Bang for the Buck: The Partner Services Experience in Washington, DC

Background:Partner Services (PS) are reportedly cost-effective and cost saving with many benefits that extend to people living with STDs/HIV, their partners, and the community.  In 2012, the HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) offered PS to all persons reported with new HIV infection, early syphilis infection, or an incident STD with prevalent HIV.  

Methods: Case Management Reports were run within STD*MIS October 30, 2013 for all HIV and early syphilis cases reported to the District of Columbia during 2012.  A descriptive analysis comparing these cases was done looking for the number of new infections identified.

Results: Of new HIV cases; 273 were reported, 189 (69.2%) were interviewed, and 195 partners were elicited (contact index = 1.0).  Of these partners; 4 (2.1%) were new infections, 59 (30.2%) were previous positives, 28 (14.4%) were HIV negative, 28 (14.4%) refused testing, 31 (15.9%) were not locatable, and 45 (23.0%) were “other” – Internet, Out of Jurisdiction and those with insufficient information to initiate.  Of early syphilis cases; 439 were reported, 338 (77.0%) were interviewed, and 402 partners were elicited (contact index = 1.2).  Of these partners; 25 (6.2%) were new infections, 71 (17.7%) had previously been treated, 57 (14.2%) were preventatively treated, 33 (8.2%) were negative, 70 (17.4%) refused testing, 93 (23.1%) were not locatable, and 53 (13.2%) were “other.”

Conclusions: Although the contact indices were similar, a greater number of early syphilis cases were identified or prevented through PS.  A new HIV diagnosis rate of 2.1% is greater than that of HIV screening at the Southeast STD Clinic (<1.0%) but less than some targeted outreach (3.4% through weekly screenings in a local bathhouse).  Thorough cost-benefit analyses need to be done comparing PS to other endeavors with the goal of computing and comparing cost of new HIV or early syphilis case detected.