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THP 60 Integration of Disease Intervention Specialists at a Sexually Transmitted Diseases Clinic on Partner Notification Services Outcomes

Thursday, September 22, 2016
Galleria Exhibit Hall
Thomas Bertrand, MPH1, Theodore Marak, MPH2, Jaime Comella, MPH2, Kristen Calcagni, MPH2, Alexi Almonte, BS3, Alec Tributino, BS3, Madeline Montgomery, MPH3, Ashley Robinette, MPH3, Jacob van den Berg, PhD3 and Philip Chan, MD, MS4, 1Office of HIV, STD, Tuberculosis, and Viral Hepatitis, Rhode Island Department of Health, Providence,, RI, 2Division of Preparedness, Response, Infectious Disease and Emergency Medical Services, Center for HIV, Hepatitis, STDs, and TB, Rhode Island Department of Health, Providence, RI, 3The Miriam Hospital, Providence, RI, 4Rhode Island Department of Health, Providence, RI

Background: Partner notification services (PNS) is one of the most effective public health interventions to address transmission of sexually transmitted diseases (STDs). Strategies to improve PNS outcomes are needed to optimize effectiveness of this intervention. We evaluated integration and physical placement of disease intervention specialists (DIS) at a publicly-funded STD clinic on PNS outcomes.

Methods: We evaluated PNS outcomes for both syphilis and gonorrhea before and after integration of DIS at the Rhode Island STD clinic.  Data were reviewed in the eight months before integration (August-March 2015) and eight months after (May-December 2015). Chi-square and t-tests were used to evaluate differences between the time periods. Significance was defined as p<0.05.

Results: A total of 145 patients qualified for PNS during the time periods at the STD clinic (N=58 before and 87 after integration of the DIS). Of these, 33% were positive for syphilis and 24% for urethral, 44% for oropharyngeal, and 34% for rectal gonorrhea (index cases).  Ninety-four percent were male, 81% were men who have sex with men (MSM), and 41% were non-White. Forty-one percent reported >5 sex partners in the previous 12 months and 81% reported condomless sex. Compared to the time period before, DIS integration resulted in a greater proportion of index cases interviewed (92% versus 76%, p<0.01) and more in-person interviews (59% versus 9%, p<0.01). DIS integration also resulted in a higher proportion of index cases who reported at least one sexual partner (85% versus 76%, p<0.01) and at least one partner treated (20% versus 12%, p=002) compared to the time period before.

Conclusions: DIS integration at an STD clinic resulted in improved PNS outcomes including a greater proportion of index cases interviewed and a greater proportion who had at least one partner treated. Integration of DIS at STD clinics should be considered to improve PNS outcomes.

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