PCRS is comprehensive and includes elicitation, notification, and testing of partners as well as education, risk-reduction counseling, and assessment of the need for referral to psychosocial services, case management, and medical care and treatment

PCRS is comprehensive and includes elicitation, notification, and testing of partners as well as education, risk-reduction counseling, and assessment of the need for referral to psychosocial services, case management, and medical care and treatment. and prevention services to people at high risk for HIV infection. Incorporating rapid HIV testing into PCRS and identifying previously undiagnosed infections likely confer individual and public health benefits. Further evaluation is needed to determine the best methods of identifying partners with previously unrecognized HIV infection. Partner notification has long been practiced to inform the sex and drug-injection partners of people infected with human immunodeficiency virus (HIV) of their possible exposure to HIV and sexually transmitted diseases (STDs).1In 1998, the Centers for Disease Control and Prevention (CDC) published guidance on partner notification for HIV, called partner counseling and referral services (PCRS), which has the objective of reducing HIV transmission. Because people who are aware of their HIV-infected status are less likely to participate in behaviors that transmit HIV,2PCRS is designed to reduce HIV transmission by providing HIV counseling and testing services to people at high risk for infection, identifying previously undiagnosed infection, and linking HIV-infected people TCEB1L to care and treatment.3 PCRS has been used by health departments to interview partners of people with known HIV infection, notify them of their possible exposure to HIV, and arrange for them to be tested.4An HIV-infected person is defined as an index client when he or she is reported to the health department. In traditional PCRS, index clients are located and interviewed by a disease intervention specialist to elicit information about current and past partners. 1Partners may be notified of their exposure to HIV by the index client, the disease intervention specialist, or both of them together. PCRS is comprehensive and includes elicitation, notification, and testing of partners as well as education, risk-reduction counseling, and assessment of the need for referral to psychosocial services, case management, and medical care and treatment. Participation in PCRS by index clients and partners is completely voluntary. CDC launched the Advancing HIV Prevention (AHP) initiative in 2003, aimed at reducing barriers to early diagnosis of HIV infection.5Preventing HIV transmission by working with HIV-infected people and their partners and implementing new models for diagnosing HIV infections outside medical settings are two key AHP initiative strategies. Incorporating rapid HIV testing into PCRS makes use of both of these strategies. Although PCRS has been used as a strategy to prevent the transmission of HIV for many (Rac)-PT2399 years, the incorporation of rapid HIV testing is new and offers partners the opportunity to be tested for HIV in the field. When conventional HIV testing methods are used in conjunction with PCRS, disease intervention specialists (Rac)-PT2399 collect venous blood or oral fluid specimens in the field, which are then processed in a laboratory. Because of the variability in the time it takes laboratories to process specimens, it may (Rac)-PT2399 take from one to 14 days for test results to be available. Moreover, this type of field-based specimen collection has not been used by all health departments, so in many instances, partners are referred for testing at health department clinics. Under the AHP initiative, CDC funded a project to demonstrate the feasibility of conducting rapid HIV testing in conjunction with traditional and alternative approaches to conducting PCRS. The primary objective of this project was to decrease barriers to early diagnosis of HIV infection among partners of HIV-infected people by demonstrating new models of PCRS that included rapid HIV testing in the field and other settings. == METHODS == In September 2003, six health departmentsChicago Department of Public Health, Colorado Department of Public Health and Environment in Denver, Los Angeles County Department of Public Health, Louisiana Office of Public Health in New Orleans, San Francisco Department of Public Health, and Wisconsin Division of Public Health in Madisonreceived funding through CDC’s AHP initiative for a demonstration project incorporating rapid HIV testing into PCRS. == Models of PCRS == The participating health departments incorporated rapid HIV testing into one or more of three different models for conducting PCRS. Three sites (Colorado, Louisiana, and Wisconsin) incorporated rapid HIV testing into the traditional model of PCRS, using disease intervention specialists employed by health departments to interview index clients and partners in their homes or workplaces or in the disease intervention.