National survey of doctors' actions following the diagnosis of a bacterial STD.
OBJECTIVE
Little is known about the post-STD diagnosis management practices of community based doctors. The purpose of this study was to describe the reported actions that doctors take after diagnosing gonorrhoea, chlamydia, or syphilis and to determine if these actions differ across the three STDs.


METHODS
A random national sample of 7300 doctors (70% response rate) practising in five medical specialties responded to 13 questions related to STD management. Mean differences across STDs were examined using the General Linear Model function of SPSS.


RESULTS
Most doctors reported instructing patients to abstain from sex during treatment, to use condoms, and to inform their sexual partners of their exposure after diagnosing gonorrhoea, chlamydia, or syphilis. For syphilis, however, doctors were less likely to treat the patients presumptively and to give them drugs for their partners; and more likely to collect partner information, to follow up with the patient to see if the partner was referred for treatment and to send patient information to the health department.


CONCLUSIONS
Doctors' post-STD diagnosis actions were similar for gonorrhoea and chlamydia compared to syphilis. Study findings suggest low levels of STD case reporting and partner follow up by doctors in the sample. Interventions are needed to educate community based doctors about the importance of partner follow up and case reporting in the management of STDs.
McCree
D H
DH
Centers for Disease Control and Prevention 1600 Clifton Rd NE, Mailstop E-44 Atlanta, GA 30333, USA. zyr1@cdc.gov
Liddon
N C
NC
Hogben
M
M
St Lawrence
J S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002690:Chlamydia Infections / Q000175:diagnosis; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis*; D013038:Specialization; D013587:Syphilis / Q000175:diagnosis