Thomas A. Peterman

Centers for Disease Control and Prevention

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Daniel R. Newman

The Patients Association

Mary L. Kamb

Centers for Disease Control and Prevention

James Matthias

Florida Department of Health

John M. Douglas

Michigan State University

Julia A. Schillinger

Merck & Co., Inc., Rahway, NJ, USA (United States)

C. Kevin Malotte

California State University, Long Beach

Gail Bolan

Centers for Disease Control and Prevention

Anna B. Cope

Centers for Disease Control and Prevention

Bruce W. Furness

Centers for Disease Control and Prevention

Melanie Taylor

Centers for Disease Control and Prevention

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National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention

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The Centers

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Johns Hopkins University

Emory University

Center for Surveillance, Epidemiology, and Laboratory Services

United States Department of Health and Human Services

AID Atlanta

New York City Department of Health and Mental Hygiene

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Preventing Congenital Syphilis—Opportunities Identified by Congenital Syphilis Case Review Boards

Sexually Transmitted Diseases (2018)

Mohammad Rahman Ashley Hoover Chaquetta Johnson Thomas A. Peterman

Louisiana has had the highest rates of congenital syphilis (CS) in the nation since 2012. Congenital syphilis case review boards were established statewide in 2016 to study CS cases and identify interventions.

Congenital syphilis

Prenatal Care

10.1097/olq.0000000000000909

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Citations (21)

Evaluating Behavioral Interventions: Need for Randomized Controlled Trials-Reply

JAMA (1994)

Thomas A. Peterman

In Reply.

—We thank Dr Gerber and colleagues for their endorsement of our recommendation for more randomized controlled trials of behavior change intervention for HIV and sexually transmitted disease prevention. We also commend the references they cite as excellent overviews of behavioral interventions to prevent HIV. Higgins et al¹document the paucity of randomized trials. Kelly,²a pioneer in HIV-related community intervention trials, writes: "After more than 12 years of the HIV epidemic—an epidemic that can only be controlled by interventions to promote risk behavior change— the lack of research evaluating outcomes of interventions to prevent HIV infection is very troubling." Our call for more randomized trials of behavioral interventions has been misinterpreted by some as a statement that behavioral interventions do not work. We believe that some behavioral interventions, like some drug therapy interventions, are effective in some instances. Randomized controlled trials help determine which interventions are

10.1001/jama.1994.03510410029018

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Transfusion-Associated Acquired Immunodeficiency Syndrome in the United States

JAMA (1985)

Thomas A. Peterman

By Aug 15, 1985, one hundred ninety-four cases of possible transfusion-associated acquired immunodeficiency syndrome (AIDS) had been reported to the Centers for Disease Control. Cases received their transfusions in 30 states. Infants account for 10% of the cases, suggesting an increased susceptibility to developing AIDS. Investigations one to six years after the transfusions have identified high-risk donors to 47 cases. Of 47 high-risk donors tested, 40 had a reactive serology for human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) antibody, including five with no risk for AIDS by history. The HTLV-III/LAV was isolated from 23 of 26 seroreactive high-risk donors, most of whom remained asymptomatic. Blood components that transmitted HTLV-III/LAV included red cells, platelets, plasma, and whole blood. The time from transfusion to diagnosis of AIDS ranged from four to 84 months. The risk of developing AIDS after a blood transfusion has been low and will be lowered further by using both self-deferral and antibody screening. (JAMA1985;254:2913-2917)

10.1001/jama.1985.03360200065028

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Citations (153)

Presumptive and Follow-up Treatment for Gonorrhea and Chlamydia Among Patients Attending Public Health Department Clinics in Virginia, 2016

Sexually Transmitted Diseases (2018)

