HIV Partner Services

1
HIV Partner Services

• Sam Dooley and Cindy Getty
• Centers for Disease Control and Prevention
• NASTAD Annual Meeting
• May 6, 2008

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
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Why this? Why now?

• 1.0-1.2 million persons living with HIV in the
  United States
• 25 are not aware of their infection
• At least 40,000 new infections per year
• 54-70 from persons not aware of their infection
• Need an array of case-finding strategies
• Partner services increases access to
  high-prevalence population and increases
  identification of HIV-infected persons

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Why this? Why now?

• Poor uptake of partner services for HIV (32 of
  reported cases interviewed)
• Two CDC guidelines two separate trainings
  related to partner services
• Duplication, discrepancies, and confusion
• Integration allows for
• Improved services at the client level
• Economies of scale and improved coverage

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Revision Process - I

• DHAP/DSTDP workgroup
• Input from end-users, stakeholders, subject
  matter experts
• Literature review
• Listening groups at national conferences
• Focus groups
• Members of affected communities
• Program managers, front-line staff, CBO staff
• Private sector clinicians
• Legal review
• Program reviews

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Revision Process - II

• Consultation (November 2006)
• Post-consultation
• Steering Committee
• Convened 7 workgroups
• Additional literature review
• Major revision
• New draft sent to 170 reviewers for evaluation
  and commentary
• Revisions made based on feedback
• Clearance and submission to MMWR

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Key Features - I

• Health department model
• Integration of recommendations for HIV and other
  STDs
• Target audience ? program managers
• Program design management, not operational
  details
• Background and rationale
• Partner services for all persons testing positive
  for HIV

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Surveillance-Program Connection

• Programs should
• Use surveillance and disease reporting systems to
  help identify persons with newly-diagnosed or
  reported HIV infection.
• Strongly consider using individual-level data if
  appropriate security and confidentiality
  procedures are in place.
• Work with providers of HIV screening, testing,
  and care to ensure that clients/patients are
  offered PS as soon as possible after diagnosis.

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Key Features - II

• Emphasis on
• Direct health department involvement (provider
  referral vs. self referral)
• Active linkage to care and prevention services
• Integration of services at the client level
• Data security
• Collaboration with external partners (e.g.,
  providers, CBOs, CPGs)

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Monitoring Evaluation

• Recommendations ? general recommendations not
  requirements
• National-level monitoring for CDC grantees
• Monitoring and evaluation questions 8
  process, 6 outcome
• Indicators

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Monitoring Evaluation

• Partner services indicators
• Proportion of eligible index patients who are
  interviewed for partner services
• Proportion of named partners who are notified of
  potential HIV exposure
• Proportion of notified partners, not previously
  HIV, who are tested for HIV
• Proportion of newly-identified, confirmed HIV
  test results returned to partners

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Monitoring Evaluation

• National-level monitoring and evaluation
  questions
• Common definitions (e.g., eligible index
  patients, named partners)
• Data collection submission
• PEMS
• STDMIS
• State/local-level monitoring
• Operational guidelines

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Dissemination Activities

• MMWR Publication
• Internet Posting
• Distribution of MMWR
• Dear Colleague Letter
• Expectations for Programs
• Resources for Grantees
• FAQ for CDC Staff
• FAQ for External Partners
• Distribution of Other Documents

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Implementation

• CDCs Implementation Plan
• Implementation Team15 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 partner services recommendations

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What CDC is Doing

• Capacity building with DHAP Project Officers and
  DSTDP Program Consultants
• Internal collaborations
• HIV PCRS Capacity Assessment
• Operations Guide and monitoring tools
• Revision of HIV and STD Partner Services training
  materials
• Interactive Website

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What CDC Would Like to Do

• Strategic planning meetings for grantees
• Create materials (including website)
• Develop a model law
• Provide training and TA
• Joint site visits
• Evaluation to the highest level we can afford

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Contact informationSam Dooley(404)
639-5229sdooley_at_cdc.govCindy Getty(404)
639-2920cgetty_at_cdc.gov