PCRS Partner Counseling and Referral Services Tereé Jerome Fern Orenstein California PCRS Program

HIV Partner Counseling & Referral Services (PCRS)   Array of Voluntary & Confidential services available to HIV positive persons and their sex and/or needle-sharing partners   Integral part of a comprehensive HIV prevention program…   Prevention With Positives

PCRS  For the HIV+ client : support and professional assistance with the notification of HIV exposure to all relevant partners For the partners : services include: For the partners : services include: notification of HIV exposure notification of HIV exposure HIV counseling and testing options, HIV counseling and testing options, referrals for other services: PCM, support groups, drug tx, STD evaluation, housing, domestic violence resources, legal assistance, etc... referrals for other services: PCM, support groups, drug tx, STD evaluation, housing, domestic violence resources, legal assistance, etc...

PCRS Guiding Principles  Voluntary  Confidential  Client Centered  On-going  Support Services and Referrals  Universal access

Disclosure Options  Self Disclosure  Dual Disclosure  Provider Disclosure (Anonymous 3 rd Party Disclosure )

Dispelling Myths about PCRS Dispelling Myths about PCRS  Clients don’t want it  Clients are too overwhelmed  Not “client centered”  Not voluntary  Not confidential  Cannot be done in anonymous settings

GIVE ME NAMESNAMESNAMES The Clinic What People Think

Role of Providers  Check in with clients about partners  Support clients in deciding whether or not to disclose their status  Help client explore which option, if any, is best –Self, Dual, or Provider (Anonymous)  Assess safety, Partner/Domestic Violence

CDC 2004 Prevention Plan Approx ¼ of persons w/HIV (950K) are not aware of their infection and their risk for transmitting HIV.   Prevent new infections by working w/HIV + persons and partners: – –Voluntary PCRS – –Rapid Testing (new models for DX HIV) – –Linking positive persons into care and treatment earlier   Prevent vertical transmission, mother to child, 180 cases last year

Benefits & Concerns  Break into three groups: Client, Partner & Provider Client, Partner & Provider  Brainstorm the benefits & concerns around PCRS, for the group you represent  You need:1) Recorder 2) Reporter *15 minutes*

Utilization of Voluntary HIV Partner Counseling and Referral Services (PCRS) California Office of AIDS & STD Control Branch

PCRS Program Data  5 Demonstration Projects –14 Local Health Jurisdictions (LHJs)  March 1999 – December 2002  1783 clients offered PCRS

How HIV + Clients are Responding to PCRS (N=1783) Prepared by California Department of Health Services: Office of AIDS and STD Control Branch

Partner Referrals 450 HIV+ clients went on to refer partner 802 total partners referred Average partners referred per client: 1.8 Range: 1-21 partners 71% designated only 1 partner 42% of partners referred to Provider, Dual or Contract services

Number of OCs choosin g each type Percent of referring OCs* Number of total partner s elicited Percent of all partner s elicited Avg # of partners elicited per client: Range of partners elicited per client: Client30668%46958% Provider14332%27534% Dual409%46<6% Contract8<2%12<2% Partner Referrals *percentages do not necessarily add to 100% as OCs can choose multiple referral choice for different partners Prepared by California Department of Health Services: Office of AIDS and STD Control Branch

161 partners (85%) were located 90 (56%) of the located partners were tested & Follow-up was initiated on 189 partners Prepared by California Department of Health Services: Office of AIDS and STD Control Branch Tested 56% (n=90) Prev neg, still neg 40% (n=36) Prev neg, new pos 2% (n=2)

Partner Follow-up  189 partners followed-up  161 located (85%) 13% already HIV + 10% new positives of those located (16/161)  90 tested (56%) 18% new positives of those tested (16/90) 1.3% state OA-funded positivity rate 4%- 7.5% ‘HIV+ partner’ high risk group Over half (58%) of those testing were 1 st time testers (n=52)

Supporting Materials from PCRS Program  Customized Training  Brochures  Palm Cards  Standards and Recommendations  Data collection tools and technical assistance  PCRS Toolkit (under construction)

Contact us Fern Orenstein PCRS Program Director State of California Tereé Jerome PCRS Regional Coordinator Bay Area