Provider and Client Acceptance of a Health Department Enhanced Approach to Improve HIV Partner Notification in New York City

Abstract

To assess provider and client acceptance of health department-delivered HIV partner services (PS) delivered in clinical and community settings. In 2006, New York city (NYC) formed the HIV field services unit (FSU), staffed with experienced sexually transmitted disease intervention specialists (DIS). DIS were stationed at 8 large hospitals to assist clinical providers and their HIV-positive patients with PS in areas with high rates of delayed HIV diagnoses and HIV-related mortality. We surveyed providers (self-administered questionnaire) and clients (staff-administered) to examine provider and patients as well as patients' HIV-exposed partners' acceptance of and concerns regarding PS. Response rates were as follows: 63% (132/211) providers; 90% (492/544) patients who accepted PS; 73% (16/22) patients who declined PS; 83% (139/168) partners who received notification; and 81% (25/31) partners who declined notification. Most providers felt the DIS focus and expert skills in PS was beneficial to providers (87%) and clients (89%). Most patients (91%) had a positive or neutral attitude about the health department-delivered PS. Most providers reported no disadvantage to DIS providing PS (69%); their most commonly cited (24%) concern was potential patient confusion about the roles of providers versus DIS. Patients' most common concerns were the intrusive nature of the interviews and the length of the interview (50/492, 20%). The partners wanted to know who named them (32/139, 23%). Health department-delivered PS by DIS in clinical and community settings was acceptable to providers, HIV-infected patients, and HIV-exposed partners. Overall, our survey showed strong provider and client support for this approach.