Module IX
Partner
Management
Objectives
Explain why partner management is
such an important part of STI
prevention and control
Describe its possible impact on the
individuals concerned
Distinguish two possible approaches
to contacting partners
2
Objectives...
List the issues to discuss with the
index cases in relation to partners
Review the educational and
motivational skills needed when
educating and counseling STI patients
on the need to treat partners
Treat patient’s partners
3
Principles and
Approaches
4
Principles
Each STI patient is a sole source of infection
to sexual partner (s) until treatment is
completed
Treated STI patient can be cured but not
immune (re-infection is possible)
5
Principles…. cont’d
Treatment of all the patient’s sexual partners
for the same STI as the index case, and
treating any new STI identified are the main
features of partner management
As the management is syndromic, the
treatment must be given presumptively and
the partner treated even if there are no
symptoms or signs of STI
6
Advantages of Partner
Notification
Break cycle of infection
Eliminate asymptomatic
infection
Prevent re-infection
Prevent complication by early
detection
Education & risk reduction
7
counseling
Two Approaches to Partner
Management
1. Patient referral (Passive
contact tracing)
2. Provider referral (Active
contact tracing)
8
Principles of Partner
Notification
Voluntary participation
Professional approach
Confidentiality
Accessibility
Quality assurance
Do not harm
9
Patient referral
The patient referral system is the most
commonly used method because of its
low cost and practicability.
Patient referral could be done in several
ways
By directly explaining about the STI & the
need for treatment
Asking the partner to attend a health center
with out specifying the purpose of the visit
By giving a partner a card to attend the
10 center
Issues to consider
Explain the importance of treating all
patients’ partners
Remind the patient how to avoid re-
infection
Help the patient decide how to
communicate with the partner
If possible, obtain names of the
patients’ partner (s)
11
Patient Referral Cards
Facilitate partner management
could be extremely useful to help
identify the necessary treatment for any
partner referred by a patient with STI
can contain any extra information that is
required, but should never threaten
anyone’s confidentiality or risk them
being stigmatized
one or more can be given to every
12 patient with an STI syndrome.
Provider Referral
Possible if index patients are prepared to
disclose full contact information
It is resource intensive
The success depends on health care
providers communication skills
Can be used when
Patients refuse to refer partner
Patient has agreed to refer partners but
they have not come for treatment
13
Challenges
Failure of patient referral
Patient refuses to refer patient
A partner fails to come for treatment
Treatment of partner
History taking, treating, educating &
managing partners is exactly the
same as the index patient
14
Partner Management
INDEX PATIENT TREATMENT OF PARTNER
Urethral discharge Treat for gonorrhea & Chlamydia
Vaginal discharge with Treat for gonorrhea , Chlamydia
risk assessment positive
(Cervicitis)
Vaginal discharge with No partner treatment needed
risk assessment negative
(Vaginitis)
PID Treat for gonorrhea & Chlamydia
Scrotal swelling Treat for gonorrhea & Chlamydia
Inguinal bubo Treat for LGV
Neonatal conjunctivitis Treat for gonorrhea & Chlamydia
Genital ulcer Treat for syphilis & chancroid
15
National Partner Notification
Card
Show samples
16
National Partner Notification
Card...
Name of the Facility:
_______________________
Index case card No.:
_______________________
Room No: ________________________________
Appointment date: ________________________
If you are not able to come on this day,
Please come as soon as you can.
Coming on appointed time is always best
17
National Partner Notification
Card..
Dx:
UD GUD VD LAP IB SS NC
Dear Colleague,
Please provide services based on the
national guidelines to the
Person who comes with this card.
Date: ______ Signature: _____ _
Name of provider: ______ (put the initial)
18
STIs
19