Support Among Persons Infected With HIV for Routine Health Department Contact for HIV Partner Notification
April 15, 2003
A central goal of CDC's recently announced Serostatus Approach to Fighting HIV (SAFE) is to increase the proportion of Americans with HIV who are aware that they are infected. One way to reach that goal may be through enhanced partner notification (PN). However, PN for HIV is controversial. Many persons diagnosed with HIV do not receive PN services from public health agencies, and existing data suggest that a majority of private providers do little more than advise their patients to notify their sex or needle-sharing partners themselves.
Efforts to link named HIV reporting to PN have been met with resistance throughout the United States. In spite of this opposition, there are few data on what people with HIV, particularly men who have sex with men (MSM), actually think about PN and how the process could be more acceptable and effective. To address such issues, the authors surveyed a random sample of persons with prevalent HIV diagnoses seen in the Harborview Medical Center (HMC) HIV/AIDS Clinic located within the public hospital of King County, Wash. Persons with newly diagnosed HIV reported to Public Health-Seattle and King County (PHSKC), the health department serving Seattle and King County, were also surveyed. A total of 95 persons, of whom 76 (80 percent) were MSM, completed an anonymous self-administered questionnaire and were included in the analysis.
Study participants reported a mean of 3.2 anal or vaginal sex partners (median=1.0, range: 0-60) in the six months prior to completing the survey. Forty participants (42 percent) reported having unprotected anal or vaginal sex in the preceding six months.
Eighty-four percent of participants believed the health department should routinely offer everyone diagnosed with HIV help in notifying their partners. Age, race, MSM, income level, diagnosis outside of a public health testing site, anonymous HIV testing, and receiving HIV care at the HMC HIV clinic were not significantly associated with support or opposition to offering PN assistance. Seventy-nine percent indicated they would be very likely or somewhat likely to provide information to a doctor, case worker, or health department employee for purposes of PN; and 20 percent indicated they wanted help in notifying a recent sex partner.
Seventy-eight percent of study participants believed the health department should contact all HIV-infected persons after diagnosis to help them access medical care and social services, and 68 percent wanted the health department to contact them about the availability of medical or social services. Persons diagnosed in settings other than public health clinics were less likely to have spoken with a social worker or case worker since their HIV diagnosis than those diagnosed in public health clinics (65 percent vs. 93 percent). Persons diagnosed outside of the public health system were more likely to report wanting to speak to a social worker about the availability of medical and social services (49 percent vs. 29 percent).
The authors' central finding is that most people with HIV, including MSM, support the universal provision of confidential and voluntary public health PN services and that restricting PN programs to public health deprives some patients of desired services. In consideration of these findings, clinical providers, community-based organizations, and health departments should reassess whether narrowly focusing PN services on persons at public health sites truly reflects patient preferences. "Efforts to improve PN should concentrate on greater integration of the process into the provision of the medical and social services patients already receive," the authors concluded.
Journal of Acquired Immune Deficiency Syndromes
02.01.03; Vol. 32; No. 2: P. 196-202; Matthew R. Golden; Sharon G. Hopkins; Martina Morris; King K. Holmes; H. Hunter Handsfield
Sex Without Disclosure of Positive HIV Serostatus in a U.S. Probability Sample of Persons Receiving Medical Care for HIV Infection
This article was provided by U.S. Centers for Disease Control and Prevention. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update. Visit the CDC's website to find out more about their activities, publications and services.