Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: email@example.com. Type 508 Accommodation and the title of the report in the subject line of e-mail.
Associate. A person, named by another person who is not infected with the disease in question, as someone who might
benefit from counseling, examination, or testing for human immunodeficiency virus (HIV) infection or other sexually
transmitted diseases (STDs). Typically, associates are persons named by noninfected partners of index patients, but they also might
be named by social contacts or other associates. Associates might include persons with symptoms suggestive of disease, partners
of other persons known to be infected, or others who might benefit from examination.
Client. Any person served by a health department or other health or social services provider.
Client referral. See self-referral.
Cluster interview. An interview with a noninfected partner (or social contact or associate), conducted to elicit
information about persons within the social network (e.g., associates) who might benefit from counseling, examination, or testing for
HIV and other STDs. Such persons might include persons with symptoms suggestive of disease, partners of other persons known
to be infected, or others who might benefit from examination.
Clustering. The process of eliciting information from index patients about persons in their social networks, other
than partners, who might benefit from counseling, examination, or testing for STDs/HIV. These persons are referred to as
social contacts (or suspects, in traditional STD program terminology) and might include persons with symptoms suggestive
of disease, partners of other persons known to be infected, or others who might benefit from examination.
Comprehensive risk counseling and services (CRCS).
An intensive, client-centered counseling process aimed at ensuring
the adoption and maintenance of HIV risk-reduction behaviors designed for HIV-infected persons who continue
demonstrating risk behaviors and for HIV-negative persons who are at high risk for acquiring HIV
infection and other types of STDs.
Confidentiality. The ethical principle associated with the health profession (or the legal right of a client receiving
health-care services) in which health professionals do not disclose
information relating to a patient unless the patient gives
consent permitting disclosure or disclosure is necessary to protect public health.
Contract referral. A partner notification strategy in which an index patient identifies a specific partner to notify the
partner of possible exposure and agrees to do so within a specific time frame, with the understanding that if notification does
not occur within the designated time frame, the disease intervention specialist (DIS) will notify the partner.
Core area. A specific, typically geographically defined area, such as a neighborhood or census tract, in which a relatively
high concentration of disease exists and which likely accounts for a large proportion of transmission in a community.
Core groups. Socially defined groups of persons who, as a consequence of continuing risky sexual or drug-injecting
behavior, are likely to be sources of continued disease transmission in a network or community (i.e., are core transmitters).
Core transmitter. A person who, as a consequence of continuing risky sexual or drug-injecting behavior, is likely to be
a source of continued disease transmission in a network or community.
Disease intervention. The process of stopping the spread of a disease and the complications of disease.
Disease intervention specialist (DIS). A health department staff member who is specially trained to interview
persons infected with HIV or another STD (i.e., index patients); elicit information about their partners and associates; notify
the partners of their possible exposure; ensure that the partners are offered appropriate services, including examination,
treatment, and referrals; and provide prevention counseling to index patients, partners, social contacts, and associates.
Drug-injection partner. A person with whom a patient shares drug-injection equipment (e.g., needles, syringes,
cottons, cookers, or rinse water). These persons have been traditionally referred to as needle-sharing partners or
Dual referral. A notification strategy in which an index patient, together with a health-care provider (typically a
disease intervention specialist) notifies a partner of the partner's possible exposure. The strategy allows the provider to provide
direct support to the index patient during the notification process and provide the partner with immediate access to counseling,
testing, and other information resources (e.g., referrals).
Duty to warn. A legal concept that a health-care provider who learns that an HIV-infected client is likely to transmit the
virus to another identifiable person must take steps to warn that person. State laws determine which circumstances constitute a
duty to warn.
Early syphilis. Primary, secondary, and early latent syphilis.
Expedited partner therapy (EPT). The process by which treatment for partners of persons diagnosed with gonorrhea
or chlamydial infection is administered before clinical evaluation. Medications or prescriptions are delivered through
either 1) the index patient (i.e., patient-delivered partner therapy) or 2) a disease intervention specialist (i.e.,
HIV prevention community planning group (CPG). A planning group consisting of local health officials,
representatives from affected communities, and technical experts who share responsibility for developing a comprehensive HIV
prevention plan for their community. The intent of the process is to increase meaningful community involvement in prevention
planning, to improve the scientific basis of program decisions, and to target resources to those communities at highest risk for
HIV transmission and acquisition.