River A. Pugsley Thomas A. Peterman

Background Presumptive antibiotic treatment is common for suspected chlamydia (CT) and gonorrhea (GC) infections before laboratory confirmation to prevent complications, reduce loss-to-follow-up, and interrupt transmission. We assessed this practice in sexually transmitted disease (STD) and family planning clinics. Methods We performed a retrospective analysis of data from clinics in Virginia in 2016 using administrative data merged with electronic laboratory reporting data. After stratifying by patient and clinic characteristics, we calculated how often patients with positive CT/GC tests were treated presumptively or during a follow-up visit, and how many patients with negative tests were treated presumptively. Results Of 63,889 patient visits with valid laboratory results from 131 clinics, 13% tested positive for CT or GC. Overall, presumptive treatment was given to 45.2% of persons with positive tests and 10.1% of persons with negative tests. Among the 9443 patients presumptively treated, 40.7% had positive test results. Presumptive treatment was more common in STD clinics compared with family planning clinics (22% vs. 4%) and for males with positive tests compared to females (65% vs. 24%); smaller variations were observed across age, race/ethnicity, and diagnosis categories. Twenty-six percent of patients with positive tests who were not treated presumptively had no treatment recorded within 30 days. Conclusions Presumptive treatment for CT/GC was commonly used in this clinic population. It improved treatment coverage and reduced time to treatment, though some uninfected persons were treated. The impact of presumptive treatment on partner notification and treatment requires further study.

10.1097/olq.0000000000000922

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Citations (9)

Extragenital Sexually Transmitted Infection Testing Among Louisiana Parish Health Units, 2016–2019

Sexually Transmitted Diseases (2023)

Mohammad M. Rahman Chaquetta Johnson Stephanie N. Taylor Thomas A. Peterman Tammy S. Bennett

Background The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) get tested annually for urethral and rectal chlamydia (CT) and gonorrhea (NG), and pharyngeal NG. There are no national recommendations to screen women and heterosexual men at extragenital sites. We assessed extragenital CT/NG screening among men and women at Louisiana's Parish Health Units (PHU). Methods The Louisiana STD/HIV/Hepatitis Program piloted extragenital screening at 4 PHUs in February 2016 and expanded to 11 PHUs in 2017. Sexual histories were used to identify gender of sex partners and exposed sites. Because of billing restrictions, up to 2 anatomical sites were tested for CT/NG. Results From February 2016 to June 2019, 70,895 urogenital and extragenital specimens (56,086 urogenital, 13,797 pharyngeal, and 1,012 rectal) were collected from 56,086 patients. Pharyngeal CT positivity was 160 of 7,868 (2.0%) among women, 54 of 4,838 (1.1%) among men who have sex with women (MSW) and 33 of 1,091 (3.0%) among MSM. Rectal CT positivity was 51 of 439 (11.6%) among women and 95 of 573 (16.6%) among MSM. Pharyngeal NG positivity was 299 of 7,868 (3.8%) among women, 222 of 4,838 (4.6%) among MSW, and 97 of 1,091 (8.9%) among MSM. Rectal NG positivity was 20 of 439 (4.6%) among women and 134 of 573 (23.4%) among MSM. Urogenital-only screening would have missed: among women, 173 of 3,923 (4.4%) CT and 227 of 1,480 (15.3%) NG infections; among MSW, 26 of 2,667 (1%) CT and 149 of 1,709 (8.7%) NG infections; and among MSM, 116 of 336 (34.5%) CT and 127 of 413 (42.1%) NG infections. Conclusions Many CT/NG infections would have been missed with urogenital-only screening. Men who have sex with men had much higher extragenital infection rates than women and MSW.

10.1097/olq.0000000000001764

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Partner Notification for Syphilis

Sexually Transmitted Diseases (1997)

Thomas A. Peterman Kathleen Toomey LINDA W. DICKER Akbar Zaidi JACK E. WROTEN

Objective: To determine the cost and effectiveness of three approaches to partner notification for infectious syphilis. Study Design: People with syphilis were randomly assigned to: (1) notification of partners by patients themselves within 2 days or disease intervention specialists would notify them; (2) immediate notification by intervention specialist; or (3) immediate notification by intervention specialists, who had the option of drawing blood in the field. Costs of intervention specialists' time, travel, and overhead were measured. Intention-to-treat analysis measured outcomes per randomized index patient. Results: From December, 1990 through March, 1993, 1,966 index patients with syphilis (primary 9%; secondary 18%; and early latent 73%) were randomized in Broward County (Ft. Lauderdale), Florida (1,191); Tampa, Florida (569); and Paterson, New Jersey (206). Index patients reported 11,272 potentially exposed partners and sufficient information to initiate investigations for 2,761. Of these, 2,236 were located, 367 had newly identified infections, and 870 others received preventive treatment. The three partner notification approaches had similar success locating partners (1.1–1.2 per index patient) and treating partners (0.61–0.67 per index). The cost was $317 to $362 per partner treated; the optimal strategy differed by study site. Conclusions: Partner notification identified many infected and potentially infected people. The cost and effectiveness of the three types of provider notification were similar. Alternative approaches are needed to reach infected partners who could not be notified.

