Form Approved
OMB No. 0920-1242
Expiration Date: ##/####/####
Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-1242)
Strengthening United States Response to Resistant Gonorrhea (SURRG)
Attachment 3D
SURRG Field Investigation Data Elements
Variable name |
Data element |
Description/Question |
Response codes |
CASE ATTRIBUTES |
|||
CS_PATIENTID
|
Patient ID |
SURRG record IDs from interviews will created and assigned (by the local or state health department) a unique patient identifier (patient ID). CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. (see SSA 9) |
Character ID |
CS_EVENTID |
Event ID/Case ID of case-patient |
This ID up to 18 characters in length. SURRG records from interviews will be assigned (by the local or state health department) a unique event identification number for each investigation. CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. |
Character ID |
CS_ASSGN_DATE |
Date of Case Assignment |
Date of assignment as a SURRG case |
YYYY/MM/DD |
CS_INT_DATE |
Date of Case Interview |
Date of SURRG case interview Note: If case interviewed more than once for the same case, you can use the initial interview date and put all data in one line in the Case table. Leave blank if not interviewed |
YYYY/MM/DD |
CS_TSTX_DISPO |
Case Disposition |
Disposition of Field investigation/Testing and Treatment for Case |
A=Preventative treatment |
CS_PSINT_DSPO |
Case Disposition of Partner Services/SURRG Interview |
Disposition of Partner Services/SURRG Interview for Case
Note: all responses other than 3 indicate not interviewed |
1=Insufficient information to attempt
locating |
CS_CASE_TYPE |
Case Type |
Case type will need to be finalized after GC status determined |
1=SURRG assigned index case (alert or other SURRG index case); 2= Investigation identified (patient GC status not known prior to SURRG partner services activities); 3=previously known (patient GC status was known to patient prior to partner services activities); 9=unknown |
CS_INT_TYPE |
Interview Type at time of first interview |
What was the status of the interviewee when they were originally interviewed?
Note: Do not leave blank. If this person was not interviewed, still assign the interview type that would have been appropriate (e.g. Case). Interviewing of social contacts is not required |
1=Case (OP); 2=Sex Partner (P1 or P3); 3=Social contact (S1-S3 or A1-A3)
|
CS_STATE |
State of residence |
2-digit FIPS state code |
Character; 99=Unknown |
CS_RESID_CITY |
City of residence |
4-digit FIPS city code |
Character; 9999=Unknown |
CS_RESID_CNTY |
County of residence |
3-digit FIPS county code |
Character; 999=Unknown |
CS_DEMO_AGE |
Age in years |
How old are you (in years)? [Can also be calculated as interview date minus birthdate, or as recent clinic visit date minus birthdate] |
Numeric; 999=Unknown |
CS_DEMO_GENDER |
Gender |
How do you describe your gender identity? |
1=Male 2=Female 3=Transgender male/trans man/Female-to-male transgender (FTM) 4=Transgender female/trans woman/Male-to-female transgender (MTF) 5= Genderqueer/gender non-conforming/neither exclusively male nor female 6=Additional or another gender identity 8=Refused to Answer 9=Unknown |
CS_DEMO_SEX_BIRTH |
Sex at birth |
What sex were you assigned at birth, on your original birth certificate? |
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CS_DEMO_HISP_ETH |
Ethnicity: Hispanic or Latino |
Is the person of Hispanic or Latino ethnicity? |
0=No, not Hispanic/Latino; 1=Yes, Hispanic/Latino; 8=Refused to Answer; 9=Unknown |
CS_DEMO_AIAN |
Race: AI/AN-American Indian or Alaskan Native |
Does the person identify as American Indian or Alaska Native? |
0=No; 1=Yes; 8=Refused to Answer; 9=Unknown |
CS_DEMO_ASIAN |
Race: Asian |
Does the person identify as Asian? |
0=No; 1=Yes; 8=Refused to Answer; 9=Unknown |
CS_DEMO_NHOPI |
Race: NH/PI-Native Hawaiian or Other Pacific Islander |
Does the person identify as Native Hawaiian or Pacific Islander? |
0=No; 1=Yes; 8=Refused to Answer; 9=Unknown |
CS_DEMO_BLACK |
Race: Black or African American |
Does the person identify as black or African-American? |
0=No; 1=Yes; 8=Refused to Answer; 9=Unknown |
CS_DEMO_WHITE |
Race: White |
Does the person identify as white? |
0=No; 1=Yes; 8=Refused to Answer; 9=Unknown |
CS_DEMO_MULTIRACE |
Race: Multirace |
Does the person identify as multiracial? |
0=No; 1=Yes; 8=Refused to Answer; 9=Unknown |
CS_DEMO_OTHRACE |
Race: Other |
Does the person identify as another race not listed? |
0=No; 1=Yes; 8=Refused to Answer; 9=Unknown |
CS_DEMO_SEX_ORIENT |
Sexual orientation |
Which of the following best represents how you think of yourself? |
1=Lesbian or gay; 3=Straight or heterosexual; 4=Bisexual; 5=Queer, pansexual, and/or questioning 5=Something else/Other; 8=Refused to Answer; 9=Unspecified/Unknown |
CS_DEMO_PREG_STAT |
Pregnancy Status |
What is your pregnant status (among women)?
Use response=7, not applicable, if patient is cisgender male or female transgender (MTF). (NOTE: Can come from clinic records from day of recent GC test; if not available, required to ask during interview) |
1=Pregnant; 2=Not Pregnant; 7=Not applicable; 9=Unknown
|
CS_PTR_INV_M |
No. of recent male sex partners in the past 2 months |
In the past 2 months, what is the number of recent male sex partners? |
Numeric; 999=Unknown |
CS_PTR_INV_F |
No. of recent female sex partners in the past 2 months |
In the past 2 months, what is the number of recent female sex partners? |
Numeric; 999=Unknown |
CS_PTR_INV_T |
No. of recent transgender sex partners in the past 2 months |
In the past 2 months, what is the number of recent transgender sex partners? |
Numeric; 999=Unknown |
CS_PTR_MAIN_INV |
No. recent main partners in the past 2 months |
How many of the sex partners you have had in the past 2 months do you consider to be a main or primary partner? |
Numeric; 999=Unknown |
CS_PTR_ANYM_INV |
No. recent anonymous partners in the past 2 months |
How many of the sex partners you’ve had in the last 2 months were anonymous? [By anonymous, I mean that you don’t know their last name and you wouldn’t be able to find them again if you wanted to] |
Numeric; 999=Unknown |
CS_PTR_CAS_INV |
No. recent casual partners in the past 2 months |
Number of casual partners. [Calculated as Total partners minus (main + anonymous) where Total partners = PTR_INV_M + PTR_INV_F + PTR_INV_T] |
Numeric; 999=Unknown |
CS_SEXACT_INS_ANAL |
Performed insertive anal sex (past 2 months) |
In the past 2 months, have you performed insertive anal sex? [Anal sex can be defined as your penis in someone else’s anus] |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown |
CS_SEXACT_RECP_ANAL |
Received/Receptive anal sex (past 2 months) |
In the past 2 months, have you had receptive anal sex? [Can define as someone else’s penis in your anus] |
0=No; 1=Yes; 9=Unknown |
CS_SEXACT_PER_ORAL |
Performed oral sex (past 2 months) |
In the past 2 months, have you performed oral sex?
