- Keywords > Clinical Practice Guidelines (CPGs)
- Keywords > criteria of medicines selection
- Keywords > HIV infection and STIs
- Keywords > opportunistic infections and other HIV-related
- Keywords > reproductive tract infections
- Keywords > sexual and reproductive health
- Keywords > sexually transmitted infections (STIs)
- Keywords > treatment guidelines
- Keywords > treatment protocols
(2004; 88 pages)
5.5. Notification and management of sexual partners
The sexual partners of STI patients are likely to be infected themselves and should be offered treatment. Further transmission of STI and re-infection are prevented by referral of sexual partners for diagnosis and treatment. Female partners of male STI patients may well be asymptomatic; thus, partner notification and management offers an opportunity to identify and treat people who otherwise would not receive treatment. Partner notification should be considered whenever an STI is diagnosed, irrespective of where care is provided.
Notification can be by patient referral or by provider referral. In patient referral an infected patient is encouraged to notify partner(s) of their possible infection without the direct involvement of health-care providers, while in provider referral health-care providers or other health-care workers notify a patient's partner(s).
Partner notification should be conducted in such a way that all information remains confidential. The process should be voluntary and non-coercive. The aim is to ensure that the sexual partner(s) of STI patients, including those without symptoms, are referred for evaluation.
Management of sexual partners is based on knowledge of the index patient's diagnosis (syndromic or specific). The following three strategies can be adopted for the treatment of partners:
• offer immediate epidemiological treatment (treatment based solely on the diagnosis of the index patient) without any laboratory investigation;
• offer immediate epidemiological treatment, but obtain specimens for subsequent laboratory confirmation;
• delay treatment until the results of definitive laboratory tests are available.
The strategy selected will depend on:
• the risk of infection
• the seriousness of the disease
• the availability of effective diagnostic tests
• the likelihood of a person returning for follow-up
• the availability of effective treatment
• the likelihood of spread if epidemiological treatment is not given
• the available infrastructure for follow-up of patients.
WHO recommends that epidemiological treatment (with the same treatment regimen used for the index patient) should be given to all sexual partners.