JMIR Publications

ABSTRACT

Background:

Viral and bacterial sexually transmitted infections (STI) are public health concerns worldwide but surveillance systems are not comprehensive enough to design and monitor accurately STI control strategies in most countries. In 2016, 320 STI clinics (CeGIDD in French) with expanded sexual health missions were implemented in France, primarily targeting most exposed populations, although access is free of charge for anybody.

Objective:

This article describes the mandatory surveillance system (SurCeGIDD) based on CeGIDDs’ individual data aiming to better guide STI prevention.

Methods:

A decree ensured the use of software to manage consultations in CeGIDDs and to transfer surveillance data. A webservice was implemented to secure data transfer from CeGIDDs’ softwares to a centralized database. CeGIDDs can also transfer data in CSV format via a secured data-sharing platform. Then, data are automatically checked before integration. Socio-demographic variables, sexual exposure, blood exposure, symptoms, STI tests, STI diagnoses and sexual health services delivery were collected for the previous year (n-1). Preliminary and descriptive analyses of 2017-2018 data, respectively transmitted in 2018 and 2019, were performed using numbers and proportions for qualitative variables.

Results:

In 2017, 54 (out of 320 , i.e. 17%) of CeGIDD transmitted their data. In 2018, this number of participants increased to 143 (45%) CeGIDDs. Corresponding volume of records increased from 2,414 in 2017 to 382,890 in 2018. In 2018, majority of attendances were hospital based (69%, n= 263,480). In 2018, attendees were mostly men (59.8%) and women (40.0%), 0.2% being transgenders. The median age was 27 years for men, 23 years for women and 30 years for transgender. Half of the attendes (46.9%) were heterosexual men, 39.5% heterosexual women, 11.9% MSM and 1.8% women who have sex with women. Majority of them were born in France (79.5%) and unemployed (54.8%). The positivity rates were 0.37% for 205,348 HIV serologies, 1.31% for 131,551 HBV serologies, 7.16% for 161,241 Ct PCR, 2.83% for 146,649 gonorrhea PCR, 1.04% for syphilis combination of treponema and non-treponema serologies, and 5.96% for 13,313 Mycoplasma genitalium PCR.

Conclusions:

Despite challenges, the effectiveness of the SurCeGID surveillance based on routine patients'records was demonstrated. The wide range of information including socioeconomic determinants, might help to better guide and evaluate the prevention policies and services delivery. However, the growing volumes of information will require adapted tools and algorithms for the data management and analyses.