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Background: In 2014, Louisiana reported 575 cases of Primary and Secondary syphilis and 1,226 HIV cases. DIS are responsible for Partner Services on syphilis and HIV cases. The Louisiana STD/HIV Program (SHP) conducted regional assessments in 2014 and found that DIS in high morbidity areas were overburdened with cases. A DIS caseload analysis was done in nine public health regions along with syphilis and HIV morbidity.
Methods: “DIS caseload” was calculated by averaging the total number of new HIV and syphilis cases per number of allotted DIS positions in each region per quarter. Average caseload was used to determine the number of DIS positions needed to be allocated to each region to eliminate or decrease regional caseload variability. Since HIV and syphilis case burden differs in most regions, a DIS deficit index was created to assess the impact of the predicted DIS deficit on the level of HIV and syphilis Partners Services activities needed. This model was used to predict the effects of potential DIS reallocation scenarios on regional DIS caseload.
Results: New Orleans, Baton Rouge, and Shreveport regions had higher than average caseloads. New Orleans had the largest caseload, an average of 248 new HIV and syphilis field records per DIS per quarter, which was almost twice the average for the entire state and up to five times higher than other regions. SHP used the results of this analysis to hire additional staff and re-domicile positions in several public health regions. The proportion of cases is more equitable based on the distribution of staff.
Conclusions: The caseload analysis proved to be a valuable tool for resource allocation within SHP. Future plans include assessing DIS caseload by expanding the current model to include the effect regional variability in DIS caseload, such as geographic distance covered, partner index, and interview success rate.