What It's Like To Be A Government STD Notifier

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STD-1
"The reason I am calling is that you have been listed as a contact for someone who has chlamydia…"

Yes, it turns out that the awkward conversation you need to have with your exes and Tindr hookups after you are diagnosed with the clap is a responsibility that can be passed on up to Uncle Sam. In most states, a new STD infection must be reported to a health department, where there are professionals on hand to go through your contact list and drop the news. Lynn Beltran is one of those professionals. For the last seven years, she has performed “partner notification services” for the Salt Lake County Health Department in Utah. A self-described “do-gooder” with degrees in community health and etiology, Beltran prides herself on doing her work “without judgment.”

So, give me the basics of your job.
"I do two different things. First, I may tell someone they’ve been exposed to someone who might have an STD, which is the 'partner services' part of things. If someone tests positive we work with them to determine who their past partners have been and then we contact those partners and let them know they’ve possibly been exposed. We usually try to link up [those past partners] with some testing and treatment services. [Secondly,] we also contact people who have tested positive through their primary care provider or a private medical community, if that provider feels more comfortable with us communicating with the patient."

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How does the process begin? Does someone call you to call the people they’ve had sex with?
"Through public health laws, which are very similar across the country, [physicians] are required by law to report STDs to the local public health department. And, depending on the disease and the policies in the local health jurisdiction, the public health department attempts to get in touch with that patient. We want to see first and foremost that they’ve been appropriately treated for that infection. We usually work with them to find [past] partners. There are two options there. We certainly give them the option of calling their partners and telling them first, or we can contact the partners. If we contact the partners, [the first patient] remains anonymous. We don’t disclose any information on the patient who had the positive test."

What is the common reaction to this call?
"Eighty percent of the time, people are really concerned and want to get it taken care of and are grateful we gave them that call. A small percentage will become rather aggressive with us, and in that situation, we let them know our program is simply here to help. They don’t have to participate with us. But, if they are in Salt Lake County, we can offer them free testing services. We try to give them the information, like they may have chlamydia, before they hang up on us. And, there are a small percentage who hang up or use a curse word or two before that."
STD-2
You don’t tell them who it was that gave you their name?
"We don’t disclose any of that information. We don’t even use gender pronouns. I have had people try different tactics to get us to [reveal] who named them. They’ll come right out and say, 'Was it my husband?' or 'What it my boyfriend?' or 'How do I know who I am not supposed to have sex with if you don’t tell me?' We always tell them, 'At least, this person cared enough about you, so that you have the information and can go in and get tested and treated if you choose.'"

Do people ever think you are prank caller?
"I have had quite a few of those, and my response is usually to give them my number at the health department and let them call me back. I have had people who thought someone was trying to get them in trouble, to admit they’d been having sex. I tell them I don’t know what they’ve done or haven’t done, but if I tell them if the person is playing a joke [by giving us your name], the joke is on them, because this is an opportunity for you to come in for a few hundred dollars’ worth of free medical services and you will have better health because of it."

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How many of these calls does your agency make per week?
"My staff that handles casework makes about 40 of these calls a week."

Is there one STD that tops the list of cause for calls?
"Chlamydia, which is a bacterial STD, is the number one reportable disease here in Salt Lake County, and in the state of Utah, and in the entire United States. That is by far the most common. Because it is common and treatable, unfortunately, people don’t treat it as seriously as they do HIV or syphilis."

Have you ever had to call someone to tell them they might be HIV-positive?
"Absolutely, several times. In those cases, we try not to disclose the disease over the phone. We try to get them to come in whenever HIV is in picture."

Does being based in a sexually conservative state like Utah have any effect on your job? Are people less open to talking about this?
"I honestly don’t think so. I think the issues are the same you’d find across the country."

What goes through your mind before you make this call? Is there any routine you have for the 60 seconds before you dial that number?
"After doing this for so long, I don’t have a lot of anxiety before the call unless it is something a little bit more serious. Keeping a calm voice no matter what is critical to being able to do this kind of work. We do many trainings with people who are trained to talk under duress."

Can I hear you at work? Let’s say someone came in and tested positive for chlamydia and gave you my name and I just picked up the phone. What would you say to me?
"First, I would make sure that I have gotten you and then I would say I am calling from the health department. Is this a good time for you to talk to me?"

It is.
"The reason I am calling is that you have been listed as a contact for someone who has chlamydia. You may have been exposed. Then I would try to react from your response. If you didn’t know what chlamydia is, I would give you some information on it. If you were panicked or angry, I would try to calm you down, let you know it is a treatable infection."

I am recording this interview through my computer, so I see the volume of your voice rise and drop as you speak. When you got to the part where you told me I might have been exposed to chlamydia, it dropped way lower than at any other point in our conversation.
"That is because I am trying not to sound panicked."

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