The treatment of sexual contacts prior to resumption of sexual intercourse is the strongest predictor for preventing re-infection.⁴⁰ This may be particularly important in salpingitis as there is evidence that repeated infections increase the risk of tubal infertility.¹⁵⁸ Therefore, effective partner notification (also referred to as contact tracing) forms an essential component of management of chlamydial infection.¹⁵⁹ Evidence level IIb

Trained interviewers have been shown to identify more partners than routine health care providers for patients with gonorrhoea or Chlamydia trachomatis.¹⁶⁰ Evidence level IIb

Patients should be referred to trained health advisers for support with partner notification.

At present the only NHS staff trained to carry out partner notification are health advisers in GUM departments.

Choice of method of partner notification is based on resource availability as well as patient / partner acceptability. ¹⁶¹ It is the role of the health adviser to advise individual patients on the best approach in their circumstances. The options are:

• Patient referral (or self-referral), when index patients themselves inform their sexual contacts to seek treatment.
• Provider referral, when the health care provider informs a patient's contacts anonymously that they should seek treatment. This is obviously more time consuming for the health care provider.
• Conditional referral, where the health care provider notifies contacts if the patient has not done so after a given number of days.

There is no evidence that any one of the traditional methods of patient, provider or conditional referral is superior to the others.¹⁶⁰ Evidence level IIb

Patients should be offered the choice of patient, provider or conditional referral for partner notification.

Where a patient requests assistance, health care providers should be available to notify partners.¹⁶¹ Where this is not possible then the health care provider should inform the patient that they should advise all recent sexual partners to seek treatment. There is evidence that simple forms of patient assistance directed at improving patient referral, such as a telephone call, can be effective.¹⁶⁰ Evidence level IIb

One study from Denmark has demonstrated superior partner testing rates where male partners were asked to mail a sample of urine from home, rather than attend a clinic.¹⁶² The acceptability of this approach has not been tested in the UK. Evidence level IIa

There is no clear evidence regarding the length of time over which previous sexual partners should be sought. The guideline development group endorses the recommendations of the Central Audit Group in Genitourinary Medicine:¹⁶³ Evidence level IV

In men with symptomatic chlamydial infection, contact all partners over the four weeks prior to onset of symptoms.

In women and asymptomatic men, contact all partners over the last six months or the most recent sexual partner (if outwith that time period).