Recommended Prevention Services
HIV partner services include a set of confidential, voluntary services to help persons with HIV notify their sex and drug-injection partners of possible HIV exposure, to offer services that can protect the health of partners, and to prevent sexually transmitted disease (STD) reinfection in persons with HIV. Studies have shown that when providers spend time counseling persons with HIV about the importance of notifying partners, partners are more likely to be notified 36. Studies have also shown that partner services provided by health department staff are effective in notifying partners of recent HIV exposure and are generally acceptable to persons with HIV, their partners, and their health care providers.37
HIV partner services should be offered to
- persons with newly diagnosed or newly reported HIV infection;
- persons with established HIV infection who have new partners or a newly diagnosed STD that indicates recent unprotected sex or that may promote HIV transmission (i.e., syphilis, gonorrhea, chlamydia, and herpes simplex virus (HSV-2) in men and women and trichomoniasis in women);38 and
- sex and drug-injection partners of persons with HIV.
Elements of partner services can be provided by
- HIV care providers and community-based HIV prevention providers who diagnose patients or clients with HIV or STD and offer HIV risk screening and risk-reduction services;
- persons with HIV who directly notify their partners; and
- health department partner services specialists who are notified about persons with HIV by health care providers, community-based organizations, and laboratories that offer HIV or STD testing, or through routine HIV and STD case surveillance.
Most of the forthcoming recommendations about HIV partner services are consistent with recommendations from existingfederal government guidance for these types of providers:
Clinicians and non-clinical HIV prevention providers who diagnose HIV or diagnose STD in persons with HIV
- Advise persons with HIV at the time of their HIV diagnosis to inform all of their sex and drug-injection partners of possible HIV exposure, and discuss methods to assist in partner notification, including voluntary, free health department partner services.38-41
- Refer persons with HIV (and any of their partners who may also be served) to health department partner services specialists as soon as possible.38-41
- Advise persons with HIV who decline health department partner services to encourage their sex and drug-injection partners to seek evaluation and treatment for the partners’ benefit and, in the case of a concurrent bacterial STD, to prevent reinfection of the person with HIV.38,39
- Inform all persons with HIV and their uninfected partners, if served, of the availability of non-occupational postexposure prophylaxis (nPEP) and preexposure prophylaxis (PrEP) that some eligible uninfected partners can take to reduce their risk of acquiring HIV.42-43a5
- Recommend condom use.38-41
Health department partner services programs 44
- Establish systems to use surveillance data to identify persons with HIV who can be offered partner services as allowed by state and local regulations.
- Reach out to HIV testing sites, clinicians, and laboratories that frequently diagnose HIV or STD to describe and offer partner services to their clients and patients.
- Establish partner services policies, procedures, and collaborations with providers who offer HIV testing and care, including those that
- safeguard confidential information;
- prioritize services to persons with HIV who are most infectious or most likely to transmit HIV to others—that is, persons who have high viral load, who have symptoms of acute infection, who are pregnant or have pregnant partners, who have clinical signs or symptoms suggestive of an STD or a recurrent STD, or who have multiple sex or drug-injection partners; and
- identify the most appropriate method to notify partners and to assess risk for potential partner abuse or violence before notification (and defer notification if risk is elevated).
- Offer partner services to persons with HIV at least once as soon as practical—preferably within 2–3 working days of the date of HIV diagnosis or case identification, identification of a new partner, or STD new diagnosis—including collection of contact information for recent sex and drug-injection partners.
- Notify identified partners of possible HIV exposure (and STD exposure if relevant) promptly—preferably within 2–3 working days after collecting contact information—and provide partners with, or link or refer them to, these services:
- HIV testing, if not already known to be HIV-infected;
- active linkage to HIV medical care, if partner known to be HIV-infected but not receiving care;
- testing and treatment for STDs and viral hepatitis;
- information about nonoccupational postexposure prophylaxis for male and female partners exposed to HIV through sexual or drug injection contact within the last 72 hours;6
- referrals to other medical or social services that may reduce risky sex or drug-injection behavior, such as risk-reduction interventions or substance use treatment; and
- advice to use condoms and not share drug injection equipment.
5See section on Antiretroviral Treatment for more information about prophylaxis to prevent HIV acquisition.
6See section on Antiretroviral Treatment for information on prophylaxis to prevent HIV acquisition.