Partner notification and confidentiality of the index patient: its role in preventing HIV

Article Abstract:

Partner notification has been a source of some controversy in the efforts to control the spread of AIDS. Some feel that all contacts of known human immunodeficiency virus (HIV) carriers should be known; others feel that this would only lead to avoidance of partner identification by the patients. A survey of 25 women infected with HIV found that 68 percent said they would identify their sexual contacts if their identity were kept confidential; only 20 percent said they would cooperate if their identity were made known to their sex partners. Using an estimated average of 1.8 sex partners per infected individual, a number based on surveys of syphilis transmission, a calculation revealed that with confidentiality, 138 partners per 100 patients would be notified; without confidentiality, only 76 partners per 100 patients would be notified. This hypothetical exercise indicates that it would benefit the public health system to retain confidentiality when notifying sexual contacts. An additional aspect of partner notification is that if the infected contact is named, the sexual partner might continue to engage in risky behavior with other individuals. However, if the infected individual is not named, then the contact might begin to practice safer sex with all partners. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Methods, Social policy, Public health, AIDS (Disease)

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Syphilis in San Diego County 1983-1992: crack cocaine, prostitution, and the limitations of partner notification

Article Abstract:

Sexual partner ascertainment and notification may not be an effective method of controlling syphilis outbreaks among inner city drug users. The effect of drug use and anonymous sex on the progression of an inner city syphilis epidemic in San Diego, CA, was analyzed. Between 1983 and 1992, a total of 2.780 syphilis cases were reported. Thirty percent of patients reported illegal drug use. The use of crack cocaine was significantly associated with prostitution. Patients were asked to estimate their total number of sex partners during the time they would have been infectious and to name as many as possible. The estimated number of sexual partners per patient was 4.2, but the number of named partners per patient was 1.5. Twenty-two percent of patients did not name any of their sexual partners. Twenty-six percent of the sexual partners were treated for syphilis. This percentage might be improved by including persons identified in the patient's social network as high risk or by offering screening to high-risk populations.

Prevention, Demographic aspects, Epidemics

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Partner notification for syphilis: a randomized, controlled trial of three approaches

Article Abstract:

Three approaches used to notify partners potentially infected with syphilis appear to be equally successful. A total of 1,966 infected patients identified 11,272 exposed partners. Patients provided enough information to locate only 2,761 of these partners. Patients were instructed to either notify the partners themselves, have an intervention specialist notify them, or have the specialist test the exposed partner when located. Of the 2,236 located partners, 870 were given preventive treatment and 367 were infected. Each approach yielded a similar number of partners and was equally cost-effective.

Social aspects, Identification and classification, Social groups

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