E5 Working It Online Internet Partner Notification JacksonPresentation Transcript
Working It Online: Internet Partner Notification 17th TEXAS HIV/STD CONFERENCE Jen Jackson, Program Consultant DSHS HIV/STD Prevention & Care Branch
Why are we here?
To enhance partner services through effective use of internet resources to reach people who are part of online sociosexual networks
Where do people meet online?
Who are we talking about?
Any patient for whom the field record includes an email or online handle as part of the locating information
Everyone we interview
Which population(s) never have internet contacts?
Get the Information
What questions can we ask patients and contacts which help us gather internet-related locating information?
Remember: There is a fine line between fishing and just standing on the shore like an idiot.
Get the Information Open-Ended Question Examples “ Where do you meet most of your sex partners?” “ How often do you meet partners online?” “ Which chat rooms do you use?” “ What is his/her email address?” “ What is his/her screen name?” “ Who is in your phone right now that we can contact?”
Give ‘em Homework!
“ Check and see what email handles are in your computer at home.”
Give the patient partner information sheets to take home, so you can capture more necessary information.
Log In Together
Have a computer available where you and the patient can log in to emails, profile sites, chat rooms and look for information together.
Work the Network
Don’t forget social networking sites like Facebook and MySpace!
There are MSM-specific social networking sites – from BigMuscle to Dlist – ask about them!
Don’t forget clusters!!
Patient doesn’t go online
Patient has only one email or handle
OP doesn’t have other locating information than email or handle
Enter the Field Record
Handle given = [email_address]
First name = Unknown, unless first name is given
Last name = [email_address]
Note section = add any additional information to help locate the partner and the complete email address
Complete description and exposure dates as stated by patient
Remember: The email address or online username MUST be entered into STD*MIS under AKA for future reference.
Is Meeting Online a Risk?
Not on its own
It’s what happens AFTER the meeting
What if nothing happens after they meet?
Don’t forget to ask how a meeting was arranged and who else was involved
Work the Contact
Work as you would any other contact
Use all available notification methods si mul ta ne ous ly
Document online notification efforts on field record as you would any other
Follow the digital breadcrumbs…
search AKAs in STD*MIS
Google the email address – not just the whole address ( [email_address] ) but also the username (SexyKitty4U)
search username on multiple sites
personal data in email addresses is common – name, DOB, hobby, etc.
people leave trails, follow them!
Send the Email
Communicate the urgency
Make it professional – edit your product for spelling, punctuation, etc.
Send from a department address, never a personal one
Include a confidentiality statement
First Email - Sent 1 st Day
Date: sent on Day 1 of the investigation
Subject: URGENT HEALTH MATTER
My name is John Investigator, and I am with the
Texas State Health Department. I have urgent and
confidential health information to discuss with you.
I can be reached at my office at (555) 234-5678.
Please contact me as soon as possible.
“ The information I need to discuss with you is sensitive and of a highly personal nature. I will maintain strict confidentiality and I need you to do the same. Any dissemination, distribution or copying of this communication is strictly prohibited. Do not forward this email to others. If you are not comfortable discussing confidential matters via email, I will be glad to call you or you may call me at (XXX) XXX-XXXX.”
Subject: HEALTH DEPARTMENT MATTER
My name is John Investigator and I work with the Texas State
Health Department. I attempted to contact you on 01/01/10; I have
some very important health information to share with you. This is
a very urgent matter, and because of the confidential nature of
this information, it is vital you contact me.
Please call me at (555) 234-5678. I can be reached at this number
from 8am to 5pm, Monday through Friday or you can contact me
using my e-mail address, firstname.lastname@example.org or my cell
phone at (555) 255-5888. To assist you in confirming my identity, I
have included my supervisor’s name and phone number: Josefina
Boss, Program Manager, (555) 234-5679. Please do not delay in
John Investigator, Disease Intervention Specialist
Texas State Health Department, South Central District Office
Second Email – Send 3 rd Day
No Response After 4 th Day
Get supervision involved
Reinterview the OP for more information
Review searches – what did you miss in your research?
Send something like one of the following on day 7
Subject: CRITICAL HEALTH MATTER
I am John Investigator with the Texas State Health Department.
This is my third attempt to contact you through this e-mail
address. On 01/01/10 and 01/03/10, I sent you an email asking
you contact me ASAP, because I have urgent health information
to pass on to you. It is vital that you contact me immediately. As
this is my only means of contacting you at this time, I hope you
take this message seriously.