|
0=No; 1=Yes; 9=Unknown |
CS_SEXACT_RECP_ORAL |
Receptive oral sex (past 2 months) |
In the past 2 months, have you received oral sex?
|
0=No; 1=Yes; 9=Unknown |
CS_SEXACT_VAG |
Vaginal sex (past 2 months) |
In the past 2 months, have you had vaginal sex? NOTE: SURRG ACCESS database does not use “not applicable”, but other sites may use through a skip pattern |
0=No; 1=Yes; 7=not applicable 9=Unknown |
CS_SEXDRG_FRQ |
Frequency of drug use for sex |
How often do you use drugs before or during sex to make sex easier, last longer, or feel better? |
1=Every time 2=Most of the time 3=Sometimes/occasionally 4=Never 9=Unknown |
CS_SEXDRG_COC |
Use of cocaine/crack prior to sex (past 2 months) |
Have you used cocaine/crack (before sex) in the past 2 months? [indicate yes, if used “Speedballs” (heroin & cocaine combined)] (use 7 if never use drugs for sex/ CS_SEXDRG_FRQ=4) |
0=No; 1=Yes; 7=not applicable; 9=Unknown |
CS_SEXDRG_HER |
Use of heroin prior to sex (past 2 months) |
Have you used speedball (before sex) in the past 2 months? [indicate yes, if used “Speedballs” (heroin & cocaine combined) or “goofballs” (heroin and meth combined) (use 7 if never use drugs for sex/ CS_SEXDRG_FRQ=4) |
0=No; 1=Yes; 7=not applicable; 9=Unknown |
CS_SEXDRG_METH |
Use of methamphetamines prior to sex (past 2 months) |
Have you used methamphetamines (e.g. crystal, "tine", "meth", "speed") (before sex) in the past 2 months? [indicate yes, if used “goofballs” (heroin and meth combined)] (use 7 if never use drugs for sex/ CS_SEXDRG_FRQ=4) |
0=No; 1=Yes; 7=not applicable; 9=Unknown |
CS_SEXDRG_ECS |
Use of ecstasy prior to sex (past 2 months) |
Have you used Ecstasy, E, Molly, MDMA, GHB, or Special K (before sex) in the past 2 months? (use 7 if never use drugs for sex/ CS_SEXDRG_FRQ=4) |
0=No; 1=Yes; 7=not applicable; 9=Unknown |
CS_SEXDRG_POP |
Use of poppers/nitrates prior to sex (past 2 months) |
Have you used poppers/nitrates (before sex) in the past 2 months? (use 7 if never use drugs for sex/ CS_SEXDRG_FRQ=4) |
0=No; 1=Yes; 7=not applicable; 9=Unknown |
CS_SEXDRG_PRESC |
Use of prescription pain killers prior to sex (past 2 months) |
Have you used prescription pain killers (e.g. oxycodone, Vicodin) (before sex) in the past 2 months? (use 7 if never use drugs for sex/ CS_SEXDRG_FRQ=4) |
0=No; 1=Yes; 7=not applicable; 9=Unknown |
CS_GRP_SEX |
Recent group sex frequency (in past 2 months) |
How many times in the past 2 months did you have sex with two or more other people at the same place, like a threesome, or at a bathhouse or sex party? [Group sex includes sex with multiple people simultaneously or when you have sex with more than 1 other person sequentially at a party, bathhouse, or someone’s home, etc.] |
Numeric; 999=Unknown |
CS_GRP_SEX_LOC |
Recent group sex location |
If CSEGRP_SEX>0: Where did the last group sex (or multiple-person sex) event/encounter take place?
(Use response=8 if CS_GRP_SEX=0) |
1=House or apartment (residence) 2=Bathhouse or sex club 3=Bar or club 4=Hotel 5=Outdoors/Outside public space (e.g. public park) 6=Brothel 7=Other 8=Not applicable 9=Unknown |
CS_GRP_SEX_SIZE |
Relative size of recent group sex event |
How many people attended this last group sex (or multiple-person sex) event/encounter? [This question seeks to know how many (approximate) people were at the place (home, club, park, etc.) where the sex event(s) occurred, not how many people the patient had sex with?] (Use response=777 if CS_GRP_SEX=0) |
Numeric; 777=Not applicable; 999=Unknown |
CS_GRP_SEX_KNOW |
Recent group sex awareness |
How did you find out about/or get connected with this recent group sex (or multiple-person sex) event/encounter? Note: Someone going to a bathhouse could indicate response option 1 or 5, and someone in a polyamorous relationship could indicate response option 7. (Use response=8 if CS_GRP_SEX=0) |
1=It happened spontaneously 2=Personal invitation through a friend, sexual partner or other acquaintance 3=From a social networking site or app 4=Through an advertisement 5=Already knew about this sex venue (e.g bathhouse) 7=Other (e.g. patient part of couple who sought a 3rd personrd) 8=Not applicable 9=Unknown |
CS_GCHX_EVER_SR |
Self-reported GC History |
Have you ever been diagnosed with gonorrhea (before this recent infection)? |
0=No; 1=Yes; 9=Unknown |
CS_GCHX_YEAR_SR |
Self-reported GC Diagnosis past year |
Have you been diagnosed with gonorrhea (before this recent infection) in the past year? |
0=No; 1=Yes; 9=Unknown |
CS_GCHX_EVER_RC |
Documented GC History in case reports/EMR |
Record of patient gonorrhea diagnosis history in case reports or clinic records |
0=No; 1=Yes; 9=Unknown |
CS_GCHX_YEAR_RC |
Documented GC History in past year in case reports |
Record of person gonorrhea diagnosis history in past year in case reports or clinic records (Past year can be defined locally as 12 months prior to interview, recent test date, or diagnosis) |
0=No; 1=Yes; 9=Unknown |
CS_HC_SEXPROV |
Provider Type for Sexual Healthcare needs |
Where have you gone most often in the past year for STD or other sexual healthcare?
