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Background: Disease Intervention Specialists (DIS) are vital to the public health response to STIs and HIV, ensuring that diagnosed individuals are given appropriate information and effective treatment, as well as conducting partner contact tracing to further prevent transmissions. Milwaukee represents the highest incidence of HIV and STIs in Wisconsin, and further understanding of DIS challenges is necessary to develop potentially more effective public health strategies.
Methods: Interviews were conducted with 4 DIS and 7 ancillary/supportive staff and/or former DIS during the winter and early spring of 2016. Interviews focused on barriers to the DIS’ efforts to prevent the spread of HIV, syphilis and other STIs. Interviews were transcribed and entered into MAXQDA for coding by two study staff, and a coding scheme was created collaboratively and revised iteratively. Targeted reading of common codes was conducted to identify main themes.
Results: Current staffing levels were perceived as inadequate, and the DIS role was seen as misunderstood by the community and overlooked by the city public health system. DIS discussed a desire to try to engage in communities more to provide education and combat stigma. DIS use multiple databases, often causing duplication of efforts and piecemeal information. DIS often encountered client resistance, as partner elicitation was sometimes inadequate, and clients wanted to maintain partners’ privacy. DIS counter resistance in multiple ways, indicating a flexible approach and the importance of soft skills in addition to comprehensive training provided on STIs and HIV, which is not reflected in numbers-based job performance evaluations.
Conclusions: Coordination of data at the State DHS level could better integrate information to prioritize clients. In addition to hiring additional DIS, the DIS job could be improved through increased recognition and improved community awareness including health care providers.