QCS Assessment

QCS Assessment.xlsx

[OADPS] The Performance Measures Project: Improving Performance Measurement and Monitoring by CDC Programs

QCS Assessment

OMB: 0920-1282

Document [xlsx]
Download: xlsx | pdf

Overview

Recipient Information
Instructions
Prevention
Evaluation
Laboratory
Treatment
Sexual History & Exam
Screening
Partner Services
Assessment Summary
Additional Information


Sheet 1: Recipient Information

CoAg Title: Enhancing STI and Sexual Health Clinic Infrastructure

Form Approved
CoAg Number: RFA PS23-0011

OMB Control No. 0920-1282
Agency: [Threaded comment] Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924 Comment: This table not needed


Exp. Date: 06/30/2026
Funded for Strategy C?



Reporting Period:



Date completed:
















































Public reporting burden of this collection of information is estimated to average 6 hours per response per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-1282).

Sheet 2: Instructions

Jump to: Prevention sheet Evaluation of STD-Related Conditions sheet Laboratory sheet Treatment sheet Sexual History & Exam sheet Screening sheet Partner Services sheet Assessment Summary sheet Additional Information sheet









Links

Microsoft website: Install the version of Power Query needed to use this workbook

CDC website: Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020

YouTube: Intro to the Assessment Tool video

YouTube: Taking the Assessment video

YouTube: Using the Assessment Summary Sheet video



















































Sheet 3: Prevention



If "no" is selected, indicate reasons for not providing services by placing an "X" in corresponding cells (select all that apply). Leave corresponding cells empty if "yes" is selected in Column C.




Prevention Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment, no lab or dispensing on premises) Insufficient staffing (capacity, qualifications, training) Population served Protocols and procedures (lack of protocol or standing orders) Referral process in place Legal and cultural barriers (minor consent, conservative environment) Limited referral network for treatment Other, please specify



On-site hepatitis B vaccination or referral











x
On-site HPV vaccination or referral












On-site hepatitis A vaccination












On-site condom provision [Threaded comment] Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924 Comment: Remove pre-filled cells No X










Brief single STD/HIV prevention counseling session (up to 30 minutes)












Moderate-intensity STD behavioral counseling (≥30 minutes)












High-Intensity STD behavioral counseling (≥2 hours)












Brief contraceptive counseling or referral












Emergency contraceptive pills












Risk assessment, education and referral or link to HIV care for pre-exposure prophylaxis (PrEP) for HIV prevention












Risk assessment, education and referral or link to HIV care for non-occupational post-exposure prophylaxis (nPEP)












Provision of PrEP for HIV prevention












Provision of nPEP of HIV












Referral or link to HIV care, if indicated












Referral or link to family planning services, if indicated












Referral or link to behavioral health services, if indicated







































Jump to:












Instructions sheet












Assessment Summary sheet












Additional Information sheet













Sheet 4: Evaluation



If "no" is selected, indicate reasons for not providing services by placing an "X" in corresponding cells (select all that apply). Leave corresponding cells empty if "yes" is selected in Column C.
Evaluation of STD-Related Conditions Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment) Insufficient staffing (capacity, qualifications, training) Population served Protocols and procedures (express visit protocol, unclear guidelines) Referral process in place Other
Evaluation (history and examination) for Genital ulcer disease   






Evaluation (history and examination) for Male urethritis syndrome






Evaluation (history and examination) for Vaginal discharge






Evaluation (history and examination) for pelvic inflammatory disease (PID)






Evaluation (history and examination) for Genital warts






Evaluation (history and examination) for Proctitis






Evaluation (history and examination) for Ectoparasitic infections






Evaluation (history and examination) for Pharyngitis






Evaluation (history and examination) for Epididymitis






Evaluation (history and examination) for Systemic or dermatologic conditions compatible with or suggestive of an STD etiology






















Jump to:






