Public health benefits of partner notification for sexually transmitted infections and HIV
This report provides a better understanding of current policies and practice related to partner notification in Europe and evaluates its public health benefits, and particularly its role in STI and HIV prevention. It also reveals the wide variety of partner notification practices in Europe which are determined by diverse legal and policy frameworks, and influenced by cultural and social factors.
To explore and evaluate current partner notification policies and practices across Europe, ECDC gathered information about existing national legal and policy frameworks. In 11 of the 24 countries that responded to the ECDC questionnaires, laws or regulations exist that make partner notification compulsory for the health care provider, the patient or both. These laws most often apply to HIV, syphilis, gonorrhoea, chlamydia, hepatitis B, and hepatitis C. While some countries have wide-ranging legal obligations to enforce partner notification, others have laws that are not enforced, and some countries have no such obligations or laws.
In general, “partner notification” describes the process when the sexual partner(s) of a patient who was diagnosed with a sexually transmitted infection (STI) are identified and informed of their exposure. During this process, the sexual partner(s) are normally invited for testing, counselling and, where necessary, treatment.
There are different approaches to partner notification which can be broadly defined as:
- patient referral, i.e. the tested patient takes the responsibility for informing their sexual partner(s) of a possible STI exposure and for referring them to services,
- provider referral where the test provider informs the sexual partner(s), and
- contract or conditional referral, where the provider informs the sexual partner(s) in case the patient fails to do so within an agreed period of time.
Patient referral preferred approach
The report shows that patient referral is the preferred approach to partner notification for all STI in most EU/EEA countries. Provider referral was used in some countries, most often for syphilis, gonorrhoea, chlamydia and HIV.
The majority of health care providers see the value of partner notification. There is little support for mandatory partner notification and concern about use of provider referral, in particular for HIV partner notification, because of patient confidentiality issues.
Partner notification has clear clinical benefits: it aims to prevent re-infection of the index patient and treat their sexual partner(s). And at the same time it also has public health benefits as partner notification aims to control the spread of STI and reduce STI-related sickness and deaths.
Information for this report was obtained through three online questionnaires, in-depth interviews with health professionals and policy-makers and literature reviews.