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Introduction to Contact Tracing

When patients are diagnosed with a treatable sexually transmissible infection it is vital that testing and treatment of their sexual partners is properly considered, discussed and supported by the diagnosing clinician. Research shows that a substantial proportion of these patient’s partners will be infected but unaware of this, warranting efforts to ensure partner notification is facilitated and completed successfully[1,2]. Treatment of infected partners will help them avoid complications and reduce the duration of infectiousness, potentially curbing further unintended sexual transmission. This is particularly important where HIV is concerned. Identification of new cases of HIV through partner notification means these individuals can commence antiretroviral therapy earlier, improving their prognosis and limiting further transmission of HIV.

The barriers to successful partner notification can, however, deter some health care providers from initiating the conversations on partner notification with their patients or prevent health care providers from contacting partners on their patient’s behalf’ Such barriers may include but are not limited to clinician discomfort raising sexual health histories with patients, a need to prioritise other health issues over partner notification, patients reluctance to disclose how many sexual partners they have had or limited knowledge or training on how to address partner notification[3].The Australasian Contact Tracing Manual aims to provide practical support and guidance to health care providers to enhance the effectiveness of partner notification. How we help patients contact partners will depend on multiple factors including patient preference and the skills of the provider. Increasingly, people are using the internet, including social media and mobile phone applications, to find their sexual partners. Use of social networks allows for anonymous sexual encounters and may facilitate risky sexual behaviours such as multiple partners and condomless sex[4,5]. In some cases, this is hindering partner notification. How these evolving technologies can be harnessed to improve partner testing and treatment should be the focus of continuing research and innovation in service delivery.

On behalf of the expert writing committee, I wish to convey my sincere thanks to everyone who has contributed their time and expertise to this updated edition of the manual and hope you will find it a helpful resource.

Jane Tomnay
August 2022

References:

[1] Rietmeijer CA, Van Bemmelen R, Judson FN et al; Incidence and repeat infection rates of Chlamydia trachomatis among male and female patients in an STD clinic: implications for screening and rescreening. Sex Transm Dis. 2002 Feb;29(2):65-72. doi: 10.1097/00007435-200202000-00001. PMID: 11818890.

[2] Ward H, Bell G. Partner notification. Medicine (Abingdon). 2014 Jun;42(6):314-317. doi: 10.1016/j.mpmed.2014.03.013. PMID: 24966787; PMCID: PMC4065334.

[3] Sally B. Rose PhD; Susan M. Garrett MPH; Susan R. H. Pullon MPHC, FRNZCGP (Dist), MBChB Overcoming challenges associated with partner notification following chlamydia and gonorrhoea diagnosis in primary care: a postal survey of doctors and nurses https://www.publish.csiro.au/hc/pdf/HC17006.

[4] Queiroz JF; Santos Medeiros K; Sarmento ACA; et al, Use of dating sites and applications by women and their risk of sexually transmitted infections: a systematic review and meta-analysis protocol BMJ Open Volume 10 Issue 11 https://bmjopen.bmj.com/content/10/11/e038738.

[5] Chan P; Crowley C; Rose JS; Kershaw T; A Network Analysis of Sexually Transmitted Diseases and Online Hookup Sites Among Men Who Have Sex With Men January 2018 Sex Transm Dis 45(7):1 DOI:10.1097/OLQ.0000000000000784.

Note: Throughout the resource, Note: The term “health care provider” encompasses reference to general practitioners, primary care providers, nurses and other medical professionals providing sexual health services.

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