Synopsis
Plan confidential, organism-specific partner notification that protects the index patient, reaches exposed contacts for testing and treatment, accounts for violence or safeguarding risk, and verifies outcomes.
- Partner notification identifies people exposed during the pathogen- and presentation-specific lookback, supports testing or treatment, and protects the index patient’s identity.
- Define partners by actual exposure and timing rather than relationship labels; different infections and stages use different lookback periods.
- Offer patient referral, provider referral or a negotiated conditional approach, choosing with the patient according to safety and likely completion.
Key red flags
Notification could provoke violence, stalking, eviction, coercion, honour-based abuse or digital surveillance; direct patient referral may be unsafe.
A contact may be pregnant, symptomatic, within an HIV PEP window or exposed to resistant gonorrhoea and needs rapid clinical access.
The index patient or contact is a child, lacks decision-making capacity or may be exploited, requiring safeguarding alongside confidential care.
Persistent gonorrhoea symptoms or a correctly timed positive follow-up test without re-exposure requires culture, susceptibility and specialist escalation.
A clinician is considering identifiable disclosure without consent; obtain senior, information-governance or legal advice unless delay creates serious harm.
Violence, coercion, stalking, shared devices or fear of retaliation favours provider-led notification and a wider safety plan.
Recent HIV exposure, pregnancy risk, symptoms or resistant gonorrhoea can require same-day clinical access rather than routine messaging.
Investigation priorities
Identify contactable partners, anatomical sites and timing within the applicable lookback.
Management branches
An index patient has a confirmed STI and two partners may have been exposed.
- Explain the purpose and confidentiality of notification, then apply the current organism-specific lookback and clarify exposure sites.
- Ask about violence, coercion, privacy and safe communication before choosing patient, provider or conditional referral.