Resource page for the Journal Club with Sydney Minnerly and Karen Surita from the Texas Department of State Health Services from August 20, 2018.

What are the implications of the article’s findings for best public health practice at the local, state, and national levels?

Local

Programs can evaluate the outcomes of partner services as it relates to persons with early syphilis diagnosis and previous diagnosis with HIV. Persons with previous “No Partners Initiated” (NPI) interviews were most predictive of subsequent NPIs. Programs should evaluate their NPI interviews and see if there are things that could address the incidence of repeat NPIs, for example, is this an indication that DIS are seeing that the person had a previous NPI and are therefore more likely to assume that subsequent interviews will be NPI as well or is this truly a factor of the era of the apps? This would be a good time for programs to track the use of geo-social applications and how they impact the intervention outcomes of partner services.

State

Public health follow-up (PHFU) programs should explore the use of alternative methods for interviewing persons, including telephone, video and internet-based platforms to make partner services more efficient and friendly to the populations most greatly impacted. Exploring these options will include conducting focus groups for communities, such as men who have sex with men (MSM), to brainstorm on viable methods to best address the increase in syphilis and HIV and improve disease intervention, while meeting the needs of the community.

National Level

Prior to completely eliminating partner services because they appear ineffective, or less effective, in the time of stagnant workforce levels and increasing morbidity, national partners need to engage in conversations with their state partners about how to best serve the populations most greatly impacted by this growth in morbidity. State programs along with national partners can begin making recommendations for best practices for tailoring partner services using data analysis and compiling responses from the focus groups conducted.

How can the findings from this article promote a change within the way an STD program uses partner services?

Persons who have had previous interactions with partner services might already feel comfortable or uncomfortable with the process. Persons who were notified as a partner to an early syphilis infection were more likely to see the value of what the local health department can offer for disease intervention. If a person was previously interviewed and did not disclose partners, programs should evaluate how DIS are approaching those individuals and whether or not perceived expectations are influencing outcomes. Programs can consider how DIS might approach an individual whose had previous interactions with partner services and adapt those interactions to make the process more time efficient for the individual while maintaining the strength of disease intervention.

What research related to partner services, or STD prevention in general, needs further exploration?

Programs could benefit from more analysis of outcomes for video and web-based syphilis/HIV interviews.

Additionally, there needs to be more research on if we are losing the art of clustering and how that is impacting disease intervention in the realm of anonymous geo-spatial hook-ups.

Another area of exploration is PrEP uptake as a result of referrals made by partner services programs and its impact on HIV infections.