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Gonorrhea prevention and clinical care in the private sector: lessons
learned and priorities for quality improvement.
Sexually Transmitted Diseases 2006; 33(11):652-662.
Tao G, Irwin KL.
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.