1. Running head: Partner Notification Program Evaluation 1
Philadelphia Fight’s Youth Health Empowerment Program (Y-HEP)
Antar T Bush & Adrienne Reguard
West Chester University Graduate School of Social Work

2. Running head: Partner Notification Program Evaluation 2
We have a powerful potential in our youth, and we must have the courage to change old ideas and practicesso
that we may direct their power toward good ends.” – Mary McLeod Bethune
Y-HEP Partner Notification Program for MSM youth of color
I. Research Problem
HIV/AIDS has been serious public health issue facing the city of Philadelphia for the last
two decades. According the AIDS Activities Coordinating Office, there are approximately
30,000 individuals living with HIV/AIDS in Philadelphia (AACO, 2012). This average is
slightly higher than other major cities in the United States. AACO states the most vulnerable
population is young men who have sex with men of color (MSM) between the ages of 15 and 25.
This young population makes up for 56% of all new diagnosis of in the city (AACO, 2012). It is
imperative for Philadelphia Fight to stay innovative with their approach to tackling sexual health
issues that face this city. One major way Philadelphia Fight is addressing is epidemic is through
opening the Youth Health Empowerment Project (Y-HEP).
Y-HEP is “comprehensive adolescent and young adult program that offers holistic health
services, sexual health education, drop in day services, and leadership activities to over 3000
high-risk/high promise, low-income, urban youth ages 13-24 living in Philadelphia” (AACO,
2012). Y-HEP assists youth through their Empowerment model. Y-HEP staff will provide the
youth with knowledge and resources to make better decisions concerning their sexual health. The
reason why it was important for Philadelphia Fight to have a youth program like this is because it
allows a young person to receive holistic treatment in one center, instead of their care being
fragmented. According, to the CDC if a person who is infected with HIV is receiving treatment it
is extremely difficult to transmit the virus to others (CDC, 2012).
Several methods have been proposed in order to combat the growing rate of HIV/AIDS
infections in the city of Philadelphia. Perhaps the two most popular is the PrEP and partner

3. Running head: Partner Notification Program Evaluation 3
notification programs (CDC, 2012). PrEP is “a single pill taken once daily, it is highly effective
against HIV when taken every day (referece). The medication interferes with HIV’s ability to
copy itself in your body after you have been exposed. PrEP prevents HIV from establishing
infection within the body and making you sick from the disease” (CDC, 2012).
A significance problem for HIV/AIDS policy and social services is the sexual/social
stigma among individuals whom contract the disease. These social barriers prevent a young
person from seeking social services and treatment. Furthermore, when a person does not get into
treatment in a timely manner it could cause economic and physical hardships. For example, a
delayed care could result in a lower white blood cell count and higher viral loads making the
individual sick and not being able to work. As a result, infected individuals may need to
eventually apply for government services to assist.
Starting a comprehensive cultural competent partner notification program, this is where
individuals who have come into contact with someone who is HIV positive would be notified
and tested immediately. Partner notification programs have been supported by public health
researchers as an effective preventive tool to combat the disease. On the other hand, an agency
must not be aware of the cultural competency challenges surrounding executing partner
notification programs.
Actions are needed from the non-profit Philadelphia Fight’s Y-HEP program for the city
if these marginalize community remain healthy. Y-HEP will do a collaborative project with the
office of HIV Planning Group to do a comprehensive survey on how improve services to this
community, and get more individuals who at high risk to start PrEP treatment. The survey will be
IRB approved from a major university in the area and compensate participates $30.00 for time
and travel.

