Beyond the Pouch: DIS in the 21 st Century Dawn Broussard, MPH Sr. Public Health Advisor Chicago Department of Public Health STD/HIV Prevention and Care Program

DIS Roles Defined ~ mid-1960s A new public health professional, the venereal disease investigator, was introduced in the 1940s. These investigators, in interviewing venereal disease patients, searched out the many sex contacts of each known infection back to the incubation period. A new public health professional, the venereal disease investigator, was introduced in the 1940s. These investigators, in interviewing venereal disease patients, searched out the many sex contacts of each known infection back to the incubation period.

Oh, the places youll go… Public and Private Hospitals Public and Private Hospitals Corrections Corrections Drug Treatment Drug Treatment Adolescent Programming Adolescent Programming Outreach Outreach Bioterrorism/Emergency Efforts Bioterrorism/Emergency Efforts Other HD units Other HD units

DIS Duties Revisited On-site surveillance On-site surveillance STD infection control STD infection control Case management Case management Formal and informal training of staff Formal and informal training of staff Interpret results and recommend treatment Interpret results and recommend treatment HIV/Hepatitis counseling and testing HIV/Hepatitis counseling and testing Prevention education Prevention education Health promotion Health promotion Specimen collection Specimen collection Movement of individuals (corrections, drug treatment) Movement of individuals (corrections, drug treatment) Liaison between agency and HD Liaison between agency and HD Other duties as assigned… Other duties as assigned…

Indigenous DIS Hired by agency Hired by agency Trained by health department Trained by health department Dual reporting to agency and HD supervisor Dual reporting to agency and HD supervisor Same performance indicators as HD DIS Same performance indicators as HD DIS Participate in trainings, staff meetings and chalk talks Participate in trainings, staff meetings and chalk talks

Howard Brown Health Center The Midwests largest LGBT health center The Midwests largest LGBT health center In 2003, reported 28% of MSM syphilis cases in Chicago In 2003, reported 28% of MSM syphilis cases in Chicago Approximately 7,500 clients annually Approximately 7,500 clients annually

Advantages to HD and Agency Fewer restrictions on how, when and where they work Fewer restrictions on how, when and where they work Financial savings Financial savings Indirect costs, fringe benefits may be less Indirect costs, fringe benefits may be less Strengthens ties between HD and agency Strengthens ties between HD and agency Expands recruitment opportunities, career ladder for both sides Expands recruitment opportunities, career ladder for both sides

Advantages Better received by clients Better received by clients Clinical and case management services in same location Clinical and case management services in same location Perceived as more empathetic, less judgmental Perceived as more empathetic, less judgmental Not viewed as government interference in personal life Not viewed as government interference in personal life Providers encourage clients to see HBHC DIS Providers encourage clients to see HBHC DIS On-site referrals to social services On-site referrals to social services

A little bit of data… CDPHClinicHBHC Syphilis Cases Interviewed 88%95% Cases Interviewed w/in 3 Days 73%79% Contact Index for MSM Cases Cluster Index H&J Rate for P/S/A 14%9%

Conclusion DIS are not relics from another era DIS are not relics from another era Indigenous DIS can enhance programs ability to reach specific target populations Indigenous DIS can enhance programs ability to reach specific target populations DIS have a unique skill set that allows them to take on numerous roles DIS have a unique skill set that allows them to take on numerous roles DIS continue to provide STD programs with the flexibility needed to respond to changing priorities DIS continue to provide STD programs with the flexibility needed to respond to changing priorities

Acknowledgements Andrew Delicata Jan Hiland Gus Conda Lisa Varella For More Information: Dawn Broussard Phone: (312)