- • Partner notification is an important component
of treating patients for most sexually transmitted diseases (STDs).
- • Partner notification for syphilis, HIV, and possibly
hepatitis B is usually best done by collaborating with experts from
the local health department.
- • Partner notification is also a priority for gonorrhea,
chlamydia, trichomoniasis, nongonococcal urethritis, and pelvic
inflammatory disease, although patients will usually need to notify
partners themselves after appropriate coaching.
- • Some patients resist notification out of fear
of losing a relationship or because a relationship has already ended.
- • Emphasizing the health benefits helps patients
initiate and successfully complete notification, thereby improving
their own health, the health of partners, and the health of the
Tracing partners of patients with STDs has been done for centuries
but was first introduced on a national scale by Surgeon General
Thomas Parran as part of his five-point plan to control syphilis in
1937. At the time, syphilis was killing about 20,000 people per
year in the United States. Parran’s campaign, and the subsequent
discovery of penicillin, led to a nadir in syphilis rates in 1956. As
rates dropped, health department efforts expanded beyond partners
to test other people in the patient’s social network, but
decreases in funding were followed by increasing rates of syphilis and
periodic epidemics. Meanwhile a gonorrhea control campaign began
in the 1970s, a chlamydia campaign began in the 1990s, genital herpes
was increasingly diagnosed, human papillomavirus was linked to cervical
cancer, and HIV infection appeared.
With an estimated 19 million new STDs each year in the United
States, the most common approach to partner notification has become
denial. Patients and clinicians who know the importance of treating
partners may ignore it because they are uncomfortable or unfamiliar
with the process. Becoming familiar with the partner notification
process can help overcome this denial and improve the patient’s
Partner notification involves talking to patients with STDs about
approaches to testing and treating their partners. Ideally, exposed
partners can be cured before they develop complications or become
infectious and transmit disease to others. Health department assistance
with notification is not available for all STDs. Health departments
seek active involvement in addressing syphilis and, to a slightly
lesser extent, HIV. Some health departments will try to notify some
partners of people with hepatitis B, gonorrhea, or chlamydia. For
many STDs, however, patients are responsible for notifying their
own partners. Most patients wonder what to do about their partners
and appreciate advice from their physicians.
Patients benefit when their partners are notified. Patients who
have been cured are susceptible to reinfection; untreated partners
pose a risk to patients who have been treated for syphilis, gonorrhea,
chlamydia, or trichomoniasis. Patients with chronic infections such
as HIV can obtain social support from partners who become aware
of their infection. Finally, most infected persons want what is
best for their partners, and thus want them to be aware of their
exposure because ...