Instructions sheet






Assessment Summary sheet






Additional Information sheet







Sheet 5: Laboratory



If "no" is selected, indicate reasons for not providing services by placing an "X" in corresponding cells (select all that apply). Leave corresponding cells empty if "yes" is selected in Column C.
Laboratory Recommendation Does your clinic provide this service? Insufficient resources (funding, lack of culture plates and inability to incubate them) Insufficient staffing (capacity, qualifications, training) Population served Protocols and procedures (procedures don’t allow for collection) Referral process in place Other, please specify
At the time of patient visit: pH paper






At the time of patient visit: Thermometer






At time of patient visit: Dark field microscopy for syphilis






At time of patient visit: Gram stain, methylene blue, or gentian violet stain for urethritis






At time of patient visit: On-site qualitative non-treponemal serologic test for syphilis






At time of patient visit: Phlebotomy






At time of patient visit: Test for bacterial vaginosis






At time of patient visit: Test for HIV






At time of patient visit: Test for pregnancy






At time of patient visit: Test for trichomoniasis






At time of patient visit: Test for vulvovaginal candidiasis






At time of patient visit: Urinalysis with microscopy






At time of patient visit: Urine dipstick






Through clinical laboratory: Extragenital (pharynx and rectum) NAAT for gonorrhea and chlamydia






Through clinical laboratory: Fourth generation antigen/antibody HIV test






Through clinical laboratory: Gonorrhea antimicrobial susceptibility testing






Through clinical laboratory: Gonorrhea culture






Through clinical laboratory: Gram stain, methylene blue, or gentian violet stain for urethritis






Through clinical laboratory: HSV serology






Through clinical laboratory: HSV viral culture or PCR






Through clinical laboratory: NAAT for trichomoniasis






Through clinical laboratory: Laboratory tests needed for providing nPEP and PrEP, as per clinical protocol






Through clinical laboratory: Oncogenic HPV NAATs with Pap smear






Through clinical laboratory: Quantitative nontreponemal serologic test for syphilis






Through clinical laboratory: Serologic tests for hepatitis A






Through clinical laboratory: Serologic tests for hepatitis B






Through clinical laboratory: Serologic tests for hepatitis C






Through clinical laboratory: Test for pregnancy






Through clinical laboratory: Treponemal serologic test for syphilis






Through clinical laboratory: Urogenital NAAT for gonorrhea and chlamydia






















Jump to:






Instructions sheet






Assessment Summary sheet






Additional Information sheet







Sheet 6: Treatment



If "no" is selected, indicate reasons for not providing services by placing an "X" in corresponding cells (select all that apply). Leave corresponding cells empty if "yes" is selected in Column C.
Treatment Recommendation Does your clinic provide this service on site? Insufficient resources (cost, procurement, don’t stock due to infrequent use) Insufficient staffing (capacity, training, qualifications) Population served Protocols and procedures (prescription given if medicine not available on site) Referral process in place Other, please specify
On site: treatment for gonorrhea






On site: treatment for chlamydia






On site: treatment for cervicitis






On site: treatment for nongonococcal urethritis






On site: treatment for proctitis






On site: treatment for PID






On site: treatment for epididymitis






On site: treatment for syphilis






On site: PrEP






On site: nPEP






On site: provider-applied regimens for genital warts






On site: emergency contraceptive pills






On site: treatment for trichomoniasis






On site: treatment for herpes






On site: treatment for bacterial vaginosis






On site: treatment for acute or new diagnosis of HIV care






On site: treatment for persistent and recurrent cervicitis and nongonococcal urethritis






On site: EPT for gonorrhea and chlamydia






By prescription: treatment for herpes






By prescription: treatment for trichomoniasis






By prescription: treatment for bacterial vaginosis






By prescription: treatment for vulvovaginal candidiasis






By prescription: treatment for UTI






By prescription: PrEP






By prescription: nPEP






By prescription: emergency contraceptive pills






By prescription: patient-applied regimens for genital warts






By prescription: treatment for ectoparasitic infections






By prescription: EPT for gonorrhea and chlamydia (EPT for gonorrhea and chlamydia, either on-site OR via prescription, is also included in the Partner Services section)






















