Partner Notification
Public Health Units in Ontario are required to ensure partners of cases of gonorrhea, chlamydia, chancroid, syphilis, and HIV are notified. This can be accomplished three ways:
- Health care provider takes responsibility for partner notification
- TPH or other public health unit take responsibility for partner notification
- Patient takes responsibility for partner notification.
A health care provider who takes responsibility for partner notification should counsel, test and treat the partner(s). In addition, indicate clearly on the epi form provided by TPH that you will be taking responsibility for partner notification. Please see Definitions of a Partner/Contact for disease specific guidance.
Definitions of a Partner/Contact
Human Immunodeficiency Virus (HIV)
- A person engaging in unprotected penetrative sex or sharing needles (injection drug, piercing or tattooing) or harm reduction supplies with the HIV+ individual.
- A person engaging in frequent protected penetrative sex with the HIV+ individual where an exposure may have occurred.
- A person engaging in any sexual or needle/harm reduction supply sharing activity with the HIV+ individual where the risk is uncertain.
- A fetus exposed to a HIV+ woman during pregnancy or birth.
- Children born to HIV+ women.
- Any organization to which the HIV+ individual has donated blood, organs, breast milk or semen should be notified for trace-back to recipients of the donation.
Contact tracing for the patient begins:
- Six weeks prior to a documented negative serological HIV test.
- Three months prior to a negative point of care (POC)/HIV self-test.
- At the onset of risk behaviour that may have resulted in HIV transmission (e.g., sexual intercourse, sharing drug use equipment, etc.), if no previous negative test.
- Consider Post-Exposure Prophylaxis (PEP) for contacts with a potential high-risk exposure in the previous 72 hours.
Chancroid
- A person having direct sexual contact with discharge from open lesions and/or pus from buboes.
Contact tracing for the patient begins:
- Two weeks prior to symptom onset or date of specimen collection (if the patient is asymptomatic).
- Examination and empiric treatment should be provided to all contacts of the patient.
Chlamydia & Gonorrhea
- A person engaging in unprotected penetrative sex with someone diagnosed with Chlamydia or Gonorrhea.
- Neonates born to infected mothers.
Contact tracing for the patient begins:
- 60 days prior to symptom onset or date of specimen collection (if the patient is asymptomatic). If no partners in the past 60 days, notify last sexual partner.
- Testing and empiric treatment should be provided to all contacts of the patient.
Syphilis
- A person engaging in unprotected penetrative sex with someone diagnosed with syphilis.
- A fetus exposed to syphilis during pregnancy or birth.
- Children born to syphilis-positive mothers.
Contact tracing for the patient begins:
- Primary – sexual partners three months prior to onset of symptoms*.
- Secondary – sexual partners six months prior to onset of symptoms*.
- Early latent – sexual partners one year before diagnosis*.
- Late latent – marital partner, long-term partners, and children.
- All stages – children born to syphilis-positive mothers.
- Testing and empiric treatment should be offered to all contacts of infectious syphilis (primary, secondary, and early latent syphilis).
*partner may test negative if the time between last exposure and testing (window period) is less than one month. Patient will need to be retested two to four weeks after their last test.
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