Form 0920-1072 SSuN Data Elements

Attachment 5
Data Dictionary
Enhanced STD Surveillance Network
(SSuN)
Revision Request
OMB#0920-1072
March 2020

SSuN Protocol (V12.2)
DE #

OMB

Data Element Name

1

Y

F1_FacilityID

2

Y

F1_SiteID

2

Strategy A Clinic Data Elements

Description/Response Coding
Strategy A (STD Clinic) Data Elements
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 MUST NOT be ‘null’ or contain missing values.

Unique site code
BA=Baltimore (Cycle II, Cycle III, Cycle IV)
CB=Columbus Ohio (Cycle IV)
CA=California (Cycle II, Cycle III, Cycle IV)
FL=Florida (Cycle III & Cycle IV)
IN=Indiana (Cycle IV)
MC=Multnomah County (Cycle III &Cycle IV)
NY=New York City (Cycle II, Cycle III, Cycle IV)
PH=Philadelphia (Cycle II, Cycle III, Cycle IV)
SF=San Francisco (Cycle II, Cycle III, Cycle IV)
WA=Washington (Cycle II, Cycle III, Cycle IV)
UT=UTAH (Cycle IV)
LA=Louisana (Cycle II)
VA=Virginia (Cycle II)
AL=Alabama (Cycle II)
CO=Colorado (Cycle II)
CH=Chicago (Cycle II)
MA=Massachusetts (Cycle III)
MN=Minnesota (Cycle III)
This data element MUST NOT be ‘null’ or contain missing values.

3

Y

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 MUST NOT be ‘null’ or contain missing values.

4

Y

F1_Visdate

Date of clinic visit
This data element MUST NOT be ‘null’ or contain missing values except fo HIV eHARS
lab match records.

5

Y

F1_EventID

Unique visit identification
This record ID should be supplied by the site and may be an event or

6

Y

F1_sex_Birth

What is the patients assigned sex at birth?
1= Male
2= Female
3=Intersex

SSuN Protocol (V12.2)

3

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
4=Unknown
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.

7

Y

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.

8

Y

F1_Age

How old is the patient?(Age in years).
If age is unknown or missing, use null value.

9

Y

F1_Hisp

Is the patient of Hispanic ethnicity?
1= Yes
2= No
9= Not captured

10

Y

F1_AIAN

Is the patient American Indian or Alaskan Native?
1= Yes
2= No
9= Not captured

11

Y

F1_Asian

Is the patient Asian?
1= Yes
2= No
9= Not captured

12

Y

F1_PIH

Is the patient Native Hawaiian or Pacific Islander?
1= Yes
2= No
9= Not captured

13

Y

F1_Black

Is the patient Black?

SSuN Protocol (V12.2)

4

DE #

OMB

Data Element Name

Description/Response Coding
1= Yes
2= No
9= Not captured

14

Y

F1_White

Is the patient White?

Strategy A Clinic Data Elements

1= Yes
2= No
9= Not captured
15

Y

F1_Multirace

Is the patient Multirace?
1= Yes
2= No
9= Not captured

16

Y

F1_Otherrace

Is the patient another race not listed above?
1= Yes
2= No
9= Not captured
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.

17

Y

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=Unknown type
5=Uninsured
9= Insurance status 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.

18

Y

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.

SSuN Protocol (V12.2)
DE #
19

OMB
Y

Data Element Name
F1_Reason_visit

5

Strategy A Clinic Data Elements

Description/Response Coding
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
7=PrEP Visit
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.

20

Y

F1_Pregnant

Is the patient currently pregnant?

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.
21

Y

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.
22

Y

F1_Contact_STD

Was the patient a contact or exposed to a STD?
1= Yes, to gonorrhea
2= Yes, to chlamydia
3= yes, unknown
4=Yes, Other STI
5= 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.

SSuN Protocol (V12.2)
DE #
23

OMB
P

Data Element Name
F1_Pelvic_exam

6

Strategy A Clinic Data Elements

Description/Response Coding
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.
24

Y

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.

25

Y

F1_FEMSEX

How many female sex partners has the patient had in the last 3
If number of female sex partners is unknown, missing, or not captured, use null value.

26

Y

F1_TRANSEX

How many transgender 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.

27

Y

F1_MSM_12

Does the patient (male) have a history of having male sex partners in the previous 12
months?
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), or 3(patient is a female).
1= Yes
2= No
9= Not captured

28

Y

F1_SEXOR3

Has the patient had sex with men only, women only or both men and women?

1= Men Only
2= Women Only
3= Both men and women
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.
29

P

F1_SEXOR3TG

Has the patient had sex with a transgender man or woman?
1= Yes
2= No
9= Not captured

SSuN Protocol (V12.2)

7

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
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.

30

Y

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.

31

Y

F1_SEXUALITY

Does the patient consider him/herself to be gay (homosexual), straight ?
1 = gay/lesbian/homosexual
2= straight/heterosexual (not Gay or Lesbian)
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.

32

Y

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).

33

Y

F1_Rectal_exposure

Does the patient report receptive anal sex with a male in the 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).

34

Y

F1_Oral_Sex

Did the patient engage in receptive oral 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).

35

P

F1_condom

Does the patient report receptive anal sex without a condom with a male in the last 3
months?

SSuN Protocol (V12.2)

8

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
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).
1= Yes
2= No
3= Unsure/ doesn’t know
9= Not captured

36

Y

F1_HIV_partner

Does the patient report having sex with a known HIV positive partner in the last 12
months?
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).
1= Yes
2= No
3= Unsure/ doesn’t know
9= Not captured

37

Y

F1_IVDU

Does the patient report use of illicit injected drugs in the past 3 months?
1= Yes
2= No
3= Patient not sure/ unknown
4= Not captured

38

Y

F1_OPIOD

Does the patient report use of opioids (but not under a physician's orders) in the past 3
months?
1= Yes
2= No
3= Patient not sure/ unknown /refused
4= Not captured

39

Y

F1_PrEP

Is the patient currently on or taking PrEP?
1= Yes
2= No
9= Not captured

40

P

F1_PEP_referral

Was the patient recommended for or given PEP at the STD clinic?
1= Yes
2= No
3= No, but a referral to outside clinic was given

41

Y

F1_PrEP_referral

Was the patient referred for PrEP?

SSuN Protocol (V12.2)
DE #

OMB

Data Element Name

9

Strategy A Clinic Data Elements

Description/Response Coding
1= Yes
2= No
3= No, but a referral to outside clinic was given

42

Y

F1_Partner_tx

Was the patient prescribed or given medication for expedited partner therapy?
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).
1= Yes
2= No
9= Not captured

43

Y

F1_SXRectal

Does the patient report rectal symptoms (e.g., discharge, rectal pain) today?
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).
1= Yes
2= No
9= Not captured

44

Y

F1_SXPharyngeal

Does the patient report any oral symptoms (e.g., sore throat) today?
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).
1= Yes
2= No
9= Not captured

45

P

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).

46

Y

F1_SXDysuria

Did the patient report dysuria?
1= Yes

SSuN Protocol (V12.2)

10

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
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).

47

Y

F1_SXDischarge

Did the patient report a vaginal/anal/urethral 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).

48

Y

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).

49

Y

F1_PEDischarge

Was there a vaginal discharge seen on physical 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), or 3(patient is a female).

50

Y

F1_PEAbdomen

Was lower abdominal pain/tenderness reported 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), or 3(patient is a female).

51

Y

F1_CMT

Was there cervical motion tenderness on exam?
1= Yes
2= No
9= Not captured

SSuN Protocol (V12.2)

11

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
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), or 3(patient is a female).

52

Y

F1_Adnexal

Was there adnextal 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), or 3(patient is a female).

53

P

F1_HIVTest

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.
54

Y

F1_HIVTestdate

When was the patient's most recent test for HIV (month and year)? (excluding HIV
testing on today’s visit)?
Null values are allowed if (1) response to F1_HIVTest is either 2, 3, 9 or (2) patient does
not know/ or not sure of the date of most recent HIV test. This should be coded as
character data (“MM/YY”) with missing information as “../..” or “../YY”

55

Y

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) response to F1_HIVTest is either 2,
3,9 or (2) patient does not know/ or not sure of the result of the most recent HIV test.

56

Y

F1_HIVTest_refuse

Did the patient refuse an HIV test today?

SSuN Protocol (V12.2)

12

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
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).

57

P

F1_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 should not be ‘null’ or contain missing values.
1=Yes
2=No

58

Y

F1_HIVcare

Is the patient currently in HIV care?
1=Yes
2=No
3= Patient is not HIV positive
4= Unknown
9= Not captured

59

P

F1_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 should not be ‘null’ or contain missing values.

1=Matching Record Found
2=No Matching Record
3=Match Not Performed
60

P

F1_HregID

Unique record number from HIV registry (such as stateno from eHARS).
This data element should not be ‘null’ or contain missing values if a matching record is
present in eHARS

61

P

F1_HDXMOYR

What is this patient's earliest indication of HIV positive result?
This information can be obtained from the eHARS person table (HIVPMOYR). If eHARS
match found. This should be coded as character data (“MM/YY”) with missing
information as “../..” or “../YY”

62

P

F1_EXPMOD

Exposure mode from HIV registry.
This data element should not be ‘null’ or contain missing values if a matching record is
present in eHARS.

SSuN Protocol (V12.2)
DE #

OMB

Data Element Name

13

Strategy A Clinic Data Elements

Description/Response Coding
1=Male who had sex with another male (MSM)
2=Injected illicit or non-prescription drugs (IDU)
3=Had sex with someone with either 1 or 2 (above)
4=Had Sex with Someone of the Opposite Sex but May Not Have Known whether HIV
Infection was diagnosed in that Person, or Any of the Risk factors of Sex Partners
Described in Items 3 or 5
5=Had Sex with Someone of the Opposite Sex in whom HIV Infection was Diagnosed
after Having Any Risk Factor for HIV Infection in Items 6 (Receipt of Clotting Factor for
Coagulation Disorder),7 (Receipt of Blood Transfusion), or 8 (Receipt of Transplant or
Artificial Insemination)
6=Received Clotting Factor Injection for Hemophilia or Another Coagulation Disorder
7=Received Transfusion of Blood or Blood Components (e.g., Platelets)
8=Received a Transplant of Tissue or Organ or Artificial Insemination
9=Worked in a Health-Care or Clinical Laboratory Setting with Possible Exposure to
Human Blood or Other Body Fluids
10=Had Other Exposure to Human Blood or Body Fluids
11=No Risk Reported

63

64

Y

Y

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).

