Internet Partner Notification

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Internet Partner Notification

• Tools and Strategies for New York City

Julia R. Cummiskey, MPH New York City Department
of Health Mental Hygiene Bureau of STD Control
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Partner Notification

• Partner notification is the most direct way to
  stop the spread of STDs.
• Ideally, all sex and needle-sharing partners of
  the critical period are notified of their
  exposure at the time the original patient is
  diagnosed.

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Partner Notification

• At the time of diagnosis, providers should
  counsel patients about partner notification and
  offer resources.
• Patients may elect to contact partners themselves
  (patient referral) or to have the provider
  contact partners (provider referral).

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Partner Notification

• Patients diagnosed in BSTDC clinics are urged to
  notify their partners or provide locating.
• Partners named by patients for provider referral
  are contacted by field staff and encouraged to
  visit a clinic for testing and/or treatment.
• All information about the original patient is
  kept strictly confidential.

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Partner Notification

• In reality, patients diagnosed by private
  providers are often unaware of partner
  notification resources.
• The NYC DOHMH needed a way to facilitate partner
  notification for patients that did not receive
  services from our clinics.

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www.inspot.org
www.inspot.org
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• Partner Notification

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Most Sent By Card
58 Sent (31)
48 Sent (26)
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HIV-Specific Tools

• Advice for talking about HIV
• Find a clinic in NYC
• Information about Post-Exposure Prophylaxis
• 5 HIV cards have been sent since June 2007

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Use to Date

• 185 Senders sent 262 Cards
• 149 Anonymous Senders
• 84 Recipients Clicked-Through to More Information
• 36 Sent From Identifiable Email Addresses
• 68 Recipients Clicked-Through to More Information

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Most Sent By Condition

• Chlamydia 40
• STD (unspecified) 38
• Crabs/Scabies 33
• Gonorrhea 24

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Keys to Success

• Broad awareness among providers and patients of
  inSPOT availability.
• Confidence in anonymity and confidentiality.
• Connection between inSPOT and resources for
  testing and treatment.
• Limiting use to legitimate partner notification
  efforts.

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Internet Partner Notification at NYC DOHMH BSTDC

• Growing number of patients find sex partners
  through internet services such as Manhunt.net,
  adam4adam.com, and others
• Many times these partners are locatable only
  through internal email and messaging services
• BSTDC needed a way to notify and refer those
  partners
• We are establishing partner notification accounts
  at popular sites

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Internet Partner Notification at NYC DOHMH BSTDC

• Only email addresses that exactly match the
  spelling provided by the original patient
• Series of emails with escalating urgency
• No mention of STD in email messages
• Meant to support traditional partner notification
  strategies, not replace them

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IPN Challenges

• Confidentiality
• Assuring that messages reach only the intended
  recipient
• Balancing the need for specificity with caution
• Measuring Success
• How many partners are notified?
• How many partners are tested and treated?

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Questions

• What sites should we target? (Manhunt.net,
  Adam4Adam.com, etc.)
• What are the concerns of our clientele? (Spam,
  confidentiality, etc.)
• Do you have any experiences or observations to
  share?

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We Need Your Help

• Use the card provided at your table
• Email me at jcummisk_at_health.nyc.gov
• Call me at [phone]
• Thank you very much for your suggestions and
  comments!