HIV/STD Partner Services Recommendations

Cindy Getty & Rheta BarnesDivisions of HIV/AIDS Prevention &

STD PreventionNational Centers for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

The findings and conclusions in this presentation are those of the authors and do not necessarily represent the views of the Centers

for Disease Control and Prevention

New and Improved

Overview

Background on Partner Services

Rationale and Process for Revising the Recommendations

Emphasis of the New Recommendations

Dissemination, Implementation and Next Steps

Background on Partner Services

What is Partner Services?

A broad array of services that can be offered to persons with HIV and other STDs and their partners which includes:• Working w/ infected patients/clients

to identify partners• Locating partners• Notifying partners that they may

have been exposed to STD/HIV• Offering partners other prevention

services

What is Purpose of Partner Services?

PS is a prevention activity with the twin goals of: • Interrupting disease transmission

(infection control): public health and community benefit

• Providing services to partners so they can receive evaluation and treatment or entry to care: individual benefit

What is Purpose of Partner Services?

Helping partners gain access to• Medical evaluation• Treatment or care• Counseling• Testing• Other prevention services

Identify PS candidates (index

patients)

Contact index patients &

interview about partners

Notify partners of their exposure

Provide counseling, testing, referral

and/or treatment to partners

PS Elements

PS – Functions Service

• Assists persons w/ HIV or STD with notifying partners & accessing medical care, prevention, & other services

• Assists partners with recognizing their risk, learning infection or disease status, and accessing medical, prevention, and other services

Ethical• Addresses partners’ “right to know” their

risk Public Health

• Provides information that may be valuable for reducing transmission at the community level

Why Revise the Recommendations and How did

CDC go About It?

Why Revise Recommendations?

Poor coverage of reported HIV cases (index interviews, partner name elicitation, partner interviews)

Separate HIV and STD Guidelines & two separate trainings related to PS:• Integrate documents• Reduce duplication, discrepancies, and

confusion New information from literature &

program experience

Why Revise Recommendations?

Emerging issues• HIV surveillance data not being

shared with PS programs• Need for ongoing partner services

for person living with HIV Unanswered questions

• Use of Internet• Emerging Technology

Who Assisted in the Development of

Recommendations? Health Department employees

(Directors, Program Managers and Disease Intervention Specialists)

Community activists (CHAMP, NMAC) Professional organizations (NCSD,

NASTAD, CSTE) Academia (Researchers, Ethicists) Lawyers (Lambda Legal) CDC staff from DHAP and DSTDP

How were the Recommendations Developed?

Workgroups with members representing health departments, CPGs, academia and special populations

Members served as subject matter experts

Workgroups wrote sections of new Recommendations

Recommendations collated into one document by DSTDP and DHAP cross divisional team

Emphasis of Partner Services Recommendations

Emphasis of Partner Services Recommendations

1. Increased emphasis on Health Department involvement in partner services provision

2. Increased emphasis on active identification of PS candidates (i.e., index patients and partners) All candidates should be offered

assistance: level and nature may vary3. Increased emphasis on linkage to care4. Increased emphasis on quality assurance

and evaluation standards

Emphasis of Partner Services Recommendations

5. Increased emphasis on collaboration with internal and external partners involved with PS

6. Increased emphasis on integration of PS into the spectrum of care Nature of integration varies by

infection7. Stronger emphasis on innovative

approaches to partner notification and subsequent case-finding

8. Shared Terminology

Dissemination, Implementation and

Next Steps

Dissemination Activities

MMWR Publication

Internet Posting

Distribution of MMWR

Distribution of Other Documents

Dissemination Communication

Dear Colleague Letter• Expectations for programs• Resources for grantees

FAQ for CDC Staff

FAQ for External Partners

Implementation Input

Partner Services Steering Committee

Partner Services Lead Team

Focus Groups for CDC Staff

Focus Groups for Sr. Public Health Advisors

Draft Recommendations Reviewer Comments

Implementation Input

Topics Barriers for Organizations

Barriers for Individuals

Training & Technical Assistance Needs

Potential Challenges

Recommendations to CDC

Implementation

Goal:

Motivate and support substantial change in STD and HIV Programs with regard to partner services

Implementation

Some examples: • Increased number of candidates

offered PS• Increased collaboration between

PS Programs and Surveillance Programs resulting in data sharing between programs—Program Integration

• Increased programmatic activities that reflect the HIV/STD Partner Services Recommendations

Implementation

CDC’s Implementation Plan• Implementation Team—15

members from DSTDP and DHAP

• 9-step framework based on Rogers Diffusion of Innovation work

• Focused on CDC activities to support uptake of HIV/STD PS Recommendations

Implementation Plan

Strategic Vision and Planning• Mission• Implementation plan

Marketing and Promotion• Presentations at conferences• Webinars

Policy Issues• Supports from CDC• Local supports

Implementation Plan

Complementary Resources• Operational guide• Tool kits

Training• Integrated curriculum design• Training plan

Technical Assistance• Individual• Agency or program-wide

Implementation Plan

Program Development and Infrastructure• Funding• New program ideas

Quality Assurance (of the plan)• Quality standards• Quality improvement

Evaluation (of the plan)• Standards• Measurement

Moving Forward

1st Draft by March 31

Meeting with DSTDP and DHAP Leadership

Input from stakeholders• Meetings• Webinars

Division of work between appropriate work units

Thank You!