I can be reached at my office Monday–Friday 7:30AM through
4:30PM or at my e-mail address, email@example.com, or
my cell phone at (555) 255-5888. To confirm my identity you can
contact my supervisor at (555) 234-5679. Please do not delay!!!
John Investigator, Disease Intervention Specialist
Texas State Health Department, South Central Office
No Response - After 4 th Day
No Response - After 4 th Day
Date: sent on Day 7 of the investigation
Subject: SUPERVISORY HEALTH MESSAGE
My name is Josefina Boss and I work with the Texas State
Health Department. You have received a prior email from one
of my employees, John Investigator. As John’s supervisor, I
am concerned that we have not heard from you. We have
some urgent and confidential information we need to discuss
with you, so please call John at (555) 234-5678, or myself at
the number below.
Josefina Supervisor, Texas State Health Department
STILL No Response?
At 10 th day of investigation, if...
No other avenue to reach patient
OP has been RI’d for more information
No response whatsoever to emails
No other research to be done...
Close the field record with H disposition.
BEFORE YOU SEND…
Flag the email:
Flag with a “read receipt”
Choose “high sensitivity”
What about subject headers?
May need to vary from what is in the examples
Sometimes NO header works best
See what gets the best response rate
Always include your area code when listing your phone number due to the use of cell phones.
China may call.
Do Not Send These!
Personal, confidential, or identifying information
Threats, harassing remarks, disrespectful language – keep it professional!
Emails with multiple copied addresses
Attach the Email…
Document on FR date/time email sent
Print copy of email from “sent” box (records time & date of email)
Attach a copy of email sent to the FR
When the contact calls…
Ask how they were contacted:
Note on door
HEADS - UP
If the contact states s/he received an email, we may not know her/his name.
Ask for the email or username by which they were contacted.
Enter this as the last name in STD*MIS until you have the contact’s actual last name.
Same technique as usual:
“ As we stated in the email, we have some highly confidential information for you, so I need to confirm you are the person we are looking for.”
“ What is your first and last name?”
“ What is your birth date?”
Don’t forget to document the phone number from which the contact called!
Clear the Line
Who else on the line (or nearby) can hear our conversation?
REVEAL THE EXPOSURE
After the Call
Make sure you got the contact’s phone number!
Fully DOCUMENT the phone conversation
Make sure the username/email address is in AKA field in STD*MIS
The Contact Responds by Email...
Respond appropriately and conserve confidentiality
Always request further contact, preferably by phone or in person
Don’t be afraid to get supervision involved!
Print and attach what you receive and how you respond
DOCUMENT all communication on field record.
The Contact Fails to Respond
As with any other field record –
Send another email
If you’ve sent two emails, get supervisory guidance
What other methods to locate?
RI the OP for more information
Have OP send email or contact them
Read confirmed, but no response
We may have a live one...
Alternative Notification Methods
ManHunt, Adam4Adam, etc.
When profile username isn’t also an email address
Make sure you have department permission
Use a health department account for notification
Follow guidelines agreed-upon with site administrators
NEVER use personal accounts for notification
NEVER pretend to be someone you’re not – no phony profiles
I nternet P artner S ervices group
Contract with Houston HD – statewide resource
Provides online notification services for programs which do not have permission to access profile-only sites
Used simultaneously in conjunction with traditional methods if there is other locating information
Who should I contact for IPS??
Tamika R. Martin, MPH, CHES
Senior Public Health Investigator
Bureau of HIV/STD and Viral Hepatitis Prevention
Houston Department of Health and Human Services
8000 N. Stadium Drive, 5th Floor
Houston, TX 77054
Document screen name(s) & social networking website(s) the infected client communicates with the exposed contact
Consult with supervisor for contact information of the current IPS.
Provide the IPS codes only to assist in identifying the nature of notification (P1 to 700; S3 to 900, etc.)
Include contact information for themselves and their Supervisor
IPS conducts follow-up, within 2 business days of notifying a contact, with investigating agency to determine if contact responded to initial message and decide whether a follow-up message is necessary
IPS will, within 7 business days from the request for notification, contact the investigating agency to determine if the contact was seen by a health care agency
Disposition of contacts in less than 7 days should be reported to the IPS immediately
DIS and FLS are encouraged to forward the IPS any additional websites clients provide during interviews in order to establish a statewide profile for that site.