|
1=Have not received STD or sexual healthcare in the past year 2=Primary Care Provider/Community Health Center 3=STD clinic or other sexual health clinic 4=Family Planning Clinic 5=HIV care provider 6=Emergency Department 7=Urgent Care 8=Other 9=Unknown |
CS_HIV_TST_INV |
Ever tested for HIV |
Have you ever tested for HIV? |
0=No; 1=Yes; 9=Unknown (NOTE: Can come from clinic records from day of recent GC test; if not available, required to ask during interview) |
CS_HIV_LAST_RESULT |
Last HIV test date (YYYY/MM) |
When was your last HIV test? |
Character; YYYY/MM (Missing information should be coded as '…./..' or 'YYYY/..') (NOTE: Can come from clinic records from day of recent GC test; if not available, required to ask during interview) |
CS_HIV_DOC_STATUS |
HIV status (documented or self-report) |
What is the patient's HIV status (from eHARS, EMR, or self-report)
|
0=Negative/Nonreactive 1=Positive/Reactive 2=Indeterminate 9=Unknown (NOTE: Can come from clinic records from day of recent GC test; if not available, required to ask during interview) |
CS_PrEP_INV |
Current daily PrEP use |
(If HIV-negative) Is the patient currently using HIV pre-exposure prophylaxis (PrEP)? [Given that some people use PrEP daily and others on-demand, you can chose to define “currently using PrEP” as someone who was taking PrEP the last time they had sex]
[Response=7 if CS_HIV_DOC_STATUS=1, i.e. HIV-positive] |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown (NOTE: Can come from clinic records from day of recent GC test; if not available, required to ask during interview) |
CS_PrEP_REF_INV |
PrEP referral |
If HIV-negative and not currently on PrEP: Was the patient offered or referred for a PrEP consultation today (if eligible)?
[Response=7 if CS_HIV_DOC_STATUS=1 (HIV-positive) or CS_PrEP_INV=1 (already on PrEP)] |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown (NOTE: Can come from clinic records from day of recent GC test; if not available, required to ask during interview) |
CS_HIVCARE_INV |
Current HIV care self-reported |
If HIV-positive: Is the patient currently receiving HIV medical care (in the past 12 months)? [Note: can use a different time frame if already used locally– e.g. received HIV care in the past 6 months]
[Response=7 if HIV-negative or unknown HIV status] |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown (NOTE: Can come from clinic records from day of recent GC test) |
CS_HIV_VL_INV |
Most recent viral load self-reported |
If HIV-positive and currently receiving HIV medical care: Was your most recent viral load undetectable?
[Response=7 if HIV-negative or unknown HIV status] |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown (NOTE: Can come from clinic records from day of recent GC test) |
CS_HIV_REF_INV |
HIV care referral |
If HIV-positive and not currently receiving HIV medical care: Was person referred to HIV care today?
[Response=7 if HIV-negative] |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown (NOTE: Can come from clinic records from day of recent GC test) |
CS_SYMPT_INV |
Resolution of GC symptoms |
If you had symptoms from the most recent episode of gonorrhea, how are your symptoms now?
[Note: Use response 5 if patient was not symptomatic with this infection; use response 7 if patient is a partner and not a case; item should not be left blank] |
1=Completely gone 2=Better, but not completely gone 3=Better, then got worse 4=Never improved 5=Asymptomatic (never symptomatic) 6=Recent case (i.e. treated today) 7=Not applicable/Not a case (e.g. a partner) 9=Unknown |
CS_UNNAMED |
Number of unnamed sex partners |
How many other (unnamed) people did you have sex with in the last 2 months? [DIS could calculate this number based on # of male, female, and transgender partners patient described earlier minus the number of named partners, or ask the question again] |
Numeric; 999=Unknown |
CS_UN_MAIN |
Number of unnamed sex partners: main sex partner |
How many of these unnamed partners you would consider main or primary sex partners? [DIS can reiterate that “main” or “primary” sex partners may include anyone they are in a committed relationship with – even if they don’t have frequent sex, the persons they are currently having the most sex with, etc.]
Response=777 if CS_UNNAMED=0 |
Numeric; 777=Not Applicable; 999=Unknown |
CS_UN_ANONY |
Number of unnamed sex partners: anonymous sex partner |
How many of these unnamed partners are anonymous? [Anonymous, means partners that you don't know their name, and it’s unlikely you'd be able to find them again, even if you wanted to]
Response=777 if CS_UNNAMED=0 |
Numeric; 777=Not Applicable; 999=Unknown |
CS_UN_CASU |
Number of unnamed sex partners: casual sex partner |
Number of casual unnamed partners. [Calculated as CT_UNNAMED minus (CT_UN_MAIN + CT_UN_ANONY)]
Response=777 if CS_UNNAMED=0 |
Numeric; 777=Not Applicable; 999=Unknown |
CS_UN_SEXOTH_UN |
Concurrency of interviewee |
In the past two months, If you had sex more than one time with any of your unnamed partners, did you also had sex with other people besides these unnamed partner(s) during that time period? Response=777 if CS_UN_MULTISEX=777 or 0] |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown |
CS_UN_EXCH_REC |
Commercial/exchange sex: Received |
Did any of these unnamed sex partners give you money, drugs, or something else you needed in exchange for sex? Response=777 if CS_UNNAMED=0 |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown |
CS_UN_EXCH_GIV |
Commercial/exchange sex: Given |
Did you give any of these unnamed partners money, drugs, or something else they needed in exchange for sex? Response=777 if CS_UNNAMED=0 |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown |
CS_UN_TRVL_ABRD |
Partner travel |
Did any of these unnamed partner(s) travel to or from another country in the past 2 months? Response=777 if CS_UNNAMED=0 |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown |
CS_UN_FRST_SEXABRD |
First sex encounter: Travel abroad |
Did you first have sex with any of these unnamed partner(s) in another country? Response=777 if CS_UNNAMED=0 |
0=No; 1=Yes; 7=Not Applicable; 9=Unknown |
CS_UN_GCCT |
GC Contact: No of unnamed partner(s) |
How many of these unnamed recent sex partners have you told may have been exposed to gonorrhea (or an STD)?
[Response=777 when either 1) no unnamed recent sex partners were reported, or 2) when someone is interviewed before they have received their GC results.] |
Numeric; 777=Not applicable; 999=Unknown
|
CS_UN_GCEXP |
Disclosure of GC exposure: No of unnamed partner(s) |
In total, how many other unnamed recent sex partners are you likely to inform that they may have been exposed to gonorrhea (or STD)?
