The index case is a person newly diagnosed with HIV.  The healthcare provider must raise with this person the possibility of notifying their partners of their risk and encouraging the partner/s to test.  Partner notification is completely dependent on the index person being prepared to discuss the matter and to identify partners who have been at risk of infection and require notifying.  If the index person chooses not to provide any information about the partners at risk, then it is impossible for a healthcare provider to notify those partners. Therefore, in order to have this discussion with an index person, it is important that the healthcare provider create a non-threatening and non-judgmental environment in which the index person is comfortable to fully disclose their sexual history.  The discussion should be confidential and private, and the language used must be appropriate and easily understood by the index person. 

It is important to determine with the index person what sexual activities took place and, therefore, which of those activities could potentially transmit HIV. By having this discussion, the healthcare provider can also identify sexual activities that do not need to be followed up, such as those where the risk of transmission does not exist.  In addition, it is important to understand the HIV testing window period and the past testing history of the patient, as this will determine how far back in time partners should be notified.  For example, when considering partners of a person diagnosed with HIV, there is no need to notify partners where the sexual activity was protected (such as with a condom) or partners who were identified where the sexual activity took place more than 3 months prior to the last negative HIV test result of the index person. 

It is important to ensure the index person understands that if a healthcare provider is to notify partners on their behalf, then the identity of the index person will remain strictly confidential and will not be divulged to the partner/s being notified.   

The index person is more likely to provide information to a healthcare provider or carry out partner notification themselves if they understand why it is important to notify partners and what the potential benefits for partners could be (4).  For example, partners who are notified within 72 hours of exposure are eligible to receive HIV PEP which may prevent the partner becoming infected. Partners whose exposure was longer than 72 hours ago will benefit enormously from being test and treated if infected.