Jump to:






Instructions sheet






Assessment Summary sheet






Additional Information sheet







Sheet 7: Sexual History & Exam



If "no" is selected, indicate reasons for not providing services by placing an "X" in corresponding cells (select all that apply). Leave corresponding cells empty if "yes" is selected in Column C.
Sexual History and Physical Exam Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment) Insufficient staffing (capacity, training, provider discomfort) Population served (patient need, reluctance) Protocols and procedures (5 Ps, express visit protocol, EMR/EHR prompts) Referral process in place Other, please specify
A sexual history and risk assessment as part of initial comprehensive or annual visit






A sexual history and risk assessment at each visit concerning reproductive, genital, or urological issues






A sexual history and risk assessment at each visit unrelated to reproductive, genital, or urologic concerns






A sexual history and risk assessment at every visit for patients with STD-related symptoms, STD-related concerns, or concerns about preventing or achieving pregnancy






A physical examination for male and female patients with STD-related symptoms, STD-related concerns, or those at high behavioral risk for incident STDs






A pelvic examination






Colposcopy for female patients with abnormal Pap smears






Anoscopy






A high-resolution anoscopy for patients with abnormal anal Pap smears






















Jump to:






Instructions sheet






Assessment Summary sheet






Additional Information sheet







Sheet 8: Screening



If "no" is selected, indicate reasons for not providing services by placing an "X" in corresponding cells (select all that apply). Leave corresponding cells empty if "yes" is selected in Column C.
Screening Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment, test not available) Insufficient staffing (capacity to follow up on abnormal results) Population served Limited referral network for treatment Other, please specify
Gonorrhea screening





Chlamydia screening





Syphilis screening





Hepatitis B screening





Hepatitis C screening





HIV screening





Cervical cancer screening





Trichomoniasis screening





Anal cancer screening



















Jump to:





Instructions sheet





Assessment Summary sheet





Additional Information sheet






Sheet 9: Partner Services



If "no" is selected, indicate reasons for not providing services by placing an "X" in corresponding cells (select all that apply). Leave corresponding cells empty if "yes" is selected in Column C.
Partner Services Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment, cost to patient) Insufficient staffing (staff discomfort, capacity, training) Protocols and procedures (e-prescribing issues, provide refill to original patient instead, no DIS referral) Legal and cultural barriers (EPT not legal, staff/leadership opposition) Other, please specify
Guidance regarding notification and care of sex partners





EPT (where legal and where local or state jurisdictions do not prohibit by regulation)





Interactive counseling for partner notification





Health department disease intervention specialist (DIS) elicitation of sex partner information to identify those who might have been exposed and to identify patient follow-up needs



















Jump to:





Instructions sheet





Assessment Summary sheet





Additional Information sheet






Sheet 10: Assessment Summary

Quality STD Services Summary Table (% of recommendations met)




Recommendations Primary Care/Should Primary Care/Could Specialized/Should Specialized/Could




Prevention 0% 0% 0% 0%




Evaluation of STD-Related Conditions 0%
0%





Laboratory 0% 0% 0% 0%




Treatment 0% 0% 0% 0%




Sexual History & Exam 0% 0% 0% 0%




Screening 0% 0% 0% 0%




Partner Services 0% 0% 0%





Total % of all recommendations met 0% 0% 0% 0%
























Prevention Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment, no lab or dispensing on premises) Insufficient staffing (capacity, qualifications, training) Population served Protocols and procedures (lack of protocol or standing orders) Referral process in place Legal and cultural barriers (minor consent, conservative environment) Limited referral network for treatment Other, please specify
On-site hepatitis B vaccination or referral








