Provider and Client Acceptance of a Health Department Enhanced Approach to Improve HIV Partner Notification in New York City

Udeagu, Chi-Chi N. MPH; Bocour, Angelica MPH; Gale, Ilona MPH; Begier, Elizabeth M. MD, MPH

Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e3181d013e0
Original Study
Abstract

Objective: To assess provider and client acceptance of health department-delivered HIV partner services (PS) delivered in clinical and community settings.

Methods: In 2006, New York city (NYC) formed the HIV field services unit (FSU), staffed with experienced sexually transmitted disease intervention specialists (DIS). DIS were stationed at 8 large hospitals to assist clinical providers and their HIV-positive patients with PS in areas with high rates of delayed HIV diagnoses and HIV-related mortality. We surveyed providers (self-administered questionnaire) and clients (staff-administered) to examine provider and patients as well as patients' HIV-exposed partners' acceptance of and concerns regarding PS.

Results: Response rates were as follows: 63% (132/211) providers; 90% (492/544) patients who accepted PS; 73% (16/22) patients who declined PS; 83% (139/168) partners who received notification; and 81% (25/31) partners who declined notification. Most providers felt the DIS focus and expert skills in PS was beneficial to providers (87%) and clients (89%). Most patients (91%) had a positive or neutral attitude about the health department-delivered PS. Most providers reported no disadvantage to DIS providing PS (69%); their most commonly cited (24%) concern was potential patient confusion about the roles of providers versus DIS. Patients' most common concerns were the intrusive nature of the interviews and the length of the interview (50/492, 20%). The partners wanted to know who named them (32/139, 23%).

Conclusions: Health department-delivered PS by DIS in clinical and community settings was acceptable to providers, HIV-infected patients, and HIV-exposed partners. Overall, our survey showed strong provider and client support for this approach.

In Brief

A survey of HIV medical provider, HIV-infected patients, and HIV-exposed partners in New York city found broad acceptance of health department-assisted HIV partner notification.

Author Information

From the Bureau of HIV Prevention and Control, New York City Department of Health and Mental Hygiene, New York, New York.

The authors thank Kyle Bernstein, Charu Jain, and Tamar Renaud for their constructive feedback in developing the data collection instruments. The author also thank R. Elliott Churchill, Tracy Agerton, and Adey Tsega for their useful advice in preparing the manuscript and Christal Taylor for her administrative assistance. The authors are grateful to all the Field Services Unit staff for their dedication and hard work in implementing this initiative and their daily contribution toward reducing HIV transmission in New York City.

C.-C. N. Udeagu conceived and directed the study, assisted in drafting the data collection instruments and prepared the manuscript. A. Bocour designed first draft of the instruments, performed statistical analyses, and contributed to the revision of the manuscript. I. Gale participated in data collection, data entry, and assisted with the exploratory data analysis. E. Begier reviewed the draft documents and provided critical input and guidance.

Correspondence: Chi-Chi N. Udeagu, MPH, Director, Field Services Unit, Epidemiology and Field Services Program, Bureau of HIV/AIDS Prevention and Control NYC Department of Health and Mental Hygiene, 346 Broadway, Room 707A, CN-44, New York, New York 10013. E-mail: cudeagu@health.nyc.gov.

Received for publication July 16, 2009, and accepted December 15, 2009.

© Copyright 2010 American Sexually Transmitted Diseases Association