1. Starting Internet Partner Services: The New York State Experience – Kelly Firenze – NYS DOH Bureau of STD Control – Judi Bulmer – NYS DOH Bureau of STD Control – Peter Laqueur, MSW – NYS AIDS Institute

2. History 2003 - NYS PTC staff attends HHS training on the STD/HIV Prevention and the Internet 2004 - BSTDC forms Internet Workgroup; = LHD survey disseminated = internet server purchased = pilot protocol developed 2005 - IPN pilot implemented for Early Syphilis 2006 - MSM cultural competency training for FO staff 2007 - Internet Committee expanded/Consultant hired for IPS guidelines development

3. 2005 Support for Internet work CDC Dear Colleague Letter in 2005 As awareness of the role and impact of the Internet on STD and HIV transmission increases, the BSTDC IPN Workgroup gains more support from key stake holders and NYS DOH policy makers

4. Emergence of Disease among MSM: Internet named as only locator 2006 - 71 internet contacts elicited from 2 Primary Syphilis investigations (Downstate and Central NY area) 2007 - HIV positive patient names over 100 partners: e-mail addresses only available locating information (Downstate area)

5. Primary and Secondary Syphilis – Reported Rates by Sex: NYS Exclusive of NYC,1992-2007 and the Healthy People 2010 (HP2010) Objective

6. Central New York Syphilis Cluster 2006 Background ES cluster yields 67 partners (54 internet screen names only) prompts expansion of IPS to Central NY Outcome 20 (37%) internet partners notified 89% of the internet partners were medically evaluated

7. Lessons Learned…. The Internet has a major impact on facilitating disease transmission as well as disease intervention Paradigm shift for partner services  IPS staff needs expansion  Staff need training  Guidelines need to be established

8. Moving Forward 2007 – expanded survey of 300 state-wide agencies (LHDs/CBOs) 2008 - training module created for selected staff 2009 - NYS guidelines finalized

9. Key adaptations Subject: Changed from “Urgent health matter” to blank New message content for emails Ability to inform of disease specific exposure Ability to capture dispositions for Internet cases into STD MIS*

10. Training for staff… Pre-training participant questionnaire used to establish baseline knowledge, skills and attitudes Two and a half day session for Regional Supervisors and selected DIS Staff Training outline  Overview of websites  Cultural sensitivity  How to set up profiles  How to Email & IM  Live mock communication between IPS staff

11. IPS Expansion To All Regions in State May 2008: One trained BSTDC staff member designated as “lead” IPS staff for each of 5 regions with RS serving as back-up

12. IPS support and communication Weekly conference calls for IPS staff

13. NYS DOH IPS Profiles have been created on many websites…. ***

14. Data collection and evaluation… statewide Contact Screen Name / E-mail database (record search) IPS Logs – documents IPS investigation activity and outcome 20 New IPS-specific Dispositions

15. Statewide IPS database

16. Reframing IPS success… A “numbers game” Fuzzy data  evaluating the “L” Dispo

17. Traditional vs. Internet Partner Services: Issues for IPS consideration… Confidentiality Out of Jurisdiction (OOJ) Adjusting the interview process HIV PN Training

18. Issues Continued… IT Cultural competency Separating “personal” from “professional” Working in online venues Time and effort

19. NYS DOH IPS Guidelines Released

20. IPS growth continues…  Creation of NYS IPS Outreach Group on…  Creation of National IPS group  Creation of National group for OOJ Coordinators

21. Questions & Discussion…

22. For Additional Questions Contact NYS DOH Bureau of STD Control Judi Bulmer (518) 474-3598 jab19@health.state.ny.us