On-site HPV vaccination or referral








On-site hepatitis A vaccination








On-site condom provision No X






Brief single STD/HIV prevention counseling session (up to 30 minutes)








Moderate-intensity STD behavioral counseling (≥30 minutes)








High-Intensity STD behavioral counseling (≥2 hours)








Brief contraceptive counseling or referral








Emergency contraceptive pills








Risk assessment, education and referral or link to HIV care for pre-exposure prophylaxis (PrEP) for HIV prevention








Risk assessment, education and referral or link to HIV care for non-occupational post-exposure prophylaxis (nPEP)








Provision of PrEP for HIV prevention








Provision of nPEP of HIV








Referral or link to HIV care, if indicated








Referral or link to family planning services, if indicated








Referral or link to behavioral health services, if indicated









Reasons not met (%) 100% 0% 0% 0% 0% 0% 0%




















Evaluation of STD-Related Conditions Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment) Insufficient staffing (capacity, qualifications, training) Population served Protocols and procedures (express visit protocol, unclear guidelines) Referral process in place Other

Evaluation (history and examination) for Genital ulcer disease   








Evaluation (history and examination) for Male urethritis syndrome








Evaluation (history and examination) for Vaginal discharge








Evaluation (history and examination) for pelvic inflammatory disease (PID)








Evaluation (history and examination) for Genital warts








Evaluation (history and examination) for Proctitis








Evaluation (history and examination) for Ectoparasitic infections








Evaluation (history and examination) for Pharyngitis








Evaluation (history and examination) for Epididymitis








Evaluation (history and examination) for Systemic or dermatologic conditions compatible with or suggestive of an STD etiology









Reasons not met (%) #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!






















Laboratory Recommendation Does your clinic provide this service? Insufficient resources (funding, lack of culture plates and inability to incubate them) Insufficient staffing (capacity, qualifications, training) Population served Protocols and procedures (procedures don’t allow for collection) Referral process in place Other, please specify

At the time of patient visit: pH paper








At the time of patient visit: Thermometer








At time of patient visit: Dark field microscopy for syphilis








At time of patient visit: Gram stain, methylene blue, or gentian violet stain for urethritis








At time of patient visit: On-site qualitative non-treponemal serologic test for syphilis








At time of patient visit: Phlebotomy








At time of patient visit: Test for bacterial vaginosis








At time of patient visit: Test for HIV








At time of patient visit: Test for pregnancy








At time of patient visit: Test for trichomoniasis








At time of patient visit: Test for vulvovaginal candidiasis








At time of patient visit: Urinalysis with microscopy








At time of patient visit: Urine dipstick








Through clinical laboratory: Extragenital (pharynx and rectum) NAAT for gonorrhea and chlamydia








Through clinical laboratory: Fourth generation antigen/antibody HIV test








Through clinical laboratory: Gonorrhea antimicrobial susceptibility testing








Through clinical laboratory: Gonorrhea culture








Through clinical laboratory: Gram stain, methylene blue, or gentian violet stain for urethritis








Through clinical laboratory: HSV serology








Through clinical laboratory: HSV viral culture or PCR








Through clinical laboratory: NAAT for trichomoniasis








Through clinical laboratory: Laboratory tests needed for providing nPEP and PrEP, as per clinical protocol








Through clinical laboratory: Oncogenic HPV NAATs with Pap smear








Through clinical laboratory: Quantitative nontreponemal serologic test for syphilis








Through clinical laboratory: Serologic tests for hepatitis A








Through clinical laboratory: Serologic tests for hepatitis B








Through clinical laboratory: Serologic tests for hepatitis C








Through clinical laboratory: Test for pregnancy








Through clinical laboratory: Treponemal serologic test for syphilis








Through clinical laboratory: Urogenital NAAT for gonorrhea and chlamydia









Reasons not met (%) #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!






















