The Interdiction Project: An Innovative Program for HIV+ Persons Presenting with a New STD

Background:  STD/HIV field investigations reveal that some persons with HIV infection have unprotected sex, multiple anonymous sex partners, and don’t disclose their HIV positive status. Recurrent STDs are common among these persons, making HIV transmission more likely.    The Interdiction Project is a clinic-based, individual-level HIV intervention that combines linkage for treatment adherence/risk reduction education and testing with ongoing monitoring of patient care and epidemiological data systems.  This project targets HIV positive persons who present with a new STD.  

Objectives: This presentation describes processes for establishing a program to reduce the spread of HIV and repeat STD infections among HIV positive persons.   The program integrates use of existing data systems and personnel (medical providers, STD field staff, and HIV health educators).  Strategies for overcoming client identification/retention and institutional barriers are reviewed.  Finally, this presentation will describe initial outcomes and how this approach helps early diagnosis of HIV and notification among clients’ sex partners.  

Methods:  Seventy-one clients were referred by medical providers to project staff for an initial HIV knowledge and risk assessment and intensive health education.  Data was collected from medical charts and STD/HIV records.   Client’s knowledge and subsequent STD infection was tracked to determine effectiveness of the health education component.   

Results:  Project screenings indicate patterns of high STD morbidity (especially syphilis), high numbers anonymous sex partners, and only 52% condom use at last sexual intercourse.  Initial post-test findings reveal improvement of HIV transmission/treatment knowledge, improved condom negotiation skills, and 96% intent to use condoms with all sex partners.  

Conclusions: The combination of HIV risk reduction behavior intervention and epidemiologic contact investigation in a clinic may help reduce unprotected sex and the spread of HIV by known previous HIV positive persons.

Implications for Programs, Policy, and/or Research: This project may show innovative use of existing resources to curb the spread HIV/STDs.