Sexually Transmitted Diseases  >  Program Guidelines  >  Partner Services

Program Operations Guidelines for STD Prevention
Partner Services

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Appendix PS-B

ORIGINAL INTERVIEW FORMAT

Introduction, Professional Role, and Purpose

The interviewer initiates the interview so as to foster productive dialogue by:

• introducing himself or herself and anyone else present, and explaining his or her professional role (avoiding titles such as DIS);
• explaining the purpose of the session; and
• emphasizing the confidential nature of the interview, defining confidentiality and its relevance to the patient's situation.

Patient Assessment

The interviewer maintains active, two-way client-centered communications throughout the interview by:

• communicating at the patient's level of understanding;
• using open-ended questions;
• using appropriate nonverbal communication;
• using positive reinforcement;
• soliciting feedback;
• listening effectively; and
• using plain paper to record interview notes (never take official forms into the interview).

Patient Concerns

The interviewer identifies and addresses the patient's concerns, determines reason for exam, and clarifies patient's concerns or misconceptions about the diagnosis.

Socio-sexual Information

The interviewer uses open-ended questions to gather information about where the patient lives; telephone, cell phone, beeper number; alternative locating information; who the patient is living with; employment; recent travel; recreation; and social groups. Explain reasons for questions if patient shows signs of concern.

Medical History and Disease Comprehension

The interviewer ensures that each patient is informed about the specific STD at issue (asymptomatic nature of disease, risk of re-infection, mode of transmission, course of disease, symptoms, sites of possible exposure, seriousness of disease, and risk reduction), uses visual aids to gather information on signs and symptoms of the original patient and ask about other persons with symptoms (S-1), and gathers information about STD history and previous testing and treatment.

Disease Intervention Behaviors

Assuring Examination of Partners and Suspects

After eliciting the names of partners and other high-risk persons (especially if pregnant), the interviewer pursues detailed identifying and descriptive information, making certain to get complete sexual exposure data and nature of symptoms when appropriate. Note: The same amount of locating and descriptive information should be pursued on all partners and suspects, even if the DIS is aware of the named individual.

"Clustering" is the process of identifying people who may be indirectly associated with the infected patient and who may benefit from an examination, even when they are not named as interview period partners. This is done by eliciting suspects during interviews with infected patients. While the number of actual partners exposed during the critical period is finite, the potential for clusters is almost limitless.

The following locating information should be pursued when a partner or suspect is elicited:

• name, nicknames, and other aliases;
• dates and frequency of exposure;
• address, phone and pager numbers;
• place and type of employment, trade, or school and phone number;
• personal appearance and description (including age or date of birth);
• co-residents and others residing at residence;
• other person(s) who can provide locating information or convey a message;
• hangouts, best places and times to encounter;
• previous place(s) of residence or employment;
• history of arrest or incarceration;
• other mailing address; and
• map and directions, especially when no address is known or there is patient uncertainty.

The DIS recognizes and addresses problem indicators through a process of:

• analysis;
• using the LOVER method (Listen, Observe, Verify, Evaluate, and Respond);
• assertive confrontation (without alienation);
• tactful persistence;
• timely uses of appropriate motivations, such as:
  • mode of transmission,
  • confidentiality,
  • asymptomatic nature of disease,
  • risk of re-infection,
  • complications and consequences,
  • social responsibility,
  • higher chance of getting or giving HIV, and
  • pregnancy and children.

Negotiating a risk reduction plan

STD prevention counseling should be incorporated into interviews. Prevention counseling with patients who are sexually active is likely to be more effective when the counseling skills and strategies are shaped to fit the individual's needs. To ensure that STD prevention counseling is client-centered, the interview should be based on appropriate CDC standards for prevention counseling, a discussion of risk-reduction or harm reduction strategies that the patient will be able to attempt, and specific strategies to help the patient with making these changes.

Conclusion

Before concluding the original interview, the interviewer should:

• clear up any remaining questions;
• restate commitments (e.g., contract referral, risk reduction plan, referrals);
• plan for reinterview; and
• provide handouts (e.g., referrals, condoms, follow-up appointments, pamphlets)

In accordance with local practices, the DIS should confer with the supervisor (or designated co-worker) before completing a clinic interview if:

• an unexplained exposure gap exists
• no source candidate has been elicited;
• information inconsistencies persist; or
• the DIS feels dissatisfaction or uncertainty regarding the results of the interview.

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