Pushing the envelope

April is STI Awareness month and this year’s emphasis is on the importance of getting young people tested. Focusing efforts on youth and young adults is important because they are more likely to engage in high risk sexual behavior. Additionally, the consequences to them of untreated STI’s can have long lasting effects such as infertility. 

Testing and treating individuals for STI’s in the age of the internet has become a hybrid of good old-fashioned public health practice and digital sleuthing.

For some people, the internet has become a means for arranging shorter term, often anonymous and often unsafe sexual encounters. This practice has added a new and challenging obstacle to our work of intervening in the spread of sexually transmitted infections. Everyday, public health staff in Baltimore and throughout the country interview people diagnosed with HIV, syphilis, or other STIs to provide appropriate education about STIs and to ensure that the person has medical care. We also reach out to their sex partners so they can get appropriate and timely medical care.

Until recently, a typical scenario when public health staff asked the patient about his or her sex partner(s) would be “I met him/her on the internet. We agreed that we would meet at an agreed to location in 45 minutes.” When asked how that person can be contacted, the patient typically says “I only know his/her screen name: ‘#1hotbodi’”. Prior to this month, that was typically the end of the public health intervention.

Now, however, the Baltimore City Health Department and the Maryland Department of Health and Mental Hygiene’s Infectious Disease and Environmental Health Administration are implementing internet partner services (IPS) to intervene in the spread of sexually transmitted diseases. Working with a nationally recognized consultant and three of the most heavily utilized “hook-up” sites in Baltimore and Maryland, we’ve developed a program to maximize the number of sexual partners we treat. The joint effort is critical because oftentimes persons like those described above have no idea where the person they meet lives. Close coordination between the city, the state, the counties and even other states is essential to reducing our rates of STI’s and HIV.

The program has been in effect four weeks and already we’ve been able to reach people exposed to an STI or HIV from places as far away as New York and are enthusiastic about the new program’s potential to intervene in the spread of disease.