Data Element Name

Description/Response Coding
Diagnosis Dataset

F2_PatientID

Unique patient identification number assigned by site
Will be a secondary key for merging laboratory and case data; should correspond to
F1_Visdate. This data element MUST NOT be ‘null’ or contain missing values.

65

66

Y

Y

F2_Eventid

Unique visit identification

F2_Visdate

Will be a secondary key for merging laboratory and case data; should correspond to
F1_Visdate. This data element MUST NOT 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 MUST NOT be ‘null’ or contain missing values.

SSuN Protocol (V12.2)

14

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding

67

Y

F2_DXCODE

Diagnosis Code
SY01=Syphilis, primary
SY02=Syphilis, secondary
SY03=Syphilis, early latent
SY04=Syphilis, late latent/Unknown
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
Null values allowed if information is collected by the facility but unknown for this
record.

Data Element Name

Description/Response Coding
Laboratory Dataset

F3_PatientID

Unique patient identification number assigned by site

68

Y

Will be a secondary key for merging laboratory and case data; should correspond to
F1_Visdate. This data element MUST NOT be ‘null’ or contain missing values.
69

Y

F3_Eventid

Unique visit identification
Will be a secondary key for merging laboratory and case data; should correspond to
F1_Visdate. This data element MUST NOT be ‘null’ or contain missing values.

70

Y

F3_Visdate

Date of clinic visit
Will be a secondary key for merging laboratory and case data; should correspond to
F1_Visdate. This data element MUST NOT be ‘null’ or contain missing values.

SSuN Protocol (V12.2)

15

Strategy A Clinic Data Elements

DE #
71

OMB
P

Data Element Name
F3_SpecColdate

Description/Response Coding
Date of specimen collection for this laboratory observation
This data element MUST NOT be ‘null’ or contain missing values.

72

Y

F3_Condtested

What condition was the patient tested for?
1 = Syphilis
2 = Gonorrhea
3 = Chlamydia
4 = Chancroid
5 = Trichomoniasis
6 = HIV/AIDS
7 = Bacterial vaginosis
8 = Herpes
9= Mycoplasm genitalium
20 = Pregnancy
Although a null value is allowed, sites should make every attempt to make sure the
value is not a null value. A record for a lab condition not included in the list above,
should not be submitted.

73

Y

F3_Anatsite

What anatomic site was tested?
1 = Urethral
2 = Vaginal/cervical
3 = Urine
4 = Rectal
5 = Pharynx
6 = Blood
8 = Other
9= Not captured
Although a null value is allowed, sites should make every attempt to make sure the
value is not a null value.

74

Y

F3_Test_Type

What type of test was used? (Will be expanded, recoded)
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 (deprecated code, see 27, 28 below)
9=Pooled RNA
10=RPR
11=VDRL
12=FTA
13=TP-PA
14=MHA
15=Wet Mount/Clue Cell
16=PH
17=Other, not listed
18=Unknown

SSuN Protocol (V12.2)
DE #

OMB

Data Element Name

16

Strategy A Clinic Data Elements

Description/Response Coding
22=HIV-1 IA (EIA or Other)
23=HIV-1/2 IA (EIA or Other)
24=HIV-2 IA (EIA or Other)
25=HIV-1/2 Ag/Ab
26=HIV-1/2 Type-Differentiating Immunoassay
27=HIV-1 Western Blot
28=HIV-2 Western Blot
29=HIV-1 IFA
30=HIV-1 Culture
31=HIV-2 Culture
32=HIV-1 p24 Antigen
33=HIV-1 RNA/DNA NAAT (Qualitative)
34=HIV-2 RNA/DNA NAAT (Qualitative)
35=HIV-1 RNA/DNA NAAT (Quantitative viral load)
36=HIV-2 RNA/DNA NAAT (Quantitative viral load)
37=CD4 T-lymphocytes
38=CD4 Percent
39=HIV-1 Genotype (PR Nucleotide Sequence)
40=HIV-1 Genotype (RT Nucleotide Sequence)
41=HIV-1 Genotype (PR/RT Nucleotide Sequence)
42=HIV-1 Genotype (IN Nucleotide Sequence)
43=HIV-1 Genotype (PR/RT/IN Nucleotide Sequence)
44=STARHS (BED)
45=STARHS (Vironostika-LS)
46=STARHS ( BIO-RAD AVIDITY)
47=STARHS (Other)
48=STARHS (Unknown)
49=Rapid (Retired)
50=HIV-1/2 Ag/Ab-Distinguishing Immunoassay
51=HIV-1 Genotype (EN Nucleotide Sequence)
52=HIV-1 Genotype (FI Nucleotide Sequence)
53=HIV-1/2 Ag/Ab and Type-Differentiating Immunoassay
54=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 p24 Antigen Analyte
55=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 Antibody Analyte
56=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-2 Antibody Analyte
57=HIV-1/2 Type-Differentiating Immunoassay (Supplemental)
58=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-1 Antibody Analyte
59=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-2 Antibody Analyte
60=HIV-1 Genotype (Unspecified)
61=WB/IFA-Legacy
62=RIPA-Legacy
63=Latex Ag-Legacy
64=Peptide-Legacy
65=Rapid-Legacy
66=Iga-Legacy
67=IVAP-Legacy
68=Other HIV Antibody-Other-Legacy
69=Other HIV Antibody-Unspecified-Legacy
70=Viral Load-Other-Legacy

SSuN Protocol (V12.2)

17

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
71=Viral Load-Unspecified-Legacy
72=HIV Detection/Antigen/Viral Load-Other-Legacy
73=HIV Detection/Antigen/Viral Load-Unspecified-Legacy
80=Pregnancy
88= Other
99=Not captured
Although a null value is allowed, sites should make every attempt to make sure the
value is not a null value.

75

Y

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
9=Not captured
Although a null value is allowed, sites should make every attempt to make sure the
value is not a null value.

76

P

F3_Quantres

Numeric - or Ratio (for RPR/VDRL, e.g. 1:2, 1:4, etc.)

77

P

F3_QuantUnits

Units for quantitative results:
1=Copies/mL
2=Log Copies/mL
3=Cells/Cubic mm
4=CD4%
5=Titer Ratio
6=Cycles/Time (rtPCR)

Data Element Name

Description/Response Coding
Treatment Dataset

78

Y

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 MUST NOT be ‘null’ or contain missing values.

79

Y

F4_Eventid

Unique visit identification
Will be a secondary key for merging treatment and case data; should correspond to
F1_EventID. This data element MUST NOT be ‘null’ or contain missing values

80

Y

F4_Visdate

Date of clinic visit
Will be a secondary key for merging treatment and case data; should not be ‘null’ or
contain missing values

SSuN Protocol (V12.2)

18

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding

81

P

F4_TxDate

Treatment Date
Date treatment dispensed or prescribed; should not be ‘null’ or contain missing values

82

Y

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)
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, Neo-Metric, Noritate,
Novonidazol)
61= Tinidazole (Tindamax)
70= Truvada (Tenofovir/emtricitabine)
88= Other
Although a null value is allowed, sites should make every attempt to make sure the
value is not a null value.

83

Y

F4_Medication_Oth

If the patient received a medication other than what is listed above as
indicated by response option #88, please provide name of other medication (Free text
description of other medication)

84

Y

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

SSuN Protocol (V12.2)

19

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
10= 500mg
11= 600mg
12= 750mg
13= 800mg
14= 1g
15= 2g
88= Other
99= Not captured
A response of 99 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.

85

Y

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.

86

Y

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.

87

Y

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.

Data Element Name

88

Y

F5_Facility_ID

Description/Response Coding
Facility Reference Dataset
Unique facility identifier

SSuN Protocol (V12.2)

20

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
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 MUST NOT be ‘null’ or contain missing values.

89

Y

F5_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
VA=Virginia (Cycle II)
AL=Alabama (Cycle II)
CO=Colorado (Cycle II)
CH=Chicago (Cycle II)
CB= Columbus (Cycle IV)
UT = Utah (Cycle IV)
IN= Indiana (Cycle IV)
This data element MUST NOT be ‘null’ or contain missing values.

90

Y

F5_Facility_name

What is the name of the facility?

91

Y

F5_Facility_type

What is the facility type?
1= STD clinic
88= Other

92

Y

F5_FQHC

Is this facility a FQHC?
1= Yes
2= No

93

Y

F5_Facility_Address

What is the physical street address of the facility?

94

Y

F5_Facility_City

In what city is the facility located?
FIPS code, example: 3290 (City of SF)

95

Y

F5_Facility_State

In what state is the facility located?
FIPS code

96

Y

F5_Facility_Zip

Zip code for the facility (9-digit ZIP code of facility)

97

Y

F5_Point_contact

Point of contact at facility

SSuN Protocol (V12.2)

21

Strategy A Clinic Data Elements

DE #

OMB

Data Element Name

Description/Response Coding

98

Y

F5_EPT

Does the facility have written policies governing EPT?
1= Yes
2= No
3= facility does not employ EPT

99

P

F5_PrEP

Does the facility have written policies governing referral or management of PrEP?
1= Yes
2= No
3= facility does not refer to or manage PrEP

100

P

F5_PrEP_Rx

Does the facility prescribe PrEP?
1= Yes
2= No
3= facility does not prescribe PrEP

101

P

F5_PEP_Rx

Does the facility prescribe PEP?
1= Yes
2= No
3= facility does not prescribe PEP

102

P

F5_PrEP_Manage

Does the facility actively manage patients on PrEP?
1= Yes
2= No
3= facility does not refer to or manage PrEP

103

Y

F5_HPV_vaccine

Does the facility have written policies governing HPV vaccination?
2= No
3= facility does not provide HPV vaccination

104

Y

F5_HIV_algorithm

Does the facility have written policies governing HIV testing?
1= Yes
2= No
3= facility does not provide HIV testing

105

Y

F5_Screening_CT

Does the facility have written policies governing chlamydia screening?
1= Yes
2= No
3= facility does not provide CT testing

106

Y

F5_Screening_GC

Does the facility have written policies governing gonorrhea screening?
1= Yes
2= No
3= facility does not provide GC testing

107

Y

F5_Billing

Does the facility bill for STD services?
1= Yes
2 = No

SSuN Protocol (V12.2)

22

DE #

OMB

Data Element Name

Description/Response Coding
3= Other

108

Y

F5_Medical_record

Type of medical record system?
1= paper-based
2= electronic
3=combination
9= not sure

109

Y

F5_Insurance

Is the facility in an insurance network?
1=Yes
2=No

Strategy A Clinic Data Elements

SSuN Protocol (V12.0)

#
110

23

OMB Data Element Name
P

FS1_FirstVis

Strategy A Survey Data Elements

Description/Response Coding
Is this your first time to this clinic?
1=Yes
2=No

111

P

FS1_Welcome

Do you feel that this clinic provides a
welcoming and respectful environment?

