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Main Forums => Someone I Care About Has HIV => Topic started by: rrsgirl on September 20, 2010, 09:30:14 am

Title: letter from dept of health and social services
Post by: rrsgirl on September 20, 2010, 09:30:14 am
Hi everyone...I haven't been on here in awhile, but I have a question and I thought maybe someone on here would know about this. My boyfriend was diagnosed hiv positive on April 29th of this year. On Saturday he got a letter from a man from the NJ dept of health and social services...the envelope was handwrittend and stamped confidential. The letter said that this man had an urgent health matter that he needed to talk to my boyfriend about immediately and he is to call and set up a visit, the letter went on to say that he could not discuss anything about this "urgent health matter" over the phone and that my boyfriend would understand when they meet. This sounds ominous to me. He's going to call today and find out what this is about, but I was just wondering if anyone ever received a letter like this and what is it about? And why would it come almost 6 months after his diagnosis? If there going to tell him he is hiv positive, I think they're a little late!
Title: Re: letter from dept of health and social services
Post by: Assurbanipal on September 20, 2010, 09:41:21 am
Same thing here and about at the 6 month mark.

The guy calls and wants your Social Security number.  You say, what idiot gives out his Social Security number to some nameless person who calls on the phone?....

The conversation goes downhill from there ....

But yes, when we spoke it boiled down to the guy saying, so "you know what you have, right?"  "and you know what that means right"?

Useless, mysterious but ultimately painless.
Title: Re: letter from dept of health and social services
Post by: leatherman on September 20, 2010, 09:56:16 am
there's a previous thread on here about this situation. It part of "contract tracing" or "partner notification" which actually helps in slowling down the spread of diseases. Of course, being 6 months behind in the game lessens the value; but still, if further people might be contacted and are diagnosed and treated in time, then lives will still be saved. Plus by following up the known infected person, they can make sure that person is receiving treatment thus saving a life and lessening the spread.

"Required interview with state health department"
http://forums.poz.com/index.php?topic=32109.0
Title: Re: letter from dept of health and social services
Post by: Ann on September 20, 2010, 11:18:32 am
It could be that he was a named contact of someone who has recently tested poz and they didn't realise he was already in the system. I got one of those letters when I was a named contact - that's how I came to be diagnosed.
Title: Re: letter from dept of health and social services
Post by: Assurbanipal on September 20, 2010, 11:56:44 am
It could be that he was a named contact of someone who has recently tested poz and they didn't realise he was already in the system. I got one of those letters when I was a named contact - that's how I came to be diagnosed.

Well, maybe..... But I think this is a New Jersey thing, I got the same letter at the same timing from the same general address.
Title: Re: letter from dept of health and social services
Post by: Ann on September 20, 2010, 12:29:58 pm

Well, maybe..... But I think this is a New Jersey thing, I got the same letter at the same timing from the same general address.

Hmmm... then NJ has an odd idea of what "urgent" means. If it's such an "urgent health matter" and needs to be discussed "immediately", why does it take six months to get in touch? Bureaucrats never cease to amaze me. :-\
Title: Re: letter from dept of health and social services
Post by: Assurbanipal on September 20, 2010, 12:44:40 pm
Honestly?  I have a sneaking suspicion that they have a goal to send out the letter within 6 months and if they meet the goal someone gets a gold star. 

(And that was the most charitable view I could muster of the process !!)
Title: Re: letter from dept of health and social services
Post by: Ann on September 20, 2010, 12:59:13 pm
I got my letter about two days after I was named as a contact. The person who named me is my current bf, but we split up for about ten years and weren't together at the time of diagnosis. They took care of giving me "the talk" and having me name my own contacts the same day as when I got my WB confirmation back. They didn't wait six months.
Title: Re: letter from dept of health and social services
Post by: leatherman on September 20, 2010, 01:06:29 pm
They didn't wait six months.
In 1992, Ohio took 6 weeks to get back to me; and in 2008, they still took that long before trying to contact my partner - who was still in the hospital. He died a couple weeks later, so they never got around to his interview. When I moved to SC, it only took 2 days after I signed up with the ASO for this health dpt to try to contact me.

