Perinatal trajectories of help-seeking stigma and correlates: a prospective cohort study.

Disease intervention specialists (DIS) are trained public health professionals that locate individuals diagnosed with or exposed to infections and provide timely linkage to testing, treatment, and prevention services; their services effectively interrupt disease progression and transmission. DIS have been a part of STI programs since at least the 1930s and are often leveraged for other communicable diseases, as well as during emergencies, with recent examples including COVID-19 and mpox. In 2023, DIS working within the New York City (NYC) Health Department STI Program conducted nearly 13,000 investigations based on positive syphilis laboratory tests and completed over 3000 syphilis interviews. The effectiveness of DIS hinges on engagement from both patients and healthcare providers. However, there is limited information regarding patients’ and providers’ awareness, perceptions, and willingness to engage with DIS or provide partner contact information during the course of an investigation. Published literature examining community perspectives and awareness shows varied levels of trust in public health professionals and contact tracers that were magnified during the COVID-19 pandemic, with notable disparities across race and ethnicity, gender, and sexual orientation. In 2021, NYC was among 59 jurisdictions that received the DIS Workforce Development supplement, funded as part of the American Rescue Plan Act of 2021, that aimed to strengthen the DIS workforce by improving retention and cross-training. With receipt of this funding, the NYC Health Department planned an ambitious suite of activities to onboard and train DIS, and develop programs and structures that support and enhance DIS work. Recognizing that perceptions and experiences of providers and community members regarding DIS shape whether and how they engage with DIS programs, we surveyed healthcare providers and community members to measure and characterize their awareness, perceptions, beliefs, and experiences interacting with DIS.