Timing and Location Matter: A Process Evaluation of HIV/STD Partner Services Interview and Elicitation Rates, New York State, 2013-2015

Background: CDC recommends Partner Services to persons with HIV, syphilis, gonorrhea and chlamydial infection and their partners. However, limited data exists on the most effective way to conduct partner services to maximize partner elicitation rates. We conducted a process evaluation to identify variation in index interview and partner elicitation outcomes among cases assigned for HIV/STD Partner Services.

Methods: Program outcomes data for HIV, early syphilis, gonorrhea, and chlamydia partner services index case investigations initiated from January 2013 – December 2015 were collected from a local performance management application.  Data were stratified by investigation type to assess differences in (1) index interview rates, (2) timeliness to interview, (3) interview location.  Differences by selected measures were examined to determine subsequent impact on partner elicitation. Chi-square analyses were conducted in SAS 9.2 to identify statistically significant differences at the bivariate level.

Results: Across all investigations (N=17,791), 66% of index patients were interviewed (N=11,736), with the majority of interviews conducted for gonorrhea and chlamydia (N=10,830, 92%). Early syphilis investigations (N=538) were significantly more likely than HIV (N=812) to be interviewed (88% vs. 53%, P<.0001), and to be interviewed within one week of assignment (87% vs 43%, P<.0001).  HIV, early syphilis and gonorrhea cases interviewed in person (field or clinic) were significantly more likely to elicit partners for notification (66% vs. 54%, P<.0001). Early syphilis, gonorrhea, and chlamydia cases interviewed within one week of assignment were also more likely to result in partner elicitation (61% vs. 51%, P<.0001).  Nearly half (49%) of new HIV cases interviewed yielded no partners for notification.

Conclusions: Partner elicitation rates can be improved by conducting in-person interviews for high priority cases, and interviewing in a timely manner.  Conducting process evaluation of program outcomes can help identify targeted areas for quality improvement to maximize the impact and reach of partner services interventions.