HIV prevention counseling. An interactive process between client and counselor aimed at reducing risky sex and
drug-injection behaviors related to HIV acquisition or transmission.
Index case. The first case recognized or reported during an outbreak or epidemic. In epidemiology, the term case
generally refers to an episode of infection or disease, not to a unique person. An index case is not necessarily the source of an
outbreak or epidemic; it is simply the first case identified. In the context of HIV/STD partner services, an index case is a newly
reported case that prompts the initiation of an investigation to identify other possibly related cases. For curable STDs, the term
index case refers to discrete episodes of infection. A person who has recurrent episodes of a curable STD during a defined
time period is counted as a separate index case for each episode. For example, a person who has three reported episodes
of gonorrhea during 1 year would represent three index cases during that year. In contrast, once a person is infected with
the person remains infected; therefore, once a person with HIV infection is identified, the person will not be counted as
an index case again in the future.
Index patient. The person in whom an index case occurs and who prompts the initiation of an investigation to identify
other possibly related cases. Index patients also are sometimes referred to as "original patients" (i.e., the original patient identified
in an investigation, not necessarily the original patient in a chain of transmission).
Indicator. A measure used to determine an organization's performance of a particular element of care over time. The
indicator might measure a particular function, process, or outcome
Interview period. The period of time for which an index patient is asked to recall sex or drug-injection partners. Because
of differences in biological factors and progression of various diseases, the recommended interview period varies by disease.
Ongoing partner services. The concept that partner services should be available to persons with HIV infection at any
time needed throughout the course of their life.
Original interview. The first interview conducted with an infected patient. The primary purpose of the original interview
is to gather information from index patients about partners they have had during the relevant interview period.
Original patient. See index patient.
Outcomes. Benefits or other results (positive or negative) for clients that might occur during or after their participation in
a program. Outcomes can be client level or system level.
Overall responsible party (ORP). The person who accepts overall responsibility for implementing and enforcing
HIV/AIDS and STD data security standards and who might be liable for any breaches of confidentiality.
Partner. For persons with syphilis, gonorrhea, or chlamydial infection: refers to sex partners (i.e., persons with whom an
index patient has had sex at least once, not just regular or main partners); for persons with HIV infection: refers to sex and
drug-injection partners (i.e., persons with whom an index patient has had sex or shared drug-injection equipment at least once,
not just regular or main partners).
Partner elicitation. The process of obtaining the names, descriptions, and locating information of persons who are
partners (or social contacts) of an index patient. Partner elicitation is one step in the process of partner referral
Partner notification. The process of locating and confidentially notifying partners that they have been exposed to
an infection. Partner notification is one step in the process of partner referral.
Partner referral. The process in which partner names are elicited (i.e., partner elicitation), partners are located and notified
of their exposure (i.e., partner notification), and notified partners receive a combination of counseling and referrals for testing
(or in some cases, testing in the field) and other social support services.
Partner services. A broad array of services that should be offered to persons with HIV infection, syphilis, gonorrhea,
or chlamydial infection and their partners. Identifying partners and notifying them of their exposure (i.e., partner
notification) are two critical elements of these services. Other elements include prevention counseling, testing for HIV and other types
of STDs, linkage to medical evaluation and treatment, and linkage or referral to other services, such as reproductive
health, prenatal care, substance abuse treatment, social support, housing, legal services and mental health services.
Patient. A client who is diagnosed with HIV infection or another STD.
Patient referral. See self-referral.
Performance measure. A quantitative tool that provides an indication of an organization's performance in relation to
a specified process or outcome.
Personal identifier. A datum or collection of data that allows the identity of a single person to be determined with a
specified degree of certainty.
Postexposure prophylaxis (PEP). Administration of antiretroviral drugs to HIV-negative persons who have been exposed
to HIV in an effort to prevent establishment of infection. The treatment is initiated within 72 hours of exposure and
generally continues over the course of a 28-day period.