[Response=777 when any of the following occur: 1) no unnamed recent sex partners were reported, and 2) when someone is interviewed before they have received their GC results, and 3) when there are no more unnamed partners (i.e. when CS_UN_GCCT= CS_UNNAMED] |
Numeric; 777=Not applicable; 999=Unknown
|
CONTACT ATTRIBUTES |
|||
CT_PATIENTID |
Patient ID of contact |
SURRG record IDs from interviews will created and assigned (by the local or state health department) a unique patient identifier (patient ID). CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. (see SSA 9) |
Character ID |
CT_EVENTID |
Event ID of contact |
SURRG records from interviews will be assigned (by the local or state health department) a unique event identification number for each investigation. CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. |
Character ID |
CT_TSTX_DSPO |
Contact Disposition |
Disposition of Field Investigation/Testing and Treatment for Contact |
Disposition of Field
Investigation/Testing and Treatment |
CT_PSINT_DSPO |
Contact Disposition of Partner Services/SURRG Interview |
Disposition of Partner Services/SURRG Interview for Contact |
1=Insufficient information to attempt
locating |
CT_ASSGN_DATE |
Date of Contact Assignment |
Date of assignment as a SURRG contact |
YYYY/MM/DD |
CT_INT_DATE |
Date of Contact Interview |
Interview date of elicited contact |
YYYY/MM/DD |
CT_INT_TYPE |
Interview Type |
Interviewee was interviewed as? |
1=Sex Partner (P1 or P3); 2=Social contact (S1-S3 or A1-A3); 9=Not applicable (not interviewed) |
CT_CASE_TYPE |
Case Type |
|
0=Not a case (i.e. negative for GC); 2= identified as a case (i.e. positive for GC) through SURRG Investigation; 3=previously known (patient GC status was known to patient prior to this SURG initiated investigation/partner services activity; 8=Not applicable (not interviewed); 9=unknown (i.e. GC status unknown) |
CT_RESID_CITY |
City of residence |
4-digit FIPS county code |
Character; 9999=Unknown/Not applicable |
CT_RESID_CNTY |
County of residence |
3-digit FIPS county code |
Character; 999=Unknown/ Not applicable |
CT_GENDER |
Gender |
How do you describe your gender identity? |
1=Male 2=Female 3=Female-to-male transgender (FTM) 4=Male-to-female transgender (MTF) 5=Other gender identity 8=Refused to Answer 9=Unknown |
CT_SEX_BIRTH |
Sex at birth |
What sex were you assigned at birth, on your original birth certificate? |
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_AGE |
Age |
Age in years |
Numeric; 999=Unknown |
CT_AIAN |
Race: American Indian or Alaskan Native (AI/AN) |
|
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_ASIAN |
Race: Asian |
|
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_NHOPI |
Race: Native Hawaiian or Other Pacific Islander (NH/PI) |
|
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_BLACK |
Race: Black or African American (AA) |
|
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_WHITE |
Race: White |
|
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_MULTIRACE |
Race: Multirace |
|
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_OTHRACE |
Race: Other |
|
1=Male; 2=Female; 8=Refused to Answer; 9=Unknown |
CT_HISP_ETH |
Ethnicity: Hispanic/Latino |
|
0=No, not Hispanic/Latino; 1=Yes, Hispanic/Latino; 8=Refused to Answer; 9=Unknown |
CT_SEX_ORIENT |
Sexual orientation |
Which of the following best represents how you think of yourself? |
1=Gay (Lesbian or gay); 3=Straight, this is not gay (or lesbian); 4=Bisexual; 5=Something else/Other; 8=Refused to Answer; 9=Unspecified/Unknown |
CT_PTR_INV_M |
No. of recent male sex partners in the past 2 months |
In the past 2 months, what is the number of recent male sex partners? |
Numeric; 999=Unknown |
CT_PTR_INV_F |
No. of recent female sex partners in the past 2 months |
In the past 2 months, what is the number of recent female sex partners? |
Numeric; 999=Unknown |
CT_PTR_INV_T |
No. of recent transgender sex partners in the past 2 months |
In the past 2 months, what is the number of recent transgender sex partners? |
Numeric; 999=Unknown |
PARTNERSHIP ATTRIBUTES |
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PTSP_NAMINGID |
Naming ID |
SURRG record IDs from interviews will created and assigned (by the local or state health department) a unique patient identifier (patient ID). CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. (see SSA 9) |
Character ID |
PTSP_NAMEDID |
Named ID |
SURRG record IDs from interviews will created and assigned (by the local or state health department) a unique patient identifier (patient ID). CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. (see SSA 9) |
Character ID |
PTSP_NAMING_EVENTID |
Event ID of NamingID |
This ID up to 18 characters in length. SURRG records from interviews will be assigned (by the local or state health department) a unique event identification number for each investigation. CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. |
Character ID |
PTSP_NAMED_EVENTID |
Event ID of NamedID |