4. Running head: Partner Notification Program Evaluation 4
II. The Agency
Philadelphia FIGHT is a full service organization that promotes HIV education,
prevention, medical services, youth programming and advocacy for individuals infected by
HIV/AIDS in the city of Philadelphia. The organization provides outreach to everyone who is
affected by the disease from the individual, their family and community at large. This program
seeks to promote culturally competent education on the topic at hand and to elevate barriers and
stigma surrounding the topic. Through testing, education, behavioral health counseling and
healthy relationships, this organization is able to assist the community with learning how to live
with the disease through the wealth of resources so that they are empowered and feel supported.
FIGHT provides services to individuals regardless of socioeconomic status, ethnic background,
sexual orientation or religious affiliation. The goal of FIGHT is to successfully end the epidemic
of AIDS within the lifetime of the population that they currently service.
Since its formation in 1990, this organization has been a leader in the area of HIV/AIDS
prevention which includes primary care and research/clinical trials. The agency is located at
1233 Locust Street, 3rd floor centrally located in what is referred to as the “gayborhood”.
FIGHT is partly funded by the AACO. Leadership is made up of an executive director, board of
directors that include a president, VP, secretary, treasurer, and a diverse advisory board. FIGHT
employs a scope of different professionals so that the agency can be a full service network for
the targeted population that include social workers, medical professionals, clergy, receptionists,
interns and volunteers. The organization also has a newsletter that the community or individuals
can subscribe to stay abreast of events, projects and resources. All individuals serviced by the
organization are treated with dignity and respect and encouraged to carry on the mission of the

5. Running head: Partner Notification Program Evaluation 5
agency through advocacy as they are all fighting for the same common goal which is to bring an
end to the AIDS epidemic.
The following programs and services are part of FIGHT:
• AIDS Education Month
• AIDS Library
• Clinica Bienestar
• Critical Path Project
• Diana Baldwin Clinic
• Education
• End AIDS in Ghana
• HIV Counseling and Testing
• Institute for Community Justice
• John Bell Health Center
• Jonathan Lax Treatment Center
• Office of Faith Initiatives
• Project TEACH
• Tree IOP
• Women’s Health
• Y-HEP Health Center
III. Rationale for Conducting the Evaluation
HIV affects over 30,000 individuals in Philadelphia, and approximately 56% of them are
men who have sex with men of color (MSM). There are several aspects that are thought to
correlate with the HIV infection rate with this population. For instance, sexual sigma, barriers to
proper health care, and ineffective partner notification programs (CDC, 2014). In this literature
review, we will explore how having effective partner notification programs among MSM of
color can decrease the rate of HIV in this population by making the exposed partners aware. It is
theorized that partner notification programs with a holistic approach will decrease the rate of
newly diagnosis individuals and get those with acute HIV infection into treatment immediately
(CDC, 2012). The following five literature reviews attempt show and support this theory on
partner notification.

6. Running head: Partner Notification Program Evaluation 6
Hosseinipour (2013), addressed if partner notification serveries could be effective in
developing countries? This is imperative because if the service could work in an under developed
country than one could expect similar results in a poor neighborhood in the United States. The
emphasis of the study was to see if the participates in the program would take advantage of 3
different types of partner notification services. They were the following:
1. Patient contacts partner by themselves
2. Partner is notified by health care worker
3. Patient agrees to notify partner with a particular time frame, if not provider will notify the
partner (reference).
This article makes the hypotheses that if offered and effectively used individuals who test
HIV positive will select one of the three strategies. The researchers did not provide the initial
sample size. However, the yield was high once an individual decided to be in the program. As a
result, when someone tested acute HIV positive approximately 59.5% of all participants chose #2
in which the partner is notified by health care worker, followed by 19.7% requesting to contact
partners themselves, and 14.3% agreeing to notify partner with a particular time frame and, if
not the provider would notify the partner. The study states for every 1 person who tested
positive, the researchers received an average of 3.2 whom may have had contact, and found
1person as HIV positive. Furthermore, these result demonstrate when you have a “test-treat”
environment it allows many of these patients to be linked to care immediately.
All of these results prove that partner notification is an effective tool in HIV prevention. One
of the limits in the study is the reader is not aware of the sexual orientation of the individuals.
Another, limitation is the study does not state a sample size. The study just gives results of using
partner notification programs in developing countries and a high risk population.
The effectiveness of partner notification is in direct relation to exploring the stigma of
HIV among men who have sex with men. Florom-Smith and De Santis (2012) explored the

