Warning:

This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:

• STD Treatment Guidelines   at http://www.cdc.gov/STD/treatment

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1993 Sexually Transmitted Diseases Treatment Guidelines

09/24/1993

SUGGESTED CITATION
Centers for Disease Control and Prevention. 1993 Sexually
transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14):
{inclusive page numbers}.

CIO Responsible for this publication:
National Center for Prevention Services,
Division of Sexually Transmitted Diseases and HIV Prevention

Management of Sex Partners
     
     The rationale for implementing partner notification is that
early diagnosis and treatment of HIV infection may reduce morbidity
and offers the opportunity to encourage risk-reducing behaviors.
Two complementary notification processes, patient referral and
provider referral, can be used to identify partners. With patient
referral, patients inform their own partners directly of their
exposure to HIV infection. With provider referral, trained health
department personnel locate partners on the basis of the names,
descriptions, and addresses provided by the patient. During the
notification process, the anonymity of patients is protected; their
names are not revealed to sex or needle-sharing partners who are
notified. Many state health departments provide assistance with
provider referral partner notification upon request.

     One randomized trial suggested that provider referral is more
effective in notifying partners than patient referral. In that
trial, 50% of partners in the provider referral group were
notified, yet only 7% of partners were notified by subjects in the
patient referral group. However, few data demonstrate whether
behavioral change takes place as a result of partner notification
and many patients are reluctant to disclose the names of partners
because of concern about discrimination, disruption of
relationships, and loss of confidentiality for the partners.

     When referring to those persons infected with HIV, the term
"partner" includes not only sex partners but also injecting drug
users who share needles or other injecting equipment. Partner
notification is a means of identifying and concentrating risk-
reduction efforts on persons at high risk for contracting or
transmitting HIV infection. Partner notification for HIV infection
must be confidential and should depend upon the voluntary
cooperation of the patient.

     Specific recommendations for implementing partner notification
procedures are listed below:

--   Persons who are HIV-positive should be encouraged to notify
     their partners and to refer them for counseling and testing.
     Providers should assist in this process, if desired by the patient,
     either directly or through referral to health department partner
     notification programs.

--   If patients are unwilling to notify their partners or if it
     cannot be assured that their partners will seek counseling,
     physicians or health department personnel should use confidential
     procedures to assure that the partners are notified.

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