1. National Guidelines for Internet-Based STD/HIV Prevention
Rachel Kachur, MPH
Stephan Adelson, Adelson Consulting Services

2. Why National Guidelines?
Evidence of the Internet as a means of transmission
Programs anxious for direction
Evidence of promising Internet-based efforts
Dear Colleague letter September 13, 2005
NCSD needs assessment

3. The Development
Input from researchers, MDs, CBOs, Health Departments, CDC, NCSD, and the private sector
Reviewed by Health Departments & Community Based Organizations
Reviewed by those most likely to use it.

4. Health Communication
Internet Outreach
Internet Partner
Notifcation

5. A foundation to build on
Nonprescriptive
Applicable for both STD and HIV prevention
Written for a broad audience
Provide best practices from those that have the most experience
Create a baseline for the production of local guidelines

6. Contents Tips from the field Examples from CBOs
Tools from existing programs
Tip from the field
Aggressive outreach can cause chat room members to leave the chat room or website and go elsewhere

7. Internet Partner Notification
Chapters include:
Introduction
Background
Before you begin
Evaluation of IPN
Getting started
Implementing IPN
The Future of IPN
The Internet is a powerful tool for communication and, as such, is a valuable tool for facilitating STD/HIV PN. Research has shown the Internet to be a venue for STD transmission11-13 as well as a venue for disease control and health promotion14-16.

8. Internet Partner Notification Addressing Concerns
IPN can be likened to leaving a letter at someone’s door. Those new to IPN or who are considering IPN often have concerns about confidentiality and the possibility of breaching confidentiality. The primary concern is that sending an , often from an such as DCSTD, will unwittingly breach confidentiality.
Sending an carries the same risks as leaving a letter on a doorstep. ..but the public health benefit of notifying someone of their possible exposure and infection outweighs the small possibility that confidentiality will be breached.
Tip from the field
Amend confidentiality agreements to include addresses, screen names & other potentially identifying information

9. Internet Partner Notification Giving examples and tools
HIV and STD
Internet Partner Notification Giving examples and tools
Tip from the Field
In addition to documenting IPN efforts some program areas have created additional forms to monitor IPN. See Appendix F for an example.

10. Internet Partner Notification Providing practical advice
For example, on
(Black Gay Chat), after creating a profile, it is necessary to chose "My Account Options" and then chose "Turn Who I Recently Visited Off."  Otherwise when an internet partner's profile is viewed, it will document the HD's visit on that particular profile.
Tip from the field
IPN should be conducted from designated department accounts and profiles, and never from personal accounts or profiles.
Programs need to be aware that different websites have different options that may help maintain or potentially breach confidentiality. 

11. Internet Outreach Chapters: Introduction Background
Principles of Outreach
Getting started
Program implementation
Limitations of Internet Outreach
Summary
Glossary
There are several approaches Internet outreach workers can take when attempting to engage a community or encourage individuals into a one-on-one chat session. There are two approaches that are currently in practice; an ‘active’ and a ‘passive’ approach.

12. Internet Outreach Addressing Concerns
It is important to note that, for agencies with limited resources other forms of Internet work such as partner notification and health communication (as outlined in the other sections of these guidelines), might be considered more cost effective over Internet outreach.
TIP from the field
When considering costs, remember that choosing where and when to perform outreach affects the cost effectiveness of the program.
The most significant portion of the cost involved with Internet outreach is related to staff salaries and time.

13. Internet Outreach Giving examples and tools
HIV and STD
Internet Outreach Giving examples and tools
Tip from the Field
Some IM programs have a log feature that can automatically save chats and allow you to print them as needed. You can typically find this feature under; preferences, setting, or options.

14. Internet Outreach Providing practical advice
Tip from the field
Most programs that conduct online outreach have, at one time or another, been removed, blocked, or had their profile deleted or their account revoked from a website.
Some Internet outreach workers may choose to actively contact online clients they suspect, from reading profiles or chat room conversations, are practicing high-risk behaviors.
Being too aggressive during outreach can threaten trust and rapport-building and will often be met with negative feedback from the online community.

15. Next steps
Final Draft of Internet Partner Notification and Outreach sections are available now in print and online as a PDF at the NCSD website
The guidelines will be finalized, including the health communications section, and available by year’s end and available online or possible as a CD-Rom
Efforts will be made to provide the means for continued communication and updating of the document thorough a listserv or other electronic means of communication

16. The Future of the Guidelines
This is the first iteration of many to come.
We hope these guidelines will be living documents, that is, documents that are constantly changing and continuously being updated based on research and program experience, so that they remain relevant and useful.
You have a say… Starting now! Complete the survey.

17. Thanks to… Partner Notification Health Outreach Contributors
David Novak
Jemima Talbot
Bruce Furness
Dan Elhman
Beau Gratzer
Jill Gatwood
Eric Roland
Frank Strona
Stephan Adelson
David Novak
Thomas Bertrand
Don Clark
Stewart Coulter
Sam Dooley
Kevin Farrell
Larry Foster
Suzanne Haecker
Tracey Hardy
Rachel Kachur
Todd Logan
Mary McFarlane
Jorge Montoya
Pam Pitts
Amy Pulver
Jan Scott
David Sullivan
Drew Thomits
Karen Thompson
Lyn Trotter
Duane Wilmot
Dan Wohlfeiler
Andrew Woodruff
Kim Seechuk
Outreach – Eric Roland, Frank Strona, Stephan Adelson, David Novak
IPN – David Novak, Jemima Talbot, Bruce Furness, Dan Elhman, Beau Gratzer, Jill Gatwood
Special thanks to the reviewers and the medical editor
Special thanks to the reviewers and the medical editor...