Contact info: Rain Mocello, MPH rain.mocello@cdph (510) 620-3717 Michael C. Samuel, DrPH

1. The California Gonorrhea Surveillance SystemCalifornia Department of Public Health STD Control Branch Contact info: Rain Mocello, MPH rain.mocello@cdph.ca.gov (510) 620-3717 Michael C. Samuel, DrPH michael.samuel@cdph.ca.gov Gail Bolan, MD gail.bolan@cdph.ca.gov Denise Gilson – Data Manager denise.gilson@cdph.ca.gov

2. METHODS • Case selection • Goal – to interview at least 1500 (5%) of reported CA gonorrhea cases (including SF) • Jurisdictions chose sampling fraction • 10% random sample • 100% of all reported cases • Planned for minimum of 50% response rate; target response rate 80% • Data weighted for analysis

3. Case Selection and Flow of Data 100% Follow-Up n = 27 LHJs 10% Sample n = 34 LHJs + GC reported to local health jurisdiction by lab report and/or CMR Case reported to the State Case Investigation Record (CIR) initiated by local staff Data analyzed by State and returned to local jurisdictions Weekly random sample taken at the State • 8 week interview • window • 8 contact attempts • 2 on evenings • 2 on weekend Completed CIR mailed to State and entered Pre-populated CIR sent to local health jurisdiction CIR initiated by local staff Patient and provider follow-up begin

4. Sample Pre-PopulatedCase Investigation Record

5. Response Rate • Response rate = % interviewed among all sampled and eligible cases with CIR on file • Increased from 56% in 2007 to 62% in 2008 • Higher in jurisdictions following all cases • In 2008, 58% response rate in sampling jurisdictions • Compared to 71% in jurisdictions following all cases • Main reasons for non-interview • Inadequate case locating information • Case non-response • Once contacted, cooperation rate was 91%

6. Response Rate Sub-analyses • Among eligible cases in 2007-08 • San Francisco excluded due to differing methodology • Case and provider-reported data for 47% of cases • Provider data only for 37% of cases • Case interview only for 3% of cases • Neither case nor provider data for 13% of cases • Analysis of 2009 data showed that 98% of interviews were completed within 6 contact attempts

7. System Performance • Feedback provided to jurisdictions monthly • Timeliness of reporting • List of active cases • Request for past due forms • Quality control • Demographics of sampled and interviewed cases are compared with those of all other reported GC cases • No meaningful differences were found in age, sex, and race/ethnicity

8. Uses of Data - Recent Analyses • Changes to the distribution of sexual orientation of interviewed cases over time • Greater proportion of MSM cases in 2009 • Popper/meth use • Increases in popper use, especially among HIV+ • Proper treatment • Over 10% of CA cases inappropriately treated or not treated by their diagnosing provider

9. Uses of Data - Interventions & Publications • Data-to-Action Working Group • Notify private providers and urgent care clinics/ERs of current treatment guidelines • Manuscripts • Methods article in Public Health Reports • Manuscript on GC treatment practices in California submitted to Journal of Clinical Infectious Diseases • Quarterly reports • Statewide, regional, and county-level summary data • Data used in local quarterly STD updates