Integration of Internet-based Partner Notification into Case Management

Background:
The Internet has become a common venue for meeting sex partners and planning participation in risky sexual behavior. Adapting disease control and health promotion activities to the Internet is a critical step for public health agencies.

Objective:
Investigate the Internet as a venue for early syphilis cases meeting sex partners in Washington, DC. Develop an Internet-based partner notification (IPN) program.

Method:
We reviewed interview notes of all available 2005 early syphilis cases in Washington, DC. In 2006, we expanded risk-factor data routinely collected for early syphilis cases to include Internet partners, and we recruited a Public Health Prevention Specialist from the Centers for Disease Control and Prevention (CDC) to act as the IPN Program Coordinator. In 2007, we created a DC-specific IPN protocol, primarily based on protocols from Howard Brown Health Center (Chicago) and The Massachusetts Department of Public Health; modified our STD*MIS data management system to capture IPN data; and trained our disease intervention specialists.

Result:
Of 171 early syphilis patients in 2005, a total of 20 (12%) admitted to using the Internet to meet sex partners. Of those, 8 (40%) used Adam4Adam.com; 8 (40%) used Manhunt.net; and 7 (35%) used multiple sites. In 2006, a total of 34 (23%) of 149 patients admitted Internet use; the number increased to 42 (28%) of 148 in 2007 (through October 2, 2007). The DC IPN protocol was approved March 16, 2007, and has subsequently been used to notify approximately 200 partners of early syphilis patients.

Conclusion:
To integrate IPN into syphilis case management, STD control programs might need to hire additional personnel, alter existing disease surveillance systems, and build on the successes and failures of other programs.

Implications:
CDC encourages STD control programs to explore Internet-based STD/HIV prevention methods (e.g., partner services and outreach).