1=Yes
2=No
3=Not Sure
What are the reasons for your visit to this
clinic today (choose all that apply)?
112

P

FS1_Reas1

Code Below
Health problem or symptoms
1=Yes
2=No

113

P

FS1_Reas2

No health problems or symptoms, but
came to get STD screening/check-up
1=Yes
2=No

114

P

FS1_Reas3

Told to get checked by partner
1=Yes
2=No

115

P

FS1_Reas4

Referred by health department/disease
intervention specialist (DIS)
1=Yes
2=No

116

P

FS1_Reas5

Follow-up visit
1=Yes

SSuN Protocol (V12.0)

#

24

OMB Data Element Name

Strategy A Survey Data Elements

Description/Response Coding
2=No

117

P

FS1_Reas6

Came to get STD test results
1=Yes
2=No

118

P

FS1_Reas7

Came to get HIV test
1=Yes
2=No

119

P

FS1_Reas8

Came to get medication that I can take
every day to prevent getting HIV infection
before I am exposed to the virus (PrEP)
1=Yes
2=No

120

P

FS1_Reas9

Came to get medication that I can take
right away because I think I was exposed
to HIV in the past few days (PEP)
1=Yes
2=No

121

P

FS1_Reas10

Came to get contraception
1=Yes
2=No

122

P

FS1_Reas11

Some other reason
1=Yes
2=No

123

P

FS1_Reas12_TXT

124

P

FS1_ReasThisClin

Specify ____________________
What is the main reason you chose this
clinic for care (choose only one)?
1=Could walk in or get same day
appointment

SSuN Protocol (V12.0)

#

25

OMB Data Element Name

Strategy A Survey Data Elements

Description/Response Coding
2=Cost
3=Privacy concern
4=Expert care
5=Embarrassed to go to usual doctor
6=Some other reason

125

P

FS1_ReasThisClin_TXT

126

P

FS1_WhereElse

Please specify other reason
______________________

Where would you have gone today if this
STD clinic did not exist (choose only one)?
1=I would have waited to see how I felt
and then decided what to do
2=Community health center
3=Public clinic/ health department clinic
4=Family planning clinic
5=Private doctor’s office
6=Urgent care clinic/walk in clinic
7=Hospital emergency room (ER)
8=Hospital outpatient department
9=School-based clinic
10=Some other place
127

P

FS1_WhereElse_TXT

Please specify other place
______________________

128

P

FS1_UsualPlace

Is there a place that you USUALLY go to
when you are sick or need advice about
your health?
1=Yes
2=No

129

P

FS1_MostOftenGo

If YES, what kind of place do you go to
most often (choose only one)?
1=Community health center
2=Public clinic/health department clinic
3=Family planning clinic
4=Private doctor’s office
5=Urgent care clinic/walk in clinic

SSuN Protocol (V12.0)

#

26

OMB Data Element Name

Strategy A Survey Data Elements

Description/Response Coding
6=Hospital emergency room (ER)
7=Hospital outpatient department
8=School-based clinic
9=Some other place

130

P

FS1_MostOftenGo_TXT

Please specify
________________________

131

P

FS1_PrevCare

Is there a place you USUALLY go to when
you need routine care or preventive care
such as a physical exam or check-up?

1=Yes
2=No
132

P

FS1_PrevCareGo

If YES, what kind of place do you go to
most often (choose only one)
1=Community health center
2=Public clinic/health department clinic
3=Family planning clinic
4=Private doctor’s office
5=Urgent care clinic/walk in clinic
6=Hospital emergency room (ER)
7=Hospital outpatient department
8=School-based clinic
9=Some other place

133

P

FS1_PrevCareGo_TXT

Please specify
________________________

134

P

FS1_Insurance

Do you have health insurance (choose
only one)?
1=Yes, parents’ insurance plan
2=Yes, government (Medicaid, Medicare,
etc.)
3=Yes, private insurance (through
employer)
4=Yes, private insurance (purchased by
yourself/healthcare.gov exchange)

SSuN Protocol (V12.0)

#

27

OMB Data Element Name

Strategy A Survey Data Elements

Description/Response Coding
5=No coverage of any type
GO TO
QUESTION # 13
6=Don’t know
GO TO QUESTION # 13

135

P

FS1_UseIns
If YES, would you be willing to use your
health insurance for today’s visit?
1=Yes
2=No

If No, why not (choose all that apply)?
136

P

FS1_NOTUseIns1

I do not want my insurance company to
know
1=Yes
2=No

137

P

FS1_NOTUseIns2

Insurance company might send records
home
1=Yes
2=No

138

P

FS1_NOTUseIns3

I do not want my
parents/spouse/significant other to know
1=Yes
2=No

139

P

FS1_NOTUseIns4

140

P

FS1_NOTUseIns5

141
142
143

P
P
P

FS1_NOTUseIns6
FS1_NOTUseIns7
FS1_NOTUseIns_TXT

144

P

FS1_BirthSex

Usual doctor might send records home
I cannot afford to pay the co-pay or
deductible
My insurance will not cover this visit
Some other reason
Please specify
What sex were you assigned at birth on
your original birth certificate?

SSuN Protocol (V12.0)

#

28

OMB Data Element Name

Strategy A Survey Data Elements

Description/Response Coding
1=Male
2=Female
3=Refused
4=Don't know

145

P

FS1_GendID

How do you currently describe yourself?
1=Male
2=Female
3=Trans, Male to Female
4=Trans, Female to Male
5=TG Unknown or Unspecified
6=Gender Queer/Non-Binary
7=Other

146

P

FS1_Age

How old are you? Age in years______

147

P

FS1_HispEth

Do you consider yourseld
Hispanic/Latino/a?
1=Yes, Hispanic
2=No, Not Hispanic
8=Unknown/Can't guess
9=Refused

148

P

FS1_RaceWhite

What is your race (choose all that apply)?
White
1=Yes
2=No

149

P

FS1_RaceBlack

Black
1=Yes
2=No

150

P

FS1_RaceAIAN

AI/AN
1=Yes
2=No

151

P

FS1_RaceAsian

ASIAN

SSuN Protocol (V12.0)

#

29

OMB Data Element Name

Strategy A Survey Data Elements

Description/Response Coding
1=Yes
2=No

152

P

FS1_RaceNHOPI

NH/OPI
1=Yes
2=No

153

P

FS1_RaceOther

Other race
1=Yes
2=No

154

P

FS1_RaceUnk

Unknown/Can't guess
1=Yes
2=No

155

P

FS1_RaceRef

Refused Race
1=Yes
2=No

156

P

FS1_SexOrient
Which of the following best represents
how you think of yourself?
1=Heterosexual/Straight
2=Gay/Lesbian/Homosexual
3=Bisexual
4=Other
5=I don't know
9=Refused
What is your current employment status
(choose all that apply)?

157

P

FS1_Employ1

Full-time employment
1=Yes
2=No

158

P

FS1_Employ2

Part-time employment

SSuN Protocol (V12.0)

#

30

OMB Data Element Name

Strategy A Survey Data Elements

Description/Response Coding
1=Yes
2=No

159

P

FS1_Employ3

Unemployed
1=Yes
2=No

160

P

FS1_Employ4

Disabled
1=Yes
2=No

161

P

FS1_Employ5

Student
1=Yes
2=No

162

P

FS1_Employ6

Other
1=Yes
2=No

163

P

FS1_Educate

What is your highest level of school you
have completed or the highest degree you
have received
1=Middle school
2=Some high school
3=High school diploma
4=GED or equivalent
5=Some college
6=College degree or higher

SSuN Protocol (V12.2)

31

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding

164

Y

P1_SiteID

165

Y

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 MUST NOT be ‘null’ or contain missing values.

166

Y

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 MUST NOT be ‘null’ or contain missing values.

167

Y

P1_RecRepDte

Earliest date this specific disease event/report received at health department?

Strategy B (Case-Based Surveillance) Data Elements
SSuN Site ID
This 2 character code primarily identifies sites funded under SSuN Cycle 2 & 3 and will
include additional sites as required for Cycle 4. This data element MUST NOT be ‘null’ or
contain missing values.
BA=Baltimore (Cycle II, Cycle III, Cycle IV)
CB=Columbus (Cycle IV)
CA=California (Cycle II, Cycle III, Cycle IV)
FL=Florida (Cycle III & Cycle IV)
IN=Indiana (Cycle IV)
MC=Multnomah County (Cycle III &Cycle IV)
NY=New York City (Cycle II, Cycle III, Cycle IV)
PH=Philadelphia (Cycle II, Cycle III, Cycle IV)
SF=San Francisco (Cycle II, Cycle III, Cycle IV)
WA= Washington (Cycle II, Cycle III, Cycle IV)
UT=UTAH (Cycle IV)
LA=Louisana (Cycle II)
VA=Virginia (Cycle II)
AL=Alabama (Cycle II)
CO=Colorado (Cycle II)
CH=Chicago (Cycle II)
MA=Massachusetts (Cycle III)
MN=Minnesota (Cycle III)

This date should reflect the earliest information available to the health department
168

Y

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 should not be ‘null’ or contain missing values. This should be coded as a
‘SAS’ numeric date.

