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Interventions to Identify HIV-Positive People Through Partner Counseling and Referral Services

Partner counseling and referral services (PCRS) are part of the spectrum of care for HIV-positive people and their sexual or needle-sharing partners. Referral involves notifying partners of exposure, after which they are (ideally) tested and receive prevention or risk reduction counseling or enter into care (if they test positive).

Methods of PCRS include:

  • Provider referral:
    • The HIV-positive patient voluntarily discloses information about partners
    • Provider or other public health professional notifies partner(s)
  • Patient referral:
    • The HIV-positive patient notifies partner(s)
  • Contract referral:
    • The HIV-positive patient voluntarily discloses information about partners
    • The patient agrees to notify partners within a certain time period
    • If all partners are not contacted and notified, the provider can complete the process

Summary of Task Force Recommendations and Findings

The Community Preventive Services Task Force recommends provider referral partner notification based on sufficient evidence of effectiveness in increasing HIV testing and identification of previously undiagnosed HIV-positive individuals.

The Task Force finds insufficient evidence to determine the effectiveness of partner notification using either patient or contract referral because too few studies qualified for review.

Task Force Finding

Results from the Systematic Review

Nine studies assessing provider referral qualified for the review and examined a series of related outcomes.

  • Number of partners located and notified: 67% (8 studies)
  • Number of notified partners (with unknown HIV status) who were tested: 63% (6 studies)
  • Number of tested partners who were HIV-positive: 20% (7 studies)
  • There was little difference among the three partner-notification methods evaluated (provider, patient, and contract referral) in terms of the mean number of infected individuals identified (although very few studies tested patient or contract referral).
  • Behavioral changes after partner notification:
    • There were changes in the direction of safer sexual behavior with HIV partner notification.
    • Small number of studies and diversity of comparisons and outcomes precludes firm conclusions.
  • Data do not suggest substantial harms to the person who is screened and found to be HIV positive resulting from partner notification services (two studies).
  • The studies in this review were conducted among a variety of populations (black and white men and women; gay, bisexual, and straight; intravenous drug users or not), in a variety of settings in the United States (statewide in seven states and locally in several cities), over a 20-year period.

Economic Review

An economic review and cost-effectiveness analysis, using the same data set as this review and comparing the three methods of referral (provider, patient, and mixed [dual]), found that provider referral is the most cost effective from both provider and societal perspectives.

Supporting Materials

Publications

Hogben M, McNally T, McPheeters M, et al. The effectiveness of HIV partner counseling and referral services in increasing identification of HIV positive individuals: a systematic review. Adobe PDF File [PDF - 333 kB] Am J Prev Med 2007;33(2S):S89–S100.

Task Force on Community Preventive Services. Recommendations to increase testing and identification of HIV-positive individuals through partner counseling and referral services. Adobe PDF File [PDF - 36 kB] Am J Prev Med 2007;33(2S):S88.

Read other Community Guide publications about Preventing HIV/AIDS, Other STIs, and Teen Pregnancy in our library.


*PDF includes all of the information available and will not be updated.



Disclaimer

The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task Force evidence-based recommendations are not mandates for compliance or spending. Instead, they provide information and options for decision makers and stakeholders to consider when determining which programs, services, and policies best meet the needs, preferences, available resources, and constraints of their constituents.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Interventions to identify HIV-positive people through partner counseling and referral services. www.thecommunityguide.org/hiv/partnercounseling.html. Last updated: MM/DD/YYYY.

Review completed: February 2005