Synopsis
Prevent onward transmission and reinfection through confidential, organism-specific partner notification while distinguishing eradication testing from later reinfection screening and routine follow-up.
- Partner notification is a clinical intervention: identify potentially exposed partners, agree a safe notification method, support testing and treatment, and document outcomes while protecting the index patient's identity.
- Use infection-specific lookback periods and exposure-site questions from current BASHH guidance; one universal number is inaccurate across chlamydia, gonorrhoea, trichomoniasis and syphilis.
- Offer patient referral, provider referral or a negotiated conditional approach according to preference, safety, likelihood of completion and local sexual-health capability.
- A test of cure asks whether treatment eradicated the diagnosed infection; a later retest mainly seeks reinfection and is not interchangeable with symptom review.
- Chlamydia test of cure is reserved for pregnancy, persistent symptoms, suspected poor adherence or another defined concern and must be delayed long enough to avoid residual DNA.
- Gonorrhoea test of cure is recommended for pregnancy, pharyngeal infection, persistent symptoms, unknown susceptibility or treatment other than ceftriaxone under the 2025 guideline.
- Resolved trichomoniasis does not require routine test of cure, but current partners should receive treatment and persistent or recurrent symptoms need correctly timed retesting.
- Syphilis follow-up uses serial quantitative RPR or VDRL interpreted by stage, baseline titre, treatment and reinfection risk; treponemal tests often remain positive for life.
- Recheck pregnancy, HIV and hepatitis window periods, vaccination and prevention needs while preserving a non-judgemental approach to relationship structure and partner number.
Key red flags
A qualifying HIV exposure within 72 hours needs immediate specialist risk assessment because delaying PEP reduces the opportunity for benefit.
Pelvic pain, fever, pregnancy-related pain or bleeding, neurological or ocular symptoms, or disseminated rash requires clinical escalation before administrative follow-up.
Disclosure of coercion, violence, exploitation, stalking or fear that notification will trigger harm requires a tailored safeguarding plan and must not default to patient referral.
A child, person lacking decision-making capacity or adult at risk requires statutory safeguarding processes alongside confidential sexual-health care.
Suspected gonorrhoea treatment failure or resistant infection requires prompt culture, susceptibility testing and specialist or public-health involvement.
Investigation priorities
Test an index patient or contact at every exposed site and perform correctly timed molecular follow-up.
Management branches
A transmissible STI is diagnosed or strongly suspected and partner action is required.
- Explain confidentiality, identify exposed partners and sites within the current disease-specific lookback, and assess risk of violence or unwanted disclosure.
- Agree patient, provider or conditional referral and record how the service can contact partners without revealing the index patient's identity.
- Specify testing, epidemiological-treatment and abstinence advice separately for each organism instead of using a generic STI script.