Partner notification

Contact tracing

Index case

Notification system

10.1097/00007435-199710000-00003

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Citations (57)

Update to CDC's sexually transmitted disease treatment guidelines, 2010 : Oral cephalosporins no longer a recommended treatment for gonococcal infections

Robert D. Kirkcaldy Kimberly Workowski Sarah Kidd Hillard Weinstock John R. Papp

Gonococcal infection

Neisseria gonorrhoeae

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Multistate Syphilis Outbreak Among American Indians, 2013 to 2015

Sexually Transmitted Diseases (2018)

Virginia B. Bowen Thomas A. Peterman Dinorah L. Calles Antoine R. Thompson Robert D. Kirkcaldy

This article summarizes a multistate outbreak of heterosexual syphilis, including 134 cases of syphilis in adults and adolescents and at least 2 cases of congenital syphilis, which occurred on an American Indian reservation in the United States during 2013-2015. In addition to providing salient details about the outbreak, the article seeks to document the case-finding and treatment activities undertaken, their relative success or failure, and the lessons learned from a coordinated, multiagency response. Of 134 adult cases of syphilis, 40% were identified by enhanced, interagency contact tracing and partner services, 26% through symptomatic testing, and 16% through screening of asymptomatic individuals as the result of an electronic medical record screening prompt. A smaller proportion of cases were identified by community screening events in high-morbidity communities; high-risk venue-based screening events; other screening, including screening upon request; and prenatal screening at first trimester, third trimester, and day of delivery. Future heterosexual syphilis outbreak responders should act quickly to coordinate a package of high-yield case-finding and treatment activities-potentially including activities that seek to do the following: (1) increase prenatal screening, (2) improve community awareness and symptomatic test seeking, (3) educate providers and improve general screening for syphilis, (4) implement electronic medical record reminders for providers, (5) screen high-morbidity communities and at high-risk venues, and (6) form novel partnerships to accomplish partner services work when the context does not allow for traditional, disease intervention specialist-only partner services.

Contact tracing

Congenital syphilis

10.1097/olq.0000000000000809

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Citations (9)

Responding to the Epidemics of Syphilis Among Men Who Have Sex With Men: Introduction to the Special Issue

Sexually Transmitted Diseases (2005)

Thomas A. Peterman Dayne Collins Sevgi O. Aral

Peterman, Thomas A. MD, MSc; Collins, Dayne E. BS; Aral, Sevgi O. PhD Author Information

10.1097/01.olq.0000180454.23228.80

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Citations (13)

Group Counseling to Prevent Sexually Transmitted Disease and HIV: A Randomized Controlled Trial

Sexually Transmitted Diseases (1998)

Bernard M. Branson Thomas A. Peterman Robert O. Cannon Ray Ransom Akbar Zaidi

Objective: To compare prevention effectiveness of multisession group counseling with standard HIV prevention counseling for reducing risk behaviors and new sexually transmitted diseases (STDs). Methods: Small groups of consenting STD clinic patients were randomized to four 1-hour small group counseling interventions based on the information-motivation-behavioral skills (IMB) model with a booster session at 2 months or to the standard two 20-minute individual counseling sessions. Follow-up interviews and examinations were 2, 6, 9, and 12 months after enrollment. Results: From March 1992 through June 1993, 996 (59%) of 1,681 eligible persons were enrolled; 32 (3%) tested HIV-positive and were excluded. Intervention attendance was 98% for one session, and 47% attended four or five counseling sessions. Follow-up was similar for both groups: 72% attended at least once; 47% returned at 12 months. Both groups had similar increases in condom use and decreases in number of partners, and similar number of new infections with gonorrhea (14%), chlamydia (10%), or syphilis (2%). Conclusions: Two 20-minute counseling sessions were as effective as four 1-hour group sessions for reducing risk behavior and STD incidence in an STD clinic patient population.

Attendance

10.1097/00007435-199811000-00011

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Citations (74)