Timing the discussion
When should contact tracing be discussed?
• Before testing. Contact tracing may sometimes be discussed prior to STI testing, particularly if a patient raises concerns, or the likelihood of an STI is high.
• When an STI is diagnosed. Contact tracing is more commonly discussed after a confirmed diagnosis, when the index patient’s sexual, injecting or other risk history should be reassessed. Ensure that the index patient tells the contact what condition or infection they have been diagnosed with.
The most appropriate time to discuss contact tracing with the patient will depend on the situation. Factors to consider include:
- The patient’s physical and emotional state. If the patient is physically unwell or emotionally distressed, it may be better to defer the discussion to a subsequent consultation.
- The patient’s own priority. For many patients the issue of notifying contacts is high on their agenda and it may suit them to deal with the issue immediately.
- The nature of the condition. For easily curable conditions, which are also infectious (for example, chlamydia, gonorrhoea and syphilis), contact tracing is usually dealt with during the same visit in which the index patient is given the diagnosis and treatment. This is important in limiting further transmission or re-infection of the index patient.
- Public health factors. If it is considered that a contact is placing others at immediate risk of infection, particularly where the infection is serious (for example HIV) contact tracing should ideally proceed immediately. The public health considerations for individual conditions are described in Conditions.