STD Program Strategies

Essential/Universal Strategies – Bold
Project-Based Strategies** – Italicized

Maintain electronic database of reports received from health care provider offices and laboratories

Facilitate standardized computerized transmission of electronic laboratory reporting

Ensure confidentiality and security guidelines for the collection, storage, and use of all surveillance data according to NCHHSTP guidance***

Ensure the quality and timeliness of case-based data collection to routinely obtain information on age, sex, race, ethnicity, gender of sex partners, pregnancy status, HIV status, treatment given, geographic location and provider information***

Geocode case-based surveillance data to target interventions***

Conduct automated matching of STD and HIV cases***

Partner with other surveillance programs(i.e. – communicable diseases, HIV, maternal and child health, tuberculosis, and viral hepatitis) through the exchange and matching of data to enhance reporting and identify co-morbidities

When/where feasible collaborate with health information exchanges

Ensure the collection of risk-group behavior data from partner notification services and where applicable from STD clinic surveys for the purpose of informing prevention efforts

Expand surveillance systems beyond case-based reporting to sentinel systems and population-based approaches***

Prepare reports on HIV co-infection rates with other reportable STDs

Prepare reports describing STD risks and health disparities using existing and enhanced surveillance data, GIS tools and external datasets related to area-based socioeconomic measures

Establish partnerships with high volume laboratories to obtain quarterly data on the number of tests they conduct and the positives they identify to assist in prevalence monitoring

Provide targeted and effective  partner services for:

–  Primary, secondary, and early latent  syphilis
–  HIV (including HIV co-infected CT, GC and syphilis cases)
-Pregnant women diagnosed with syphilis
-GC cases with possible GC treatment failure or suspected or probable cephalosporin-resistant N. gonorrhoeae isolate using the criteria in the Cephalosporin-Resistant N. gonorrhoeae***

Provide DIS services to at-risk/infected pregnant women as determined by the project area

Collaborate on the provision of HIV Partner Services according to local morbidity, priorities and resources

Provide effective partner services through social media websites adn other digital or communication technologies (e.g. internet partner services)****

Implement Outbreak Response Plan, including health alerts and case investigation, when detection systems indicate disease rates are above background levels

Identify health department and other public and private partners to assist in outbreak response efforts

Maintain a resource guide private or public health laboratories in the jurisdiction that have the capacity to conduct
N. gonorrhoeae culture and Antimicrobial Susceptibility Testing (AST***)

Provide information on disease prevention, symptoms, and treatment

Promote Health Department web sites

Provide information on condom availability and other risk reduction strategies including but not limited to PrEP as appropriate to the target risk audience

Develop, promote and/or collaborate in the dissemination of effective behavioral and community interventions and strategies 

Collaborate with the Department of Education (or equivalent) and other organizations to implement STD health promotion, prevention, and intervention activities****

Participate in expert and community review panels of STD resources

Provide training and technical support for outreach education and collaboration/partnership efforts.

Establish internal and external Department of Health collaborations with colleagues such as HIV/AIDS, Hepatitis, Immunization, Communicable Disease, public health labs, Department of Correction, Department of Education, Chronic Disease and Department of Social Services

Develop partnerships or strategies with businesses to impact prevention efforts.

Actively participate as a member of associations such as NACCHO, NASTAD, NCSD, NFPRHA and state and national public health associations.

Improve the delivery of STD screening and treatment and HIV screening and linkage to care services through the healthcare delivery system

Establish third party billing system as permissible

Educate public, providers and key stakeholders on the positive potential or proven impacts of policies on reducing sexually transmitted disease***

Propose/support legislation for Expedited Partner Therapy (EPT) and promotion and funding for STD-related vaccines.

Recommend STD objectives in state, regional, and local HIV Prevention Plans

Use the Affordable Care Act to encourage health care providers to improve access and quality of STD prevention services through enhanced collaboration with primary care***

Recommend STD objectives in health department or project area planning initiatives (e.g. – adolescent health, reducing health disparities, women’s health)

In the short-term, identify and implement strategies to enhance coverage and reimbursement, where possible

In the long-term, seek agreements with health plans to assure adequate coverage and reimbursement

Promote dual reporting from laboratories and health care providers

Conduct periodic assessments of morbidity data to match health care provider and laboratory reports on individual cases in order to identify those entities not reporting per state requirement

Seek enforcement of legal violations such as provider refusal to provide information needed to conduct investigations of known positives 

Send annual mailing of STD reporting regulations and project area and community-specific incidence/ prevalence data to prioritized health care providers and/or newly licensed health care providers

Implement testing and treatment of minors regulations

Implement confidentiality regulations, policies, and/ or procedures

Post on department website a copy of STD related statutes and administrative rules and regulations. Note: this would be more inclusive then just posting reporting requirements and would include confidentiality, prenatal screening for syphilis, partner services, etc.

Participate in the development of regulations governing the reporting of STDs, HIV, and AIDS

Measure and assure annual syphilis and rectal GC screening rates among MSM seen in high volume HIV care facilities and other health care settings***

Assess and ensure the proportion of GC cases that are treated correctly according to current CDC STD Treatment Guidelines***

Link newly identified HIV-infected individuals and/or partners contacted who have not been diagnosed previously with HIV who test positive to HIV care and safety net services regardless of insurance status.***

Promote re-screening individuals after having been effectively treated for Chlamydia, Gonorrhea, and Syphilis as promoted by CDC recommendations and/ or guidelines

Promote STD screening and referral for sexual health services in adolescent sites, schools, HIV testing venues and primary health care sites when appropriate

Promote the use of EPT to the medical community

Ensure prenatal STD screening. In jurisdictions with congenital syphilis: measure screening for syphilis among pregnant individuals in prenatal care****

Identify and ameliorate health disparities and barriers that reduce access to testing, treatment, care and prevention services.

Assess performance of publicly supported STD clinics through analysis of wait times, geographic accessibility, and other barriers (i.e. costs)

Identify the STD clinical and prevention service gaps for at-risk individuals who are receiving care (e.g., missed opportunities by providers including safety net providers***

Estimate the proportion of uninsured or underinsured, at-risk individuals in the jurisdiction

Within state law, increase the provison of expedited partner therapy (EPT) for CT and GC according to current CDC treatment guidelines****

On an annual basis, conduct surveys of patient satisfaction of STD clinic services for quality improvement

Provide and/or actively refer STD clinic clients to reproductive health, family planning, HIV services, and for needed immunizations including HPV and hepatitis B

Distribute STD clinical educational materials to health care providers

Distribute STD Treatment Guidelines to health care providers who report STD conditions (including HIV) and to those health care providers (based on their patient populations) for whom STD screening is an appropriate activity

Provide and evaluate  STD educational opportunities including conferences and workshops, webinars and other training modalities

Incorporate STD training/education in academic curriculum of medical schools, nursing schools, social work, residency programs, public health etc.

Meet annually with established labs and providers and as needed with new labs and providers to educate regarding reporting regulations and how to report 

Use surveillance data to allocate STD workforce in support of STD program core components

Advocate for adequate resources for STD program core components

Educate health care providers who report incorrect treatment on case reports.

Monitor timeliness of treatment rates for Chlamydia and gonorrhea by clinics

Contact clinics with locally identified long delays in treatments and develop plan for improvement in timeliness of treatment

Monitor HEDIS measure performance of managed care organizations in your program area.

Utilize all available data, including cost, to evaluate effectiveness of programs. 

Attend STD conferences

Subscribe to STD and other public health journals