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Partner notification/ contact tracing (Process (Referral (Provider/active…
Partner notification/
contact tracing
Definition
Process of contacting sexual partners
of an individual with an STI to advise
that they may have been exposed
and to encourage testing and treatment
Purpose
Reduce risk of complications
Prolonged untreated infections
Behaviour change
Information, education, support
Break chain of infection
Reduce risk of reinfection
Identify undiagnosed/asymptomatic cases
Benefits
Prevents late diagnosis and complications
Prevents reinfection
Reduces onward transmission by behaviour change
Look back
period
Factors to consider
Nature/site of infection
Duration of symptoms
Incubation period
Timelines
Current partner
TV, HBV/HCV, HIV
Herpes, warts, HPV
EO, PID
6m
NG, CT
2y
Secondary syphilis
3m
Primary syphilis
Lifetime
Tertiary syphilis
6wk
NSU
Aims
Trace, treat, cure
NG, CT, syphilis, TV
NSU, EO, PID
Test and treat
HBV, HCV, HIV
Advice on safe sex and risk reduction
Herpes, warts, HPV
Process
Sexual behaviours
Total abstinance until self and partner tx
Medication adherance
Contacts
Identify at risk contacts
Education
Nature of infection (transmission, treatment,
reinfection, complications)
Referral
Provider/active
HCP informs partner, keeping confidentiality
Telephone/letter
Conditional/contract/negotiated
Hybrid method - pt referral with FU privider after agreed time if contact does not present for testing
Patient/passive
Index patient informs directly (verbal, text, email)
+/- contact slip (anonymity for patient,
info for partner, info for HCP)
Consultation
Support
ICE
Discuss barriers
Encourage
Action plans
Motivational interviewing
Facilitate
Information and advice to patient
Contact slips for partner and HCP
Outcome
Untraceable
Attended
Informed
HIV
Issues with
contact tracing
Partner
Aim : is counselling not cure
Contact slip rarely used
Index patient
Fears about confidentiality
Fears of rejection
Fear of legal action
Both
Consistent behaviour change needed
HIV criminal law
Act
UK Offence Against the Persons Act 1981
Grevious bodily harm by reckless or intentional transmission
Reckless
transmission
Criteria
Sex with someone who didn't know you were HIV+
Knew you had HIV at the time
Understood transmission of HIV
Had UPSI
Transmitted HIV to the person
Penalty
Max prison 5y for each infected person
Intentional
transmission
Criteria
Proven they maliciously and intentionally
gave the other person HIV
Penalty
Max lifelong prison