Steve Beagle is a UNC Field Coordinator and Disease Intervention Specialist for the North Carolina Department of Health and Human Services eHealth Services. He wrote the following blog post about confidential partner notification for Adam4Adam, an online dating website designed for men to meet other men.
I wanted to say “Hello” and introduce myself to The Community.
My name is Steve and I have worked in public health for almost 16 years.
I am a Disease Intervention Specialist (DIS) in Raleigh, NC. Other states have DIS, and other states may refer to their DIS as CDS (Communicable Disease Specialists), PHAs (Public Health Advisors), or PHRs (Public Health Representatives). A running joke is that we are the “Sex Police.” I hope I can convince you that we are not.
When I applied for this job, I did not know that this job existed. I was not surprised, as I understood the need for the job. The job description mentioned educating people about STDs and drawing blood. I figured since my degree was in education and I had learned how to draw blood on dogs and cats (during my time as a veterinary technician) that I could do this job.
The job centers around confidential partner notification, that is, notifying individuals of their exposure to Syphilis and HIV, though some DIS also do confidential partner notification for Gonorrhea and Chlamydia exposures. You may see partner notification referred to as “partner services” or “contact tracing” within the literature.
The way the process works is when someone tests positive for an STD/STI (Sexually Transmitted Infection is the more modern term for Sexually Transmitted Disease), a DIS meets with them to ensure that they received adequate treatment for the infection, to answer any questions about the infection, and to ensure that the sex and needle sharing partners of the person are informed about the exposure, since one of the partners transmitted the infection to the person with the infection, and the person with the infection may have unknowingly transmitted the infection to their partner(s).
Some believe the person that tested positive for the infection has a moral and ethical obligation as a human being to inform their partner(s) about the exposure. Others believe that we are all responsible for ourselves and that the assumption is we are aware of what could happen as it relates to our health following a sexual encounter. Feel free to read a detailed discussion about this topic.
There are three ways in which partner notification may occur. The first way is when the person that has the STI informs their partner themselves. A partner may be more likely to get tested following an exposure if the person with the STI informs their partner. The DIS in this case makes a cooperative effort to ensure that the partner receives adequate testing and treatment depending upon the type of exposure based on CDC Guidelines.
The second way is when the person that has the STI prefers that the DIS informs the partner of the exposure, confidentially. This means that the DIS cannot tell the partner who gave them the partner’s identifying and locating information. People who test positive for STIs often feel embarrassed or guilty when they have been diagnosed with an STI. To preserve their anonymity, they choose not to inform the partner themselves but still understand that the partner should know about their exposure and have an opportunity to receive free testing and treatment following the exposure.
The third way is when the person that tested positive for the STI meets with their partner and the DIS together. The person or the DIS can inform the partner about the exposure, and the DIS can be on hand to answer any questions the partner may have about the infection or exposure. The DIS may also be able to offer testing immediately, on the spot, to the partner, or transport the partner to a health department or clinic for testing and treatment whenever necessary.
DIS acknowledge that there are times when people do not know the names of their partners, or may only know a screen name for their partner. Since 1999, certain states and areas across the US have decided to try and reach those partners as well. Adam4Adam.com was one of the first sites to devote profiles to Health Counselors (some of which are DIS) for this purpose.
In closing, I hope that I have been successful in convincing you that DIS are not “Sex Police.” We understand that infections are transmitted when people have sex (even when they are using protection). DIS realize that we must not focus on “who gave it to who,” rather, the health and well-being of everyone within The Community.
For free, confidential testing near you, click here.
For HIV care and related services, click here.