Dallas County Health and  Human Dallas County Health and Human Services Dallas County Health and Human Services Public Hea...
AHI Protocol Laboratory Director or Assistant is notified immediately Assistant STD/HIV Program Manager is notified immedi...
 
 
Enhanced Partner Notification DIS elicits names of high risk contacts of AHI cases High risk contacts are interviewed with...
 
* Note: because identifying the AHI individual by name to the contact violates confidentiality, contacts who mention unpro...
Public Health Follow-up for NAAT  July 2009-May 2010 <ul><li>26 Positive  NAAT Test  </li></ul><ul><li>2 from San Antonio ...
Public Health Follow-up Dispositions for Partners Named <ul><li>40 Partners Named </li></ul><ul><li>14 Previous Positive <...
Public Health Follow-Up Dispositions for Suspects Named <ul><li>25 Suspects Named </li></ul><ul><li>18 tested negative </l...
Case Management Activity  Case #1 <ul><li>592 interviewed patient X who was a volunteer to the STD clinic with palmer/plan...
Case Management Outcome <ul><li>The contact was negative for syphilis and a new NAAT positive </li></ul><ul><li>This conta...
Case Management Activity Case #2 <ul><li>579 tested an inmate in the jail, NAAT test was positive </li></ul><ul><li>Inmate...
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Worthey naat presentation for state conference 2010

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Worthey naat presentation for state conference 2010

  1. 1. Dallas County Health and Human Dallas County Health and Human Services Dallas County Health and Human Services Public Health Follow-Up for Acute HIV Infection La Shonda Worthey STD/HIV Program Manager Dallas County Health and Human Services
  2. 2. AHI Protocol Laboratory Director or Assistant is notified immediately Assistant STD/HIV Program Manager is notified immediately Program Manager notified if Assistant Manager is not available Surveillance Administrative Support Staff enters case immediately Field Record is created immediately Case is assigned to a DIS immediately DIS Successfully Interviews Case within 72 hours of test result Field Operations Manager receives copy of record DIS Unsuccessful in interviewing case within 72 hours Immediate Enrollment into Early Intervention Clinic (within 24 hours) Medical clinic appointment made for case to outside provider Field Operations Manager notifies Assistant Program Manager AHI patient is seen by area medical provider within 21 days of testing date Field Operations Manager Attempts to interview case Review of cases where AHI patient is not seen by medical provider within 21 days of test date by Medical Directors Enhanced Partner Notification Notification Protocol for AHI Cases Assistant Program Manager documents unsuccessful interview
  3. 5. Enhanced Partner Notification DIS elicits names of high risk contacts of AHI cases High risk contacts are interviewed within 72 hours High risk contact has had unprotected sex and/or shared needles with AHI case* within the last 72 hours Perform Rapid HIV test either in the field or in the STD Clinic High risk contact has had unprotected sex and/or shared needles with AHI case* within 72 hours – 4 weeks High risk contact has had unprotected sex and/or shared needles with AHI case* > 4 weeks Partner r Notification Protocol for AHI Cases Rapid HIV test + Rapid HIV test - Refer to Early Intervention as a presumptive positive Perform HIV testing Notify Medical Director for potential referral for possible PEP Perform HIV testing Perform Rapid HIV test either in the field or in the STD Clinic Rapid test + Refer to Early Intervention as a presumptive positive Rapid test - Recommend retesting in 1 month if negative Perform Rapid HIV test either in the field or in the STD Clinic Rapid test + Refer to Early Intervention as a presumptive positive Perform HIV testing Perform HIV testing Rapid test - Perform HIV testing Perform HIV testing
  4. 7. * Note: because identifying the AHI individual by name to the contact violates confidentiality, contacts who mention unprotected sex or sharing needles with any individual in listed timeframes should follow above.
  5. 8. Public Health Follow-up for NAAT July 2009-May 2010 <ul><li>26 Positive NAAT Test </li></ul><ul><li>2 from San Antonio and 24 in Dallas </li></ul><ul><li>23 Cases interviewed (2 Cases Still Open) </li></ul><ul><li>40 contacts initiated and 25 suspects initiated </li></ul>
  6. 9. Public Health Follow-up Dispositions for Partners Named <ul><li>40 Partners Named </li></ul><ul><li>14 Previous Positive </li></ul><ul><li>13 Negative </li></ul><ul><li>11 closed as unable to locate and refused testing (H and J) </li></ul><ul><li>2 New HIV cases found </li></ul>
  7. 10. Public Health Follow-Up Dispositions for Suspects Named <ul><li>25 Suspects Named </li></ul><ul><li>18 tested negative </li></ul><ul><li>2 Previously Positive for HIV </li></ul><ul><li>5 Unable to locate (H) </li></ul>
  8. 11. Case Management Activity Case #1 <ul><li>592 interviewed patient X who was a volunteer to the STD clinic with palmer/plantar rash. Patient X tested positive for syphilis and NAAT and was linked to Early Intervention Services </li></ul><ul><li>Patient X named 6 contacts and 1 suspect </li></ul><ul><li>One partner from patient X could not be found by 592 and was closed as unable to locate </li></ul><ul><li>593 continued public health follow-up on the contact who was located and tested for syphilis and HIV. </li></ul>
  9. 12. Case Management Outcome <ul><li>The contact was negative for syphilis and a new NAAT positive </li></ul><ul><li>This contacts Rapid HIV Test was negative on 4/28/10 and positive for NAAT on 4/28/10 </li></ul><ul><li>Patient was linked to Early Intervention Services </li></ul>
  10. 13. Case Management Activity Case #2 <ul><li>579 tested an inmate in the jail, NAAT test was positive </li></ul><ul><li>Inmate tested because of IV drug use, girlfriend a prostitute and two brothers that he shared needles with. </li></ul><ul><li>579 conducted a screening to locate to two brothers and was unsuccessful. </li></ul><ul><li>579 found a new NAAT positive that was not case related from the screening. </li></ul><ul><li>Another screening was conducted a month later at the same site and the girlfriend was located and tested. She was a previous positive but had not received an interview. </li></ul><ul><li>The inmate tested negative for HIV 5 months prior to the positive NAAT </li></ul>

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