Population-based gonorrhea surveillance through the STD Surveillance Network (SSuN)

Background:
Recent increases in gonorrhea in the U.S. are concerning, but case reporting in most states consistently provides only the age, sex, and race/ethnicity of patients with gonorrhea. STD programs require better characterization of affected populations to effectively implement control measures.

Objective:
To describe the uses and limitations of data obtained through population-based gonorrhea surveillance.

Method:
Data are collected from 10 counties in 5 geographic sites (Denver CO, Minneapolis MN, Richmond VA, San Francisco CA, and Seattle WA) that participate in the STD Surveillance Network (SSuN). Sites use a common set of demographic, clinical, and behavioral questions. SSuN sites interview annually approximately 120 men and 120 women with gonorrhea who are not diagnosed at the principal STD clinic(s) in each site. Data collection was initiated between February 2006 and January 2007, and is ongoing. Analysis for presentation will include data collected through January 1, 2008.

Result:
As of September 1, 2007, 9,972 cases of gonorrhea were reported from the 5 sites since SSuN data collection was initiated. Of the 900 gonorrhea patients interviewed for SSuN, 53.7% were female, 17.3% were men who have sex with men, 51.5% were black, and 52.6% were under age 25. Approximately 43.2% had been diagnosed in emergency rooms, urgent care facilities, or hospitals, 19.7% reported never having been tested for HIV, 13.1% reported incarceration of themselves or their partners in the past 3 months, and 34.4% of those age 18 or older reported being unemployed.

Conclusion:
Population-based gonorrhea surveillance can provide detailed data on demographic, clinical, and behavioral characteristics of patients with gonorrhea.

Implications:
Data obtained from interviewing a subset of gonorrhea cases can be used to guide gonorrhea control interventions such as targeted screening, improved provision of clinical services, more relevant behavioral change messages, and population-specific partner management strategies.