Submitted By

Julie Hartley
Monroe County Health Department, Indiana
February 10, 2016

As a Disease Intervention Specialist (DIS), I’m often the first person responding to a patient’s sexual health crisis. In addition to doing the background work of keeping statistics and ensuring each patient is properly treated for their sexually transmitted infection, a large part of my job is educating and interviewing patients, confidentially notifying partners, and providing linkages to testing and treatment.

Before coming into this position, I was a public health student with a strong interest in STIs and no idea such an occupation even existed. I was a few days into an internship at the local health department when I overhead my supervisor explain the role of a DIS. As I heard her describe the responsibilities, I could feel my eyes light up and my jaw drop as I thought, “That’s a job?” I found out that it is in fact a position, applied immediately to the opening, and have just completed my first year as a DIS. Our county’s mission statement is “To protect, promote, and improve the health of all people in Monroe County” and I often feel like the unseen protector of Monroe County’s sexual health.

Because DIS have such diverse responsibilities and require a number of skills, the training for new DIS can be somewhat lengthy. Our work ranges from notifying partners of a potential exposure to syphilis and HIV, testing them for infection, and linking them to care and treatment as needed, to responding to outbreaks such as the one that happened in Scott County, Indiana in January 2015. Each day is different and we need to be prepared for the various cases we might encounter. To prepare us to do this work, we receive intensive educational training that takes approximately three months to complete and a DIS isn’t considered trained until 6 months. The main educational component is called Passport to Partner Services and modules include a number of infectious disease topics such as HIV, syphilis, chlamydia, gonorrhea, and hepatitis, and skills such as communication, interviewing, field investigations and notifications, and referrals and linkages to care.

I returned from training feeling better about my skills, but it is one thing to learn everything in a training and another to go forth in the world and apply it to people who are feeling a wide range of emotions regarding a newly acquired STI. On the day I returned from the final in-person training (also known as “track D”), I had a client with a new syphilis case. It was a married man who insisted he hadn’t had any sexual activity whatsoever in the past five years despite his secondary rash that insisted otherwise. After leveraging my communications and interpersonal skills, he ended up giving me the name of a friend he was “close” with so I could begin contact tracing. Because DIS experience so many diverse situations that aren’t able to be covered through the training, shadowing a current/former DIS is a critical part of the learning experience.

Shadowing other DIS can be difficult to coordinate, since in many jurisdictions the closest DIS are located a couple of hours away which is the case in Indiana. When shadowing other DIS, I made the trek a few times to spend the day with them and tag along on their field visits. It was also impossible to plan when the journey would result in a client interaction; in this instance, no one answered their doors and the days ended up being pretty uneventful, something they apologized for since I wasn’t able to witness a more exciting time. It was okay because I was able to spend the day talking with them and picking their brains for advice and ways to approach various situations and how to respond in situations like this where we can’t get in touch with patients. The tips they offered helped immensely as I applied them to my day-to-day work. What has also been helpful for my career is that my direct supervisor and the health department administrator are both former DIS and leave an open channel for communication. Being able to go to my supervisor and leadership with questions and get an experienced answer is incredibly beneficial. Many DIS supervisors are epidemiologists, public health nurses, or other health department staff who haven’t been a DIS themselves, which makes training especially critical for a DIS.

Although I’m officially done with training and have been serving as a DIS for a year, I’m still learning new techniques and tweaking the way I approach situations as my experience grows. Perhaps in time, I can be the seasoned DIS who passes on what I’ve learned to those starting out.