7. Running head: Partner Notification Program Evaluation 7
problem this article explored was the concept of HIV-related stigma as being unclear. Plus, they
addressed the question that despite all the advances in HIV care and treatment why does HIV-
related stigma remain a challenge in HIV testing, care, and prevention. The focus of the study
was to do an integrative literature review to understand the existing awareness of concept
development. The literature used was research conducted in the US from 2000 to 2010.
. The following questions were used as a guild to assist with the integrative literature:
1. How can the concept been previously defined
2. What perspectives have been used to study the concept
3. How can previous work be expanded
4. What relationships exist between the concepts of interest and other concepts
5. What research methods have been used to study the concept
The results of this study concluded after reviewing all the literature on HIV-related stigma a
clear definition could be formed using internal, external consequences of HIV. The definition
the authors emerged with this:
“HIV-related stigma is the collection of adverse attitudes, beliefs and actions of others against people living
with or affected by HIV which may or result in deleterious internalized beliefs or actions taken by persons living
with or affected by HIV infection that result in negative health outcomes” (reference).
The biggest limitation of the study was the lack of a clear definition of HIV-related stigma
from the beginning. In addition, the other limit to this study is there are no instruments that
measures all of the different components of HIV –related stigma. The results of this research
were able to clarify the concept of HIV-related stigma.
Next, the topic of partner notification in and how it is relative to men who have sex with
men. Brown, al. (2011) predicted, partner HIV testing and counseling following a partner
notification intervention. The main objective of the research was to find out once partner
notification was implemented how many people would come get a HIV test. The sample size was

8. Running head: Partner Notification Program Evaluation 8
170 patients (93 males and 77 females) from Malawi from their own clinics. The researcher
sought to create a “risk score algorithm” to predict if notified partners would come in a get HIV
testing and counseling (Brown, 2011).
The results indicate that individuals with a less than two partners are less likely to use
partner notification. However, if a participant had 3 or more partners they were more likely to
take advantage of the partner notification. This study was able to use the number of partners an
individual had sexual contact with to determine the likelihood of them using partner notification.
These results give the importance of partner notification and when a patient may decide to use
the program.
When evaluating all the results that partner notification and sexual stigma play a crucial
role in HIV prevention. When partner notification is implemented along with cultural
competency it can be highly effective to prevent the spread of the disease. One can conclude
from these literature reviews on partner notification can influence HIV linkage to care. It is
imperative to understand the how the years of sexual stigma play a major in when a person
decides to get tested and treated.
IV. Research Questions & Evaluation Hypothesis
Y-HEP’s partner notification program goals are to notify individuals whom may have
been infected into treatment, decrease the rate of HIV infections among MSM of color through
PrEP Program, and increase knowledge and willingness to adopt safer sex practices to lower risk
of contracting STIs (Sexually Transmitted Infections). Partner notification programs are
evidence based and is used all over the world as a tool to get individuals who has been infected
into care immediately. The research questions for this evaluation are intended to find out what
social precautions public health counselors need to take in order to get greater long-term

9. Running head: Partner Notification Program Evaluation 9
outcomes of Y-HEP’s partner notification program. In this study, quantitative questions will be
used when interviewing MSM youth of color who have recently tested positive or negative for
acute HIV positive.
The principle hypothesis for this program evaluation is to increase the participant’s
willingness to be a part of the partner notification program. Furthermore, to get more individuals
tested for HIV whom may not know they were exposed to the virus. As a result, participants who
test positive will be place into treatment at Y-HEP health center and those whom test negative
will be assed for PrEP treatment or other behavioral health services. Here is a work base
structure of how the partner notification program would work (reference).
Improvements will be based on the number of individuals whom are tested and linked to
care quarterly (every 3 months). In addition, to increase testing among this population a post-
performance survey given to all individuals whom get tested through the Y-HEP program. The
hypothesis that is set will be the framework for the research and evaluation of the Y-HEP partner
notification program .

