captured
Null values are allowed for (1) non-GISP patients or (2) GISP patients
when the information is collected but unavailable for patient record. A
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12 December 2014
response of 9 indicates the information is not captured or collected by
the facility or is not provided to SSuN.
216 F1_GISP_Sex_work
Does the patient have a history of giving or receiving drugs/money for
sex in the previous 12 months?
1= Yes
2= No
9= Not captured
Null values are allowed for (1) non-GISP patients or (2) GISP patients
when the information is collected by the facility but unavailable for
patient record. A response of 9 indicates the information is not
captured or collected by the facility or is not provided to SSuN.
217 F1_GISP_Antibiotic
Has the patient had any antibiotic use during the previous 60 days?
1= Yes
2= No
9= Not captured
Null values are allowed for (1) non-GISP patients or (2) GISP patients
when the information is collected by the facility but unavailable for
patient record. A response of 9 indicates the information is not
captured or collected by the facility or is not provided to SSuN.
218 F1_GISP_IDU
Does the patient have a history of injection drug use in the previous 12
months?
1= Yes
2= No
9= Not captured
Null values are allowed for (1) non-GISP patients or (2) GISP patients
when the information is collected but unavailable for patient record. A
response of 9 indicates the information is not captured or collected by
the facility or is not provided to SSuN.
219 F1_GISP_Non_IDU
Does the patient have a history on non-injection drug use in the
previous 12 months?
1= Yes
2= No
9= Not captured
Null values are allowed for (1) non-GISP patients or (2) GISP patients
when the information is collected but unavailable for patient record. A
response of 9 indicates the information is not captured or collected by
the facility or is not provided to SSuN.
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220 F1_GISP_GC_12
How many previous episodes of gonorrhea are documented in the
patient's medical record within the past 12 months?
Null values allowed (1) for non-GISP patients, (2) for GISP patients
when the information is collected but unavailable for patient record,
or (3) if information is not captured by underlying electronic medical
record or is not provided to SSuN .
221 F1_Gisp_GC_Ever
Has the patient ever (lifetime) been diagnosed with GC?
1= Yes
2= No
9= Not captured
Null values are allowed for (1) non-GISP patients or (2) GISP patients
when the information is collected but unavailable for patient record. A
response of 9 indicates the information is not captured or collected by
the facility or is not provided to SSuN.
Has the patient ever been tested for HIV? (excluding HIV testing on
today’s visit)?
1= Yes
2= No
3= Patient does not know/ not sure
9= Not captured
If information is collected by the facility but patient is not sure, then
appropriate response is 3. A response of 9 indicates the information is
not captured or collected by the facility or is not provided to SSuN. Null
values allowed if information is collected by the facility but unknown
for this record.
222 F1_HIVTest
223 F1_HIVTestdate
When was the patient's last (most recent) test for HIV (month and
year)? (excluding HIV testing on today’s visit)?
Null values are allowed if (1) response to #222 is either 2, 3, 9 or (2)
patient does not know/ or not sure of the date of most recent HIV test.
224 F1_HIVResultlast
What was the result of the patient's most recent test for HIV (excluding
HIV testing on today’s visit)?
0 = Negative
1 = Positive/preliminary positive
2 = Indeterminant
3= Patient does not know/ not sure
9 = Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null value are allowed if (1)
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12 December 2014
response to #222 is either 2, 3,9 or (2) patient does not know/ or not
sure of the result of the most recent HIV test.
225 F1_HIVTest_refuse
Did the patient refuse an HIV test today?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if the
information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
226 F1_HPVVaxadmin
Was the patient given HPV vaccination at this visit?
1= Yes
2= No, not indicated/refused
3= No, clinic does not administer/offer HPV vaccination
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if the
information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
227 F1_SXAbdomen
Did the patient report abdominal pain?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if the
information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
228 F1_SXDysuria
Did the patient report dysuria?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if the
information is collected by the facility but (1) is unknown for this
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12 December 2014
record or (2) there is not an opportunity for a “no” response (radio
button).
