Role With It Baby: DIS & Their Roles. Featuring: The apolloza Tour! Jen Jackson, Program Consultant DSHS HIV/STD Prevention & Care. Why are we here?.
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Jen Jackson, Program Consultant
DSHS HIV/STD Prevention & Care
To gain an understanding of what Partner Services is and to learn how we can support DIS in their disease intervention efforts to help stop the spread of disease in communities.
Disease Intervention Specialist:
identifies people who are infected or at risk of infection
notifies of risk and offers testing, treatment
ultimate goal is to understand and stop the movement of disease (source, spread)
STD History Slides adapted from “STIs: A Historical Perspective.” –CDC, PTC ISTDI (www.stdhivtraining.org)
DIS are part of public health follow-up
STD/HIV are not the only diseases which prompt public health investigation
Many other diseases public health investigates: tuberculosis, rabies, anthrax, measles, mumps, brucellosis, cryptosporidiosis...
DIS rely on data collected by surveillance (it’s not what you think!)
Disease surveillance: systematic collection and analysis of data to understand trends in disease
Passive surveillance: collection of data
Active surveillance: case finding
DIS use this data to:
know when to begin an investigation
direct efforts in disease intervention to specific areas or populations
analyze outcomes for quality control
Notify infected or at-risk clients
Counsel and Test
Lather, rinse, repeat
refer to appropriate services (including treatment)
assist clients in reducing risk
DIS interview infected and uninfected people in the course of an investigation
Partner elicitation is the process of gathering names and locating information of people at risk of infection
Partner notification is the process of notifying those people of their risk and offering services
DIS first research all information available on the client
Telephone call and/or email, if possible
Field notification – visits to locations where the client may be located
Often home, but can include other locations – hangouts, work, shelters, clubs, online, virtually anywhere
Notification should be performed ONLY by trained DIS
DIS are trained to carefully guard confidentiality when notifying clients
If any method of notification is deemed a confidentiality risk, another method is chosen
Notification should NEVER occur with others present or through others
Pre-counsel: discuss status, address concerns, pre-test education
Blood draw and/or clinic visit as necessary
Post-test counsel, interview if investigation requires it
Re-start the cycle
Medication is offered to infected and some uninfected clients
Treatment for uninfected: sex partners within incubation periods (potentially developing disease)
Treatment is always at the medical provider and client’s discretion
Primary intervention: treatment which aborts incubating infection
Prevents development of symptoms, potential to spread disease to others
Secondary intervention: treatment of infection indicated by symptoms and/or positive test results
Gonorrhea, chlamydia, PID, LGV
Partners exposed last 60 days
Primary: 3 months plus symptom duration
Secondary: 6 months plus symptom duration
Early latent: within the last year
Partners exposed in the last 10 days
In limited cases, there has been success with post-exposure prophylaxis (PEP), typically in the case of occupational exposures (needle-sticks)
PEP is rare at this time
good communication skills
careful, methodical, good eye for detail
able to adjust rapidly to changing situations
Insufficient public health resources to utilize partner services for STDs other than HIV and syphilis.
Expanding services for STD partner self-notification to the web.
The preferred method for notification for syphilis and HIV is DIS notification; however DIS may refer clients to inSpot Texas for e-mail self-notification to augment sexual contact notification efforts.
What’s that in my inbox?
Oh look! An email from Jesse!
Boy, I sure am glad I let my partners know!
How will inSpot be promoted in Texas?
Sample inSpot card – front Sample inSpot card – back
inSpot Community Guidelines:
Take inSpot for a test drive!
Have questions or suggestions??
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Wanna hang out?