Treatment Recommendation Does your clinic provide this service on site? Insufficient resources (cost, procurement, don’t stock due to infrequent use) Insufficient staffing (capacity, training, qualifications) Population served Protocols and procedures (prescription given if medicine not available on site) Referral process in place Other, please specify

On site: treatment for gonorrhea








On site: treatment for chlamydia








On site: treatment for cervicitis








On site: treatment for nongonococcal urethritis








On site: treatment for proctitis








On site: treatment for PID








On site: treatment for epididymitis








On site: treatment for syphilis








On site: PrEP








On site: nPEP








On site: provider-applied regimens for genital warts








On site: emergency contraceptive pills








On site: treatment for trichomoniasis








On site: treatment for herpes








On site: treatment for bacterial vaginosis








On site: treatment for acute or new diagnosis of HIV care








On site: treatment for persistent and recurrent cervicitis and nongonococcal urethritis








On site: EPT for gonorrhea and chlamydia








By prescription: treatment for herpes








By prescription: treatment for trichomoniasis








By prescription: treatment for bacterial vaginosis








By prescription: treatment for vulvovaginal candidiasis








By prescription: treatment for UTI








By prescription: PrEP








By prescription: nPEP








By prescription: emergency contraceptive pills








By prescription: patient-applied regimens for genital warts








By prescription: treatment for ectoparasitic infections








By prescription: EPT for gonorrhea and chlamydia (EPT for gonorrhea and chlamydia, either on-site OR via prescription, is also included in the Partner Services section)









Reasons not met (%) #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!






















Sexual History and Physical Exam Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment) Insufficient staffing (capacity, training, provider discomfort) Population served (patient need, reluctance) Protocols and procedures (5 Ps, express visit protocol, EMR/EHR prompts) Referral process in place Other, please specify

A sexual history and risk assessment as part of initial comprehensive or annual visit








A sexual history and risk assessment at each visit concerning reproductive, genital, or urological issues








A sexual history and risk assessment at each visit unrelated to reproductive, genital, or urologic concerns








A sexual history and risk assessment at every visit for patients with STD-related symptoms, STD-related concerns, or concerns about preventing or achieving pregnancy








A physical examination for male and female patients with STD-related symptoms, STD-related concerns, or those at high behavioral risk for incident STDs








A pelvic examination








Colposcopy for female patients with abnormal Pap smears








Anoscopy








A high-resolution anoscopy for patients with abnormal anal Pap smears









Reasons not met (%) #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!






















Screening Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment, test not available) Insufficient staffing (capacity to follow up on abnormal results) Population served Limited referral network for treatment Other, please specify


Gonorrhea screening








Chlamydia screening








Syphilis screening








Hepatitis B screening








Hepatitis C screening








HIV screening








Cervical cancer screening








Trichomoniasis screening








Anal cancer screening









Reasons not met (%) #DIV/0! #DIV/0! #DIV/0! #DIV/0!























Partner Services Recommendation Does your clinic provide this service? Insufficient resources (funding, equipment, cost to patient) Insufficient staffing (staff discomfort, capacity, training) Protocols and procedures (e-prescribing issues, provide refill to original patient instead, no DIS referral) Legal and cultural barriers (EPT not legal, staff/leadership opposition) Other, please specify


Guidance regarding notification and care of sex partners








EPT (where legal and where local or state jurisdictions do not prohibit by regulation)








Interactive counseling for partner notification








Health department disease intervention specialist (DIS) elicitation of sex partner information to identify those who might have been exposed and to identify patient follow-up needs









Reasons not met (%) #DIV/0! #DIV/0! #DIV/0! #DIV/0!




