Performance Improvement 2003. National Center for HIV, STD, and TB Prevention


Discharge Planning and Continuity of Care for HIV-Infected State Prison Inmates as They Return to the Community: A Study of Ten States

The purpose of this study was to examine discharge planning programs for HIV-infected inmates in ten states. The study’s goals were to describe the discharge planning systems for HIV-infected releases currently in place in the ten states, and the key policy and programmatic elements that influenced continuity of care for this population. Currently, many HIV-infected inmates do not have access to transitional services for continuity of care, and many states do not designate resources for this purpose. Failure to provide inmates with transitional support may have public health and public safety consequences. A total of 96 respondents--representing correctional health care departments, parole agencies, state and local public health departments, and community based organizations--participated in the study. The study found that services for HIV-infected inmates were often fragmented because Federal and state benefits programs did not cover individuals served by other government programs.

Incarcerated individuals were under the care of the department of corrections and therefore generally could not apply for or receive services until after they had been released. Many community service providers also had eligibility criteria (e.g., current homelessness) that made it difficult for inmates to develop a transitional plan before release.

FEDERAL CONTACT: Karina Rapposelli, 404-639-3641 PIC ID: 7749

PERFORMER: Program Support Center, Rockville, MD


Evaluation Adherence to CDC’s Sexually Transmitted Diseases (STD) Treatment Guidelines

The objective of this project was to: evaluate the impact of STD Treatment Guidelines in public and private settings, identify factors associated with compliance with the guidelines, and assess the relationship between adherence to the guidelines and the associated health outcomes. Plans were developed to assess adherence to treatment for one bacterial STD [acute, uncomplicated infection with Chlamydia trachomatic (CT)] and one viral STD (genital warts, a manifestation of infection with human papilloma virus). The task order was supplemented in 1999 to conduct four focus groups of providers at HealthPartners (HP) about knowledge, attitudes, and practices concerning CDC and other guidelines for STD treatment and treatment of CT and genital warts. The focus groups’ findings were intended to guide the development of the survey and to help interpret the survey findings. The findings indicated that adherence to CDC-recommended treatment for uncomplicated CT infection in these two medical care organizations was very high during the study period. Adherence to CDC recommendations for the treatment of genital warts was also very high.

FEDERAL CONTACT: Nancy Cheal 404-639-7222 PIC ID: 7047

PERFORMER: The HMO Group, New Brunswick, NJ


HIV Vaccine Efficacy Trial Site and Community-Level Factors Associated with Enrollment, Retention, and Protocol Compliance

This project evaluated how trial site and community-level variables were associated with vaccine trial enrollment, retention, and protocol compliance using the VaxGen trial data and additional data collected as part of this project. The primary objectives of this evaluation were to: (1) identify individual-, site-, and community-level factors associated with vaccine trial enrollment, retention, and protocol compliance,

(1) establish evaluation criteria that will inform the development and selection of future HIV vaccine efficacy trial sites, and (3) identify “best practices” and provide recommendations that will inform the conduct of future HIV vaccine efficacy trials including trial-site development and selection. It was found that sites having mainstream and gay media coverage enrolled participants reported a higher level of unprotected sex at baseline compared to sites without such media coverage. Recommendations include the following: (1) media events and opinion leader endorsement were associated with the enrollment of higher-risk efficacy trial participants. (2) Trial sites should work with the media and community opinion leaders to ensure that balanced information about trials is disseminated. (3) Alternatives to advertising such as outreach should be considered for enrolling younger and minority participants at risk of infection.

