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Barriers, facilitators, and cost of integrating HIV-related activities into STD partner services in Jackson, Mississippi
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3 01 2021
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Source: Sex Transm Dis. 48(3):145-151
Details:
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Alternative Title:Sex Transm Dis
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Personal Author:
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Description:Background:
Many US health departments now integrate HIV-related outcomes (e.g., re-linkage to HIV care; PrEP) into STD partner services (PS) programs. We sought to determine the barriers, facilitators, and cost of integrating these activities into PS.
Methods:
From 2016–2018, The Mississippi State Department of Health integrated three new activities into STD PS: HIV testing for partners of HIV-negative men who have sex with men (MSM) with gonorrhea/chlamydia, re-linkage to HIV care for STD PS recipients previously diagnosed with HIV, and PrEP referrals. We conducted direct observations and interviews with disease intervention specialists (DIS) in Jackson to assess barriers and facilitators to implementing these activities. We completed time and motion studies with eight DIS and case tracking forms for 90 unique cases to estimate the incremental staff time and associated personnel cost of added services compared to a standard PS case.
Results:
DIS were optimistic about integrating HIV-related activities but noted disparate data systems, non-systematic documentation, and lack of training as barriers. The mean time for a standard STD PS case without HIV-related activities was 195 minutes (cost=$77.69/case). The cost to conduct PS for HIV-negative MSM with gonorrhea/chlamydia was 36% higher than a standard case. Integrating re-linkage to care and PrEP referrals resulted in a 44% and 20% increase in cost, respectively.
Conclusions:
Integrating HIV care re-linkage and PrEP referrals into STD PS was generally acceptable by DIS and added marginal cost per case. Coupling these cost metrics with an assessment of the effectiveness of these activities can inform prioritization of PS activities.
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Pubmed ID:32976363
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Pubmed Central ID:PMC9033159
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