The apollooza Tour Starring: inSpot.org
“ Gotta get myself…gotta get myself…gotta get myself connected….”
Self notification tool (for those diagnosed with an STD)
User-friendly IPN service, created in 2004 by ISIS Inc ( http://www.isis-inc.org )
Purpose: To utilize current technology to prevent the transmission of disease and educate communities
“ Here’s a little story, I got to tell…”
inSpot was first launched in San Francisco, CA
Moved to servicing specific states, targeted cities, and some international locations
Recent changes to InSpot – National inSpot (U.S.)
inSpot currently services: Canada, United States, Guam, American Samoa, Northern Mariana and Puerto Rico
“More than words….”
Default Language: U.S. English
“ Voices Carry”: Other language selections
Hello, eh? Bonjour! Hola!
“I want you to want me.”
“ Where it’s at…”: (web address)
inSpot currently provides:
Tell them: STD self-notification through a variety of anonymous or confidential e-mail postcards
STD info: Up-to-date information on STD signs and symptoms
Testing: Links to local testing
Resources: Links to websites with more information
Tips for self-notification
“ What I am is what I am…”
What inSpot is:
A tool for notification of partners of persons with gonorrhea, Chlamydia and other STDs for which health department notification services are not available.
What inSpot is not:
inSpot is not an alternative to Partner Services.
It does not contain any tracking software to identify individuals or confirm testing/treatment.
It is not a site that compiles names of people with STDs to “out” those infected and it does not post names on the internet.
Not a data collection tool:
Keeps a count of number of e-cards sent and received
Collects optional demographic and disease data
“ Is it worth it? Let me work it.”
How can public health use inSpot?
Referrals to inSpot can be made by:
Family Planning Clinics
Referrals can be made by anyone who counsels patients about notifying their sexual partners of a possible exposure:
Risk Reduction Specialists
“ I always feel like somebody’s watching me…..”
The preferred method for notification for syphilis and HIV is DIS notification; however DIS may refer clients to inSpot Texas for e-mail self-notification to augment sexual contact notification efforts.
“ I wish that I had Jesse’s Girl.” * * All celebrity STDs have been impersonated. Man, it really burns when I pee!
“ Wow. This STD is no fun. I guess I should tell my partners so they can get tested and treated!”
“ Okay…my language is English (U.S.) and my region is Texas. Hmmm…time to pick a card.”
“ Yup. I guess sometimes there ARE strings attached. This is a good card to send them.”
“ Wow. A security question. I guess they really don’t want bots spamming inSpot e-cards!”
“ Okay..what’s next? Time to create my message, huh?
“ Okay…message created. All six email addresses entered.”
“ What’s next? Optional demographics used for statistical purposes only? Hmm…ok. I’ll fill it in.”
“ Time to preview this card so I can send it and get back to work.”
“ Rock!! Hey, that was easy!” (Hey there, baby…what are you doing later…?)
Sending an inSpot card is as easy as 6 simple steps:
Pick a card (enter the security words)
Create message (optional statistical data)
“ Wait! Oh yes, wait a minute mister postman!” What’s that in my inbox? Oh look! An email from Jesse!
“ Oh no! I better get tested!!!
“ Oh look! I can find testing services in my area on this site!”
“ Wow! There are 10 clinics right in my zipcode!!
“ Here’s where the story ends.” Boy, I sure am glad I let my partners know!
“ How do rumors get started…”
How will inSpot be promoted in Texas?
Print materials: posters, flyers, cards
Locations: health depts, CBOs, community clinics, family planning clinics
Sample inSpot card – front Sample inSpot card – back
“ I’ll send an SOS to the world. I hope that someone gets my…”
inSpot Marketing Activities:
Training and Information
Periodic inSpot Reminders
“ Treat me like your mother.”
POST NO HATE
Any expressions of hatred, bigotry, abuse or harassment will not be tolerated by inSPOT.org. The people responsible for sending hateful or harassing words are subject to immediate and permanent suspension from the site. inSpot asks that all users refrain from profanity and defamatory comments on their cards.
PLEASE REPORT ANY PROBLEMS
If you are having problems with a person who may have maliciously sent ecards from the site, please contact inSpot at [email_address] . If you feel another person is violating these community and membership guidelines, please contact the site as well, or if you have questions about or problems with sending/receiving ecards yourself.