PCRS Partner Counseling and Referral Services
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Transcript of PCRS Partner Counseling and Referral Services
PCRSPCRSPartner Counseling and Partner Counseling and
Referral ServicesReferral Services
Tereé JeromeTereé JeromeFern OrensteinFern Orenstein
CaliforniaCaliforniaPCRS ProgramPCRS Program
HIV Partner Counseling & Referral HIV Partner Counseling & Referral Services (PCRS)Services (PCRS)
Array of Voluntary & Confidential services available to HIV positive persons and their sex and/or needle-sharing partners
Integral part of a comprehensive HIV prevention program…
Prevention With Positives
PCRSPCRS
For the HIV+ client :For the HIV+ client : support andsupport and professional assistance with the notification professional assistance with the notification of HIV exposure to all relevant partnersof HIV exposure to all relevant partners
• For the partners :For the partners : services include: services include:
• notification of HIV exposurenotification of HIV exposure• HIV counseling and testing options,HIV counseling and testing options,• referrals for other services: PCM, referrals for other services: PCM,
support groups, drug tx, STD evaluation, support groups, drug tx, STD evaluation, housing, domestic violence resources, housing, domestic violence resources, legal assistance, etc...legal assistance, etc...
PCRS PCRS Guiding PrinciplesGuiding Principles
VoluntaryVoluntary ConfidentialConfidential Client CenteredClient Centered On-goingOn-going Support Services and ReferralsSupport Services and Referrals Universal accessUniversal access
Disclosure Options Disclosure Options
Self Disclosure Self Disclosure Dual Disclosure Dual Disclosure Provider Disclosure (Anonymous 3Provider Disclosure (Anonymous 3rdrd
Party Disclosure )Party Disclosure )
Dispelling Myths about PCRSDispelling Myths about PCRS
Clients don’t want it Clients don’t want it Clients are too overwhelmedClients are too overwhelmed Not “client centered”Not “client centered” Not voluntaryNot voluntary Not confidentialNot confidential Cannot be done in anonymous Cannot be done in anonymous
settingssettings
GIVE MENAMES
NAMESNAMES
The Clinic
What People Think
Role of ProvidersRole of Providers
Check in with clients about partners Check in with clients about partners Support clients in deciding whether Support clients in deciding whether
or not to disclose their statusor not to disclose their status Help client explore which option, if Help client explore which option, if
any, is best any, is best – Self, Dual, or Provider (Anonymous)Self, Dual, or Provider (Anonymous)
Assess safety, Partner/Domestic Assess safety, Partner/Domestic Violence Violence
CDC 2004 Prevention PlanCDC 2004 Prevention Plan
Approx ¼ of persons w/HIV (950K) are not Approx ¼ of persons w/HIV (950K) are not aware of their infection and their risk for aware of their infection and their risk for transmitting HIV. transmitting HIV.
Prevent new infections by working w/HIV + persons and partners: – Voluntary PCRS– Rapid Testing (new models for DX HIV)– Linking positive persons into care and
treatment earlier
Prevent vertical transmission, mother to child, 180 cases last year
Benefits & ConcernsBenefits & Concerns
Break into three groups: Break into three groups:
Client, Partner & ProviderClient, Partner & Provider Brainstorm the benefits & concerns Brainstorm the benefits & concerns
around PCRS, for the group you around PCRS, for the group you representrepresent
You need:You need: 1) Recorder1) Recorder
2) Reporter2) Reporter
*15 minutes**15 minutes*
Utilization of Voluntary HIV Utilization of Voluntary HIV Partner Counseling and Partner Counseling and
Referral Services (PCRS)Referral Services (PCRS)
California Office of California Office of AIDS & STD Control AIDS & STD Control
BranchBranch
PCRS Program DataPCRS Program Data
5 Demonstration Projects5 Demonstration Projects– 14 Local Health Jurisdictions (LHJs)14 Local Health Jurisdictions (LHJs)
March 1999 – December 2002March 1999 – December 2002 1783 clients offered PCRS1783 clients offered PCRS
How HIV + Clients are Responding to PCRS (N=1783)
Did not refer partner
75%
Referred at least one partner
25%Prepared by California Department of Health Services: Office of AIDS and STD Control Branch
Partner ReferralsPartner Referrals
• 450 HIV+ clients went on to refer partner
• 802 total partners referred
• Average partners referred per client: 1.8
• Range: 1-21 partners
• 71% designated only 1 partner
• 42% of partners referred to Provider, Dual or Contract services
Number Number of OCs of OCs choosinchoosing each g each typetype
Percent Percent of of
referring referring OCs*OCs*
Number Number of total of total
partnerpartners s
elicited elicited
Percent Percent of all of all
partnerpartners s
elicitedelicited
Avg # Avg # of of
partners partners elicited elicited
per per client:client:
Range of Range of partners partners elicited elicited
per per client:client:
ClientClient 306306 68%68% 469469 58%58% 1.51.5 1-191-19
ProviderProvider 143143 32%32% 275275 34%34% 1.91.9 1-191-19
DualDual 4040 9%9% 4646 <6%<6% 1.11.1 1-51-5
ContracContractt
88 <2%<2% 1212 <2%<2% 1.51.5 1-51-5
Partner Referrals
*percentages do not necessarily add to 100% as OCs can choose multiple referral choice for different partnersPrepared by California Department of Health Services: Office of AIDS and STD Control Branch
Not tested25%
(n=41)
Refused contact6%
(n=9)
No prev test, new neg
42%(n=38)
Already known HIV positive
13%(n=21)
No prev test, new pos
16%(n=14)
161 partners (85%) were located
90 (56%) of the located partners were tested
&
Follow-up was initiated on 189 partners
Prepared by California Department of Health Services: Office of AIDS and STD Control Branch
Tested56%
(n=90)
Prev neg, still neg
40%(n=36)
Prev neg,new pos
2%(n=2)
Partner Follow-up 189 partners followed-up 161 located (85%)
• 13% already HIV +• 10% new positives of those located (16/161)
90 tested (56%)• 18% new positives of those tested (16/90)
• 1.3% state OA-funded positivity rate• 4%- 7.5% ‘HIV+ partner’ high risk group
• Over half (58%) of those testing were 1st time testers (n=52)
Supporting Materials from PCRS Supporting Materials from PCRS ProgramProgram
Customized TrainingCustomized Training BrochuresBrochures Palm Cards Palm Cards Standards and RecommendationsStandards and Recommendations Data collection tools and technical Data collection tools and technical
assistance assistance PCRS Toolkit (under construction)PCRS Toolkit (under construction)
Contact usContact us
Fern OrensteinFern Orenstein
PCRS Program PCRS Program DirectorDirector
State of California State of California
[email protected]@dhs.ca.gov
Tereé JeromeTereé Jerome
PCRS Regional PCRS Regional CoordinatorCoordinator
Bay AreaBay Area
510-540-2907510-540-2907
[email protected]@dhs.ca.gov. .