SSuN Protocol (V12.2)

32

DE #

OMB

Data Element Name

Description/Response Coding

169

Y

P1_DxCode

Diagnosis
This data element should not be ‘null’ or contain missing values.

Strategy B Data Elements

10273=Chancroid
10274=Chlamydia
10280=Gonorrhea
10311=Syphilis, primary
10312=Syphilis, secondary
10313=Syphilis, early non-primary non-secondary
10320=Syphilis, unknown duration or late
170

Y

P1_RandSamp

Is this record/case selected in the random sample?
This data element MUST NOT be ‘null’ or contain missing values.
. = Not Sampled
0=Not in random sample
1=In random sample

171

Y

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 should not be ‘null’ or contain
missing values. This should be coded as a ‘SAS’ numeric date.

172

Y

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 should not 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
173

Y

P1_PrevPtx

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 should not 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.
0=New Patient, not previously reported
1=Patient previously reported

SSuN Protocol (V12.2)

DE #
174

OMB
Y

Data Element Name
P1_InitSx

33

Strategy B Data Elements

Description/Response Coding
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

175

Y

P1_HregMatch

Was eHARS registry match done for this patient?
This data element may be initially coded as ‘2’ if the grantee conducts a periodic 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 should not be ‘null’ or contain missing values.
1=Yes
2=No

176

Y

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 periodic 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 should not be ‘null’ or contain missing values.

1=Matching Record Found
2=No Matching Record
3=Match Not Performed
177

Y

P1_HregID

Unique record number from HIV registry (such as stateno from eHARS).
This data element should not be ‘null’ or contain missing values if a matching record is
present in eHARS.

178

Y

P1_HDXMOYR

What is this patient's earliest indication of HIV positive result?
This information can be obtained from the eHARS person table (HIVPMOYR). If eHARS
match found. This should be coded as character data (“MM/YY”) with missing information
as “../..” or “../YY”

179

Y

P1_EXPMOD

Exposure (HIV transmission) mode from HIV registry.
This data element should not be ‘null’ or contain missing values if a matching record is
present in eHARS.
1=Male who had sex with another male (MSM)
2=Injected illicit or non-prescription drugs (IDU)
3=Had sex with someone with either 1 or 2 (above)
4=Had Sex with Someone of the Opposite Sex but May Not Have Known whether HIV
Infection was
Diagnosed in that Person, or Any of the Risk factors of Sex Partners Described in Items 3 or
5

SSuN Protocol (V12.2)

DE #

OMB

Data Element Name

34

Strategy B Data Elements

Description/Response Coding
5=Had Sex with Someone of the Opposite Sex in whom HIV Infection was Diagnosed after
Having Any Risk Factor for HIV Infection in Items 6 (Receipt of Clotting Factor for
Coagulation Disorder), 7 (Receipt of Blood Transfusion), or 8 (Receipt of Transplant or
Artificial Insemination)
6=Received Clotting Factor Injection for Hemophilia or Another Coagulation Disorder
7=Received Transfusion of Blood or Blood Components (e.g., Platelets)
8=Received a Transplant of Tissue or Organ or Artificial Insemination
9=Worked in a Health-Care or Clinical Laboratory Setting with Possible Exposure to Human
Blood or Other Body Fluids
10=Had Other Exposure to Human Blood or Body Fluids
11=No Risk Reported

180

Y

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.

181

Y

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 (deprecated)
2=Viral Hepatitis Registry
3=Other Disease Registry
4=Unknown

182

Y

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 above,
indicate the diagnosis documented by that record. Should be ‘Null’ if no previous
diagnosis is confirmed.
10311=Syphilis, primary
10312=Syphilis, secondary
10313=Syphilis, early non-primary non-secondary
10320=Syphilis, unknown duration or late
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

SSuN Protocol (V12.2)

35

DE #

OMB

Data Element Name

Description/Response Coding
20003=Other

183

Y

P1_PrevDxDte

Date of most recent previous diagnosis documented above.
Should not be null if P1_PrevDx is not null.

184

Y

P1_PrevGCDx

Has the patient been previously diagnosed and reported with GC?

Strategy B Data Elements

1=Yes
2=No
3=Registry records not searched
185

Y

P1_PrevGCDxDte

Date of most recent previous diagnosis of GC documented above.
Should not be null if P1_PrevGCDx = 1. This should be coded as a ‘SAS’ numeric date.

186

P

P1_ConcurCTDx

Was this patient diagnosed with CT at the same time as their current GC diagnoses?

1=Yes, tested and found to be CT positive
2=No, tested and found to be CT negative
3=No, patient not tested for CT/No CT information available
187

Y

P1_CaseDup

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 should not be ‘null’ or contain
missing values.
0=New Case
1=Duplicate Case (previously reported <30 days)
9=Unknown, site surveillance system does not capture

188

Y

P1_FacilityID

Site generated facility ID. Each reporting provider/facility must have a unique ID.
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 or unknown
providers, this field should be populated with that facility’s new number and be included
in the next update of the provider reference file. This data element should not be ‘null’ or
contain missing values.

189

Y

P1_Dispo

What is the status of the internal health department look-back investigation (Includes HIV
and other disease registry matching)?

SSuN Protocol (V12.2)

DE #

OMB

Data Element Name

36

Strategy B Data Elements

Description/Response Coding
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 should not be ‘null’ or contain missing values. Jurisdictions may choose to initiate
provider investigations on all reported cases, regardless of whether they fall into the
random sample, or may elect to initiate investigations on only those records in the
random sample.

0=Investigation complete: record referred to provider investigation
1=Investigation complete: no further action, record determined to be a duplicate of
existibng case
2=Investigation complete: no further action, case determined to reside OOJ
3=Investigation complete: no further action, case not in Sample
4=Investigation complete: no further action, case not eligible for SSuN
10=Investigation not complete: investigation pending (May be default value)
11=Investigation not complete: no further action, insufficient contact/provider
information
22=Investigation not complete: other reason
190

Y

P1_Referral1

Is this record/case referred for provider investigation?
This indicates whether the record has been referred to provider investigation. If provider
is not contacted, surveyed or otherwise followed up with to supply any additional casespecific information, code as ‘1’. This data element should not be ‘null’ or contain missing
values.
0=Referred to Provider Investigation
1=Not Referred to Provider Investigation
2=Referral Pending

191

Y

P1_PtxSex

Current sex of the patient as indicated on initial health department report?
This data element should not be ‘null’ or contain missing values.
1=Male
2=Female
9=Unknown

192

P

P1_PtxGendID

Gender Identity of the patient as indicated on initial health department report.
1=Male-to-Female Transgender
2=Female-to-Male Transgender
3=Transgender, not specified
4=CIS Gender (Male or Female, NOT transgendered)
9=Gender Identity not documented

193

Y

P1_PtxRace_White

White Race

SSuN Protocol (V12.2)

DE #

OMB

Data Element Name

37

Strategy B Data Elements

Description/Response Coding
Information from case/lab reports to the health department only. Patient self-report from
interviews should be captured in interview variables. If additional information from any
source (other than patient report) is received, these data may be updated as required by
underlying surveillance system.
1=Yes
2=No
3=Unknown
4=Refused

194

Y

P1_PtxRace_Black

Black Race
Information from case/lab reports to the health department only. Patient self-report from
interviews should be captured in interview variables. If additional information from any
source (other than patient report) is received, these data may be updated as required by
underlying surveillance system.
1=Yes
2=No
3=Unknown
4=Refused

195

Y

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 interview variables. If additional information from any
source (other than patient report) is received, these data may be updated as required by
underlying surveillance system.
1=Yes
2=No
3=Unknown
4=Refused

196

Y

P1_PtxRace_Asian

Asian Race
Information from case/lab reports to the health department only. Patient self-report from
interviews should be captured in interview variables. If additional information from any
source (other than patient report) is received, these data may be updated as required by
underlying surveillance system.
1=Yes
2=No
3=Unknown
4=Refused

197

Y

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 interview variables. If additional information from any
source (other than patient report) is received, these data may be updated as required by
underlying surveillance system.
1=Yes
2=No

SSuN Protocol (V12.2)

38

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
3=Unknown
4=Refused

198

Y

P1_PtxRace_Other

Other Race
Information from case/lab reports to the health department only. Patient self-report from
interviews should be captured in interview variables. If additional information from any
source (other than patient report) is received, these data may be updated as required by
underlying surveillance system.
1=Yes
2=No
3=Unknown
4=Refused

199

Y

P1_PtxRace_UNK

Is all information on race and Hispanic ethnicity missing from initial
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 below.

1=Yes
2=No
200

Y

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 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
201

Y

P1_PtxHisp

Patient Hispanic ethnicity
Information from case/lab reports to the health department only. Patient self-report from
interviews should be captured in interview variables. If additional information from any
source (other than patient report) is received, these data may be updated as required by
underlying surveillance system.
1=Hispanic
2=Non-Hispanic
3=Unknown
4=Refused

202

Y

P1_PtxHISPSource

What is the source of the final Hispanic ethnicity information

SSuN Protocol (V12.2)

DE #

OMB

Data Element Name

39

Strategy B Data Elements

Description/Response Coding
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

203

Y

P1_PtxAGE

Age of patient from initial reporting record/document .
If age information is missing/unknown from all sources, use null value.

204

Y

P1_PtxAgeUnit

Age unit
If #32 is null, use null value for this data element (‘.’)
1=Years
2=Months

205

Y

P1_PtxCountyres

County of patient residence
If information is missing/unknown, code to null value ( ‘.’)

206

Y

P1_PtxCTract

Census Tract of patient residence
If information is missing/unknown, code to null value (‘.’)

