Beyond the Pouch:Beyond the Pouch:DIS in the 21DIS in the 21stst Century Century

Dawn Broussard, MPHDawn Broussard, MPHSr. Public Health AdvisorSr. Public Health Advisor

Chicago Department of Public Chicago Department of Public HealthHealth

STD/HIV Prevention and Care STD/HIV Prevention and Care ProgramProgram

DIS Roles Defined DIS Roles Defined ~ mid-1960’s~ mid-1960’s

““A new public health professional, A new public health professional, the venereal disease investigator, the venereal disease investigator, was introduced in the 1940’s. These was introduced in the 1940’s. These investigators, in interviewing investigators, in interviewing venereal disease patients, searched venereal disease patients, searched out the many sex contacts of each out the many sex contacts of each known infection back to the known infection back to the incubation period”.incubation period”.

Oh, the places you’ll go…Oh, the places you’ll go…

Public and Private Public and Private HospitalsHospitals

CorrectionsCorrections Drug TreatmentDrug Treatment Adolescent Adolescent

ProgrammingProgramming OutreachOutreach Bioterrorism/Bioterrorism/

Emergency EffortsEmergency Efforts Other HD unitsOther HD units

DIS Duties RevisitedDIS Duties Revisited

On-site surveillanceOn-site surveillance STD infection controlSTD infection control Case managementCase management Formal and informal Formal and informal

training of stafftraining of staff Interpret results and Interpret results and

recommend treatmentrecommend treatment HIV/Hepatitis HIV/Hepatitis

counseling and testingcounseling and testing

Prevention educationPrevention education Health promotionHealth promotion Specimen collectionSpecimen collection Movement of Movement of

individuals (corrections, individuals (corrections, drug treatment)drug treatment)

Liaison between Liaison between agency and HDagency and HD

Other duties as Other duties as assigned…assigned…

““Indigenous” DISIndigenous” DIS

Hired by agencyHired by agency Trained by health departmentTrained by health department Dual reporting to agency and HD Dual reporting to agency and HD

supervisorsupervisor Same performance indicators as HD Same performance indicators as HD

DISDIS Participate in trainings, staff meetings Participate in trainings, staff meetings

and chalk talks and chalk talks

Howard Brown Health Howard Brown Health CenterCenter

The Midwest’s The Midwest’s largest LGBT health largest LGBT health centercenter

In 2003, reported In 2003, reported 28% of MSM syphilis 28% of MSM syphilis cases in Chicagocases in Chicago

Approximately Approximately 7,500 clients 7,500 clients annuallyannually

Advantages to HD and Advantages to HD and AgencyAgency

Fewer restrictions on how, when and Fewer restrictions on how, when and where they workwhere they work

Financial savingsFinancial savings Indirect costs, fringe benefits may be lessIndirect costs, fringe benefits may be less

Strengthens ties between HD and Strengthens ties between HD and agencyagency

Expands recruitment opportunities, Expands recruitment opportunities, career ladder for both sidescareer ladder for both sides

AdvantagesAdvantages

Better received by clientsBetter received by clients Clinical and case management services in Clinical and case management services in

same locationsame location Perceived as more empathetic, less Perceived as more empathetic, less

judgmentaljudgmental Not viewed as “government” interference in Not viewed as “government” interference in

personal lifepersonal life Providers encourage clients to see HBHC DISProviders encourage clients to see HBHC DIS On-site referrals to social services On-site referrals to social services

A little bit of data…A little bit of data…CDPH CDPH

Clinic Clinic HBHCHBHC

Syphilis Cases InterviewedSyphilis Cases Interviewed 88%88% 95%95%

Cases Interviewed w/in 3 Cases Interviewed w/in 3 DaysDays

73%73% 79%79%

Contact Index for MSM Contact Index for MSM CasesCases

1.01.0 1.01.0

Cluster IndexCluster Index 0.20.2 0.10.1

H&J Rate for P/S/AH&J Rate for P/S/A 14%14% 9%9%

ConclusionConclusion DIS are not relics from DIS are not relics from

another eraanother era ““Indigenous” DIS can Indigenous” DIS can

enhance program’s ability to enhance program’s ability to reach specific target reach specific target populationspopulations

DIS have a unique skill set DIS have a unique skill set that allows them to take on that allows them to take on numerous roles numerous roles

DIS continue to provide STD DIS continue to provide STD programs with the flexibility programs with the flexibility needed to respond to needed to respond to changing prioritieschanging priorities

AcknowledgementsAcknowledgementsAndrew DelicataAndrew Delicata

Jan HilandJan HilandGus CondaGus CondaLisa VarellaLisa Varella

For More Information:For More Information:Dawn BroussardDawn Broussard

Phone: (312) 747-3447Phone: (312) 747-3447Email: broussard_dawn@cdph.orgEmail: broussard_dawn@cdph.org