Partner Notification

2015 - 2016 1
 Learning Outcomes

At the end of this session you should be

able to:
Describe the aims of partner notification (PN)
List the key elements of PN process
Evaluate the issues relating to PN in Primary Care

2
 Definition of partner notification
..the process of contacting the sexual partners of an individual
with a sexually transmitted infection including HIV, and
advising them that they have been exposed to infection.
By this means, people who are at high risk of STI/HIV, many of
whom are unaware that they have been exposed, are
contacted and encouraged to attend for counselling, testing
and other prevention and treatment services. W.H.O. 1999
Further information:
http://www.ssha.info/wp-content/uploads/ha_manual_2004_section_a.pdf

3
 Challenges around PN
Use PN scenario from this online video clip:
http://www.youtube.com/watch?v=RwVUkfKBgPw

What challenges can you identify?

In your practice what issues may affect undertaking PN?
 Rationale for PN

Break the chain of transmission

Prevent re-infection of the index
patient
Prevent complications of untreated
infection
Moral duty/ ethics to inform?

5
 Securing co-operation with PN
Voluntary
Non-judgmental and supportive approach
Emphasize patient choice / control
Confidentiality
Patient risk of re-infection
Partner at risk from untreated infection
Risk of transmission to others

6
 Contact tracing
issues
2010 - 2011 7
Partner notification methods

Patient referral
Provider referral
Conditional or contract referral

8
PLEASE BRING THIS SLIP WITH YOU AND BE ON TIME:

You are invited to come to us for an interview on a matter

that may be of great importance to you personally.

It will be to your benefit to have a check-up which will

include a free blood test at Queens Park Counselling
Centre and Clinic between the hours of 8.00 a.m. and
3.00p.m.

Date: Diagnosis Code:

No:.. Remarks:

Client gives to partner 9

 Contact slips / cards
Can provide anonymity and
confidentiality for the index
patient
Enable sexual contacts to seek
medical advice or treatment
Inform the contacts clinic of
index patients diagnosis, and
date of diagnosis.
Enable cross-referencing and
evaluation of partner notification

10
 Identifying partners at risk
Look-back periods
Refer to sexual history
Condom use/ safer sex advice
Memory prompts may help recall
Document details to track progress

11
 Provider referral methods
Tracing partners from incomplete data
Contact methods phone, letter, text
Encouraging attendance

12
 Request for Follow-up
CLINIC

NAMEAgeSex.RACE....................................

HOME ADDRESS.....

..CLINIC.

PLACE OF WORK OCCUPATION

Diagnosis.DATE 1st DIAGNOSEDRESULT............................

NEXT OF KIN..RELATIONSHIP.

ADDRESS......................................

REMARKS.

DATE:SIGNATURE OF INVESTIVGATION.

House Visit 13
 PLEASE BRING THIS SLIP WITH YOU AND BE ON TIME:

.
LAST NAME FIRST NAME DATE

ADDRESS

. . ..
AGE SEX RACE

YOU ARE INVITED TO COME TO US FOR AN INTERVIEW ON A MATTER

THAT MAY BE OF GREAT IMPORTANCE TO YOU, AT THE QUEENS PARK
COUNSELLING CENTRE & CLINIC.#5 QUEENS PARK EAST, PORT OF SPAIN
OPPOSITE THE MEMORIAL PARK ON:

.
DAY DATE TIME

REFERRING DEPARTMENT:

Contact Investigator 14
gives to Partner
 C.M.C. SYPHILIS INTERVIEW RECORD

CHART NO:.INTERVIEW NO.

NAMESEXDATE OF BIRTH.

ADDRESS.RACE.AGE.

TELEPHONE..NEXT OF KIN..

REASON FOR EXAMINATION: VOLOUNTARY CONTACT REFERRAL OTHER

2011 - 2012 15
 CARIBBEAN MEDICAL CENTRE EPIDEMIOLOGICAL REPORT
PARTICULARS OF INFORMANT CONTACT

NAME NO:.CLINIC.

ADDRESS DIAGNOSIS.DATE..

DATE REPORTED Disposition of Contact

TYPE OF SUSPECT Preliminary examination only ..

RELATIONSHIP TO PATIENT Examined not infected

AGESEXRACE. Examined and infected Diagnosis

EYES.HAIR. ClinicNo........

HEIGHTBUILD Under Rx, prior Diagnosis...

to invest,

COMPLEXIONOTHER. ClinicNo.

PLACE OF ENCOUNTER Epid.Treatment...

PLACE OF WORK Not Located

OCCUPATION Moved to
======================================
Suspect to Report to: Description inadequate...

Did not Report.Other.

ClinicDate.

16
 Innovative Approaches
Social Media
Young people now report using Facebook
and other social websites for contact tracing.
Caution: - if posted to the wall all friends will
see message.

17
 Internet partner notification

You may have been exposed to I didn't know I had Chlamydia

Gonorrhoea. Please get checked when we were together. You should
get tested.
soon. oops
18
 PN resolution
Follow up for each partner identified
Re-interview patient if partner/s not attended
Audit outcomes against national standard
(Chlamydia is currently 0.4 contacts per index
case in large towns/cities and 0.6 contacts
elsewhere- verified per case within 4 weeks)
www.bashh.org.uk

20
 PN in Primary Care
Advise patients with an STI that partner/s will
need testing / treating
Offer choices of partner notification e.g.
patient to inform their contacts
Consider local referral pathways for
management of patient with STI to include
PN arrangements

21
 Management options for STIs
diagnosed in primary care
1. Manage all aspects of PN in- house, including
provider referral and follow-up
2. Treat, interview patient re partners, pass details to
HA if provider referral requested
3. Treat and refer to GUM / Community Health
Adviser for PN only (HA to telephone pt , no trip to
GUM needed)
4. Treat and refer to GUM for Test Of Cure / PN
5. Refer patient to GUM for all management

22
 Practical Session
Healthcare provider information:
Sarah is a 25 year old nurse who presented to 2
weeks ago with 2 months irregular inter-menstrual
bleeding despite taking her COC pill correctly. She re-
attends and you have already explained that she has
Chlamydia, what it is and how it should be treated.
NOW DISCUSS PARTNER NOTIFICATION.

23
 Practical Session (2)
Patient information:
You are Sarah, a 25 year old woman who attended your GP
surgery 2 weeks ago, complaining of 2 months history of
irregular bleeding between periods. You are currently taking
COC correctly. Your GP has just informed you that your
Chlamydia test from the previous visit 2 weeks ago is positive.

You have a regular partner called Tom who you have been with
for the last 6 months. Prior to this you recently split with Dick
after a year of being together. Three months ago you had
unprotected sex with an old friend Harry.

24
 Outcomes

At the end of this session you should be

able to:
Describe the aims of partner notification (PN)
List the key elements of PN process
Evaluate the issues relating to PN in Primary Care

25