229 F1_SXDischarge
Did the patient report a discharge?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if
the information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
230 F1_SXLesion
Did the patient report a genital lesion?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if
the information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
231 F1_Pedischarge
Was there vaginal discharge on exam?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if
the information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
232 F1_Peabdomen
Was there lower abdominal pain on exam?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if
the information is collected by the facility but(1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
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233 F1_CMT
Was there cervical motion tenderness on exam?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if
the information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
234 F1_Adnexal
Was there adnexal tenderness on exam?
1= Yes
2= No
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null values are allowed if
the information is collected by the facility but (1) is unknown for this
record or (2) there is not an opportunity for a “no” response (radio
button).
Facility Component – Diagnosis Records
235 F2_PatientID
Unique patient identification number assigned by site
Will be a secondary key for merging diagnosis and case data; should
correspond to F1_PatientID. This data element cannot be ‘null’ or
contain missing values.
236 F2_Eventid
Unique visit identification
Will be a secondary key for merging diagnosis and case data; should
correspond to F1_EventID. This data element cannot be ‘null’ or
contain missing values.
Date of clinic visit
Will be a secondary key for merging diagnosis and case data; should
correspond to F1_Visdate. This data element cannot be ‘null’ or
contain missing values.
237 F2_Visdate
238 F2_DXCODE
Enhanced SSuN Cycle 3
Diagnosis Code
SY01=Syphilis, primary
SY02=Syphilis, secondary
SY03=Syphilis, early latent
SY04=Syphilis, late latent/Unknown
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SY05=Syphilis, neurosyphilis
SY06=Syphilis, unspecified/other
GC01=Gonorrhea
CT01=Chlamydia
GW01=Genital Warts
HI01=HIV/AIDS
BV01=Bacterial vaginosis (BV)
TR01=Trichomoniasis
GH01=Genital Herpes
NU01=Nongonococcal Urethritis (NGU)
MC01=Muco-purulent cervicitis (MPC)
PI01=Pelvic Inflammatory Disease (PID)
EP01=Epididymitis
CC01=Chancroid
LV01=Lymphogranuloma venereum (LGV)
GI01=Granuloma Inguinale
CD01=Candidiasis
SC01=Scabies
PD01=Pediculosis
CS01=Contact to STD
PG01=Pregnancy
NE01=Normal exam/diagnosis
OT01=Other
Null values allowed if information is collected by the facility but
unknown for this record.
Facility Component – Laboratory Records
239 F3_PatientID
240 F3_Eventid
241 F3_Visdate
Enhanced SSuN Cycle 3
Unique patient identification number assigned by site
Will be a secondary key for merging laboratory and case data; should
correspond to F1_PatientID. This data element cannot be ‘null’ or
contain missing values.
Unique visit identification
Will be a secondary key for merging laboratory and case data; should
correspond to F1_EventID. This data element cannot be ‘null’ or
contain missing values.
Date of clinic visit
Will be a secondary key for merging laboratory and case data; should
correspond to F1_Visdate. This data element cannot be ‘null’ or
contain missing values.
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242 F3_Condtested
What condition was the patient tested for?
2 = Gonorrhea
3 = Chlamydia
6 = HIV/AIDS
20 = Pregnancy
Null values allowed if patient was not tested for any of these
conditions during the clinic visit or if information is collected by the
facility but unknown for this record.
243 F3_Test_Type
What type of test was used?
1= Culture
2= Nucleic acid amplification test (NAAT)
3= Non-amplified nucleic acid test/DNA probe
4= Gram stain
10= HIV Nucleic acid test (NAT)
11= rapid HIV-1 or HIV-1/2 antibody (Ab) test
12= HIV-1 Immunoassay (IA)
13= HIV-1/2 IA
14= HIV-1/2 Ag/Ab IA
15= HIV-1 WB
16= HIV-1 IFA
17= HIV-1/HIV-2 differentiation IA
18= pooled RNA
40= Pregnancy
88= Other
Null values allowed if information is collected by the facility but
unknown for this record.