207

Y

P1_PtxAddrStat

Was patient street address present and complete in initial reporting documents?
This data element should not be ‘null’ or contain missing values.
1=Street Address Known
2=Street Address Missing
3=Street Address Incomplete

208

Y

P1_GCAccuracy

What is the basis of census tract assignment (XY coordinates, street segment, centroid,
etc.)
This data element should not be ‘null’ or contain missing values.
1=Close (based on direct street segment, parcel, or lon/lat match.)
2=Approximate (modification of address required to match to to street segment)
3=Very approximate (based only on zip or city centroid)
4=Not-geocodable (insufficient data to geocode, PO Box, General Delivery)
9=Missing (no address available)

209

Y

P1_SiteUrine

Urine 'site' of infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No

SSuN Protocol (V12.2)

40

DE #

OMB

Data Element Name

Description/Response Coding
3=Unknown

210

Y

P1_SiteVagCerv

Vaginal or cervical site of infection in women
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

211

Y

P1_SiteUreth

Urethral site of infection - only if this is specifically indicated.
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

212

Y

P1_SiteRect

Rectal site of infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

213

Y

P1_SitePhar

Pharyngeal site of infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

214

Y

P1_SiteEye

Ocular site of infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

215

Y

P1_SiteSera

Blood or sera infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

216

Y

P1_SiteJoint

Joint or synovial fluid infection
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

217

Y

P1_SiteOTH

Site of infection, not specified above

Strategy B Data Elements

SSuN Protocol (V12.2)

DE #

OMB

Data Element Name

41

Strategy B Data Elements

Description/Response Coding
If information is missing/unknown, code as ‘3’
1=Yes
2=No
3=Unknown

218

Y

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
219

Y

P2_ProvID

Unique facility/provider ID
This data element MUST NOT be ‘null’ or contain missing values for cases in the random
sample. SHOULD NOT be null for all other cases (collaborators requested to include this
information for all gonorrhea case records – this can be accomplished with a default
coding of P2_ProvID= P1_FacilityID.

220

Y

P2_ProvCO

County FIPS code for provider/facility physical location
This should be coded as the 3-digit FIPS code for the county.

221

Y

P2_ProvZIP

Facility/provider physical location 5-digit ZIP

222

Y

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
self-identification (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
223

Y

P2_ProvFQHC

Is facility/provider a Federally Qualified Health Center (FQHC)?
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

224

Y

P2_ProvPTXvisitDte

Date of patient initial visit for this issue, can be supplied/filled in from initial case report.
This should be formatted as a ‘SAS’ numeric date.

SSuN Protocol (V12.2)

42

DE #

OMB

Data Element Name

Description/Response Coding

225

Y

P2_ProvClinType

What was the category of provider examining/treating this patient?
1=MD
2=RN
3=PA
4=ARNP
5=LPN
6=Other
7=Unknown/Not Ascertained

226

Y

P2_ProvPTX_GenderSP

Provider documented gender of sex partners
1=Males only
2=Females only
3=Both Males and Females
4=Not Documented

227

Y

P2_ProvPTX_Insure

Insurance status of patient from provider's records
1=Yes, Insured
2=No, Not Insured
3=Unknown/Missing

228

Y

P2_Urethritis

Was urethritis found on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No

229

Y

P2_Proctitis

Was proctitis found on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No

230

Y

P2_Epididymitis

Was epididymitis found on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No

231

Y

P2_PID

Was PID diagnosed.
Missing/unknown information code as null (‘.’).
1=Yes
2=No

232

Y

P2_Discharge

Was discharge found on exam
Missing/unknown information code as null (‘.’).

Strategy B Data Elements

SSuN Protocol (V12.2)

43

DE #

OMB

Data Element Name

Description/Response Coding
1=Yes
2=No

233

Y

P2_OtherFinding

Were there other STD-related findings on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No

234

Y

P2_NoFinding

Were there NO findings on exam
Missing/unknown information code as null (‘.’).
1=Yes
2=No

235

Y

P2_ProvScrnUreth

Was patient screened/tested for infection at urethral site
1=Yes
2=No
3=Unknown
4=Refused

236

Y

P2_ProvScrnVagCerv

Was patient screened/tested for infection at vaginal/cervical site
1=Yes
2=No
3=Unknown
4=Refused

237

Y

P2_ProvScrnAnal

Was patient screened/tested for infection at anorectal site
1=Yes
2=No
3=Unknown
4=Refused

238

Y

P2_ProvScrnPhar

Was patient screened/tested for infection at pharyngeal site
1=Yes
2=No
3=Unknown
4=Refused

239

Y

P2_ProvScrnHIV

Was patient screened/tested for HIV infection at time of visit
1=Yes
2=No
3=Unknown
4=Refused

Treatment Repeating Table

Strategy B Data Elements

SSuN Protocol (V12.2)

44

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding

240

Y

P2_PR_EventID

Primary key for merging treatment records with case file, should be the same as
P1_EventID
Must not be missing or null.

241

Y

P2_PR_ProvPTX_TxDte

Treatment date (or date of administration, date prescription given)
This should be coded as a ‘SAS’ numeric date. Missing/unknown information code as null
(‘.’).

242

P

P2_PR_DrugName

What drug was patient treated with?
01=Penicillin G (benzathine, aqueous procaine, or aqueous crystalline)
02=Probenacid
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)
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, Neo-Metric, Noritate,
Novonidazol)
61= Tinidazole (Tindamax)
70= Truvada (Tenofovir/emtricitabine)
88= Other (provide text in P2_PR_OthMedTXT)
Must not be missing or null.

243

P

P2_PR_OthMedTXT

Other medication if value of 88 selected for P2_PR_DrugName

244

P

P2_PR_Dosage

Dosage - numeric
Missing/unknown information code as null (‘.’).

245

P

P2_PR_Dose_Units

Dosage units
01-Miligrams (mg)

SSuN Protocol (V12.2)

45

DE #

OMB

Data Element Name

Description/Response Coding
02-Grams (g)
03-Units
04-Units/Kilogram
05-Million Units
06-Million Units/Kilogram
07-Milliliters (ml)

246

P

P2_PR_Method

Method of administration
01=PO - oral dosing
02=IM - intramuscular
03=IV - intravenous/infusion
04=Other
05=Unknown
Missing/unknown information code as null (‘.’).

247

P

P2_PR_Number

Number of doses/day
0=Single dose, STAT
Numeric value for all other
Missing/unknown information code as null (‘.’).

248

P

P2_PR_Duration_Number

Days duration or frequency of doses
Missing/unknown information code as null (‘.’).

249

Y

P2_ProvPTX_PDPT

Were any medications/prescriptions provided for patient's partner(s)?
Missing/unknown information code as null (‘.’).
1=Yes
2=No

250

Y

P2_ProvPTX_HIBC

Was patient counseled to prevent transmission/reinfection?
Missing/unknown information code as null (‘.’).
1=Yes
2=No

251

Y

P2_ProvPTX_Refer

Was patient referred to HD (or other) for partner services?
Missing/unknown information code as null (‘.’).
1=Yes
2=No

252

Y

P2_ProvPTX_PrepRefer

Was patient referred for PrEP?
Missing/unknown information code as null (‘.’).
1=Yes
2=No
Patient Interview

Strategy B Data Elements

SSuN Protocol (V12.2)

46

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding

253
1

Y

P3_IDX_ID

(1) Interviewer/Investigator ID
This is a locally assigned ID to uniquely identify the person conducting patient interview.
This data element should not be ‘null’ or contain missing values for interviewed cases.

254
2

Y

P3_PatientID

(2)Unique identifier for person/patient
Will be a secondary key for merging data; should correspond to P1_PatientID. This data
element should not be ‘null’ or contain missing values for interviewed cases.

255
3

Y

P3_EventID

(3) Unique identifier for record
Will be a primary key for merging data; should correspond to P1_EventID. This data
element should not be ‘null’ or contain missing values for interviewed cases.

256
4

Y

P3_IDX_CADate1

(4) Contact attempt date 1
This data element should not be ‘null’ or contain missing values for interviewed cases.

257
5

Y

P3_IDX_CAout1

(5) Contact attempt outcome 1
This data element should not 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
7=Number out of service
8=Other
258
6

Y

P3_IDX_CADate2

(6) Contact attempt date 2
This should be coded as a ‘SAS’ numeric date.

259
7

Y

P3_IDX_CAout2

(7) 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

260
8

Y

P3_IDX_CADate3

(8) Contact attempt date 3
This should be coded as a ‘SAS’ numeric date.

SSuN Protocol (V12.2)

DE #
261
9

OMB
Y

Data Element Name
P3_IDX_CAout3

47

Strategy B Data Elements

Description/Response Coding
(9) 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

262
10

Y

P3_IDX_CADate4

(10) Contact attempt date 4
This should be coded as a ‘SAS’ numeric date.

263
11

Y

P3_IDX_CAout4

(11) 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
7=Number out of service
8=Other

264
12

Y

P3_IDX_Ixdate

(12) Interview/Disposition Date
This should be coded as a ‘SAS’ numeric date.

265
13

Y

P3_IDX_Dispo

(13) Patient Investigation/Interview Disposition
Should not be ‘null’ for cases included in random sample.
0=Investigation complete: patient contacted, interview
1=Investigation complete: patient contacted, partial interview
10=Investigation not complete: P3 investigation pending
11=Investigation not complete: patient contacted, refused
12=Investigation not complete: patient contacted, unable to
22=Investigation not complete: patient did not respond to at
33=Investigation not complete: patient contact not initiated
44=Investigation not complete: patient contact not initiated
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

266
14

Y

P3_PTX_age

(14) What is your age?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.