FEDERAL CONTACT: Bradford Bartholow, 404-639-6164

PIC ID: 7850

PERFORMER: Research Triangle Institute, Research Triangle Park, NC


Phase IV: National Physician Survey of STD Diagnosis, Treatment and Control Practices

The purpose of this study was to measure STD diagnosis, treatment, and control practices among a nationally representative sample of physicians in five specialties that diagnose most STDs: obstetrics and gynecology, family and general practice, general internal medicine, pediatrics, and emergency medicine. The objective was to provide the baseline data necessary to characterize infection control practices, especially partner notification practices for syphilis, gonorrhea, HIV, and chlamydia, and to measure the contextual factors that influence those practices. The survey data helped CDC to better focus STD control and partner notification program efforts and to allocate program resources. Completed surveys were received from 4,226 physicians. The STD contact survey data was used by CDC to describe and assess STD diagnosis experience, STD management and treatment practices, and STD partner management. It was also used to identify differences between subgroups of physicians in STD diagnosis, management and treatment practices, and STD reporting and partner management practices. It identified factors such as physician specialty, practice characteristics, and physician beliefs and attitudes that are associated with STD management, treatment, reporting, and partner notification practices. Finally, it summarized protocol, education, practices, and needs regarding STD control in a national sample of physicians.

Completed surveys were received from 4,226 physicians. The cumulative response rate was 70.2 percent. Respondents came from all 50 states and the District of Columbia, with a balanced regional distribution.

FEDERAL CONTACT: Janet St. Lawrence, 601-632-5636 PIC ID: 7054

PERFORMER: Battelle Corporation, Arlington, VA


Telephone Survey Measuring HIV/STD Risk Behavior: Pretest Final Report

This is the second part of a methodological investigation that was designed to determine the effectiveness of a survey administration procedure--Telephone-Audio Computer-Assisted Self Interviewing (T-ACASI)- to collect sensitive information on sexual behavior, drug use, and HIV testing status. Under sections of a survey interview administered via T-ACASI, a telephone-facility-based computer reads the survey question and records the respondent’s keypad-tone-based response, bypassing the need for human interviewer involvement. The focus of the current investigation was sensitive sections of several questionnaires that were appropriate for general-population administration. Three issues were examined:

(1) item non-response due to refusals, (2) the frequency with which sensitive behaviors were reported, and (3) respondent self-report concerning comfort and truthfulness within the survey environment. It was found that item non-response was infrequent, leading to the conclusion that respondents who completed the interview were not at all resistant to answering the sensitive survey questions from the HIV/STD Standard Set. Almost no one reported engaging in risk behavior, leading to the conclusion either that the survey did not reach a high-risk population; that it did so but that high-risk individuals selected out through survey non-response; or that it reached high-risk individuals, but they simply chose not to report such behaviors.

FEDERAL CONTACT: John Anderson, 404-639-2046 PIC ID: 7775

PERFORMER: Research Triangle Institute, Research Triangle Park, NC


The Development of a National HIV/AIDS Prevention Intervention Taxonomy for Program Evaluation

This project: (1) identified known taxonomies of interventions, (2) collected and organized categories of interventions used in CDC-funded health departments, (3) convened a group of experts from a variety of applicable fields and backgrounds to discuss the feasibility of a systematic taxonomy of HIV/AIDS interventions that can be integrated into and used by local, state, and national groups and organizations for program development, improvement, and evaluation, and (4) suggested a chronology of necessary activities CDC and its partners could undertake to develop a common vocabulary of HIV prevention interventions. Without a standard taxonomy of HIV prevention interventions, CDC and its prevention partners struggle to scientifically determine how CDC funding is affecting designated and whether CDC- funded programs are having the intended impact on the HIV/AIDS epidemic. The more consistent CDC and its partners were in classifying a type of HIV/AIDS intervention program or strategy, the more successful CDC would have been in providing higher quality data to Congress, federal agencies, state and local health departments and other constituencies for decision-making regarding funding allocation and targeted program development, improvement and evaluation. This is especially critical in making the link between prevention services provided and impacts on the epidemic assessed through surveillance systems and other data sources. The final report summarized the methods and results for each of the activities and concluded with recommendations synthesized from these findings.

FEDERAL CONTACT: Gary Uhl, 404-639-0950 PIC ID: 7707

PERFORMER: Macro International, Inc., Calverton, MD

View full report


"pi_2003.pdf" (pdf, 346.19Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®