STIs can be a difficult subject to talk about in any context; let alone address with a current or previous partner.
However, if you’ve recently discovered that you have an STI, informing your current and past partners is vitally important, for obvious reasons.
Untreated STIs can pose a risk of health complications, and in some cases these can be very serious. It’s also possible if someone isn’t aware that they have an STI that they will unsuspectingly pass it on to somebody else (or possibly even back to you if they’re your current partner).
Notifying your partners of your diagnosis will prompt them to get tested, and have the treatment they need if necessary.
In recent years, sexual health services have begun to incorporate partner notification into the support they offer to patients. This means that they can either provide assistance or guidance on informing previous partners, or do it for you.
Here, we’ll look at the subject of partner notification in a little more detail, including how the process works, and which of your partners need to be informed.
Upon receiving a diagnosis
As stated above, you will need to let your current partner and any previous partners who may be at risk know as soon as possible if you have received an STI diagnosis. The sooner they find out, the sooner they can be tested themselves, and get treatment if required.
Most sexual health services in the UK will offer partner notification support at the point of diagnosis. This can be given in one of two forms:
- If you’ve received a diagnosis but wish to tell your partner(s) yourself, the service will offer some guidance on how to do so, and provide contact slips for each partner (or ‘contact’) that needs to be notified. You can then pass this slip on to the person who needs to be notified. The slip won’t contain any details about you, but it will have on it details about the infection. When the person takes this slip to any sexual health clinic, it provides the clinic with the information they need to carry out the appropriate tests.
- The other option is that the service notifies your contact(s) on your behalf. They will simply inform them that someone they have previously come into contact with has received an STI diagnosis, and advise them to attend a clinic for screening. In many cases, this will be done via text message or email, prior to a follow-up telephone conversation. At no point will they reveal your identity to the contact.
The health practitioner you speak to will ask you for some details about your contact, such as their name, where they live and their date of birth. It is important when asked to give as much information about your contact as possible, as it will help the service to ensure they have been able to visit a clinic and access the support they need.
Who needs to be informed?
The practitioner at the sexual health clinic will have a discussion with you about your recent sexual history. If you are notifying your previous sexual contacts yourself, they will advise you on who you need to notify.
You should be as honest and open as you can when discussing your sexual health and previous partners with them. Although it’s an intimate subject and may feel embarrassing to talk about, the staff at these clinics deal with sexual health on a daily basis, and are there to offer confidential help.
Sexual health services will use ‘look-back intervals’ to help them decide how far back into the patient’s history notifications should cover. These were developed by the British Association for Sexual Health and HIV (BASHH) in 2012, and an interval can vary depending on the condition diagnosed, the sex of the person being diagnosed, and whether or not they have symptoms.
For instance, in the case of a chlamydia infection:
- if the patient is male and presenting urethral symptoms (pain when passing urine or discharge from the tip of the penis), then all partners since and in the 28 days prior to the appearance of symptoms should be notified;
- otherwise (so all female cases, males with no symptoms or with non-urethral or extra-urethral symptoms) all partners in the six months prior to presentation need to be informed.
- if the patient is male, then all partners since and in the two weeks before the onset of symptoms need to be informed;
- otherwise (as with chlamydia, all female cases, asymptomatic males and males with symptoms in other places), all contacts in the three months prior to presentation need to be told.
- all partners with 28 days prior to presentation should be informed and given treatment.
- in primary cases, all partners since and within the 90 days prior to the beginning of symptoms need to be informed;
- in secondary and early latent cases, all partners since and in the two years prior to the beginning of symptoms should be notified;
- in late latent or tertiary cases, it may be necessary to inform all contacts since the patient last had a blood test which confirmed that they definitely didn’t have the infection. If this record cannot be found, then it may be necessary to go as far back as informing all contacts (as is feasible) from the patient’s sexual lifetime.
- an assessment is carried out in order to estimate a date when infection occurred, and all contacts since and within 90 days prior to this infection date should be informed. If an estimate cannot be made, all prior sexual partners need to be notified.
The above is only a summary of the guidance published on the BASHH website.
The guidance notes that these intervals should apply irrespective of whether or not latex condoms were used. BASHH do however point out that these intervals are only to be used as guidance; and that each case should be reviewed considering the sexual history and individual circumstances presented.
If you suspect you may have come into contact with an STI, the best place to start is by getting tested yourself at a GUM clinic as soon as possible, so you can get the treatment you need if required. If you do test positive, the staff at the clinic will be able to offer confidential advice and support on informing your previous partners.
STIs don't just happen spontaneously; they're transmitted from one person to another, so when you or your partner are diagnosed it might raise questions about who else you or they have been having sex with.
This can often be very distressing and make people question their relationships. It isn't usually possible to tell how long someone has had an infection for and in some cases (for instance with herpes or genital warts) they may have had the infection for many years without knowing about it.
So, although your or your partner’s initial reaction to an STI diagnosis may be to take a drastic decision and end the relationship, the better option may be to try and talk things through with each other.
In addition to your local sexual health clinic, there are other services that can help you with this and offer support, such as: Brook, the Family Planning Association (FPA), Relate, and the Terrence Higgins Trust.