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Sexually Transmitted Disease (STD) Prevention in the U.S. Integrated Evaluation of Public and Private Sector Disease Reporting and Service Delivery

The purpose of this project was to provide CDC with an estimate of the accuracy of its STD surveillance system.  The CDC surveillance system for STDs depends on physician reporting to State Departments of Public Health, which then pass the information on to CDC.  A variety of factors contribute to what is believed to be significant under-reporting of STDs.  This project provided estimates of the magnitude and characteristics of the under-reporting by carrying out an independent sample survey of physicians in four states.  We identified physicians and other service providers who saw the greatest number of STD patients, and ascertained the number of cases of various STDs they saw over a two-week period.  We used both a prospective and retrospective approach with rolling admission to correct for seasonality effects.  The information obtained during the study of physicians in four states was used for two further studies.  The first study investigated compliance with CDC's STD treatment guidelines and determined reasons for noncompliance, also using physician interviews. The second study replicated the four-state study on a national level.