244 F3_Qualres
What was the qualitative test result?
0 = Negative
1 = Positive
2 = Nonreactive
3 = Reactive
4 = Indeterminate
5= Weakly Reactive
6 = QNS/Contaminated/Unsaturated
8 = Other/pending
Null values allowed if information is collected by the facility but
unknown for this record.
245 F3_Anatsite
What anatomic site was tested?
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1 = Urethral
2 = Vaginal/cervical
3 = Urine
4 = Rectal
5 = Pharynx
6 = Blood
8 = Other
9 = Not captured
Null values allowed if information is collected by the facility but
unknown for this record.
Facility Component – Treatment Records
246 F4_PatientID
Unique patient identification number assigned by site
Will be a secondary key for merging treatment and case data; should
correspond to F1_PatientID. This data element cannot be ‘null’ or
contain missing values.
247 F4_Eventid
Unique visit identification
Will be a secondary key for merging treatment and case data; should
correspond to F1_EventID. This data element cannot be ‘null’ or
contain missing values.
248 F4_Visdate
Date of clinic visit
Will be a secondary key for merging treatment and case data; should
correspond to F1_Visdate. This data element cannot be ‘null’ or
contain missing values.
249 F4_Medication
What medication was prescribed to the patient (brand name)?
10= Amoxicillin (Amoxil, Polymox, Trimox, Wymox)
11= Ampicillin (Omnipen, Polycillin, Polycillin-N, Principen,
Totacillin)
20= Azithromycin (Zithromax)
21= Erythromycin base
22= Clindamycin (Cleocin)
23= Gentamicin (Garamycin, G-Mycin, Jenamicin)
30= Cefixime (Suprax)
31= Ceftizoxime (Cefizox)
32= Cefotaxime (Claforan)
33= Cefoxitin (Mefoxin)
34= Cefpodoxime (Vantin)
35= Ceftibuten (Cedax)
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36= Cefdinir (omnicef)
37= Ceftriaxone (Rocephin)
38= Cefuroxime (Ceftin, Kefurox, Zinacef, Zinnat)
40= Ciprofloxacin (Cipro, Cipro XR, Ciprobay, Ciproxin)
41= Levofloxacin (Cravit, Levaquin)
42= Moxifloxacin (Avelox, Vigamox)
43= Ofloxacin (Floxin, Oxaldin, Tarivid)
44= Gemifloxacin (Factive)
50= Doxycycline (Doryx, Vibramycin)
60= Metronidazole (Flagyl, Helidac, Metizol, Metric 21, NeoMetric, Noritate, Novonidazol)
61= Tinidazole (Tindamax)
70= Truvada (Tenofovir/emtricitabine)
88= Other
99= No medication prescribed
Null values allowed if information is collected by the facility but
unknown for this record.
249.1 F4_Medication
Description for other medication
Free text description of other medications
250 F4_Dosage
What was the dosage of the medication prescribed?
1= 100mg
2= 125mg
3= 150mg
4= 200mg
5= 240mg
6= 250mg
7= 300mg
8= 320mg
9= 400mg
10= 500mg
11= 600mg
12= 750mg
13= 800mg
14= 1g
15= 2g
88= Other
99= Not captured
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A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null value allowed if dosage
is unknown or missing.
251 F4_Number_doses
Total number of doses prescribed?
Null value allowed if (1) number of total doses is unknown or missing
or (2) the information is not captured or collected by the facility or is
not provided to SSuN.
252 F4_Dose_Freq
What is the frequency of doses?
1=one single dose
2= twice day
3= three times a day
4= four times a day
8= other
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null value allowed if
frequency of doses is unknown or missing.
253 F4_Duration
What duration was the medication prescribed for?
1= 1 day
2= 3 days
3= 5 days
4= 7 days
5= 10 days
6= 14 days
8= Other
9= Not captured
A response of 9 indicates the information is not captured or collected
by the facility or is not provided to SSuN. Null value allowed if
duration of medication is unknown or missing.