Sheet 11: Additional Information

Jump to: Prevention sheet Evaluation of STD-Related Conditions sheet Laboratory sheet Treatment sheet Sexual History & Exam sheet Screening sheet Partner Services sheet Assessment Summary sheet Instructions sheet











Recommendation Additional Information
PREVENTION
Brief single STD/HIV prevention counseling session (up to 30 minutes) Brief prevention counseling is conducted in a single session using strategies, such as motivational interviewing and building rapport, and includes patient circumstances and needs in the counseling plan. Moderate-intensity and high-intensity behavioral counseling is contact time of 30–120 minutes and ≥2 hours, respectively.
Moderate-intensity STD behavioral counseling (≥30 minutes) Brief prevention counseling is conducted in a single session using strategies, such as motivational interviewing and building rapport, and includes patient circumstances and needs in the counseling plan. Moderate-intensity and high-intensity behavioral counseling is contact time of 30–120 minutes and ≥2 hours, respectively.
High-intensity STD behavioral counseling (≥2 hours) Brief prevention counseling is conducted in a single session using strategies, such as motivational interviewing and building rapport, and includes patient circumstances and needs in the counseling plan. Moderate-intensity and high-intensity behavioral counseling is contact time of 30–120 minutes and ≥2 hours, respectively.
Risk assessment, education and referral or link to HIV care for pre-exposure prophylaxis (PrEP) for HIV prevention Provided by a clinician or other appropriately trained staff.
Risk assessment, education and referral or link to HIV care for non-occupational post-exposure prophylaxis (nPEP) Provided by a clinician or other appropriately trained staff.
Emergency contraceptive pills If emergency contraceptive pills are not available on site or by prescription, patients can be advised that levonorgestrel emergency contraceptive pills are available over the counter and ulipristal acetate emergency contraceptive pills are only available by prescription. Emergency contraceptive pills should be taken as soon as possible within 5 days of unprotected sex.
On-site condom provision Providers can partner with local organizations, such as the local health department and community-based organizations, to procure condoms. In some states, prescriptions can be written for condoms. For certain settings, such as family planning clinics, condoms should be available on-site.
Provision of PrEP for HIV prevention Basic STD Care: PrEP could be available by starter packs or prescription with on-site follow-up care for basic STD care. If PrEP is not provided, navigator-assisted referral for PrEP should be provided with first appointment made while the patient is on site.

Specialized STD Care: PrEP should be available in starter packs or by prescription with on-site follow-up care for specialized STD care. If PrEP is not provided, navigator-assisted referral for PrEP should be provided with first appointment made while the patient is on site.
Provision of nPEP of HIV Basic STD Care: nPEP starter pack (3–7 days of medication) could be available on site, with either on-site follow-up care or referral for basic STD care. nPEP starter pack or complete 28-day course could be available by prescription, with either on-site follow-up care or referral, with first appointment made while the patient is on site. Provision of the complete 28-day nPEP medication supply at the initial visit rather than a starter pack of 3–7 days has been reported to increase likelihood of adherence, especially when patients find returning for multiple follow-up visits difficult. Routinely providing starter packs or the complete 28-day course requires that health care providers stock nPEP drugs in their practice setting or have an established agreement with a pharmacy to stock, package, and urgently dispense nPEP drugs with required administration instructions (https://www.cdc.gov/hiv/pdf/programresources/cdc-hiv-npep-guidelines.pdfpdf icon).

