The use of technology in Partner Services isn’t actually as new as many of us think. Technology in some form or another has been used as a way to find hard to reach at-risk communities since the early days of AOL, Gay.com, and the table top computer.
The use of technology in Partner Services isn’t actually as new as many of us think. Technology in some form or another has been used as a way to find hard to reach at-risk communities since the early days of AOL, Gay.com, and the table top computer. In fact, informal and community based HIV and STD health educators were some of the first to take to the internet almost 20 years ago, using it as a tool to reduce HIV and STD increases.
As early as 1999, Disease Investigation Specialists (DIS) from San Francisco began to report on the increase of STDs and the relationship to social networks in online venues. By 2005,CDC “Dear Colleague” letters were encouraging program areas to explore the internet as a disease intervention and prevention tool. 2008 Centers for Disease Control and Prevention (CDC) Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection.
Today, the use of technology in partner services or Internet Partner Services (IPS), as it is commonly called, continues to be adaptive and flexible. And, we’ve seen huge gains and growing support from senior leadership on the role that the integration of technology offers in public health response. With the increase in opportunities for people to connect online now integrated into smart devices, tablets, and mobile phones the CDC’s National Internet Partner Services Workgroup recently launched a new interactive 2016 Internet Partner Services Toolkit designed to assist programs seeking to improve how they use technology for partner services and other prevention activities.
The Toolkit builds on the day-to-day insight and experience that trained DIS are incorporating into the IPS patient experience. In many areas around the country, the patient interview has been expanded to include codes and fields to collect not only the known names, but also the “Profile Names” that patients and sex partners use, as well as the ability to record which websites and apps the patient uses to meet partners. Now, in addition to sending letters and making phone calls, many DIS now send messages through social media sites or by text message. New protocols are in place that allow for the use of online search engines like Google and social networking sites such as Facebook to locate partners.
San Francisco’s City Clinic staff who lead the local DIS efforts shared some of the creative ways that they continually incorporate IPS, from laptops in the exam rooms to the ability to create limited use profile accounts on some apps that allow for members to ask HIV/STD related questions to trained staff. The implementation of IPS in that city has led to hundreds of clients and partners being notified of the infections and/or exposure to infections.
By equipping the DIS with the skills and the protocols necessary to elicit and notify internet-based partners, the time-proven intervention of partner elicitation and contact continues to have utility and relevance in the internet era.
Now nearly 20 years after some of the first uses of the internet, collecting the screen names of the original/index patient and their partners has not only become routine among DIS in San Francisco, but more importantly it has become somewhat normalized among clients, many of whom have had an STD in the past. While making the initial contact is not always a comfortable moment for the client, we have found in many cases even clients that would normally be fine with phone conversations are becoming less likely to answer calls from unfamiliar numbers and therefore sending an email or text message may increase the chance of receiving a return call.
One client summed it up nicely for us:
‘I thought it was a bad joke when I received a message from the health department on this site. Why would the health department be on this site and how did they know my handle? I was angry when I called the counselor who messaged me. He was very patient with me and explained to me why he was contacting me. He said that he could talk to me in person if I preferred and even offered me free confidential testing at the clinic he worked at. The staff at the clinic were amazing they kept reassuring me that everything was confidential.’