10. Running head: Partner Notification Program Evaluation 10 10
Youth Health Empowerment Project (Y-HEP) & Partner Notification Program Logic Model
Problem Statement: To provide MSM youth of color (15- 24) in Philadelphia a safe spaceto explore effective partner notification among this marginalized population. Thechallenges this
population face is sexual stigma, isolation from family, and racism. Furthermore, theyoung MSM population has a high risk for contracting HIV and STIs. TheYouth Health Empowerment
Project wants to provide a more effective partner notification programs using a cultural competency framework to decrease the rate of HIV infections in Philadelphia.
Goal: TheMSM population can be challenging to evaluate due to sexual and social stigma but using this evaluation will assist in reducing this problem. Y-HEP wants to provide to cultural
competent testing and counseling, increase therate of enrollment into the PrEP program, get individuals who are acute HIV positiveinto care immediately.
Inputs
Outputs Outcomes -- Impact
Activities Participation Short Medium Long
Staff :
 1 Director
 2 Prevention
Counselor
 1 CommunityLiaison
 2 Nurse
 4 Nurse Aides
 1 Office Manager
FundingSource:
 AIDS Activity
CoordinatingOffice
(AACO)
 Behavioral Health
MedicaidProgram
(CBH)
 Department of
Human Resources
(DHS)
 Private Donors
Training:
 Trauma Informed
Approach
 Holistic Approach
Materials, Supplies,Trainings
 Culural Competency
Training
 Car for travelingto
homes
 Test andCounseling
Training
 HIV testingKits
Prep Program via The
University of Penn
STI education classes
Support Groups
Drop –in Center provides
late night hours
Risk reduaction treatment plan
quarterly.
MSM youth ofcolorwho
are at high risk for
contractingHIV(ages 15-
24)
To improve cultural
competence with HIV
testing andcounseling.
Provide a list
comprehensive list ofall
sexual partners whommay
have been exposed to the
virus.
If test positive forHIVget
into treatment immediately
and explore partner
notification service.
If test negativeemploy risk
reduction methods with
STIs and assess forPrEP
Enroll in Medicaid
Continue to improve
practice riskreduction
methods
Employ harm reduction
strategieswith mental
health.
Adhere to PrEP
Provide orrefer to
8behavioraland social
services
To improve sexualhealth
knowledge and awareness
Improve partnersexual
negotiationskills.
To improve theirphysical
and emotionalhealth
To improve teach back
program.
Remain into care for a
termof 1 yearormore.
Decrease the HIVrate
among the MSM ofcolor
population.
Assumptions:
All participants were born male
All participants have sex withother menwithinthe last year.
Do not have sexual negoitation skills
All participants have expericedsomeform of trauma intheir lives due to sexaul orientation
External Factors:
Politics- Fundingchanges as newpolical leaders are elected.
Funding- Programs in thecenterhave budgets that dependonfundingfrom donors. If thedonations are
not there programing will be cut.

11. Running head: Partner Notification Program Evaluation 11
V. Methods
Probability sampling will be employed to get participants to do the survey and into the
partner notification program. Every two person that get tested by a health counselor at Y-HEP
tests for HIV will be asked to fill out the survey as part of the partner notification program
evaluation, between May 2015 and September 2015. According to the CDC, individual tend to
test more for STIs during the summer months than others (CDC, 2014). The expected sample
number is 200 surveys will be done by MSM youth of color between the ages of 15 and 24. The
cultural competent partner notification program survey will not have any advertisements due to
sexual or social stigma. Participants will only be asked to do the survey once they have
completed their HIV test. It is imperative to explore the experience of the participant had testing
positive and notifying other partners the participant may have exposed.
To effectively collect information about the partner notification program, the evaluation
will have a survey to be completed in-person by the participant; rather they test HIV positive or
negative. The evaluation will follow a longitudinal study design which is aimed at observing the
same participants over a period of time. With design we will be able to detect the development or
changes in characteristics of the MSM community.
When examining the evaluation, threats to internal validity must be explored. Participants
may not want to do the survey due to the overwhelming amount of stigma with HIV.
Furthermore, participants may be concerned if they participate in partner notification program
they may be subjected to violence or abuse. As a result, this may cause an individual to give
fruitless or dishonest information to the health counselor.
The issue of cultural competence must be considered throughout the entire study.
Although, everyone will receive free HIV testing and counseling, it is imperative the counselor
understands the language of the community. For example, the counselor using phases such as

