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When Documentation of Domestic Violence Screening is Missing

Documentation of Domestic Violence Screening is Important

Careful documentation and communication of any deferrals is critically important to assure that public health follow-up does not inadvertently put individuals at risk for domestic violence. Local health commissioners need to have access to information that risk of domestic violence exists and that notification of a partner is deferred. Systems and procedures to protect the confidentiality of HIV-related domestic violence information are required.

Documentation of Domestic Violence Risk Informs Public Health Follow-Up

Risk of domestic violence must be taken into consideration by local health officers before proceeding in cases in which public health assistance to notify partners of possible exposure to HIV seems warranted to protect the public health.

When Documentation of Domestic Violence Screening is Missing

In those cases for which documentation of screening for risk of domestic violence is missing or the status of such screening is uncertain, PNAP and CNAP staff follow-up with the provider. PNAP/CNAP will take every step to encourage the physician to conduct the domestic violence screen. If the individual has not returned for posttest counseling PNAP/CNAP will consult with the provider concerning options and strategies for enabling posttest counseling to proceed. In some cases, the provider may already plan to conduct a follow-up counseling session to further explore partner issues or to conduct the screening.

When the Physician is Unable to Conduct the Domestic Violence Screen

If posttest counseling has been completed, but the physician is unable to conduct the domestic violence screen, PNAP/CNAP will make a good faith effort to contact the HIV-infected individual to administer the screen. No partner notification will occur unless the domestic violence screen has been performed, unless the HIV-infected individual refuses to participate in the screening or is not located. In these cases, health officials, in consultation with the responsible physician, will make a good faith effort to ascertain the risk of domestic violence before a decision to proceed with notification of a known partner.

When PNAP/CNAP Follow-up Directly With Infected Individuals

In some cases a decision is made for PNAP/CNAP to follow-up directly with an infected individual concerning risk of domestic violence. This follow-up may take place to conduct the domestic violence screening. Such follow-up takes place in close consultation with the physician and, if a release form is in place with a domestic violence service provider, with a domestic violence specialist.

In these cases, individuals who are screened by public health staff and found to be at risk of severe domestic violence are:

  • Routinely provided with a domestic violence referral and information enabling them to contact PNAP/CNAP at any point in the future.
  • Asked to sign a specific release form (if one is not in place already) to enable communication between public health staff, the physician and the domestic violence service agency.
  • Offered the opportunity for a follow-up appointment in 30-120 days time or, as specific circumstances necessary, at some other point in the future.
  • Asked if they would like PNAP/CNAP to let their care provider know that partner notification has been deferred and that a referral for domestic violence services has been made.