Maryland: Bearing Bad Tidings in a Good Cause

James Leber has worked for nearly two decades at the Anne Arundel County Health Department, chiefly as a disease intervention specialist. Specifically, he interviews people diagnosed with STDs and tracks down their partners.

"You have to understand that a lot of people are not going to like you," he said of delivering the bad news.

The process begins when a test comes back positive for a reportable disease. The patient is interviewed, particularly about his or her sexual partners. Armed with a list of contacts, Leber sets out to break the news, something he prefers to do in person instead of over the phone. "You try to be as non-threatening as you can. You have to set it up so that they see you as helping them, and ultimately you are, by providing them with information they need," he said.

After he tells a contact that he or she may be infected, he moves to gain more information about who else they have had sex with. Sometimes he can get no more information than the name of the bar where the contacts met. In some instances, the biological stage of the disease itself will give clues to when transmission occurred.

Leber is now a supervisor in the department and directs STD-prevention education efforts. "Now I do more proactive work than reactive, breaking the chain before it has a chance to hit," he said.

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