Prevention counseling. An interactive process between client and counselor aimed at reducing risky sex and
drug-injection behaviors related to acquisition or transmission of HIV and other types of STDs.
Prison Rape Elimination Act of 2003 (PREA). A public law that provides for analysis of the incidence and effects of
prison rape in federal, state, and local institutions and for information, resources, recommendations, and funding to protect
persons in prison from rape.
Privilege to warn. The legal concept that a health-care worker is legally permitted to warn the partners of an
HIV-infected person of the risk of past or future exposure to HIV.
Program collaboration and service integration. A mechanism of organizing and blending interrelated health
concerns, separate activities, and services to maximize public health impact through new and established linkages among programs
to facilitate delivery of services.
Provider referral. A notification strategy in which a health department specialist (e.g., disease intervention
specialist) confidentially notifies a partner of possible exposure.
Quality. The degree to which a health or social service meets or exceeds established professional standards and
Quality improvement. An approach to the continuous study and improvement of the processes of providing services to
meet the needs of the person and others.
Reactor grid. The use of quantitative test results, age, and sex criteria to identify which persons with reactive syphilis tests
are most likely to be untreated and infectious cases.
Reinterview. An interview that follows the original interview with an index patient. The reinterview is used to gather
additional locating information about partners identified by index patients during the original interview, monitor the status of
partners index patients initially decided to notify themselves, elicit names of additional partners index patients might not have recalled
in the original interview, and verify that index patients have received adequate treatment or additional tests.
Ryan White CARE Act Amendments of 1996. The law reauthorizing the Ryan White HIV/AIDS Program, a
program administered by the Health Resources and Services Administration that provides for grants to support the medical care
needs of low-income, uninsured, and underinsured persons living with acquired immunodeficiency syndrome (AIDS) and
Self-referral. A notification strategy in which an index patient accepts full responsibility for informing a partner of
possible exposure and referring the partner to appropriate services. A health-care provider helps the index patient determine
when, where, and how to notify the partner as well as how to cope with potential reactions. This process is also known as
client referral and patient referral.
Social contact. A person named by the index patient during an interview as part of the social network who is not a sex
or drug-injection partner of the index patient. Social contacts (referred to as suspects in previous STD partner services
guidelines) might include persons with symptoms suggestive of disease, partners of other persons known to be infected, or others
who might benefit from examination.
Social network. A group of persons connected by various types of social relationships, such as family, work and
recreational relationships, sexual partnerships, and drug-using relationships. The social network might also include venues in
which interactions among members of a social network occur. Persons in a social network might share social, economic, cultural,
or behavioral characteristics that influence their risk for various health conditions, including HIV infection and other STDs.
Standards. Elements or procedures that must be followed by CDC grantees in virtually all instances in which CDC funds
are used to support services.
Suspect. A social contact. This term has historically been used to describe a person named by an index patient as part of
the social network who is not a sex or drug-injection partner of the index patient. These persons might have symptoms
suggestive of disease, might be partners of other persons known to be infected, or might be other persons who might benefit
System. A group of related processes.
Third-party provider. A health or social services professional not affiliated with a health department (e.g., physicians,
nurses, or counselors) who might participate in certain aspects of partner services, such as partner elicitation or partner
notification via dual referral
Third-party referral. A notification strategy by which a partner is notified of exposure to HIV or another STD by
a professional other than a health department staff member (e.g., a private physician).
Window period. The time interval after infection during which a serologic test might be negative because antibodies have
not reached a detectable level.
Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of
Health and Human Services.References to non-CDC sites on the Internet are
provided as a service to MMWR readers and do not constitute or imply
endorsement of these organizations or their programs by CDC or the U.S.
Department of Health and Human Services. CDC is not responsible for the content
of pages found at these sites. URL addresses listed in MMWR were current as of
the date of publication.
All MMWR HTML versions of articles are electronic conversions from typeset documents.
This conversion might result in character translation or format errors in the HTML version.
Users are referred to the electronic PDF version (http://www.cdc.gov/mmwr)
and/or the original MMWR paper copy for printable versions of official text, figures, and tables.
An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S.
Government Printing Office (GPO), Washington, DC 20402-9371;
telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to