Module IX
Partner/s
Management
1
Objectives
Explain why partner/s management is such
an important part of STI prevention and
control
Describe its possible impact on the
individuals concerned
Distinguish two possible approached to
contacting partner/s
2
Objectives
List the issues to discuss with the index
cases in relation to partner/s
Review the educational and motivational
skills needed when educating and
counseling STI patients on the need to treat
partner/s
Treat patient’s partner/s
3
Brainstorming session
Why do you think partner/s management
is important in STI case management?
4
Principles and
Approaches
5
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)
6
Principles cont’d
Treatment of all the patient’s sexual
partner/s 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/s treated even if there are
no symptoms or signs of STI
7
Advantages of Partner/s
Notification
Break cycle of infection
Eliminate asymptomatic infection
Prevent re-infection
Prevent complication by early detection
Education & risk reduction counseling
8
Issues to consider
Explain the importance of treating all
patients’ partner/s
Remind the patient how to avoid re
infection
Help the patient decide how to
communicate with the partner/s
9
Two Approaches to Partner/s
Management
1. Patient referral (passive contact tracing)
2. provider referral (active contact tracing)
10
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/s to attend a health
center with out specifying the purpose of
the visit
By giving a partner/s a card to attend the
11 center
Patient Referral Cards
Facilitate partner/s management
Could be extremely useful to help identify
the necessary treatment for any partner
referred by a patient with STI
Should never threaten anyone’s
confidentiality or risk them being
stigmatized
One or more can be given to every patient
with an STI syndrome.
12
National Partner/s
Notification Card
Show samples
13
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 came for treatment
If the index case is volunteer and agreed ,
it is highly advisable to devise mechanism
with health extension workers and the
index case on how to bring the partner/s to
health facility.
14
Brainstorming session
What are the challenges of partner/s
management? How can we address the
challenges?
15
Challenges of partner/s
treatment
Patient refuses to refer partners
A partner fails to come for treatment
16
Treatment of partner/s
History taking, P/E, treatment, education and
counseling & managing partners is exactly
the same as the index patient
17
continued
INDEX PATIENT TREATMENT OF PARTNER
Urethral discharge Treat for gonorrhea & Chlamydia
Vaginal discharge with risk Treat for gonorrhea , Chlamydia
assessment
positive( Cervicitis)
Vaginal discharge with risk No partner treatment needed
assessment negative
(Vaginitis)
PID Treat for gonorrhea & Chlamydia
Scrotal swelling Treat for gonorrhea & Chlamydia
Inguinal bubo Treat for LGV and chancroid ,GI
Neonatal conjunctivitis Treat for gonorrhea & Chlamydia
Genital ulcer Treat for syphilis & chancroid
NB: Any additional STI diagnosed on the partner/s should be
also treated
Treatment for HSV is not necessary for asymptomatic partner/s
18