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Partner Notification
Partner notification (PN) is a fundamental component of sexually transmitted infection (σTI) prevention and control programs in many state jurisdictions and may help prevent the spread of STIs and human immunodeficiency virus (HIV) among individuals who engage in risky sexual behaviors outside the context of a monogamous relationship. Traditional PN uses three different strategies for notifying the sexual partners of patients infected with an STI or HIV: provider referral (notification of sexual partners via a third party, such as an individuals’ medical provider), partner referral (notification of sexual partners via the index patient), and contract referral (an agreement between the patient and provider, whereby the patient is given the opportunity to notify their sexual partners on their own, with the understanding that their partners will be notified by a third party if they have not been notified by a predetermined date).
PN was previously referred to as contact tracing, though more recently it includes the comprehensive category of partner services—the process of obtaining from individuals recently diagnosed with an STI information about their sexual partners and facilitating the triage procedure for the examination and treatment of those partners. Conducting PN assumes that the index patient has identifying and locating information for their sexual partners, which is often not the case for individuals with multiple anonymous partners, such as individuals who meet their partners on the Internet sexual Web sites or public and private sex venues. It is also important to note that laws regarding PN for STIs and HIV infection differ from state to state, and that PN is traditionally a voluntary process, and that patient confidentiality is protected by law.
Partner Services for Individuals Diagnosed with STIs
In an attempt to avoid STI reinfection and/or continued transmission and acquisition of infection, it is imperative that examination and treatment of the sexual partner(s) be addressed when medical providers diagnose patients with an STI. The partner services process includes notification of partners in the case of STIs and HIV partner counseling and referral services (PCRS). PCRS programs provide services to HIVinfected persons and their sexual and needle-sharing partners in an attempt to curb infection or, if already infected, to prevent transmission to other individuals. In addition, these programs aid sexual partners of the index patient in gaining earlier access to individualized counseling, HIV testing, medical evaluation, treatment, and other prevention and health services.
Partner Counseling and Referral Services for HIV Infection
In addition to providing partner services for individuals diagnosed with an STI, some state-level PN programs also provide partner services for individuals infected with HIV. PCRS are typically available to individuals with HIV infection as long as contact with program staff is voluntary. Traditionally, the individual does not have to identify himself or herself and may choose whether or not to identify partners after discussion with the PN staff. Program staff do not have access to individuals’ medical records related to the HIV infection unless they have the consent of the patient, typically requiring a medical release form.
Discussion about disclosing HIV infection to past and current sexual and injection-drug-using partners should routinely occur for all HIV-infected people and be integrated into the larger system of preventive and clinical care. Whereas the central goal of PCRS for STIs is the eradication of infection through treatment, the success of PCRS for HIV is evidenced by the prevention of new infections. HIV-infected patients should be informed of the benefits and advantages of PCRS, facilitating informed decision making about this service.
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