Reaching people who have been exposed to disease, and then providing an appropriate intervention, is at the very core of public health practice. With STDs, the sexual or needle-sharing partner is identified by the infected individual, informed of his/her exposure, and offered services to prevent, cure or manage the infection. The Division of STD Prevention has been using PN as a tool to limit the number of cases of syphilis and gonorrhea for the past 50 years. We have extended this tool to HIV prevention for the past five years.
Reaching infected persons and providing them with counseling and education are critical elements of an HIV prevention program. PN provides for this on an individual and personalized basis, while providing feed-back on the effectiveness of broader, community-based efforts. As a prevention tool, PN can help fine-tune and target the messages for those at greatest risk.
Tenets of Partner Notification
- PN IS ALWAYS VOLUNTARY - No one is forced to use the service.
- STD INTERVIEWERS DO NOT NEED TO KNOW THE CLIENT'S NAME - we only need the counselor or other professional to assure us we are interviewing an HIV infected person.
- NOTIFICATION IS ALWAYS FACE-TO-FACE, IN PRIVATE - this assures to the greatest extent possible that the person being informed is the same as who was named by the partner.
- PARTNERS ARE NOTIFIED OF POSSIBLE EXPOSURE, not that they are infected.
- THE SOURCE OF INFORMATION IS NEVER REVEALED OR ACKNOWLEDGED.
- NO RECORDS ARE KEPT ON HIV-INFECTED PEOPLE USING PN - notes kept by the STD interviewer with names of partners are shredded and burned after notification is performed.
Advantages of PN for the HIV-Infected Person
- safety - many HIV-infected people, particularly women, fear the possibility of emotional or physical abuse. PN provides a safe way to reach partners and minimize risk of harm to the infected person.
- selective notification - an infected person who fears for his/her safety from a particular partner need not name that person, but there may be other partners who could be named without the same concern for safety.
- empowerment - the HIV-infected person is taking an active role in their own care and in the care of those important to them.
Advantages of HIV-PN for Partners
- Partners are informed of risks of which they may not be aware.
- HIV-PN provides personalized education to those at highest risk of infection, i.e., partners of HIV-infected people, with advice on how to continue expressing their sexuality while reducing future risks of exposure and infection.
- Partners are informed of risks to which they may be exposing other partners.
- Partners are offered counseling/medical care/social services to help determine whether they're infected and to help cope with such news - thus, HIV-PN is a gateway to services for those at highest risk of infection.
Protecting the Infected Person
- The STD interviewer does not need to know the infected person's name; the person notifying the partner(s) may not be the one who interviewed the infected person, so there's little chance of inadvertently providing any identifying clues.
- Pronouns (he, she) regarding the infected person are avoided.
- Partners are directed away from dwelling on "Who named me?" and focus instead on learning about HIV and the need to deal with the possibility of being infected.
- Partners are informed only that the person naming them was a contact during the past 10 years.
To Obtain Services or Ask Questions
PN notification services are offered through anyone who works with HIV-infected people, e.g., clinicians, counselors, social workers, etc. The provider can call the STD Prevention Division whenever their client decides to use the service and can arrange a meeting between the client and the STD representative. By working through the provider, the client's identity is not divulged and the STD representative will have the provider's assurance that the person requesting PN services is actually HIV-infected. This protects against false notifications perpetrated against other people.
Call the Division of STD Prevention to receive further information.
Greater Boston: (617) 983-6940
This information is provided by Division of Sexually Transmitted Disease (STD) Prevention within the Department of Public Health.