SSuN Protocol (V12.2)

48

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
888=Refused

267
15

Y

P3_PTX_sex

(15) What gender or sex do you consider yourself to be?
Gender Identity
1= CIS Male
2=CIS Female
3=Male-to-Female TG
4=Female-to-Male TG
5=TG Unspecified
6=Queer, Gender Non-binary
7=Other
8=Refused

268
16

Y

P3_PTX_HispEthnic

(16) Do you consider yourself to be Hispanic or Latino/a?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Unknown
4=Refused

269
16.1

P

P3_PTX_HISPOrgin

Do you consider yourself to be…?
1=Mexican, Mexican Am., Chicano/a, Latino/a
2=Puerto Rican
3=Cuban
4=Central American (Guatemalan, Honduran, Nicaraguan, El Salvadoran)
5=Other Hispanic Origin
6=Unknown
9=Refused

270
16.2
271
17

P

P3_PTX_HISPTXT

Other Hispanic Origin

Y

P3_PTX_White

(17) patient reported White race
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Unknown
4=Refused

272
18

Y

P3_PTX_Black

(18) patient reported Black race
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Unknown
4=Refused

SSuN Protocol (V12.2)

49

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding

273
19

Y

P3_PTX_AIAN

(19) patient reported AIAN race
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Unknown
4=Refused

274
19.1
275
20

P

P3_PTX_AIAN_TXT

Tribal Affiliation

Y

P3_PTX_Asian

(20) patient reported Asian race
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Unknown
4=Refused

276
20.1

P

P3_PTX_AsianOrigin

Asian Origin
1=Asian Indian (India)
2 =Japanese
3=Chinese/Taiwanese
4=Korean
5=Filipona/o
6=Southeast Asian (Vietnamese, Thai, Cambodian, Burmese)
7=Indonesian
8=West Asians (Middle East)
9=Other/Unk Asian
10=Refused

277
21

Y

P3_PTX_NHOPI

(21.1) patient reported NHOPI race
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Unknown
4=Refused

278
21.1

P

P3_PTX_PIOrigin

(21) patient reported NHOPI origin
1=Native Hawaiian
2=Guamanian/Chamorro/Fijian/Chuukese/Carolinian
3=Samoan/Tokelauan/Tongan/Yapese
4=Niuean/Palauan/Pohnpeian
5=Kosraean/Marshallesse
6=Other Pacific Island

SSuN Protocol (V12.2)

50

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
9=Refused

279
22

Y

P3_PTX_OTHrace

(22) patient reported other race
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Unknown
4=Refused

280
22.1

Y

P3_PTX_OTHraceTxt

Patient-reported other race

281
23

Y

P3_PTX_RefRace

(23) patient refuses provision of all race information
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

282
23.1

P

P3_PTXNativity

Where were you born?
1=In the US
2=Outside the US

283
23.2
284
23.3
285

P

P3_PTXBirtState

Birth State

P

P3_PTXBirtCount

Birth County

Y

P3_PTX_Insure

(24) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.

24

1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
286
25

Y

P3_PTX_InsType

(25) What kind of healthcare insurance do you have?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (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
4=Active or retired military or dependent plan like the V.A. or
5=Bureau of Indian Affairs/IHS/Urban Indian Health

SSuN Protocol (V12.2)

51

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
7=Other
8=Don‘t know / Not sure
9=Refused

287
25.1
288

Y

P3_PTX_OthInsSpecify

(25a) Other type of insurance (text)

Y

P3_PTX_PriCareDoc

(26) Do you have one person you think of as your personal doctor or health care
provider?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.

26

1=Yes, only one
2=More than one or facility
3=No
4=Don't Know /Not Sure
5=Refused
289

Y

P3_PTX_Hccost

27

(27) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

290

Y

P3_PTX_OOPE

28

(28) When you went to see _______________ (mention 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

291

28.1

Y

P3_PTX_SYMP1

(28.1) Before you went to see _______________ (mention provider, clinic or facility
name) when you were diagnosed with gonorrhea, did you have any unusual discharge or
oozing from your (penis/vagina)?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

SSuN Protocol (V12.2)

DE #
292

OMB
Y

Data Element Name
P3_PTX_SYMP2

28.2

52

Strategy B Data Elements

Description/Response Coding
(28.2) Before you went to see _______________ (mention provider, clinic or facility
name) did you notice any unexplained sores or bumps on your (penis/vagina)?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

293

Y

P3_PTX_SYMP3

28.3

(28.3) Before you went to see _______________ (mention provider, clinic or facility
name) when you were diagnosed with gonorrhea, did you have any pain or burning when
you urinated?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

294

Y

P3_PTX_SYMP4

29

(289) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

295

Y

P3_PTX_Delay

30

(30) How long did you have these symptoms or pains before you were able to see the
doctor?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=1 Day
2=2 - 6 Days
3=1 - 2 weeks
4=More than 2 weeks
5=Don‘t know / Not sure / Don’t remember
6=Refused

296
31

Y

P3_PTX_ExpSTD

(31) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes

SSuN Protocol (V12.2)

53

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

297

Y

P3_PTX_reasA

(32) Reason for going to specific doctor: regular doctor: Because this is your usual/regular
doctor.
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.

32

1=Yes
2=No
298
33

Y

P3_PTX_reasB

(33) Reason for going to doctor: Because you could get seen for free?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

299
34

Y

P3_PTX_reasC

(34) Reason for going to doctor: Because they take your insurance?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

300

Y

P3_PTX_reasD

35

(35) Reason for going to specific doctor: Because you felt more comfortable about your
privacy there?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

301
36

Y

P3_PTX_reasE

(36) Reason for going to specific doctor: Because you could get seen right away?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

302

Y

P3_PTX_reasF

37

(37) Reason for going to specific doctor: Because you wanted to see an expert specializing
in STDs.
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

303

Y

P3_PTX_reasI

(38) Reason for going to specific doctor: Because this doctor is close to your house and
easy to get to.

SSuN Protocol (V12.2)

DE #
38

OMB

Data Element Name

54

Strategy B Data Elements

Description/Response Coding
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

304

Y

P3_PTX_reasG

39

(39) Reason for going to specific doctor: Because you were embarrassed and didn’t want
to go to your regular doctor.
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

305

Y

P3_PTX_reasH

40

(40) Reason for going to specific doctor: Because I didn’t want the insurance papers/info
sent to my home/parents.
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

306
41

Y

P3_PTX_reasJ

(41) Reason for going to specific doctor: Any other reason?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

307
42
308
43

Y

P3_PTX_othReasonText

(42) Other reason text.

Y

P3_PTX_refusreason

(43) Refused all reasons
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No

309

Y

P3_PTX_PartnerTest

44

(44) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

310

Y

P3_PTX_TellParts

(45) In the time since your visit, did you tell any of your sex partners they may need to
tested or treated for STDs?

SSuN Protocol (V12.2)

DE #
45

OMB

Data Element Name

55

Strategy B Data Elements

Description/Response Coding
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

311

Y

P3_PTX_EPToffer

46

(46) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

312

Y

P3_PTX_EPTWHO

47

(47) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (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

313

Y

P3_PTX_EPTGET

48

(48) Did you actually get the additional medications or prescriptions for your sex partners?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

314

Y

P3_PTX_EPTMEDORRX

49

(49) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=I got additional medications
2=I got prescription(s)
3=Don‘t know / Not sure

315

Y

P3_PTX_EPTGAVE

(50) Did you give the additional medications or prescriptions to at least one of your sex
partners?

SSuN Protocol (V12.2)

DE #
50

OMB

Data Element Name

56

Strategy B Data Elements

Description/Response Coding
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
9=Refused

316
51

P

P3_PTX_EPTPARTTAKE

Do you think at least one of your sex partners took this medication?
1=Yes, I think at least one of my partner(s) took this medicine
2=No, I do not think any of my partner(s) took these medicines
9=Refused

317
52

Y

P3_PTX_HIVtested

(52) Did you get tested for HIV at that visit?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ (P3_IDX_Dispo) = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

318
53

Y

P3_PTX_HIVresult

(53) What was the result of your HIV test at that visit?
This data element should not be ‘null’ or contain missing values if P3_PTX_HIVtested=1.

1=Positive
2=Negative
3=Don't Know / Not Sure / did not get results
4=Refused
319
54

Y

P3_PTX_everHIVtst

(54) Have you ever been tested for HIV?
May be ‘Null’ if P3_PTX_HIVtested=1. This data element should not be ‘null’ or contain
missing values for cases responding with 2, 3 or 4 to P3_PTX_HIVtested.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

320

Y

P3_PTX_whenHIVtest

(55) When was your last HIV test? Just month and year is ok? (IF PATIENT UNABLE TO
RECALL, PROBE UNTIL APPROXIMATE RESPONSE ELICITED)
This should be character data ”MM/YYYY”, missing/REFUSED information as”../YYYY” or
“../….”

Y

P3_PTX_HIVeverResult

(56) What was the result of that HIV test?
This data element should not be ‘null’ or contain missing values for cases responding to
P3_PTX_everHIVtst=1.

55

321
56

1=Positive

SSuN Protocol (V12.2)

57

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
2=Negative
3=Don't Know / Not Sure / did not get results
4=Refused

322
57

Y

P3_PTX_inHIVcare

(57) When was your most recent visit to a doctor, nurse or other health
This data element should not be ‘null’ or contain missing values for cases identifying as
HIV positive (P3_PTX_HIVResult=1 or P3_PTX_HIVeverResult=1). This should be entered
as character data ”MM/YYYY”, missing/REFUSED information as”../YYYY” or “../….”

323
58

Y

P3_PTX_ART

(58) Are you taking antiretroviral medicines to treat your HIV infection?
This data element should not be ‘null’ or contain missing values for cases identifying as
HIV positive (P3_PTX_HIVResult=1 or P3_PTX_HIVeverResult=1). This should be entered
as character data ”MM/YYYY”, missing/REFUSED information as”../YYYY” or “../….”

1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
324

Y

P3_PTX_PrEP

58.1

(58.1) When you were diagnosed with gonorrhea, did your health care provider or anyone
else discuss medications to help you prevent getting HIV? This is often called PrEP, or preexposure prophylaxis.
This data element should be ‘null’ for patients reporting being HIV positive. This data
element should not be ‘null’ or contain missing values for patients identifying as HIV
negative or unknown HIV status.
1=Yes
2=No
3= Don‘t know / Not sure
4=Refused

325
58.2

Y

P3_PTX_PREP1

(58.2) Did your health care provider offer to prescribe or give you
medications to help you prevent getting HIV?
This data element should not be ‘null’ or contain missing values if patient reports PrEP.

1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
326

Y

P3_PTX_PREP2

(58.3) Did you fill a prescription or get medications to help you prevent getting HIV?

58.3
This data element should not be ‘null’ or contain missing values for those answering “Yes”
to P3_PTX_PrEP.
1=Yes
2=No

SSuN Protocol (V12.2)

58

DE #

OMB

Data Element Name

Description/Response Coding
3=Don't Know /Don't Remember/ Not Sure
4=Refused

327
58.4

Y

P3_PTX_PREP3

(58.4) Are you currently taking daily medications to help you prevent
getting HIV (on PrEP)?
This data element should not be ‘null’ or contain missing values.