Specialized STD Care: nPEP starter pack (3–7 days of medication) should be available on site, with either on-site follow-up care or referral to specialized STD care. nPEP complete 28-day course should be available by prescription, with either on-site follow-up care or referral, with first appointment made while the patient is on site. Provision of the complete 28-day nPEP medication supply at the initial visit rather than a starter pack of 3–7 days has been reported to increase likelihood of adherence, especially when patients find returning for multiple follow-up visits difficult.
EVALUATION
Proctitis Evaluation for proctitis might include visual examination of the anus, anorectal examination with a rectal swab, digital anorectal exam, or anoscopy. For specialized STD care, high-resolution anoscopy might be included.
LABORATORY
At the time of patient visit "At the time of patient visit" refers to providing a service the same day of the patient encounter. The intent is for a patient to receive test results prior to the conclusion of a clinic visit to ensure same day diagnosis and initiation of treatment as needed.
Test for trichomoniasis On-site test for trichomoniasis can include wet mount microscopy and OSOM® Trichomonas.
Test for bacterial vaginosis On-site test for bacterial vaginosis can include wet mount microscopy, OSOM® BVBlue®, and Affirm™.
Test for vulvovaginal candidiasis On-site test for vulvovaginal candidiasis can include wet mount microscopy.
Gonorrhea antimicrobial susceptibility testing Access needs to be established for transport medium that adequately maintains the viability of Neisseria gonorrhoeae until the specimen reaches a laboratory (e.g., transport medium in transport container, transport system, or transport swab). Providers should contact their state or local health department if they have concerns about resistant N. gonorrhoeae infection or if assistance is required for culture and antimicrobial susceptibility testing.
TREATMENT
Gonorrhea Providers might not receive reimbursement for oral medications without an on-site pharmacy. Providers can partner with local organizations, such as the local health department and community-based organizations, to procure oral medications or refer patients to local organizations.
Chlamydia Providers might not receive reimbursement for oral medications without an on-site pharmacy. Providers can partner with local organizations, such as the local health department and community-based organizations, to procure oral medications or refer patients to local organizations.
Nongonococcal urethritis Providers might not receive reimbursement for oral medications without an on-site pharmacy. Providers can partner with local organizations, such as the local health department and community-based organizations, to procure oral medications or refer patients to local organizations.
Syphilis Providers can partner with local health departments to procure injectable benzathine penicillin G or refer patients to local health department and verify treatment.
Emergency contraceptive pills If emergency contraceptive pills are not available on site or by prescription, patients can be advised that levonorgestrel emergency contraceptive pills are available over the counter and ulipristal acetate emergency contraceptive pills are only available by prescription. Emergency contraceptive pills should be taken as soon as possible within 5 days of unprotected sex.
EPT for gonorrhea and chlamydia Information on the legal status of EPT for each state is available at https://www.cdc.gov/std/ept/legal/default.htm.
PARTNER SERVICES
Partner services Partner services consist of various strategies with differing levels of time and effort to enable persons who are exposed to an STD to be identified, tested, and treated. (Refer to the 'Partner Services' section of the Recommendations for additional information.)
Guidance regarding notification and care of sex partners Guidance regarding notification and care of sex partners is described as providers giving how-to information to their patients about the need to notify their sex partner(s) of the exposure, the need for sex partner(s) to seek care and treatment even if they do not have symptoms, and where partner(s) could go for STD care. (Refer to the 'Partner Services' section of the Recommendations for additional information.)
EPT (where legal and where local or state jurisdictions do not prohibit by regulation) Expedited Partner Therapy (EPT), also termed patient-delivered partner therapy (PDPT), is the clinical practice of treating the sex partner(s) of persons who receive chlamydia or gonorrhea diagnoses by providing medications or prescriptions to the patient. Patients then provide partner(s) with these therapies without the health care provider having examined the partner(s) (see www.cdc.gov/std/ept).

Information on legal status of EPT for each state is available at http://www.cdc.gov/std/ept/legal/default.htm.
Interactive counseling for partner notification In interactive counseling, the provider and patient both actively participate in an individualized plan to notify the patient’s sex partner(s). Interactive counseling typically is conducted by staff with specific training or skills in communication, interviewing, or counseling. The patient provides information about their sex partner(s) and develops a plan with the counselor to notify partner(s).
DIS A disease intervention specialist (DIS) is a public health professional with applied expertise in client-centered interviews; partner services that include contact tracing, directly observed therapy, field specimen collection, and field investigation in outbreaks; and navigation of health care systems to ensure patient evaluation and treatment, among other areas. (Refer to the 'Partner Services' section of the Recommendations for additional information.)
Health department DIS elicitation of sex partner information to identify those who might have been exposed and to identify patient follow-up needs Partner services can be provided on site or by referral.
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