This ID up to 18 characters in length. SURRG records from interviews will be assigned (by the local or state health department) a unique event identification number for each investigation. CDC will only receive the unique identifier and will not have the ability to back-convert the Patient ID or other event ID to a medical record number, name, social security number, or date of birth. |
Character ID |
PTSP_INT_DATE |
Date of Interview/re-interview |
Date of interview that contact(s) were named with provided description(s) of their relationship. [One entry per named contact and interview date. A case/contact could have multiple interview dates associated if they named additional contacts at different time points] |
YYYY/MM/DD |
PTSP_INT_REL |
Relationship type |
What is the relationship with this contact? |
1=Sex partner; 2=Social contact
|
PTSP_TYPE |
Partnership type |
Is the sex partner a main or casual partner? [Let client define if they consider the person to be more of a main or casual sex partner. DIS can clarify that a main partner could include anyone they are in a committed relationship with – even if they don’t have frequent sex, or the person(s) they are currently having the most sex with; a casual partner could include someone they don’t feel like they are in a serious relationship with, or someone they have had/have sex with infrequently. The terms are not mutually exclusive. Let the client define if main or casual] If Relationship type=2 then Partnership type=7 |
1=Main; 2=Casual, 7=Not applicable 9=Unknown
|
PTSP_AGE |
Approximate age of partner
|
What is the approximate age of your partner? Aggregated age categories |
1=≤19 |
PTSP_RACE |
Race of partner |
How do you describe the race of your partner? |
1=White |
PTSP_ETH |
Ethnicity of Partner: Hispanic or Latino |
|
0=No, not Hispanic/Latino; 1=Yes, Hispanic/Latino; 9=Unknown |
PTSP_LIVE |
Area of residence of partner |
Where does the partner live? Note: DIS can complete PTSP_LIVE, PTSP_LIVE_STATE, PTSP_LIVE_CNTRY based on address information provided, i.e. these three questions do not need to be asked of the patient. |
1=Same city/county (as case
interviewee that named them) |
PTSP_LIVE_STATE |
State of residence of partner |
If PTSP_LIVE=3: What state does this partner live? [Note: State codes are Census core FIPS codes (Jul 2015)] Note: DIS can complete PTSP_LIVE, PTSP_LIVE_STATE, PTSP_LIVE_CNTRY based on address information provided, i.e. these three questions do not need to be asked of the patient. |
1=Alabama; 2=Alaska; 4=Arizona; 5=Arkansas; 6=California; 8=Colorado; 9=Connecticut; 10=Delaware; 11=District of Columbia; 12=Florida; 13=Georgia; 15=Hawaii; 16=Idaho; 17=Illinois; 18=Indiana; 19=Iowa; 20=Kansas; 21=Kentucky; 22=Louisiana; 23=Maine; 24=Maryland; 25=Massachusetts; 26=Michigan; 27=Minnesota; 28=Mississippi; 29=Missouri; 30=Montana; 31=Nebraska; 32=Nevada; 33=New Hampshire; 34=New Jersey; 35=New Mexico; 36=New York; 37=North Carolina; 38=North Dakota; 39=Ohio; 40=Oklahoma; 41=Oregon; 42=Pennsylvania; 44=Rhode Island; 45=South Carolina; 46=South Dakota; 47=Tennessee; 48=Texas; 49=Utah; 50=Vermont; 51=Virginia; 53=Washington; 54=West Virginia; 55=Wisconsin; 56=Wyoming; 99=unknown |
PTSP_LIVE_CNTRY |
Country of residence of partner |
If PTSP_LIVE=4: What country does this partner live? Note: Codes are ISO codes (2-character ISO 3166-2 codes) using Foreign Trade Statistics of U.S. Census Note: DIS can complete PTSP_LIVE, PTSP_LIVE_STATE, PTSP_LIVE_CNTRY based on address information provided, i.e. these three questions do not need to be asked of the patient. |
Country list: AD=Andorra; AE=United Arab Emirates; AF= Afghanistan; AG=Antigua and Barbuda; AI=Anguilla; AL=Albania; AM=Armenia; AO=Angola; AQ=Antarctica; AR=Argentina; AS=American Samoa; AT=Austria; AU=Australia; AW=Aruba; AX=Åland Islands; AZ=Azerbaijan; BA=Bosnia and Herzegovina, BB=Barbados; BD=Bangladesh; BE=Belgium; BF=Burkina Faso; BG=Bulgaria; BH=Bahrain; BI=Burundi; BJ=Benin; BL=Saint Barthélemy; BM=Bermuda; BN=Brunei Darussalam; BO=Plurinational State of Bolivia; BQ=Sint Eustatius and Saba Bonaire; BR=Brazil; BS=Bahamas; BT=Bhutan; BV=Bouvet Island; BW=Botswana; BY=Belarus; BZ=Belize; CA=Canada; CC=Cocos (Keeling) Islands; CD=The Democratic Republic of the Congo; CF=Central African Republic; CG=Congo; CH=Switzerland; CI=Côte d'Ivoire; CK=Cook Islands; CL=Chile; CM=Cameroon; CN=China; CO=Colombia; CR=Costa Rica; CU=Cuba; CV=Cape Verde; CW=Curaçao; CX=Christmas Island; CY=Cyprus; CZ=Czech Republic; DE=Germany; DJ=Djibouti; DK=Denmark; DM=Dominica; DO=Dominican Republic; DZ=Algeria; EC=Ecuador; EE=Estonia; EG=Egypt; EH=Western Sahara; ER=Eritrea; ES=Spain; ET=Ethiopia; FI=Finland; FJ=Fiji; FK=Falkland Islands (Malvinas); FM=Federated States of Micronesia; FO=Faroe Islands; FR=France; GA=Gabon; GB=United Kingdom; GD=Grenada; GE=Georgia; GF=French Guiana; GG=Guernsey; GH=Ghana; GI=Gibraltar; GL=Greenland; GM=Gambia; GN=Guinea; GP=Guadeloupe; GQ=Equatorial Guinea; GR=Greece; GS=South Georgia and the South Sandwich Islands; GT=Guatemala; GU=Guam; GW=Guinea-Bissau; GY=Guyana; HK=Hong Kong; HM=Heard Island and McDonald Islands; HN=Honduras; HR=Croatia; HT=Haiti; HU=Hungary; ID=Indonesia; IE=Ireland; IL=Israel; IM=Isle of Man; IN=India; IO=British