12. Running head: Partner Notification Program Evaluation 12
top, bottom, verse, or bear with hesitations or judgment. The MSM youth of color that come get
tested are Latino, Black, or Asian, counselors cannot have preconceived notions formed solely
off of the participants’ race.
To make sure the partner notification program is evaluated with high standards, each
health counselor will have thorough training surrounding all challenges and barriers this
community face. Health counselor will be asked about their understanding of this community
and what may be some counter-transference issues they have to take into consideration when
addressing the needs of this population.
VI. Measurement
The dependent variables that will assess the effectiveness of the partner notification
program are finding individuals exposed to HIV, linkage to care, linkage to PrEP, knowledge,
and holistic experience of being tested for HIV. The independent variable will be to get
individuals who test HIV positive or negative to produce information about their sexual health
practices and how to best render services. The variable about finding clients who have been
exposed to the virus will be measured by the number of in-person or over the phone contacts the
health counselor make with a potential positive. For example, if the MSM comes into Y-HEP
and tests positive for HIV and states he had sexual intercourse with 6 sexual partners in the past
year. The goal would be to contact all six of the individuals and get them test as soon as possible,
all with the currents client’s permission. In addition, from what the research showed earlier there
should be at least 2 other positive men from one participant. The survey will be reviewed by the
University of Pennsylvania’s IRB on HIV research, who are experts in cultural sensitivity and
effective HIV prevention methods.

13. Running head: Partner Notification Program Evaluation 13
VII. Expected Outcomes
It is expected that using effective cultural competent partner notification should yield 1
new positive with 3 or sexual partners, should yield 1 other positive. The problems that happen
during the evaluation process is participants may be reluctant to give information on their last
sexual partners. In addition, some participate may be in the sex industry or have anonymous sex
may not know any information about their sex partners. This could cause challenges in the
research because there would no way of contacting those individuals to give the knowledge of
their recent exposure.
At the end of the evaluation, the results will be shared with Philadelphia Fight executive
director, AIDS Activities Coordinating Office of Philadelphia, Center for Disease Control. The
success of the this Y-HEP cultural competent partner notification program will allow other
Health Centers in Philadelphia to adopt a similar framework for doing effective testing and
counseling MSM youth of color.

14. Running head: Partner Notification Program Evaluation 14
References
AIDS Activities Coordinating Office. (2012) AACO surveillance report 2012. Retrived
November 3, 2015 from AIDS Activities Coordinating Office:
http://www.phila.gov/health/pdfs/2012SurveillanceReportFinal.pdf
Brown, L. B., Miller, W. C., Kamanga, G., Nyirenda, N., Mmodzi, P., Pettifor, A., ... &
Hoffman, I. F. (2011). HIV partner notification is effective and feasible in sub-Saharan
Africa: opportunities for HIV treatment and prevention. Journal of acquired immune
deficiency syndromes (1999), 56(5), 437.
Centers for Disease Control and Prevention. (2012, December) CDC fact Sheet: New HIV
infections in the United States. Retrieved November 5, 2015 from Centers for Disease
Control and Prevention:
http:www.cdc.gov/nchhstp/newsroom.docs/2012/HIV-Infections-2007-2010.pdf
Centers for Disease Control and Prevention. (2014, July) HIV and young men who have sex with
men. Retrieved November 5, 2015 from Centers for Disease Control and Prevention:
http:www.cdc.gov/healthyyouth/sexualbehaviors/pdf/hiv_factsheet_ymsm.pdf
Florom‐Smith, A. L., & De Santis, J. P. (2012, July). Exploring the Concept of HIV‐Related
Stigma. In Nursing forum (Vol. 47, No. 3, pp. 153-165). Blackwell Publishing Inc
Hosseinipour, M. C., & Rosenberg, N. E. (2013). HIV Partner Notification: Possible and
Essential. Sexually transmitted diseases, 40(12), 915-916.
.