Strategy B Data Elements

1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
328
59

Y

P3_PTX_Pregnant

(59) Were you pregnant at the time you were told that you had gonorrhea?
This data element should not 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

329

Y

P3_PTX_GenderSP

60

(60) During the past 12 months, have you had sex with only males, only females or both?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo) = ‘1’, partial interview.
1=Males only
2=Females only
3=Both Males and Females
4=Unknown
9=refused

330

P

P3_PTX_TGSP

During the past 12 months, have you had sex with a transgender man or transgender
woman?

60.1
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused
331
61

Y

P3_PTX_Sxorient

(61) Do you consider yourself to be…
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo) = ‘1’, partial interview.
1=Heterosexual/Straight (not Gay or Lesbian)
2=Gay/Lesbian/Homosexual
3=Bisexual
4=Other/Don't Know
9=Refused

332

Y

P3_PTX_MaleSPL3MO

(62) Thinking back to the 3 months before you were diagnosed with

SSuN Protocol (V12.2)

59

Strategy B Data Elements

DE #
62

OMB

Data Element Name

Description/Response Coding
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview. Probe for approximate response or
‘best’ guess. Enter 0 to indicate ‘None’, 9999 to indicate “Refused”.

333
63

Y

P3_PTX_FemaleSPL3MO

(63) Thinking back to the 3 months before you were diagnosed with
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview. May be ‘Null’ if P3_IDX_Dispo = ‘1’,
partial interview. Probe for approximate response or ‘best’ guess. Enter 0 to indicate
‘None’, 9999 to indicate “Refused”.

334
63.1

Y

P3_PTX_SPtreatOne

(63.1) 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
6=No need/no partners infected

335

Y

P3_PTX_SPtreatMult

63.2

(63.2) 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
7=No need/no partners infected

336

Y

P3_PTX_SexExch

64

(64) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Don't Remember/ Not Sure
4=Refused

337
64.1

Y

P3_PTX_Opioid

(64.1) In the past year, how often have you used prescription pain medications
other than as prescribed by a doctor?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if #107 (P3_IDX_Dispo) = ‘1’, partial interview.
1=Never

SSuN Protocol (V12.2)

60

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
2=Once or Twice
3=Monthly
4=Weekly
5=Daily or Almost Daily
9=Refused

338

Y

P3_IVDU

In the past year, have you used any injection drugs such as heroin, cocaine or meth?

64.2
1=Yes
2=No
3=Don’t Know/Can’t Remember
4=Refused
339
64.3

Y

P3_IVDU_HER

In the past year, did you inject heroin?
1=Yes
2=No
3=Don’t Know/Can’t Remember
4=Refused

339.1 Y
64.4

P3_IVDU_COC

In the past year, did you inject cocaine/crack?
1=Yes
2=No
3=Don’t Know/Can’t Remember
4=Refused

339.2 Y
64.5

P3_IVDU_MTH

In the past year, did you inject Crystal Meth/Methamphetamine/Methadrone?
1=Yes
2=No
3=Don’t Know/Can’t Remember
4=Refused

339.3 Y

P3_IVDU_OXY

In the past year, did you inject Oxycodone/morphine/Fentanyl/Carfentanil/some other
opioid?

64.6
1=Yes
2=No
3=Don’t Know/Can’t Remember
4=Refused
339.4 Y
64.7

P3_IVDU_OTH

In the past year, did you inject other durgs not listed?
1=Yes
2=No
3=Don’t Know/Can’t Remember
4=Refused

340

Y

P3_IVDU_DR_TX

Other drug injected text.

SSuN Protocol (V12.2)

61

Strategy B Data Elements

DE #
64.8

OMB

Data Element Name

Description/Response Coding

341
65

Y

P3_PTX_LastSex

(65) When was the last time you had sex?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if 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

342

Y

P3_PTX_GenderMRSP

66

(66) Thinking back to the last time you had sex, was the person you had sex
with…(male/female)?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
1=Cis Male
2=Cis Female
3=Male-to-Female TG
4=Female-to-Male TG
5=TG Unknown or Unspecified
9=Unknown

343

Y

P3_PTX_AgeMRSP

(67) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.

Y

P3_PTX_HISPMRSP

(68) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.

67

344
68

1=Yes, Hispanic
2=No, Not Hispanic
8=Unknown/Can't guess
9=Refused
345
69

Y

P3_PTX_RaceMRSP

(69) 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 should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
1=White
2=Black
3=AI/AN
4=ASIAN
5=NH/OPI
6=Multiple Races

SSuN Protocol (V12.2)

62

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
7=Other race
8=Unknown/Can't guess
9=Refused

346

Y

P3_PTX_MRSPHIV

(70) Thinking back to the last person you had sex with, do you know if that person HIV
positive?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.

70

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
347

Y

P3_PTX_SexAgainMRSP

71

(71) Thinking back to the last person you had sex with; do you think you will have sex with
this person again?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
1=Yes
2=No
3=Don't Know /Maybe/ Not Sure
4=Refused

348
72

Y

P3_PTX_DIS_EPT

(73) Did the interviewer/DIS provide EPT/PDPT to patient?
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
1=Yes
2=No

349
73

Y

P3_PTX_DIS_EPTnum

(74) Number of partners EPT provided for
This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.

350

Y

P3_PTX_DIS_OtherPS

(75) Did interviewer/DIS provide other partner services to patient (DIS referral?)

74

This data element should not be ‘null’ or contain missing values for interviewed cases.
May be ‘Null’ if P3_IDX_Dispo = ‘1’, partial interview.
1=Yes
2=No
Data Element Name

351

Y

P1_L1_EventID

Description/Response Coding
Laboratory Observation Dataset
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 MUST NOT be ‘null’ or contain missing values.

SSuN Protocol (V12.2)

63

Strategy B Data Elements

DE #
352

OMB
Y

Data Element Name
P1_L1_LabID

Description/Response Coding
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 record with a locally defined ID
corresponding to unknown lab that they will use throughout the SSuN data collection
period. This data element should not be ‘null’ or contain missing values.

353

Y

P1_L1_Accession

Unique identifier (accession number) for laboratory record
Leave blank (null) if not available/ascertained

354

Y

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 MUST NOT be ‘null’ or contain missing values.

355

Y

P1_L1_CondTested

specific condition/pathogen tested
This data element MUST NOT 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

356

Y

P1_L1_SpecColDte

Specimen collection date - this is often used as a proxy for diagnosis
This data element should not be ‘null’ or contain missing values. This should be coded as a
‘SAS’ numeric date.

357

Y

P1_L1_LabRepDte

This is the date that the performing lab reported the results to the
This should be coded as a ‘SAS’ numeric date.

358

Y

P1_L1_SecType

Type of specimen
This data element should not be ‘null’ or contain missing values.
1=Exudate
2=Blood/sera
3=Synovial fluid
4=Urine
5=CSF
6=Tissue
7=Saliva
8=Other
9=Unknown

359

Y

P1_L1_AnatSite

This is the anatomic site from which the specimen was obtained and is important in
determining the anatomic site of infection.

SSuN Protocol (V12.2)

DE #

OMB

Data Element Name

64

Strategy B Data Elements

Description/Response Coding
This data element should not 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

360

Y

P1_L1_TestType

As test technology advances, it is important to obtain the type of test performed
This data element should not 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 (deprecated code, see 27, 28 below)
9=Pooled RNA
10=RPR
11=VDRL
12=FTA
13=TP-PA
14=MHA
15=Wet Mount/Clue Cell
16=PH
17=Other, not listed
18=Unknown
22=HIV-1 IA (EIA or Other)
23=HIV-1/2 IA (EIA or Other)
24=HIV-2 IA (EIA or Other)
25=HIV-1/2 Ag/Ab
26=HIV-1/2 Type-Differentiating Immunoassay
27=HIV-1 Western Blot
28=HIV-2 Western Blot
29=HIV-1 IFA
30=HIV-1 Culture
31=HIV-2 Culture
32=HIV-1 p24 Antigen
33=HIV-1 RNA/DNA NAAT (Qualitative)
34=HIV-2 RNA/DNA NAAT (Qualitative)
35=HIV-1 RNA/DNA NAAT (Quantitative viral load)
36=HIV-2 RNA/DNA NAAT (Quantitative viral load)
37=CD4 T-lymphocytes

SSuN Protocol (V12.2)

65

Strategy B Data Elements

DE #

OMB

Data Element Name

Description/Response Coding
38=CD4 Percent
39=HIV-1 Genotype (PR Nucleotide Sequence)
40=HIV-1 Genotype (RT Nucleotide Sequence)
41=HIV-1 Genotype (PR/RT Nucleotide Sequence)
42=HIV-1 Genotype (IN Nucleotide Sequence)
43=HIV-1 Genotype (PR/RT/IN Nucleotide Sequence)
44=STARHS (BED)
45=STARHS (Vironostika-LS)
46=STARHS ( BIO-RAD AVIDITY)
47=STARHS (Other)
48=STARHS (Unknown)
49=Rapid (Retired)
50=HIV-1/2 Ag/Ab-Distinguishing Immunoassay
51=HIV-1 Genotype (EN Nucleotide Sequence)
52=HIV-1 Genotype (FI Nucleotide Sequence)
53=HIV-1/2 Ag/Ab and Type-Differentiating Immunoassay
54=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 p24 Antigen Analyte
55=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-1 Antibody Analyte
56=HIV-1/2 Ag/Ab and Type-Differentiating IA - HIV-2 Antibody Analyte
57=HIV-1/2 Type-Differentiating Immunoassay (Supplemental)
58=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-1 Antibody Analyte
59=HIV-1/2 Type-Differentiating IA (Suppl) - HIV-2 Antibody Analyte
60=HIV-1 Genotype (Unspecified)
61=WB/IFA-Legacy
62=RIPA-Legacy
63=Latex Ag-Legacy
64=Peptide-Legacy
65=Rapid-Legacy
66=Iga-Legacy
67=IVAP-Legacy
68=Other HIV Antibody-Other-Legacy
69=Other HIV Antibody-Unspecified-Legacy
70=Viral Load-Other-Legacy
71=Viral Load-Unspecified-Legacy
72=HIV Detection/Antigen/Viral Load-Other-Legacy
73=HIV Detection/Antigen/Viral Load-Unspecified-Legacy
80=Pregnancy
88= Other
99=Not captured

361

Y

P1_L1_QualRes

Qualitative result: For most pathogens/tests, positive, negative,
This data element should not 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

SSuN Protocol (V12.2)

66

DE #

OMB

Data Element Name

Description/Response Coding
9=Unknown

362

Y

P1_L1_Quantres

Numeric - or Ratio (for RPR/VDRL, e.g. 1:2, 1:4, etc.)

