Treatment verification and contact elicitation are core
approaches used to control the spread of sexually transmitted diseases (STDs).
Methodology adapted from the HIV care continuum is presented as an evaluation
and communication tool for STD control activities.
Sexually transmitted disease surveillance and program data
for Los Angeles County in 2013 were used to construct a 2-part continuum to
examine syphilis (all stages) and gonorrhea outcomes among index patients and
elicited contacts. The Index Case Continuum (Part 1) assesses the proportion of
patients who were treated, assigned for interview, interviewed, and provided
name and locating information for at least 1 contact. The Elicited Contact
Continuum (Part 2) assesses the proportion of contacts who were located,
interviewed, and treated.
Among 3668 patients with syphilis, 97% (n = 3556) were
treated, 72% (n = 2633) were interviewed, and 25% (n = 920) provided name and
locating information for at least 1 contact. The corresponding numbers for
12,541 gonorrhea cases were 95% (n = 11,936), 45% (n = 5633), and 16% (1944),
respectively. Among the 1392 contacts elicited from syphilis cases, 53% (n =
735) were either interviewed or determined to not need an interview and 43% (n
= 595) were treated. The corresponding numbers for the 2323 contacts elicited
from gonorrhea cases were 53% (n = 1221) and 46% (n = 1075), respectively.
Adaptation of the HIV continuum is a useful tool for
evaluating treatment verification and contact elicitation activities. In Los
Angeles County, this approach revealed significant drop-offs in the proportion
of index cases naming contacts and in the proportion of contacts who are
interviewed and treated.
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- 1From the Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles CA.
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