P94 Standard CDC Disposition Codes Overestimate the Effectiveness of HIV Partner Counseling and Referral Services

Wednesday, March 10, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Julia L. Marcus, MPH, Kyle T. Bernstein, PhD, ScM, Giuliano Nieri, Robert P. Kohn, MPH and Susan S. Philip, MD, MPH, STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA

Background: The Centers for Disease Control and Prevention (CDC) recommend that all persons with newly diagnosed HIV receive partner counseling and referral services (PCRS). CDC disposition codes do not distinguish between partner outcomes that occur before and after index cases receive PCRS. A recent evaluation in King County, WA, found that these codes overestimated program success.

Objectives: To evaluate the San Francisco Department of Public Health HIV PCRS program by using disposition codes that account for the timing of partner outcomes.

Methods: We used documented and self-reported HIV-test dates for partners to determine the number of index cases staff needed to interview to identify 1 new HIV case among partners who were newly diagnosed after the index case received PCRS.

Results: During July 2008–June 2009, 146 persons with newly diagnosed HIV received PCRS. The 146 index cases provided sufficient contact information for staff to assign dispositions to 150 partners; 58 (39%) had previously received HIV diagnoses. Among the remaining 92 partners, 72 (78%) were located, 57 (62%) were tested, and 11 (12%) were newly diagnosed. Test dates were available for 42 (74%) of the 57 who were tested; among those 42, 30 (71%) tested after the index case received PCRS. Using CDC disposition codes, the number of cases staff needed to interview to identify 1 new HIV case was 13.3. Including only partners who were tested after the index case received PCRS, the number of cases staff needed to interview to identify 1 new HIV case was 20.9.

Conclusions: Standard CDC disposition codes overestimate success by including partners who were newly diagnosed with HIV before the index case received PCRS.

Implications for Programs, Policy, and/or Research: Evaluations of PCRS programs should account for the timing of partner outcomes. Further research is needed to determine the effectiveness of PCRS in identifying new cases of HIV.

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