Internet Partner Notification


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Internet Partner Notification: approaches, challenges and future steps. Presentation given by DaviJason Asselin at the AFAO National Syphilis Forum, 23 October 2009.

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  • So what happened after we started to implement the sexually explicit campaign described previously? Talk about issues appearing and some themes that came out of both the media and community responses to the campaign, and unpack what they might mean for the environment in which we do our work.
  • Internet Partner Notification

    1. 1. Approaches, Challenges, and Future Steps Jason Asselin, Health Educator Victorian AIDS Council/Gay Men’s Health Centre Melbourne, Australia
    2. 2. <ul><li>Rationale </li></ul><ul><li>IPN to date: </li></ul><ul><ul><li>InSPOT </li></ul></ul><ul><ul><li>Drama Downunder/Whytest </li></ul></ul><ul><li>Issues in Current Practice </li></ul><ul><li>The Washington Model </li></ul>
    3. 3. <ul><li>Traditionally, partner notification has been done in person, by phone, or by mail, with the assistance of a public health investigator; </li></ul><ul><li>With gay men, who tend to have higher numbers of anonymous/casual partners, online notification can be an effective strategy to increase partner notification </li></ul>Background
    4. 4. Traditional PN vs Internet PN (IPN) <ul><li>IPN provides a useful alternative given: </li></ul><ul><ul><ul><li>MSM more likely to have anonymous/casual sex partners and higher number of partners – creates challenges for traditional PN; </li></ul></ul></ul><ul><ul><ul><li>Limited contact information of sex partners found on the internet </li></ul></ul></ul>
    5. 5. IPN Initiatives to date <ul><li>Internet Partner Notification (IPN) is nothing new: </li></ul><ul><li>San Francisco, 2000: </li></ul><ul><ul><li>At the start of the syphilis resurgence, two men with syphilis revealed the source of their many sex partners to be an AOL chat room called SFM4M. </li></ul></ul><ul><ul><li>By teaming up with the Internet service provider and a local marketing firm specializing in web access for gays, the Department of Public Health electronically identified five other men infected with the STI. </li></ul></ul>
    6. 6. IPN Initiatives to Date <ul><li>InSPOT: </li></ul><ul><ul><li>Originally in San Francisco, in 2004; </li></ul></ul><ul><ul><li>Anonymous email partner notification system supported by sexual health information and referrals; </li></ul></ul><ul><ul><li>Pathology forms readily downloadable to simplify testing process. </li></ul></ul>
    7. 8. IPN Initiatives to Date <ul><li>inSPOT: </li></ul><ul><ul><li>Since its 2004 launch in San Francisco, inSPOT has been replicated in three countries, ten cities, and nine states. </li></ul></ul><ul><ul><li>Various local jurisdictions have additional modifications on their sites, such as banner ads (Portland, Oregon), electronic antibiotic prescriptions available to notified contacts of Chlamydia or gonorrhea as expedited partner therapy (San Francisco, CA), and second languages (Ottawa, Canada). </li></ul></ul>
    8. 9. Drama Downunder (2006-present) <ul><li>Integrated within AFAO's national gay men's sexual health testing and treatement campaign website was a similar feature. </li></ul>
    9. 10. Drama Downunder – LET HIM KNOW
    10. 12. Drama Downunder n.b. not possible to determine the extent to which receipt of notification resulted in increased STI testing.
    11. 13. Drama Downunder <ul><li>Initially developed to be a patient led partner notification service; </li></ul><ul><li>Has been used as a clinician-led service at the Melbourne Sexual Health Centre by some clinicians – with patients also being signed up on the spot for STI check reminders. </li></ul>
    12. 14. Issues within current practice <ul><li>SMS/email services: </li></ul><ul><ul><li>Evidence of hoax use </li></ul></ul><ul><ul><ul><li>What effect does this have on the credibility of the service in the long term? </li></ul></ul></ul><ul><ul><li>Misses out on those without mobile/email address </li></ul></ul><ul><ul><ul><li>(i.e. Met strictly on Gaydar/Manhunt/etc.) </li></ul></ul></ul><ul><ul><ul><li>Contacts at beats, SOPVs, etc. </li></ul></ul></ul><ul><li>Centralised state public health services not reaching adequate success rates under the current model. </li></ul>
    13. 15. The Washington D.C. Model <ul><li>Public Health agencies create Contact Tracing Profiles on gay sex sites (GSS) (Manhunt, Gay.Com, Adam4Adam, etc) </li></ul><ul><li>GSS members diagnosed with STIs are invited to provide the profile names of recent sexual contacts </li></ul><ul><li>Contact tracers use the GSS's internal message system to send messages to contacts via Contact Tracing profiles on that particular GSS. </li></ul><ul><li>Messages are pre-formatted & approved by the GSS management </li></ul><ul><li>No more than 3 messages can be sent if no response </li></ul>
    14. 16. Something to consider? <ul><li> operates as a partner within the state public health PN project: </li></ul><ul><li>AFAO has been invited to broker Australian participation </li></ul><ul><li>Manhunt has 80,000 members in Australia (2 nd largest) </li></ul>
    15. 17. What other gaps? <ul><li>SOPV? </li></ul><ul><li>Beats? </li></ul><ul><li>Squirt? </li></ul>
    16. 18. “ Combination” Partner Notification <ul><li>Not a one-size fits all approach; </li></ul><ul><li>Needs to respect the partners and venues; </li></ul><ul><li>“ Mechanisms for partner notification should consider patient-led, clinician-led and centralised notification models that use a variety of means and technologies” </li></ul>