Indian Ocean Territory; IQ=Iraq; IR=Islamic Republic of Iran; IS=Iceland; IT=Italy; JE=Jersey; JM=Jamaica; JO=Jordan; JP=Japan; KE=Kenya; KG=Kyrgyzstan; KH=Cambodia; KI=Kiribati; KM=Comoros; KN=Saint Kitts and Nevis; KP=Democratic People's Republic of Korea; KR=Republic of Korea; KW=Kuwait; KY=Cayman Islands; KZ=Kazakhstan; LA=Laos (Lao People's Democratic Republic); LB=Lebanon; LC=Saint Lucia; LI=Liechtenstein; LK=Sri Lanka; LR=Liberia; LS=Lesotho; LT=Lithuania; LU=Luxembourg; LV=Latvia; LY=Libya; MA=Morocco; MC=Monaco; MD=Republic of Moldova; ME=Montenegro; MF=Saint Martin (French part); MG=Madagascar; MH=Marshall Islands; MK=The Former Yugoslav Republic of Macedonia; ML=Mali; MM=Myanmar; MN=Mongolia; MO=Macao; MP=Northern Mariana Islands; MQ=Martinique; MR=Mauritania; MS=Montserrat; MT=Malta; MU=Mauritius; MV=Maldives; MW=Malawi; MX=Mexico; MY=Malaysia; MZ=Mozambique; NA=Namibia; NC=New Caledonia; NE=Niger; NF=Norfolk Island; NG=Nigeria; NI=Nicaragua; NL=Netherlands; NO=Norway; NP= Nepal; NR=Nauru; NU=Niue; NZ=New Zealand; OM=Oman; PA=Panama; PE=Peru; PF=French Polynesia; PG=Papua New Guinea; PH=Philippines; PK=Pakistan; PL=Poland; PM=Saint Pierre and Miquelon; PN=Pitcairn; PR=Puerto Rico; PS=State of Palestine; PT=Portugal; PW=Palau; PY=Paraguay; QA=Qatar; RE=Réunion; RO=Romania; RS=Serbia; RU=Russian Federation; RW=Rwanda; SA=Saudi Arabia; SB=Solomon Islands; SC=Seychelles; SD=Sudan; SE=Sweden; SG=Singapore; SH=Saint Helena Ascension and Tristan da Cunha; SI=Slovenia; SJ=Svalbard and Jan Mayen; SK=Slovakia; SL=Sierra Leone; SM=San Marino; SN=Senegal; SO=Somalia; SR=Suriname; SS=South Sudan; ST=Sao Tome and Principe; SV=El Salvador; SX=Sint Maarten (Dutch part); SY=Syrian Arab Republic; SZ=Swaziland; TC=Turks and Caicos Islands; TD=Chad; TF=French Southern Territories; TG=Togo; TH=Thailand; TJ=Tajikistan; TK=Tokelau; TL=Timor-Leste; TM=Turkmenistan; TN=Tunisia; TO=Tonga; TR=Turkey; TT=Trinidad and Tobago; TV=Tuvalu; TW=Province of China Taiwan; TZ=United Republic of Tanzania; UA=Ukraine; UG=Uganda; UM=United States Minor Outlying Islands; UY=Uruguay; UZ=Uzbekistan; VA=Holy See (Vatican City State); VC=Saint Vincent and the Grenadines; VE=Bolivarian Republic of Venezuela; VG=British Virgin Islands; VI=U.S. Virgin Islands; VN=Viet Nam; VU=Vanuatu; WF=Wallis and Futuna; WS=Samoa; YE=Yemen; YT=Mayotte; ZA=South Africa; ZM=Zambia; ZW=Zimbabwe; ZZ=Unknown |
PTSP_FRST_SEX |
Date of first sex |
When is the first time you had sex with this person? |
YYYY/MM/DD (Missing information should be coded as '…./../..' or 'YYYY/../..' etc.) |
PTSP_LST_SEX |
Date of last sex |
When is the last time you had sex with this person? |
YYYY/MM/DD (Missing information should be coded as '…./../..' or 'YYYY/../..' etc.) |
PTSP_RPT_SEX |
Repeated sex encounter |
Do you think you will have sex again with this person in the future? |
0=No; 1=Yes; 9=Unknown/unsure |
PTSP_SEX_FREQ |
Frequency of sex |
How many times (on how many occasions) have you had sex with this person in the past 2 months? |
1=Once; 2=2-5 times; 3=6-10 times; 4=11-20 times; 5=>20 times; 9=Don't remember/Unknown |
PTSP_CDU_LSTSEX |
Condom use at last sex |
Did you (or your partner) use a condom the last time you had sex? |
0=No; 1=Yes; 9=Unknown/unsure |
PTSP_MET_LOC |
Physical location of first meeting |
Where did you first meet this partner face-to-face? |
1=Home 2=Partner’s home 3=Friend's home 4=Party (not a sex party) 5=Sex party 6=Bar or club 7=Public cruising (park, beach, pier) 8=Mall or shopping center 9=Bathhouse or sex club 10=Massage Parlor/brothel 11=Sex shop or adult book store 12=On the street or public transportation 13=Gym 14=Public restroom 15=At work 16=School 17=Hotel 18=Place of worship 19=Community event 20=AA or NA meeting 21=Other type of support group 22=Jail or Prison 77=Other 88=Refused to Answer 99=Unknown |
PTSP_MEET_APP |
Identification of internet site/social app used |
If first contact using an escort service, internet sites or mobile social apps, which did you use? |
1=Craigslist.com 2=Tinder.com 3=Facebook.com 4=Grindr.com 5=Jack’d.com 6=Adam 4 Adam 7=SCRUFF 8=Hornet.com 9=OKcupid.com 10=Manhunt.com 11=Thrinder 12=Plenty of Fish (POF) 13=Bumble 14=DaddyHunt 15=Escort service 77=Other 88=Refused to Answer 99= Don’t Know/Unknown |
PTSP_MEET_OTHAPP |
Identification of other internet site/social app used |
If PTSPMEET_APP=77, inclusion of other apps not currently provided (NOTE: Required to collect for local analyses, but variable will not be submitted to CDC) |
Character (Text field) |
PTSP_MEET_INV |
Name of venue |
(NOTE: Required to collect for local analyses, but variable will not be submitted to CDC) |
Character |
PTSP_MEET_LATLON |
Coordinates of venue where first met |
Latitude and longitude coordinates (Note: Required to collect Lat/Long and/or Census tract for local epi and network analyses, but these variables will not be submitted to CDC) |
Character |
PTSP_MEET_GEOCODE |
Geocode of venue where first met |
Census tract (Note: Required to collect Lat/Long and/or Census tract for local epi and network analyses, but these variables will not be submitted to CDC) |
