Partner Notification and risk factors for sti Flashcards
What is partner notification also known as
Contact tracing
What is the aim of partner notification
Break the chain of infection by reducing the risk of re infection to the index case (person presenting with the infection)
To identify previously undiagnosed infection in the population.
Secondary objectives are to reduce the risk of complications arising from untreated infection and to facilitate behaviour change.
Partner notification should be considered whenever an STI is diagnosed, irrespective of where care is provided
What does the “look back” period depend on
The nature and site if the infection
The incubation period
Duration the symptoms have been present
When should partner notifications take place
They should take place for all bacterial and parasitic STI and hep b, c, hiv
What does a partner notification usually includes
An explanation of the nature of the infection diagnosed including transmission, treatment and reinfection
Say the importance of total sexual abstinence until the patient and all sexual partners have completed tx and the importance of adherence to medication
Identify at risk sexual contacts and a discussion and who and how they might be notified
Other card for the ways they might be notified
Options for how partners can be notified for partner notification
Patient referral where the patient is given the responsibility to contact sexual partners
Contact slips can be issued for the patient to give them coma to which provide anonymity and confidentiality for the index patient whilst enabling contacts to seek help
Provider referral
Where the patient is asked to provide names and addresses /phone numbers of the partners to the health worker os that members of the health staff can contact them and ask them to attend for treatment
Reasons for partner notification not having occurred include
Index patient won’t identify partner, reflection, violence doesn’t know the person well doesn’t have contact details for them Partner refuses to attend Index not interested in PN process Untraceable Unaware where partner went Transient population in large cities Doesn’t attend for follow up
What are the resolution outcomes for partner notification
Untraceable, informed, attended, verified attended
Specific issues with regard to HIV partner notification
Contact informed of the nature of infection
Contact slips almost never used
Aim is to get as many partners in for counselling and testing rather than to break the chain of disease
Fear of rejection
Need to achieve sustained behaviour change to reduce onwards transmission
Individual versus public health ethos
Confidentiality/ rejection fear with all partner notification but inc with hiv
Fear of legal action related to the new application of the offence against the oerson act 1861 allowing someone to be convicted for deliberately or recklessly transmitting hiv to another person without there consent
Risk factors for STD
Young adult age Female gender Civil status Occupation - navy Contraception No of sexual partners MSM Commercial sex worker Overseas travel Drug use Young age at first coitus Socioeconomic status