I would imagine it all depends on worker case load and finances of the local health dpt on how soon they go about tracking down contacts.
Title: Re: letter from dept of health and social services
Post by: Ann on September 20, 2010, 01:34:08 pm
I would imagine it all depends on worker case load and finances of the local health dpt on how soon they go about tracking down contacts.

It probably does. Here the nurse gives the talk and asks about contacts after they give you the news that you're poz. Seems a lot more simple than having to go through a case worker and health department. It also seems to make a lot more sense.
Title: Re: letter from dept of health and social services
Post by: leatherman on September 20, 2010, 02:26:43 pm
Seems a lot more simple than having to go through a case worker and health department.
ah, to make things murkier there are multiple outlets for getting a diagnosis around here. A Canton OH City health dpt nurse informed me, our Infectious Disease doctor (in OH) informed Randy, a hospital doctor (OH) informed Jim. Then of course, my ASO case worker (SC) informed the SC health dpt. That's why all this gets reported back to the health dpt and they, as a duty of protecting the public health, rather than the private doctors et al, have the authority and do the partner notification/contact tracing.

of course, once you're diagnosed, your doctor, nurse and/or case worker go through all this BS again (and again and again LOL). I think the philosophy is better safe than sorry; plus you never know when someone will disclose information and to whom.
Title: Re: letter from dept of health and social services
Post by: Ann on September 20, 2010, 02:35:18 pm
Another reason why socialised medicine such as you get with the NHS is so much better - it's more streamlined. Less hassle. Totally.
Title: Re: letter from dept of health and social services
Post by: Assurbanipal on September 20, 2010, 03:28:40 pm
Just to be clear -- the phone call I got in NJ never mentioned the words "contract tracing" nor did they ask about contacts then (my doc did months before)  Maybe that is what the process is supposed to be about, but the surly guy on the other end of the phone never got to that point.  It really was just the questions I listed above.
Title: Re: letter from dept of health and social services
Post by: leatherman on September 20, 2010, 04:35:32 pm
Maybe that is what the process is supposed to be about,
it's all part of "infectious disease surveillance" and STD/HIV "partner notification"/"contract tracing", which has been done for decades and is proven to help reduce the spread of diseases. This information is used to make sure infected people get proper medical treatment, that gov't funds are allocated properly to help test people and treat those infected, along with stemming the spread of the diseases by finding possible contacts and getting them more educated and protected, tested, and/or treated.

of course, while it all sounds high-minded and like good public health policy, to many case workers its just more paperwork and more bad news to deliver ;) hence your surly guy and my jerk in SC (who wasn't even in the office at all on the day of my appt); but on the other hand, the lady I met with in 92 from the Canton health dpt was nice as pie, as was the man and woman agents in 08 who tried to contact my partner in the hospital. In that other thread, you'll see that there is a mixed bag of responses from various health dpt agents - and a wide range of responses from those they are trying to contact too. ;)

Here's a couple links I pulled out of that other thread that you might find useful.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00000042.htm
Current Trends Partner Notification for Preventing Human Immunodeficiency Virus (HIV) Infection -- Colorado, Idaho, South Carolina, Virginia

http://findarticles.com/p/articles/mi_m1272/is_n2596_v123/ai_16399937/
"Why the opposition to AIDS contact tracing?"

http://std.about.com/od/prevention/f/contacttracing.htm
which is often used for Chlamydia, Gonorrhea, Syphilis. TB management also includes contact tracing

http://www.cdc.gov/hiv/topics/surveillance/reporting.htm
http://www.cdc.gov/std/treatment/2006/clinical.htm
http://www.aclu.org/lgbt-rights_hiv-aids/hiv-partner-notification-why-coercion-wont-work

http://www.cdc.gov/hiv/topics/surveillance/reporting.htm

here's a link about the general issue of STD contact tracing http://std.about.com/od/prevention/f/contacttracing.htm  which is often used for Chlamydia, Gonorrhea, Syphilis. TB management also includes contact tracing.
Title: Re: letter from dept of health and social services
Post by: Assurbanipal on September 20, 2010, 05:20:58 pm
it's all part of "infectious disease surveillance" and STD/HIV "partner notification"/"contract tracing", which has been done for decades and is proven to help reduce the spread of diseases. This information is used to make sure infected people get proper medical treatment, that gov't funds are allocated properly to help test people and treat those infected, along with stemming the spread of the diseases by finding possible contacts and getting them more educated and protected, tested, and/or treated.