Character |
PTSP_SEXOTH |
Concurrency of interviewee |
(If had sex with this person more than once) Did you have sex with someone else during the period of time you were having sex or having a sexual relationship with this person? |
0=No; 1=Yes; 8=Not applicable (e.g. PTSP_SEX_FREQ=1); 9=Unknown |
PTSP_SEXOTH_PTNR |
Concurrency of interviewee's discussed partner |
(If had sex with this person more than once) Do you think this person had sex with anyone else during the period of time you were having sex or a sexual relationship with them? |
0=No/unlikely; 1=Yes/likely; 8=Not applicable (e.g. PTSP_SEX_FREQ=1); 9=Unknown |
PTSP_EXCH_REC |
Commercial/exchange sex: Received |
Did this person give you money, drugs, or something else you needed in exchange for sex? |
0=No; 1=Yes; 9=Unknown |
PTSP_EXCH_GIV |
Commercial/exchange sex: Given |
Did you give this person money, drugs, or something else they needed in exchange for sex? |
0=No; 1=Yes; 9=Unknown |
PTSP_GRPSEX |
Group sex with partner |
Did you have group sex with this partner in the past 2 months? |
0=No; 1=Yes; 9=Unknown |
PTSP_FRST_SEXABRD |
First sex encounter: Travel abroad |
Did you first have sex with this person in another country? |
0=No; 1=Yes; 9=Unknown |
PTSP_FRST_SEXABRDLOC |
First sex encounter: Travel abroad Location |
If PTSP_FRST_SEXABRD=1: What country? |
Country list: AD=Andorra; AE=United Arab Emirates; AF= Afghanistan; AG=Antigua and Barbuda; AI=Anguilla; AL=Albania; AM=Armenia; AO=Angola; AQ=Antarctica; AR=Argentina; AS=American Samoa; AT=Austria; AU=Australia; AW=Aruba; AX=Åland Islands; AZ=Azerbaijan; BA=Bosnia and Herzegovina, BB=Barbados; BD=Bangladesh; BE=Belgium; BF=Burkina Faso; BG=Bulgaria; BH=Bahrain; BI=Burundi; BJ=Benin; BL=Saint Barthélemy; BM=Bermuda; BN=Brunei Darussalam; BO=Plurinational State of Bolivia; BQ=Sint Eustatius and Saba Bonaire; BR=Brazil; BS=Bahamas; BT=Bhutan; BV=Bouvet Island; BW=Botswana; BY=Belarus; BZ=Belize; CA=Canada; CC=Cocos (Keeling) Islands; CD=The Democratic Republic of the Congo; CF=Central African Republic; CG=Congo; CH=Switzerland; CI=Côte d'Ivoire; CK=Cook Islands; CL=Chile; CM=Cameroon; CN=China; CO=Colombia; CR=Costa Rica; CU=Cuba; CV=Cape Verde; CW=Curaçao; CX=Christmas Island; CY=Cyprus; CZ=Czech Republic; DE=Germany; DJ=Djibouti; DK=Denmark; DM=Dominica; DO=Dominican Republic; DZ=Algeria; EC=Ecuador; EE=Estonia; EG=Egypt; EH=Western Sahara; ER=Eritrea; ES=Spain; ET=Ethiopia; FI=Finland; FJ=Fiji; FK=Falkland Islands (Malvinas); FM=Federated States of Micronesia; FO=Faroe Islands; FR=France; GA=Gabon; GB=United Kingdom; GD=Grenada; GE=Georgia; GF=French Guiana; GG=Guernsey; GH=Ghana; GI=Gibraltar; GL=Greenland; GM=Gambia; GN=Guinea; GP=Guadeloupe; GQ=Equatorial Guinea; GR=Greece; GS=South Georgia and the South Sandwich Islands; GT=Guatemala; GU=Guam; GW=Guinea-Bissau; GY=Guyana; HK=Hong Kong; HM=Heard Island and McDonald Islands; HN=Honduras; HR=Croatia; HT=Haiti; HU=Hungary; ID=Indonesia; IE=Ireland; IL=Israel; IM=Isle of Man; IN=India; IO=British Indian Ocean Territory; IQ=Iraq; IR=Islamic Republic of Iran; IS=Iceland; IT=Italy; JE=Jersey; JM=Jamaica; JO=Jordan; JP=Japan; KE=Kenya; KG=Kyrgyzstan; KH=Cambodia; KI=Kiribati; KM=Comoros; KN=Saint Kitts and Nevis; KP=Democratic People's Republic of Korea; KR=Republic of Korea; KW=Kuwait; KY=Cayman Islands; KZ=Kazakhstan; LA=Laos (Lao People's Democratic Republic); LB=Lebanon; LC=Saint Lucia; LI=Liechtenstein; LK=Sri Lanka; LR=Liberia; LS=Lesotho; LT=Lithuania; LU=Luxembourg; LV=Latvia; LY=Libya; MA=Morocco; MC=Monaco; MD=Republic of Moldova; ME=Montenegro; MF=Saint Martin (French part); MG=Madagascar; MH=Marshall Islands; MK=The Former Yugoslav Republic of Macedonia; ML=Mali; MM=Myanmar; MN=Mongolia; MO=Macao; MP=Northern Mariana Islands; MQ=Martinique; MR=Mauritania; MS=Montserrat; MT=Malta; MU=Mauritius; MV=Maldives; MW=Malawi; MX=Mexico; MY=Malaysia; MZ=Mozambique; NA=Namibia; NC=New Caledonia; NE=Niger; NF=Norfolk Island; NG=Nigeria; NI=Nicaragua; NL=Netherlands; NO=Norway; NP= Nepal; NR=Nauru; NU=Niue; NZ=New Zealand; OM=Oman; PA=Panama; PE=Peru; PF=French Polynesia; PG=Papua New Guinea; PH=Philippines; PK=Pakistan; PL=Poland; PM=Saint Pierre and Miquelon; PN=Pitcairn; PR=Puerto Rico; PS=State of Palestine; PT=Portugal; PW=Palau; PY=Paraguay; QA=Qatar; RE=Réunion; RO=Romania; RS=Serbia; RU=Russian Federation; RW=Rwanda; SA=Saudi Arabia; SB=Solomon Islands; SC=Seychelles; SD=Sudan; SE=Sweden; SG=Singapore; SH=Saint Helena Ascension and Tristan da Cunha; SI=Slovenia; SJ=Svalbard and Jan Mayen; SK=Slovakia; SL=Sierra Leone; SM=San Marino; SN=Senegal; SO=Somalia; SR=Suriname; SS=South Sudan; ST=Sao Tome and Principe; SV=El Salvador; SX=Sint Maarten (Dutch part); SY=Syrian Arab Republic; SZ=Swaziland; TC=Turks and Caicos Islands; TD=Chad; TF=French Southern Territories; TG=Togo; TH=Thailand; TJ=Tajikistan; TK=Tokelau; TL=Timor-Leste; TM=Turkmenistan; TN=Tunisia; TO=Tonga; TR=Turkey; TT=Trinidad and Tobago; TV=Tuvalu; TW=Province of China Taiwan; TZ=United Republic of Tanzania; UA=Ukraine; UG=Uganda; UM=United States Minor Outlying Islands; UY=Uruguay; UZ=Uzbekistan; VA=Holy See (Vatican City State); VC=Saint Vincent and the Grenadines; VE=Bolivarian Republic of Venezuela; VG=British Virgin Islands; VI=U.S. Virgin Islands; VN=Viet Nam; VU=Vanuatu; WF=Wallis and Futuna; WS=Samoa; YE=Yemen; YT=Mayotte; ZA=South Africa; ZM=Zambia; ZW=Zimbabwe; ZZ=Unknown |