363

P

P1_L1_QuantUnits

Units for quantitative results:
1=Copies/mL
2=Log Copies/mL
3=Cells/Cubic mm
4=CD4%
5=Titer Ratio
6=Cycles/Time (rtPCR)

Data Element Name

Description/Response Coding
Provider Reference Dataset

364

Y

P4_ProvID

Unique identifier for provider/facility
This data element MUST NOT be ‘null’ or contain missing values.

365

Y

P4_ProvName

Name of provider or facility

366

Y

P4_ProvCO

FIPS code for provider/facility physical location

367

Y

P4_ProvZIP

Facility/provider physical location 5-digit ZIP
This data element should not be ‘null’ or contain missing values.

368

Y

P4_UpdateDate

Date provider information last updated/verified
This data element should not be ‘null’ or contain missing values. This

369

Y

P4_LocationLon

Provider physical location longitude

370

Y

P4_LocationLat

Provider physical location latitude

371

Y

P4_CensusTract

Census tract of provider physical location

372

Y

P4_Prov_Fac_Type

Facility or provider type code (PHINVAD compatible)
This data element MUST NOT 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,
9=HIV Care Facility

Strategy B Data Elements

SSuN Protocol (V12.2)

DE #

373

OMB

67

Data Element Name

Description/Response Coding
Includes and care facility whose primary service is HIV care
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
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
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
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

P4_ProvCHC

Is facility/provider a Community Health Center (CHC)?
This data element should not be ‘null’ or contain missing values.
1=Yes
2=No
3=Unknown/Missing

374

P4_ProvFQHC

Is facility/provider a Federally Qualified Health Center (FQHC)?
This data element should not be ‘null’ or contain missing values.
1=Yes
2=No
3=Unknown/Missing

Strategy B Data Elements

SSuN Protocol (V12.2)

68

Strategy B Syphilis Extended

DE #

OMB

Data Element Name

Description/Response Coding

375

Y

P5_S1SiteID

Site ID
This 2 character code primarily identifies sites funded under SSuN Cycle
2 & 3 and will include additional sites as required for Cycle 4. This data
element MUST NOT be ‘null’ or contain missing values.

376

Y

P5_S1EventID

377

Y

P5_S1PatientID

BA=Baltimore (Cycle II, Cycle III, Cycle IV)
CB=Columbus (Cycle IV)
CA=California (Cycle II, Cycle III, Cycle IV)
FL=Florida (Cycle III & Cycle IV)
IN=Indiana (Cycle IV)
MC=Multnomah County (Cycle III &Cycle IV)
NY=New York City (Cycle II, Cycle III, Cycle IV)
PH=Philadelphia (Cycle II, Cycle III, Cycle IV)
SF=San Francisco (Cycle II, Cycle III, Cycle IV)
WA= Washington (Cycle II, Cycle III, Cycle IV)
UT=UTAH (Cycle IV)
LA=Louisana (Cycle II)
VA=Virginia (Cycle II)
AL=Alabama (Cycle II)
CO=Colorado (Cycle II)
CH=Chicago (Cycle II)
MA=Massachusetts (Cycle III)
MN=Minnesota (Cycle III)
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 MUST NOT be ‘null’ or contain missing values. This must
match the syphilis record in the Strategy B case file.
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 MUST NOT be ‘null’ or contain missing
values. This must match the syphilis record in the Strategy B case file.

378

Y

P5_S1PREG_NETSS

Pregnancy status for female syphilis cases
1=Yes
2=No

SSuN Protocol (V12.2)

69

Strategy B Syphilis Extended

DE #

OMB

Data Element Name

Description/Response Coding
9=Unknown

379

Y

P5_S1HIVSTAT_NETSS

Documented or self-reported HIV status at the time of event.
P = HIV positive
N = HIV negative
E = Equivocal HIV test
U = Unknown
R = Refused to answer
D = Did not ask

380

Y

P5_S1MSex12_NETSS

Had sex with a male within past 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

381

Y

P5_S1FSex12_NETSS

Had sex with a female within past 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

382

Y

P5_S1AnSex12_NETSS

Had sex with an anonymous partner within past 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

383

384

Y

Y

P5_S1SxIDU12_NETSS

Had sex with an IVDU within past 12 months?

P5_S1SxINTX12_NETSS

Y=Yes
N=No
R=Refused
D=Did not ask
Had sex wwhile intoxicated within past 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

385

Y

P5_S1SxEX12_NETSS

Exchanged drugs/money for sex within past 12 months?

SSuN Protocol (V12.2)
DE #

OMB

Data Element Name

70
Description/Response Coding
Y=Yes
N=No
R=Refused
D=Did not ask

386

Y

P5_S1SxFMSM12_NETSS

Had sex with MSM in last 12 months (females only)?
Y=Yes
N=No
R=Refused
D=Did not ask

387

Y

P5_S1IVDU12_NETSS

Engaged in injection drug use in last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

388

Y

P5_S1Crack12_NETSS

Used crack last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

389

Y

P5_S1Coke12_NETSS

Used cocaine last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

390

Y

P5_S1Heroin12_NETSS

Used heroin last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

391

Y

P5_S1Meth12_NETSS

Used methamphetamine last 12 months?
Y=Yes
N=No

Strategy B Syphilis Extended

SSuN Protocol (V12.2)

71

DE #

OMB

Data Element Name

Description/Response Coding
R=Refused
D=Did not ask

932

Y

P5_S1Pops12_NETSS

Used poppers/nitrates last 12 months?

Strategy B Syphilis Extended

Y=Yes
N=No
R=Refused
D=Did not ask
393

Y

P5_S1EDdru12_NETSS

Used ED drugs last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

394

Y

P5_S1OTHdru12_NETSS

Used other drugs last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

395

Y

P5_S1NOdru12_NETSS

No drug use reported last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

396

Y

P5_S1INCAR12_NETSS

Incarcerated in last 12 months?
Y=Yes
N=No
R=Refused
D=Did not ask

397

Y

P5_S1STIever_NETSS

Does the patient have a history of ever having had an STD prior to the
condition reported in this case report?
Y=Yes
N=No
U=Unknown
R=Refused

SSuN Protocol (V12.2)

72

Strategy B Syphilis Extended

DE #

OMB

Data Element Name

Description/Response Coding

398

Y

P5_S1SxInet12_NETSS

Did the patient use an online computer site to exchange messages by
typing them onscreen to engage in conversation with other visitors to
the site for the purpose of having sex?
Y=Yes
N=No
R=Refused
D=Did not ask

399

Y

P5_S1TotSP12_NETSS

Total number of sex partners last 12 months (###)
888=Refused
999=Unknown

400

Y

P5_S1LSNANUS_NETSS

One or more lesion(s) indicative of syphilis were present in the anus or
rectum.
Y=Yes
U=Default

401

Y

P5_S1LSNPENIS_NETSS

One or more lesion(s) indicative of syphilis were present on the penis.

Y=Yes
U=Default
402

Y

P5_S1LSNSCRO_NETSS

One or more lesion(s) indicative of syphilis were present on the
scrotum.
Y=Yes
U=Default

403

Y

P5_S1LSNVAGI_NETSS

One or more lesion(s) indicative of syphilis were present on the vagina.

Y=Yes
U=Default
404

Y

P5_S1LSNCERV_NETSS

One or more lesion(s) indicative of syphilis were present on the cervix.

Y=Yes
U=Default

SSuN Protocol (V12.2)
DE #
405

OMB
Y

Data Element Name
P5_S1LSNPHAR_NETSS

73

Strategy B Syphilis Extended

Description/Response Coding
One or more lesion(s) indicative of syphilis were present in the
nasopharynx.
Y=Yes
U=Default

406

Y

P5_S1LSNORAL_NETSS

One or more lesion(s) indicative of syphilis were present in the
mouth/oral cavity.
Y=Yes
U=Default

407

Y

P5_S1LSNEYE_NETSS

One or more lesion(s) indicative of syphilis were present in the
eye/conjunctiva.
Y=Yes
U=Default

408

Y

P5_S1LSNHEAD_NETSS

One or more lesion(s) indicative of syphilis were present on the head.

Y=Yes
U=Default
409

Y

P5_S1LSNTORS_NETSS

One or more lesion(s) indicative of syphilis were present on the torso.

Y=Yes
U=Default
410

Y

P5_S1NEURO_NETSS

Does the patient have neurologic manifestations of syphilils?
. = Missing
1=Yes, Verified
2=Yes, Likely
3=Yes, Possible
4=No
9=Unknown

411

Y

P5_S1OCULAR_NETSS

Does the patient have ocular manifestations of syphilils?
. = Missing
1=Yes, Verified
2=Yes, Likely
3=Yes, Possible
4=No
9=Unknown

SSuN Protocol (V12.2)

74

Strategy B Syphilis Extended

DE #

OMB

Data Element Name

Description/Response Coding

412

Y

P5_S1OTIC_NETSS

Does the patient have otic manifestations of syphilils?
. = Missing
1=Yes, Verified
2=Yes, Likely
3=Yes, Possible
4=No
9=Unknown

413

Y

P5_S1LATE_NETSS

Does the patient have late clinical manifestations of syphilils?
. = Missing
1=Yes, Verified
2=Yes, Likely
4=No
9=Unknown

SSuN Protocol (V12.0)
DE #

OMB

414
415
416

Y
Y
P

75

Strategy C LGV Data Elements

Data Element Name
Description/Response Coding
Strategy C (LGV Surveillance) Data Elements
LGV1_EventID
Event ID from Facility Visit File
LGV1_PatientID
Patient ID from Facility Visit File
LGV1_SecimenID
Specimen ID - locally assigned, unique specimen tracking ID