Partner notification for HIV prevention: a critical reexamination.

The history, current role, and potential enhanced functions of HIV partner notification are reviewed. What is known about the effectiveness of partner notification is summarized and five general findings are reported: (1) many, if not most, HIV-infected individuals will cooperate in notifying at least some of their sex partners of exposure to HIV; (2) sex partners are generally receptive to being notified and will seek HIV testing; (3) patient referral is probably not as effective as provider referral in reaching sex partners; (4) sex partners often are unaware of or misunderstand their HIV risks; and (5) sex partners frequently have high rates of HIV infection. Means for enhancing partner notification are reviewed, including social network interventions, coupling partner notification with behavioral interventions, reaching persons earlier in their HIV infection, using data collected from partner notification as a source of program evaluation information, and addressing important community concerns about partner notification.