The Centers for Disease Control and Prevention (CDC) is currently soliciting public feedback on significant revisions to its Sexually Transmitted Infection (STI) Surveillance Network (SSuN), a critical program for monitoring STI trends and patient data across the United States. This call for comments, published in the Federal Register on September 18, 2026, initiates a 30-day window for stakeholders to review and provide input on the updated information collection request (ICR) before it receives final approval from the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995.
Background on the STI Surveillance Network (SSuN)
SSuN is a cornerstone of national STI surveillance efforts, designed to augment data collected through the National Notifiable Diseases Surveillance System (NNDSS). While NNDSS captures basic case counts, SSuN provides richer, more granular data, including patient demographics, risk behaviors, treatment details, co-infections, preventive services, and sexual network information. Initiated to fill these critical data gaps, SSuN enables public health authorities to better understand disease burden, assess health disparities, and monitor the effectiveness of treatment and prevention strategies. The program also serves as a sentinel monitoring system for emerging health threats, such as mpox.
Key Revisions to the SSuN Information Collection Request
The current submission to OMB represents a revision of an existing, approved ICR for SSuN (OMB Control No. 0920-1072), seeking approval for an additional three-year period. The CDC has outlined four primary changes within this revision:
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Updated Title: The official title of the ICR has been revised.
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Doxy PEP Data Inclusion: New data elements related to Doxycycline Post-exposure Prophylaxis (Doxy PEP) have been added. This reflects evolving public health strategies for STI prevention.
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Deletion of Data Elements: Several data elements that are no longer deemed necessary for surveillance have been removed, streamlining the collection process.
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Revised Patient Survey: The anonymous patient clinic survey has been updated to better capture relevant information.
These adjustments reflect the CDC's ongoing efforts to ensure that its surveillance activities remain current, efficient, and responsive to emerging public health needs and advancements in prevention.
Methodology and Data Collection Strategies
SSuN Cycle 5, spanning 2024-2029, involves 15 US local and state health departments funded to conduct surveillance activities. These jurisdictions implement one or both of two core strategies:
Strategy A: Sentinel Surveillance in Specialty Sexual Health Clinics
This strategy involves data abstraction from existing electronic medical records (EMRs) at 16 participating STI clinics across 12 funded jurisdictions. Data, already collected during routine clinical care, is de-identified and securely transmitted to the CDC six times per year. This process also includes matching records with HIV surveillance registries to gather data on HIV co-infection. Additionally, participating clinics are required to administer a brief, one-time patient survey to approximately 3,000 patients over the cycle's duration.
Strategy B: Enhanced Population-Based Surveillance
Strategy B focuses on enhanced surveillance for individuals diagnosed with gonorrhea and adult syphilis. This includes the abstraction, recoding, and reporting of all such cases within collaborating jurisdictions. A random sample of diagnosed individuals undergoes enhanced investigations, which may involve further clinical data abstraction from providers, registry matching, and brief demographic and behavioral interviews. In 2023, approximately 7% of the 187,833 gonorrhea cases reported across the 11 Strategy B jurisdictions were sampled for enhanced investigation, totaling about 13,148 cases.
Uniformly coded data on demographics, risk factors, clinical care, laboratory results, and healthcare-seeking behaviors are compiled into a national dataset after rigorous quality assurance at the CDC. Data managers at participating health jurisdictions are responsible for transmitting validated datasets every other month.
Estimated Burden and Public Comment Focus
The revised information collection is projected to reduce the total estimated annual burden hours for respondents from 7,510 to 7,237 hours. This decrease is primarily attributed to a reduction in the number of participating clinical sites and a lower expected number of patient interviews, stemming from declines in reported gonorrhea cases. Respondents will not receive federal funds for their participation, with costs limited to their time.
During this 30-day comment period, the OMB is particularly interested in public feedback regarding:
- The necessity and practical utility of the proposed information collection.
- The accuracy of the CDC's burden hour estimates and the validity of its methodology.
- Ways to enhance the quality, utility, and clarity of the collected information.
- Methods to minimize the burden on respondents, including through technological solutions.
- An assessment of information collection costs.
Comments and recommendations are crucial for ensuring the effectiveness and efficiency of federal information collection activities. The public can submit comments via www.reginfo.gov/public/do/PRAMain or directly to the CDC Desk Officer at OMB.
