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The contemporary effectiveness of assisted partner notification services (APS) in the United States is uncertain.State and local jurisdictions in the United States that reported ≥300 new HIV diagnoses in 2018 and were participating in the Ending the Epidemic Initiative.The study surveyed health departments to collect data on the content and organization of APS and aggregate data on APS outcomes for 2019. Analyses defined contact and case-finding indices (i.e., sex partners named and newly diagnosed per index case receiving APS) and estimated staff case-finding productivity.Sixteen (84%) of 19 jurisdictions responded to the survey, providing APS outcome data for 14 areas (74%). Most health departments routinely integrated APS with linkage of cases and partners to HIV care (88%) and pre-exposure prophylaxis (88%). A total of 19,164 persons were newly diagnosed with HIV in the 14 areas. Staff initiated APS investigations on 14,203 cases (74%) and provided APS to 9937 cases (52%). Cases named 6799 partners (contact index = 0.68), of whom 1841 (27%) had previously diagnosed HIV, 2202 (32%) tested HIV negative, 541 (8% of named and 20% of tested partners) were newly diagnosed with HIV, and 2215 (33%) were not known to have tested. Across jurisdictions, the case-finding index was 0.054 (median = 0.05, range 0.015-0.12). Health departments employed 292 full-time equivalent staff to provide APS. These staff identified a median of 2.0 new HIV infections per staff per year. APS accounted for 2.8% of new diagnoses in 2019.HIV case-finding resulting from APS in the United States is low.

Background: Assisted partner services (APS) are a longstanding component of public health efforts to control HIV in the United States, but their contemporary effectiveness is uncertain. Methods: The study surveyed U.S. state and local health departments that reported > 300 new HIV diagnoses in 2018 and were participating in phase 1 of the Ending the Epidemic Initiative. The study collected data on the content and organization of APS and aggregate data on APS outcomes for 2019. Analyses defined the APS continuum, contact and case-finding indices (i.e., sex partners named and newly diagnosed per index case receiving APS), and estimated staff case-finding productivity. Findings: Fifteen (79%) of 19 jurisdictions responded to the survey, providing APS outcome data for 13 (68%) areas. Most health departments integrated APS with efforts to link index cases and partners to HIV care (93%) and pre-exposure prophylaxis (86%). A total of 18,833 persons were newly diagnosed with HIV in the 13 areas. Health departments initiated APS investigations on 13,899 (74%) cases and offered and provided APS to 12,338 (66%) and 9,733 (52%) index cases, respectively. Cases named 6,704 partners (contact index=0.69), of whom 2,650 (39%) had previously diagnosed HIV, 2,134 (32%) tested HIV negative, 516 (7.7% of named and 19% of tested partners) were newly diagnosed with HIV, and 2,239 (33%) were not known to have tested. Across all jurisdictions, the case-finding index was 0.053 (median=0.047, range 0.015-0.10). Health departments employed 288 full-time equivalent staff to provide APS. These staff interviewed a mean of 43 index cases annually, identifying a median of 1.8 new HIV infections in partners per staff per year. APS accounted for 2.7% of new diagnoses in 2019. Interpretation: HIV case-finding resulting from APS in the U.S. is low, reflecting low contact elicitation and attrition at each step along the continuum from case initiation to partner testing. Funding Information: Research was supported by NIH award AI027757. Declaration of Interests: None to declare. Ethics Approval Statement: The University of Washington institutional review board (IRB) defined the study as exempt from the need for IRB review.

Background Chlamydia screening in high schools offers a way to reach adolescents outside of a traditional clinic setting. Using transmission dynamic modeling, we examined the potential impact of high-school-based chlamydia screening programs on the burden of infection within intervention schools and surrounding communities, under varying epidemiological and programmatic conditions. Methods A chlamydia transmission model was calibrated to epidemiological data from three different settings. Philadelphia and Chicago are two high-burden cities with existing school-based screening programs. Rural Iowa does not have an existing program but represents a low-burden setting. We modeled the effects of the two existing programs to analyze the potential influence of program coverage and student participation. All three settings were used to examine a broader set of hypothetical programs with varying coverage levels and time trends in participation. Results In the modeled Philadelphia program, prevalence among the intervention schools’ sexually active 15–18 years old population was 4.34% (95% credible interval 3.75–4.71%)after 12 program years compared to 5.03% (4.39–5.43%) in absence of the program. In the modeled Chicago program, prevalence was estimated as 5.97% (2.60–7.88%) after 4 program years compared to 7.00% (3.08–9.29%) without the program. In the broader hypothetical scenarios including both high-burden and low-burden settings, impact of school-based screening programs was greater in absolute terms in the higher-prevalence settings, and benefits in the community were approximately proportional to population coverage of intervention schools. Most benefits were garnered if the student participation did not decline over time. Conclusions Sustained high student participation in school-based screening programs and broad coverage of schools within a target community are likely needed to maximize program benefits in terms of reduced burden of chlamydia in the adolescent population.