PTSP_TRVL_ABRD |
Partner travel |
Did this partner travel to another country in the past 2 months? |
0=No; 1=Yes; 9=Unknown |
PTSP_TRVL_CNTRY |
Partner travel location |
If PTSP_TRVL_ABRD=1: What country? [Note: Can just record most recent foreign travel location in the past two months, or list multiple counties separated by an *) |
Country list: AD=Andorra; AE=United Arab Emirates; AF= Afghanistan; AG=Antigua and Barbuda; AI=Anguilla; AL=Albania; AM=Armenia; AO=Angola; AQ=Antarctica; AR=Argentina; AS=American Samoa; AT=Austria; AU=Australia; AW=Aruba; AX=Åland Islands; AZ=Azerbaijan; BA=Bosnia and Herzegovina, BB=Barbados; BD=Bangladesh; BE=Belgium; BF=Burkina Faso; BG=Bulgaria; BH=Bahrain; BI=Burundi; BJ=Benin; BL=Saint Barthélemy; BM=Bermuda; BN=Brunei Darussalam; BO=Plurinational State of Bolivia; BQ=Sint Eustatius and Saba Bonaire; BR=Brazil; BS=Bahamas; BT=Bhutan; BV=Bouvet Island; BW=Botswana; BY=Belarus; BZ=Belize; CA=Canada; CC=Cocos (Keeling) Islands; CD=The Democratic Republic of the Congo; CF=Central African Republic; CG=Congo; CH=Switzerland; CI=Côte d'Ivoire; CK=Cook Islands; CL=Chile; CM=Cameroon; CN=China; CO=Colombia; CR=Costa Rica; CU=Cuba; CV=Cape Verde; CW=Curaçao; CX=Christmas Island; CY=Cyprus; CZ=Czech Republic; DE=Germany; DJ=Djibouti; DK=Denmark; DM=Dominica; DO=Dominican Republic; DZ=Algeria; EC=Ecuador; EE=Estonia; EG=Egypt; EH=Western Sahara; ER=Eritrea; ES=Spain; ET=Ethiopia; FI=Finland; FJ=Fiji; FK=Falkland Islands (Malvinas); FM=Federated States of Micronesia; FO=Faroe Islands; FR=France; GA=Gabon; GB=United Kingdom; GD=Grenada; GE=Georgia; GF=French Guiana; GG=Guernsey; GH=Ghana; GI=Gibraltar; GL=Greenland; GM=Gambia; GN=Guinea; GP=Guadeloupe; GQ=Equatorial Guinea; GR=Greece; GS=South Georgia and the South Sandwich Islands; GT=Guatemala; GU=Guam; GW=Guinea-Bissau; GY=Guyana; HK=Hong Kong; HM=Heard Island and McDonald Islands; HN=Honduras; HR=Croatia; HT=Haiti; HU=Hungary; ID=Indonesia; IE=Ireland; IL=Israel; IM=Isle of Man; IN=India; IO=British Indian Ocean Territory; IQ=Iraq; IR=Islamic Republic of Iran; IS=Iceland; IT=Italy; JE=Jersey; JM=Jamaica; JO=Jordan; JP=Japan; KE=Kenya; KG=Kyrgyzstan; KH=Cambodia; KI=Kiribati; KM=Comoros; KN=Saint Kitts and Nevis; KP=Democratic People's Republic of Korea; KR=Republic of Korea; KW=Kuwait; KY=Cayman Islands; KZ=Kazakhstan; LA=Laos (Lao People's Democratic Republic); LB=Lebanon; LC=Saint Lucia; LI=Liechtenstein; LK=Sri Lanka; LR=Liberia; LS=Lesotho; LT=Lithuania; LU=Luxembourg; LV=Latvia; LY=Libya; MA=Morocco; MC=Monaco; MD=Republic of Moldova; ME=Montenegro; MF=Saint Martin (French part); MG=Madagascar; MH=Marshall Islands; MK=The Former Yugoslav Republic of Macedonia; ML=Mali; MM=Myanmar; MN=Mongolia; MO=Macao; MP=Northern Mariana Islands; MQ=Martinique; MR=Mauritania; MS=Montserrat; MT=Malta; MU=Mauritius; MV=Maldives; MW=Malawi; MX=Mexico; MY=Malaysia; MZ=Mozambique; NA=Namibia; NC=New Caledonia; NE=Niger; NF=Norfolk Island; NG=Nigeria; NI=Nicaragua; NL=Netherlands; NO=Norway; NP= Nepal; NR=Nauru; NU=Niue; NZ=New Zealand; OM=Oman; PA=Panama; PE=Peru; PF=French Polynesia; PG=Papua New Guinea; PH=Philippines; PK=Pakistan; PL=Poland; PM=Saint Pierre and Miquelon; PN=Pitcairn; PR=Puerto Rico; PS=State of Palestine; PT=Portugal; PW=Palau; PY=Paraguay; QA=Qatar; RE=Réunion; RO=Romania; RS=Serbia; RU=Russian Federation; RW=Rwanda; SA=Saudi Arabia; SB=Solomon Islands; SC=Seychelles; SD=Sudan; SE=Sweden; SG=Singapore; SH=Saint Helena Ascension and Tristan da Cunha; SI=Slovenia; SJ=Svalbard and Jan Mayen; SK=Slovakia; SL=Sierra Leone; SM=San Marino; SN=Senegal; SO=Somalia; SR=Suriname; SS=South Sudan; ST=Sao Tome and Principe; SV=El Salvador; SX=Sint Maarten (Dutch part); SY=Syrian Arab Republic; SZ=Swaziland; TC=Turks and Caicos Islands; TD=Chad; TF=French Southern Territories; TG=Togo; TH=Thailand; TJ=Tajikistan; TK=Tokelau; TL=Timor-Leste; TM=Turkmenistan; TN=Tunisia; TO=Tonga; TR=Turkey; TT=Trinidad and Tobago; TV=Tuvalu; TW=Province of China Taiwan; TZ=United Republic of Tanzania; UA=Ukraine; UG=Uganda; UM=United States Minor Outlying Islands; UY=Uruguay; UZ=Uzbekistan; VA=Holy See (Vatican City State); VC=Saint Vincent and the Grenadines; VE=Bolivarian Republic of Venezuela; VG=British Virgin Islands; VI=U.S. Virgin Islands; VN=Viet Nam; VU=Vanuatu; WF=Wallis and Futuna; WS=Samoa; YE=Yemen; YT=Mayotte; ZA=South Africa; ZM=Zambia; ZW=Zimbabwe; ZZ=Unknown |
PTSP_GCCT |
GC Contact: partner |
Have you told this partner that they may have been exposed to gonorrhea? |
0=No; 1=Yes; 9=Unknown |
PTSP_GCEXP |
Disclosure of GC exposure |
If PTSP_GCCT=0: Are you VERY LIKELY to tell this person that they may have been exposed to gonorrhea? |
0=No; 1=Yes; 9=Unknown/unsure |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Johnson, Shacara (CDC/OID/NCHHSTP) |
File Modified | 0000-00-00 |
File Created | 2021-08-18 |