Provider Referral Partner Notification
Provider referral interventions prevent the transmission of HIV from people with HIV to sexual and
needle-sharing partners. In provider referral interventions, people with HIV voluntarily disclose information
about partners. Providers or other public health professionals notify partners that they were potentially
exposed to HIV.
This notification can help prompt these individuals to get tested for HIV, learn more about prevention, and
begin seeking treatment if they test positive during screening. It may also bring them into care sooner, before
they are symptomatic, which can prevent the spread of the virus. Partner counseling and referral services are
generally provided by health departments rather than private organizations.
This model is recommended
by the Guide
to Community Preventive Services as an effective intervention both to increase rates of HIV testing and
to identify new HIV-positive cases.
Examples of Programs Identifying HIV-Positive People through Provider Referral Partner Notification:
The Idaho Department of
Health and Welfare provides funding to help supplement Partner Services staffing and activities in
all seven of the state's local public health districts. Disease Intervention Specialists work with people
who test positive to collect contact information for partners and then locate and inform the partner of
his/her potential exposure. Specialists then provide counseling to partners on reducing HIV risk behaviors
and refer the partner to an appropriate location for testing.
York State Department of Health Partner Services program serves urban and rural areas of New York.
Healthcare providers who identify new cases of HIV and other sexually transmitted infections connect people
with Partner Services. Partner Services will then help make a notification plan for each partner and will
assist with notification if the person prefers to remain anonymous. The Partner Services Specialist can then
assist partners in accessing HIV testing and counseling.
Considerations for Implementation
Partner notification services require special attention and sensitivity to maintain the trust and privacy of
people who choose to disclose information about sexual and needle-sharing partners. Though identifying partners
is voluntary, people may fear stigma and personal repercussions associated with providing this information.
Providers and health departments with strong connections to the community may be most successful at implementing
this model, since patients who feel safe may be more likely to provide this information.
Integrating couples counseling to facilitate disclosure of testing results is encouraged by both the World
Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). When partners learn
their HIV status together, they can work together to make decisions about mutual disclosure to any third parties
Together (TT) is a public health service that facilitates communication and disclosure of HIV status.
During a TT session, two or more persons who are in or planning to be in a sexual relationship receive HIV
testing services together, including their HIV test results. Providers may also use a TT session to link
partners to HIV medical care, pre-exposure prophylaxis (PrEP), and other appropriate services. CDC TRAIN offers eLearning modules for providers
who are interested in TT training.
In addition, the Guide to Community Preventive Services notes that a major
challenge for implementing partner notification services in some locations relates to the presence of
laws criminalizing people living with HIV who fail to disclose their status to partners. The Centers for Disease
Control and Prevention (CDC) outlines HIV laws in each
state that are important to consider. In particular, 21 states legally require HIV-positive
individuals to disclose this information to all sexual partners and 12 states require sharing this
information with needle-sharing partners.
An additional consideration, which varies by state, is whom a provider is legally allowed to notify of HIV
exposure. For example, in Illinois,
providers who identify an HIV-positive person can only disclose this information to an individual's married
spouse or legal partner through civil union. Before providers can notify a spouse, they are also required to
first allow and encourage the person to self-disclose to their partner.
Since confidentiality risks are an important concern in partner notification services, providers need to also
consider the personal consequences that people may experience because of disclosure.
Resources to Learn More
How Can Partner Services
Programs Help Me and My Patients?
Describes free services offered by local and state health department staff to people infected with HIV and other
sexually transmitted diseases (STDs) by helping them locate their partners and inform them of their risk for HIV
and STDs. Offers testing, counseling, referrals, and access to treatment for partners at risk of who test
Organization(s): National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease
Control and Prevention (CDC)
Find the Laws in Your State
A database organized by state to show HIV criminal laws and policies. Includes guidelines for HIV testing,
healthcare workers with HIV, and minors' access to testing and treatment for sexually transmitted infections
(STIs) and HIV. Includes a searchable HIV Policy Resource Bank providing reports, research, court decisions, and
guides on topics of interest to people with HIV and to their advocates.
Organization(s): The Center for HIV Law and Policy