Partner Notification Services
15% of partners tested by Partner Services were positive for HIV and previously undiagnosed.
Partner Services provides an array of free services to people with HIV or other sexually transmitted diseases (STDs, such as syphilis, gonorrhea, and chlamydia) and their partners. Partner Services is a function of local and state health department staff, who help to identify and locate sexual or drug injection partners to inform them of their risk for HIV and to provide them with testing, counseling, and referrals for other services.
For partners who test positive, Partner Services can provide linkage to treatment and care, risk-reduction counseling, and other services.
For those who test negative, Partner Services can provide them with information on various HIV-prevention methods, including pre-exposure prophylaxis (PrEP), condoms, and other sexual and drug-use options. For partners at high risk for HIV, consider PrEP. PrEP is a powerful HIV-prevention tool and has been shown to be about 99% effective in reducing the risk of sexual HIV transmission.
Additionally, access to other services may lead to reductions in high-risk sexual and drug-use behaviors.
Partner Services Programs Reduce HIV Transmission by Helping Your Patients Inform Partners of Their HIV Status
Health Care Provider Role in Initiating Partner Services
While you are not expected to take on the role of partner notification yourself, it is very helpful for you to educate your patients about Partner Services and its importance in preventing HIV transmission.
For Patients Being Tested for HIV/STDs
- Talk with your patients about Partner Services and let them know that if they test positive for a reportable disease, they may be contacted by someone from the health department.
- Discuss how Partner Services can help your patients and their sexual or drug injection partners through early access to testing, treatment, and other services.
- Emphasize the importance of participating in the Partner Services process as a way to help stop the transmission of HIV/STDs.
- Conduct brief discussions with your patients on how to reduce high-risk sexual and drug-use behaviors.
For People Newly Diagnosed With HIV
If you are seeing a patient for the first time, speak with him or her about Partner Services to determine if partner notification was previously addressed. If not, repeat the same process listed above.
For Patients With HIV
For patients who present with an STD or inform you of high-risk behavior (for example, sex without condoms or needle sharing during injection drug use), consider the following:
- Make your patient aware that he or she may be contacted by someone from the health department.
- Discuss the importance of taking HIV medicine, or antiretroviral therapy (ART), to treat HIV as soon as possible. Viral suppression, or having an undetectable viral load, is the best thing people with HIV can do to stay healthy. Another benefit of reducing the amount of virus in the body is that it helps prevent transmission to others through sex or syringe sharing, and from mother to child during pregnancy, birth, and breastfeeding.
- Refer your patient directly to the Partner Services program.
Notifying sexual or drug injection partners that they may have been exposed to an infectious disease is formally known as partner notification. Health departments use one of three methods in this process:
- Health Department Tells Patient’s Partners (“Provider Referral”)
- Your patient provides partner contact information to the health department.
- Partners are located by health department staff and made aware of their potential exposure.
- Partners are provided, or referred for, counseling, testing, treatment, and other services by the health department.
- Patient Tells Partners (“Self-Referral”)
- Your patient takes on the responsibility of letting sexual or drug injection partners know that they have possibly been exposed.
- Your patient provides partners with the information about local services, including counseling and testing.
- Both the Patient and the Health Department Tell Partners (“Dual Referral”)
- Your patient, with assistance from health department staff, lets partners know of their potential exposure.
- Health department staff are there to help your patient during the process and provide partners with information and access to counseling, testing, and other resources.
Best Practice: The Health Department Informs Partners
When health departments take responsibility for notification, more partners are successfully notified of their possible exposure.1 For patients, this method helps maintain their anonymity and relieves them of the burden of disclosure.
Additionally, health departments link patients to other resources, such as counseling and risk-reduction services. For the partner who may have been exposed, this method facilitates quick access to testing and linkage to care for treatment and other services.
Patients With HIV Who Present With Gonorrhea or Chlamydia
Due to resource limitations, health departments do not always follow up on cases of gonorrhea or chlamydia. However, if a patient with HIV presents with either of these STDs, it is important that you alert health departments of this co-infection with HIV to ensure appropriate follow up with potentially exposed partners. Certain STDs can increase HIV viral load and genital HIV shedding, which may increase the risk of sexual and perinatal HIV transmission.
About 15% of people with HIV in the United States are not aware of their status, and about 23% received a diagnosis but are not receiving care. Together, they account for about 80% of new HIV infections.2
The Centers for Disease Control and Prevention’s (CDC’s) recommendations for Partner Services for patients with HIV and other STDs3 have created a renewed focus on this public health priority.
Reportable Diseases and Your Patient
Health care providers and clinical laboratories are required by law to report certain types of infections to their local or state health departments. If your patient tests positive for one of these infections, he or she will likely be contacted by someone from the health department. Therefore, it is important to let patients know that the health department may contact them if they test positive for one of the reportable infections and that this is a normal procedure.
The list of reportable infections varies from state to state, but it typically includes HIV, syphilis, gonorrhea, and chlamydia. Other infections may also be reportable, and it is important for you as a health care provider to know which ones are reportable in your area.
Goals of Partner Services
The goals of Partner Services include:
- Providing services to people with HIV or other STDs, including risk-reduction counseling and referrals for medical care and other services (e.g., psychosocial support and prevention interventions).
- Ensuring that sexual and drug injection partners of people with HIV or other STDs are notified of their potential exposure, provided with counseling and testing, treated or linked to medical care if needed, and provided with other appropriate referrals.
- Reducing future rates of transmission by facilitating early diagnosis.
Partner Services programs are not intended to have you, the health care provider, take on more responsibility. In fact, they are designed to ease your workload by offering another free resource to help your patients notify their sexual or drug injection partners of their possible exposure to an infectious disease.
Partner Services also:
Presents an opportunity for you to identify behaviors that increase your patients’ risk of transmitting HIV or another STD and helps you initiate discussions with patients about how to reduce those behaviors.
Leverages your relationships with patients and maximizes the trust they have in you to help prevent the transmission of HIV and other STDs.
To learn more about how Partner Services works in your area and to obtain information about state and local laws related to Partner Services, contact your local or state health department. To find your local health department, go to www.healthfinder.gov external icon › Find Services Near You › State Health & Human Services.
Ensure that trained professionals contact your patients and inform their partners of their possible exposure without using your patients’ names, removing the burden of disclosure from your patients.
For patients who choose self-referral, ensure that adequate time is spent coaching your patients on how to inform their partners about their potential exposure.
Increase your patients’ knowledge about how to protect themselves and maintain their own health.
Present another free resource for your patients to access education and counseling about how to live well with HIV.
Help partners get tested quickly and facilitate timely treatment or linkage to care.
- Task Force on Community Prevention Services. Recommendations to increase testing and identification of HIV-positive individuals through partner counseling and referral services. Am J Prev Med. 2007;33(2Suppl):S88. Accessed April 29, 2019.
- Li Z, Purcell DW, Sansom SL, Hayes D, Hall HI. Vital Signs: HIV Transmission Along the Continuum of Care — United States, 2016. MMWR Morb Mortal Wkly Rep 2019;68:267–272. Accessed April 29, 2019.
- CDC. Recommendations for partner services programs for HIV infection, syphilis, gonorrhea, and chlamydial infection. MMWR Recomm Rep. 2008;57(RR-9):1–83. Accessed April 29, 2019.