Association of Reproductive Health Professionals
Association of Reproductive Health Professionals
Reproductive Health Topics Publications & Resources Professional Education Newsroom Membership Policy & Advocacy About Us
Quick Reference Guide for Clinicians
Send To A Friend Send To A Friend Bookmark this Page Share this page
Hot Topics in Sexually Transmitted Infections and Associated Conditions

(Published November 2013)

Management of Sex Partners

The goals of partner management in STI clinical services include the following:9

  • Increasing the number of individuals with STIs who access treatment
  • Preventing re-infection of the index patient
  • Interrupting transmission networks

Partner notification is a central but often neglected aspect of STI management and is carried out either by the care providers of the index patient or public health authorities. It includes identification of sex partners of the index patient and arranging for their evaluation and treatment.

Traditionally, partner management for treatable STIs has involved treatment of the index patients partner(s) in a clinical setting.

Clinicians should encourage individuals with treatable STIs to notify their sex partners and urge them to seek treatment. Clinicians can also request that patients bring their partners when they return for treatment or follow-up.

Expedited partner therapy (EPT) is the treatment of the sex partners of index patients with STIs outside of the clinical setting, that is, without medi­cal evaluation or prevention counseling. When partner referral is not likely to be successful, EPT may be helpful. EPT is meant to supplement other partner management strategies, such as provider-assisted referral, which may be limited by available resources. EPT should be considered a routine practice when it is the best option to ensure partner treatment for gonorrhea or chlamydial infection and where legally permissible.9

  • EPT is used most commonly for partners of patients diagnosed with Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (GC) and may also be considered for the partners of patients with trichomoniasis.
  • EPT is legally permitted in most states but still prohibited by law in some. To check on the legal status by state, see www.cdc.gov/std/ept/legal.
  • EPT should be accompanied by instructions and warnings about the medication (including allergy or pregnancy), general health counseling, and the advice that partners seek medical evalu­ation themselves, especially in the presence of STI symptoms.
  • Generally EPT should not be used for men who have sex with men (MSM), because of the high risk for coexisting STIs, including undiagnosed HIV infection.

Table 1: Recommended Management of Sex Partners by STI or Associated Condition9

STI or Associated Condition Recommended Partner Management

BV

Treatment of sex partners is not recommended.

Heterosexual men or women with CT or GC

All sex partners within preceding 60 days should be evaluated and treated. EPT should be considered, where allowable by law, if the sex partner is unlikely to present for treatment.
Genital herpes Providers should ask symptomatic sex part­ners about previous history of genital lesions and should offer type-specific HSV serologic testing.
HIV Partners not previously diagnosed with HIV should be tested and counseled; selected partners may be candidates for post-exposure prophylaxis (PEP) with antiretroviral drugs (see CDC guidelines).
HPV Patients should be encouraged to inform partners, and counseling about communication with sex partners may be helpful in the adoption of prevention strategies; clinical evaluation is optional for asymptomatic partners.
Syphilis Patients should receive a clinical exam and serologic testing; partners of patients with syphilis less than a year in duration should be treated without awaiting diagnostic test results (for specific regimens, see CDC guidelines).
Trichomoniasis Male partners of infected women should be treated; EPT may be considered where legally permissible.
Cervicitis Partners should receive treatment for the same STI(s) as the index patient.
Women with pelvic inflammatory disease (PID) Sex partners should be treated with regimens that are effective against both CT and GC, regardless of the etiol­ogy of PID.