Sexually Transmitted Infection Data Request, F-03346 (01/2025)

Instructions: The Wisconsin Department of Health Services (DHS) Sexually Transmitted Infection (STI) Unit produces statewide, regional, and county-level summaries of annual STI data, including data tables and visualizations that can be found on the DHS STI Surveillance Data web page. If you require data that is not already provided in these annual reports, please fill out this form.

1. Requester name

First
Last

2. Requester job title

3. Name of person/entity requesting data (if requesting for someone else)

4. Type of request

5. Email address

6. Phone number (optional)

7. Provide a brief overview of your request, including how you plan to use the information, any questions you are trying to answer with the requested data, and how the information may be shared with the public. Context provided here will help STI epidemiologists to best provide the requested data.

8. When do you need the data provided by? In general, provide at least two weeks’ notice for most requests. Time may vary depending upon capacity and the complexity of the request.

9. Select which STIs you want included in this request (check all needed)

Syphilis: all stages
Congenital syphilis
Syphilis stages (specify): Please enter an 'other' value for this selection.
Chlamydia
Uncomplicated Gonorrhea
Disseminated Gonococcal Infections (DGI)
Other - specify: Please enter an 'other' value for this selection.

10. Provide a time period for your data** (for example, annual for 2023; data from 2024 by quarter)

Year(s)

11. Provide a stratification for your data** (ex. annual for 2023; data from 2024 by quarter)

Please enter an 'other' value for this selection.

12. Select your desired metric(s):

Counts
Incidence rates per 100,000
Other, specify: Please enter an 'other' value for this selection.

13. If you want this data stratified by demographics, select the stratification(s) (select all needed):

14. If you want these data stratified by geography, select the stratification(s) (select all needed):

County
City
Other, specify Please enter an 'other' value for this selection.

15. Would you like data for all counties or an individual county? (Please specify which county)

Please enter an 'other' value for this selection.

Data related to STI co-infections with HIV will require a separate request to the HIV Unit using Sexually Transmitted Infection and HIV Co-Infections Data Request (F-03346A). Data related to people living with HIV only may be requested by emailing Yi Ou (yi.ou@dhs.wisconsin.gov). Data related to co-infections with STIs and other, non-sexually transmitted infections or diseases (for example, COVID or influenza) will not be provided.

Not all requests will be able to be filled, but DHS epidemiologists will work with requestors to ensure data provided meets the needs of the requestor and does not violate DHS data sharing policies.

*Note DHS suppression policies will be applied to all data requests and data will be provided de-identified. Data for demographic stratifications will not be provided if the count by disease and stratification is less than five cases or has an estimated population size (denominator) less than 100.

**Data prior to 2011 may not be provided. Annual STI counts and rates for years as early as 2011 by demographics level may be found on the DHS STI Surveillance Data webpage.