Facility Component – Provider Metadata File (Annual)
254 F5_Facility_ID
Enhanced SSuN Cycle 3
Unique facility identifier
This ID should be supplied by the site and is a unique facility identifier
from underlying surveillance systems or may be generated specifically
for SSuN. Regardless of source, this ID must be unique and allow for
longitudinal tracking of the facility. This data element cannot be ‘null’
or contain missing values.
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255 F5_Site
Unique site code
BA=Baltimore
CA=California
FL=Florida
MA=Massachusetts
MN=Minnesota
MC=Multnomah county
NY=New York City
PH=Philadelphia
SF=San Francisco
WA= Washington
This 2 character code primarily identifies sites funded under SSuN Cycle
3 and may include additional sites as required throughout the grant
period. Supplemental codes – for SSuN cycle II historical data only:
VA=Virginia (Cycle II)
AL=Alabama (Cycle II)
CO=Colorado (Cycle II)
CH=Chicago (Cycle II)
This data element cannot be ‘null’ or contain missing values.
256 F5_Facility_name
257 F5_Facility_type
What is the name of the facility?
What is the facility type?
1= STD clinic
2=FP/RH
88= Other
258 F5_FQHC
Is this facility a FQHC?
1= Yes
2= No
259 F5_Title_X
Is this facility a Title X clinic?
1= Yes
2= No
260 F5_CHC
Is this facility a Community Healthcare Center?
1= Yes
2= No
261 F5_School_based
Is this facility a school-based facility?
1=Yes
2=No
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262 F5_Facility_Address
What is the physical street address of the facility?
263 F5_Facility_City
In what city is the facility located?
FIPS code, example: 3290 (City of SF)
264 F5_Facility_State
In what state is the facility located?
FIPS code
265 F5_Facility_Zip
Zip code for the facility 9-digit ZIP code of facility
266 F5_Point_contact
Point of contact at facility
267 F5_EPT
Does the facility have written policies governing EPT?
1= Yes
2= No
3= facility does not employ EPT
268 F5_HPV_vaccine
Does the facility have written policies governing HPV vaccination?
1= Yes
2= No
3= facility does not provide HPV vaccination
269 F5_HIV_algorithm
Does the facility have written policies governing HIV testing?
1= Yes
2= No
3= facility does not provide HIV testing
270 F5_Screening_CT
Does the facility have written policies governing chlamydia screening?
1= Yes
2= No
3= facility does not provide CT testing
271 F5_Screening_GC
Does the facility have written policies governing gonorrhea screening?
1= Yes
2= No
3= facility does not provide GC testing
272 F5_Billing
Does the facility bill for STD services?
1= Yes
2 = No
3= Other
Enhanced SSuN Cycle 3
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273 F5_Medical_record
Type of medical record system?
1= paper-based
2= electronic
3=combination
9= not sure
274 F5_Insurance
Is the facility in an insurance network?
1=Yes
2=No
Enhanced SSuN Cycle 3
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Appendix 3: STD/HIV screening recommendations
Women
-Annual HIV test
-HIV test at time of STD diagnosis
-Test for other STDs at time of STD diagnosis
-Chlamydia/gonorrhea test if at risk (young women or older at increased risk)
-Rescreening for chlamydia/gonorrhea if positive
MSM
-Annual syphilis, HIV, chlamydia/gonorrhea (at exposed sites) or more frequently if indicated
-Test for other STDs at time of STD diagnosis
-rescreening for chlamydia/gonorrhea if positive
Heterosexual men
-Annual HIV test
-HIV test at time of STD diagnosis
-Test for other STDs at time of STD diagnosis
-Gonorrhea test if at risk
-Rescreening for chlamydia/gonorrhea if positive
Other preventive services
-Pregnancy test
Enhanced SSuN Cycle 3
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| File Type | application/pdf |
| File Title | Microsoft Word - IntegratedProtocol_FinalDraft_December2014 |
| Author | gge3 |
| File Modified | 2014-12-12 |
| File Created | 2014-12-12 |