of course, while it all sounds high-minded and like good public health policy, to many case workers its just more paperwork and more bad news to deliver ;) hence your surly guy and my jerk in SC (who wasn't even in the office at all on the day of my appt); but on the other hand, the lady I met with in 92 from the Canton health dpt was nice as pie, as was the man and woman agents in 08 who tried to contact my partner in the hospital. In that other thread, you'll see that there is a mixed bag of responses from various health dpt agents - and a wide range of responses from those they are trying to contact too. ;)

Here's a couple links I pulled out of that other thread that you might find useful.
http://www.cdc.gov/mmwr/preview/mmwrhtml/00000042.htm
Current Trends Partner Notification for Preventing Human Immunodeficiency Virus (HIV) Infection -- Colorado, Idaho, South Carolina, Virginia

http://findarticles.com/p/articles/mi_m1272/is_n2596_v123/ai_16399937/
"Why the opposition to AIDS contact tracing?"

http://std.about.com/od/prevention/f/contacttracing.htm
which is often used for Chlamydia, Gonorrhea, Syphilis. TB management also includes contact tracing

http://www.cdc.gov/hiv/topics/surveillance/reporting.htm
http://www.cdc.gov/std/treatment/2006/clinical.htm
http://www.aclu.org/lgbt-rights_hiv-aids/hiv-partner-notification-why-coercion-wont-work

http://www.cdc.gov/hiv/topics/surveillance/reporting.htm

here's a link about the general issue of STD contact tracing http://std.about.com/od/prevention/f/contacttracing.htm  which is often used for Chlamydia, Gonorrhea, Syphilis. TB management also includes contact tracing.

You have missed the point.. 

And you have no direct knowledge of NJ law nor of the actual process  -- you are merely speculating.  Surprise! I know about contact tracing and the OP has not asked any questions about it.  The point is to answer the original posters question about what to expect.   

Title: Re: letter from dept of health and social services
Post by: leatherman on September 20, 2010, 05:29:07 pm
And you have no direct knowledge of NJ law nor of the actual process  -- you are merely speculating.
ok, then, if this is not part of surveillance and/or contact tracing, then what is it?
Title: Re: letter from dept of health and social services
Post by: Assurbanipal on September 20, 2010, 06:42:06 pm
ok, then, if this is not part of surveillance and/or contact tracing, then what is it?

Now you are asking me to speculate.


As indicated above, my actual experience in the interview was that it was all about getting me to confirm I knew I had a virus.

There could be several good public policy goals associated with this.  Perhaps it was intended to be part of contact tracing or surveillance, and the guy just did a lousy job that day.  Or maybe it is just to make sure people have a confirmed result, since that often changes people's behaviour.   Maybe it is some legal device. I don't know  -- but what actually happened was just my confirmation that I knew I had a virus (the actual virus went unnamed in the interview).



So, rrs girl as far as what to expect -- they will likely want him to confirm he knows he has an HIV infection.  They may be rude, or I may just have gotten someone on an off day.  And maybe they will want to go further in his interview than they did with me. But it appeared to be brief and you can probably have him do it by phone rather than having to take time off from work or anything.

Good luck.  Let us know how it goes.
Title: Re: letter from dept of health and social services
Post by: leatherman on September 20, 2010, 07:21:14 pm
Now you are asking me to speculate.
No, you seemed to think I was dreaming this all up though I had links to proof, so I wanted links to your proof. Instead you tried to dinegrate the facts I offered while offering up your own guess. but there's no need for you, or me, to speculate. If you had bothered to read the CDC guidelines, which are implemented in most states (maybe all by now, I haven't double checked this stuff in a while since it was all in that previous thread I referenced; however, I know name-reporting is also part of the process and this IS done in every state now, see statehealthfacts.org for that info) including NJ, you would have seen that people being contacted by the health dpt as notification of their disease, treatment, and partners is what surveillance and contact tracing/partner notification is all about.

There could be several good public policy goals associated with this. Perhaps it was intended to be part of contact tracing or surveillance, and the guy just did a lousy job that day. Or maybe it is just to make sure people have a confirmed result, since that often changes people's behaviour.   Maybe it is some legal device.
that's it's exactly ;), so I don't know what your beef was with me about this. you just described contact tracing/surveillance exactly.

