1. Barriers, Facilitators, and Cost of Integrating HIV-Related Activities Into Sexually Transmitted Disease Partner Services in Jackson, Mississippi
- Author
-
Christie Lewis, Kendra Johnson, Tigran Avoundjian, Christine M Khosropour, Ruanne V. Barnabas, Matthew R. Golden, David Peyton, and Peder Digre
- Subjects
Male ,Microbiology (medical) ,Sexually transmitted disease ,Marginal cost ,medicine.medical_specialty ,Gonorrhea ,Sexually Transmitted Diseases ,HIV Infections ,Dermatology ,Disease ,Article ,Men who have sex with men ,Sexual and Gender Minorities ,03 medical and health sciences ,Mississippi ,0302 clinical medicine ,Documentation ,Intervention (counseling) ,medicine ,Humans ,Syphilis ,030212 general & internal medicine ,Homosexuality, Male ,030505 public health ,Chlamydia ,business.industry ,Public Health, Environmental and Occupational Health ,virus diseases ,medicine.disease ,Sexual Partners ,Infectious Diseases ,Family medicine ,Contact Tracing ,0305 other medical science ,business - Abstract
BACKGROUND Many US health departments now integrate HIV-related outcomes (e.g., relinkage to HIV care and preexposure prophylaxis [PrEP]) into sexually transmitted disease (STD) partner services (PS) programs. We sought to determine the barriers, facilitators, and cost of integrating these activities into PS. METHODS From 2016 to 2018, the Mississippi State Department of Health integrated 3 new activities into STD PS: HIV testing for partners of HIV-negative men who have sex with men with gonorrhea/chlamydia, relinkage to HIV care for STD PS recipients previously diagnosed with HIV, and PrEP referrals. We conducted direct observations and interviews with disease intervention specialists (DIS) in Jackson to assess barriers and facilitators to implementing these activities. We completed time and motion studies with 8 DIS and case tracking forms for 90 unique cases to estimate the incremental staff time and associated personnel cost of added services compared with a standard PS case. RESULTS Disease intervention specialists were optimistic about integrating HIV-related activities but noted disparate data systems, nonsystematic documentation, and lack of training as barriers. The mean time for a standard STD PS case without HIV-related activities was 195 minutes (cost, $77.69/case). The cost to conduct PS for HIV-negative men who have sex with men with gonorrhea/chlamydia was 36% higher than a standard case. Integrating relinkage to care and PrEP referrals resulted in a 44% and 20% increase in cost, respectively. CONCLUSIONS Integrating HIV care relinkage and PrEP referrals into STD partner services was generally acceptable by DIS and added marginal cost per case. Coupling these cost metrics with an assessment of the effectiveness of these activities can inform prioritization of partner services activities.
- Published
- 2020
- Full Text
- View/download PDF