title: Gonorrhea prevention and clinical care in the private sector: lessons learned and priorities for quality improvement.
abstract: We reviewed literature on gonorrhea prevention and clinical care in the private sector, the setting where most gonorrhea cases in the United States are now diagnosed. Although most private-sector health settings had a low prevalence of gonorrhea (0.1-2.5%), some private emergency departments and specialty clinics that serve a large number of high-risk or infected patients had prevalences ranged from 1.7% to 11.0%. Studies of diverse settings and populations suggest that, in general, diagnostic testing of symptomatic patients (69-83%), appropriate treatment (61-100%), and case reporting (64-94%) are delivered more commonly than risk assessment for asymptomatic patients (15-28%), routine screening of pregnant women (31-77%), risk-reduction counseling (35-78%), and sex partner management (0-82%). To sustain the recent declines in gonorrhea incidence in the United States, private-sector providers and health systems must continue to offer gonorrhea prevention and clinical services and consider implementing interventions to improve delivery of risk assessment, risk-reduction counseling, and partner management services.
authors.affiliation: Health Services Research & Evaluation Branch, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA. gat3@cdc.gov
authors.forename: Guoyu
authors.initials: G
authors.lastname: Tao
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Irwin
mesh_terms: D003955:Diagnostic Tests, Routine / Q000592:standards; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009344:Neisseria gonorrhoeae / Q000276:immunology; D015995:Prevalence; D011331:Private Practice / Q000592:standards*; D011785:Quality Assurance, Health Care; D012698:Serologic Tests / Q000592:standards*; D014481:United States / Q000453:epidemiology