1. E-STD Prevention and Control
Jeffrey D. Klausner, MD, MPH
Director, STD Prevention and Control Services
San Francisco Department of Public Health Associate Clinical Professor of Medicine University of California, San Francisco

2. Internet-based disease control interventions
Surveillance
Education and health promotion
Screening and test results
Partner notification and treatment
Prevention

3. Internet-based disease control interventions
Surveillance
Education and health promotion
Screening and test results
Partner notification and treatment
Prevention

4. CA DPH STD Control Branch (rev 3/2008)

5. CA DPH STD Control Branch (rev 3/2008)

6. Internet-based disease control interventions
Surveillance
Education and health promotion
Screening and test results
Partner notification and treatment
Prevention

7. SF City Clinic website
Klausner JD. Sex Transm Dis Oct;26(9):548.

8. hookinguponline.org

9. Brief sexual health videos

10. Health department profiles on sex partnering sites

11. Internet-based disease control interventions
Surveillance
Education and health promotion
Screening and test results
Partner notification and treatment
Structural changes

12. Online access to chlamydia test kits
Forty-one of 400 (10.3%) women were chlamydia positive; 95.1% treated
Gaydos CA, et al., Sex Transm Dis Jul;33(7):451-7

13. STDTest.org
Levine D et al., Sex Transm Dis. 2005

14. Frequency of online syphilis testing by quarter, 2003-2007
= Reactive tests (6.0%)

15. Online STD clinic test results
Kohn R et al, CDC NSTD Conference, 2006

16. Online access increases persons learning STD test results
Month
Kohn R et al, CDC NSTD Conference, 2006

17. Internet-based disease control interventions
Surveillance
Education and health promotion
Screening and test results
Partner notification and treatment
Structural changes

18. Internet guidelines for health departments
Messages sent from Internet service provider less likely to be discarded; use same provider as case. Health departments may need multiple accounts.
Include reference to “Serious health matter” in message header; include verifiable information
No group messages; use same principles of confidentiality as with postal service or telephone
Upon response, collect information to develop more personal contact

19. InSpot: online peer-to-peer partner notification for STDs/HIV

21. InSpot partner prescription
About 120 CT prescriptions; 100 GC prescriptions in 2007

22. Internet-based disease control interventions
Surveillance
Education and health promotion
Screening and test results
Partner notification and treatment
Prevention

23. Sex partnering sites facilitating safer hook-ups

24. Site modifications promote safer sex
Requires persistence, voluntary cooperation from business owner
Increasing public health and community advocacy; no regulatory authority
Potentially very effective and low cost

25. Site modifications promote safer sex 
Requires persistence, voluntary cooperation from business owner
Increasing public health and community advocacy; no regulatory authority
Potentially very effective and low cost

26. E-STD prevention and control
Primary prevention
Education, health promotion, structural changes to modify networks
Secondary prevention
Screening, test results, partner notification and treatment

27. Conclusions
Internet sex partnering is common among persons at high risk for STD/HIV
Web offers opportunity for STD prevention and control interventions

28. Acknowledgments
SFDPH STD Services—Jacque McCright, Robert Kohn, Rachael Perez, Florence Yu, SF City Clinic, 1360 Staff
SFDPH Business Enterprise Systems—Donna Childers
SF Partners in STD/HIV Prevention
STOP AIDS
Full Circle Fund
CDC—Wendy Wolf, Dayne Collins
Gay.Com, Craigslist, Manhunt.net
ISIS-Inc—Deb Levine
Scarlet Letter Services—Frank Strona
CA DPH STD Branch—Dan Wohlfeiler