1. Initiating Partner Notification on the Internet Wednesday, March 10 10:00-11:45 Andrew Delicata Former Lead DIS Howard Brown Health Center PCRS Coordinator Chicago Department of Public Health

2. Overview History Goals Method Results Lessons learned

3. History Performed at Howard Brown Health Center Numerous original patients (OP’s) gave contact information for sex partners (SP’s) sought over the Internet Creation of policies and procedures for doing Internet partner notification was long overdue

4. History (cont.) Prior to this project: Only 53% of people contacted over the Internet (e-mail) responded with a phone call All chat conversations failed to produce a phone call We were loosing about half of all Internet contacts, all of whom had screen names

5. History (cont.) – The E-mail Hey, My name is Andy Delicata from Howard Brown Health Center. I am contacting you through e-mail because I have no other contact information for you (i.e. phone number or address). I really need to talk with you about your personal health as soon as you get this message. Due to potential confidentiality breaches I cannot tell you more in an e-mail. Therefore, I think we should talk over the phone or in person. Please take this seriously. THIS IS NOT A JOKE. I really need to talk with you. My phone number is xxx-xxx-xxxx. Please try to call during these hours: M- Th 4-8pm or F 12-4pm. Otherwise leave a message. Also, for more information about Howard Brown and what we do visit our web page at www.howardbrown.org. Sincerely, Andy Delicata xxx-xxx-xxxx

6. Goals There was a great need to better utilize chat To notify sex partners that had been missing Maintain safety and respect of all involved Preserve confidentiality Not to appear solicitous, or to appear to be seeking sex Offer legitimacy

7. The Goal is NOT For Partner Notification initiated in chat, the goal is NOT To educate To do any type of prevention work To notify the partner in the chat room itself

8. Method Solicit sex partners’ e-mail address/ screen names Find the person in chat first Send an e-mail Attempt to initiate partner notification Shift from passive (e-mail) to active (chat)

9. Find a Person in Chat All chat environments are different Use a buddy list, if available Never approach a client in an “open room” Always use private Instant Messages (IM)

10. Initiate Partner Notification Introduction Focus Confidentiality Respect

11. Introduce yourself i.e. “Hi. My name is Andy Delicata. I’m from Howard Brown Health Center. My phone number is xxx-xxx-xxxx. Is this a good time to talk?” “I have something important to tell you. It concerns your health. But I can’t tell you in an IM. Can you call me?”

12. Minimize the conversation/focus “I can tell you that over the phone. For now, the only thing I can tell you is that this concerns your health and it is very important.”

13. Maintain confidentiality Never state your title Never state the disease Never give your job description Do not try to educate Do not use a profile

14. Maintain respect Do not use the person’s real name Instead ask, “Are you the only person who uses this screen name?” Acknowledge this is confusing

15. Results (After the Project) We collected 10 sex partner’s online information from four different cases in a period of four months All were screen names, 8 were also e-mail addresses

16. Results (cont.) 8/10 (80%) were found online in a chat room 7/8 (88%) called the DIS (one person did not accept the invitation to chat) E-mails were sent to four of the 8, but chat was the reason they called None responded to the e-mail alone

17. Results (cont.) Using chat resulted in a 70% (7/10) call rate All (100%) of chat conversation with the DIS resulted in a phone call All phone calls resulted in the person being tested for syphilis Two were positive and resulted in the linkage of cases

18. Lessons Learned Time intensive, but well worth it More research needed (small subset of MSM in Chicago) Introduction is key Simultaneous e-mail can hinder efforts No one way to initiate PN over the Internet

19. Thank you For questions: AndrewDelicata@hotmail.com To request a copy of the policy: BeauG@howardbrown.org