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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!