Do you really think that health dpts around the country have time to just contact people for the heck of it? Obviously, you, me, my partners, other people here, and rssgirl's beau were contacted became we were HIV positive and the health dpt was mandated to "track and surveil" us as a public deterrent to the spread of HIV and/or STDs. Without telling me what else you would think this contact was about, your complaint about how I offered the facts about this situation as being just "speculation" was just specious.

Obviously your interaction with that case worker - and the interactions mentioned by others in the aforementioned "other thread" - were not handled properly. Unfortunately case workers are often over-worked, under-paid, or sometimes lack the proper commitment to do their job properly, and that causes all of the "interviews" to not be handled uniformly and sometimes to not be handled properly at all.

the whole purpose of contact tracing and surveillance is to confirm the result, change behavior, suggest treatment, and followup of partners - and yes it's a legal device. It's also how NJ and other states are able to report how many infected people they have in their borders to get federal funding - like ADAP and Ryan White funds.

but i didn't need to speculate anyway, I already posted the federal CDC links, so here's the same info and a link from the NJ dpt of health ;)

http://www.state.nj.us/health/aids/documents/hivaids_annualrptt_07.pdf
pg 12
The monitoring of disease through surveillance is a basic public health function and an essential part of the Division’s mission.  Surveillance is critical in helping determine source allocation and targeting and evaluating HIV services. Routine AIDS surveillance has been conducted in New Jersey since 1983, and HIV surveillance since 1992.

pages 12-15 describes special programs (Never in Care, Incidence Surveillance, Partner Study, National HIV Behavioral Surveillance, Medical Monitoring Project) that NJ takes part in tracking subdivisons( Latinos, women, MSM, etc) of the HIV population in NJ

pg 16 Partner Notification
In 2007, NAP counseled 612 individuals infected with HIV compared to 315 individuals in 2006.  This increase is due to the following change in procedure. Prior to 2006, NAP staff only contacted HIV infected individuals that were referred by testing sites because the individual had failed to return for their test results.  Beginning in 2006, NAP staff also began contacting HIV infected individuals who were reported to the HIV/AIDS disease registry.

Of the 612 HIV infected individuals counseled, 407 were contacted as a result of interfacing with the HIV/AIDS registry.  A total of 287 were referred into medical care.  Field staff investigators elicited 200 names of partners or “contacts” for a contact index of .70.  NAP staff also found 152 partners during 2007, with 9 testing positive, for an overall seropositivity rate of 10 percent.


edited to run spellcheck which I had forgotten to do  ;)
Title: Re: letter from dept of health and social services
Post by: rrsgirl on September 20, 2010, 07:36:32 pm
Thank you to all who took the time to reply to me...i just got home and read through the whole thread. Unfortunatley, my boyfriend never got a chance to make that phone call today, because in keeping with the way our life has been going these past months, he had to rush his mom to the emergency room and we spent the whole day at the hospital. So, we still don't know what the letter is about. Hopefully, he'll have time to make the call tomorrow, and I'll let you all know what happened.
Title: Re: letter from dept of health and social services
Post by: leatherman on September 20, 2010, 07:42:12 pm
because in keeping with the way our life has been going these past months, he had to rush his mom to the emergency room and we spent the whole day at the hospital.
ouch! when it rains, it pours.
Best wishes to your boyfriend's mom and I hope she recovers quickly from whatever her problem is. Contacting the health dpt is the last thing y'all need to be bothered with or worried about right now. ;)
Title: Re: letter from dept of health and social services
Post by: rrsgirl on September 20, 2010, 08:12:57 pm
Thank you...they've admitted her for more testing. Shes having problems with her heart and liver and they think she's bleeding internally somewhere..he has to spend the night at his parents house with his father because he has alzeheimers and can't be left  alone...his father has no idea whats going on and keeps asking when his wifes coming home.  I'm worried that the stress is going to affect my boyfriends health. You're right, when it rains it pours....and when I wrote this post this morning I had no idea what the day was going to bring.
Title: Re: letter from dept of health and social services
Post by: mewithu on September 20, 2010, 09:23:41 pm
If you already Know your status there really is no need to further this contact in my opinion. I think it to be dangerous as it may be hand written.