Going beyond 'regular and casual': development of a classification of sexual partner types to enhance partner notification for STIs.

Estcourt, Claudia S; Flowers, Paul; Cassell, Jackie A; Pothoulaki, Maria; Vojt, Gabriele; Mapp, Fiona; Woode-Owusu, Melvina; Low, Nicola; Saunders, John; Symonds, Merle; Howarth, Alison; Wayal, Sonali; Nandwani, Rak; Brice, Susie; Comer, Alex; Johnson, Anne M; Mercer, Catherine H (2022). Going beyond 'regular and casual': development of a classification of sexual partner types to enhance partner notification for STIs. Sexually transmitted infections, 98(2), pp. 108-114. BMJ Publishing Group 10.1136/sextrans-2020-054846

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To develop a classification of sexual partner types for use in partner notification (PN) for STIs.


A four-step process: (1) an iterative synthesis of five sources of evidence: scoping review of social and health sciences literature on partner types; analysis of relationship types in dating apps; systematic review of PN intervention content; and review of PN guidelines; qualitative interviews with public, patients and health professionals to generate an initial comprehensive classification; (2) multidisciplinary clinical expert consultation to revise the classification; (3) piloting of the revised classification in sexual health clinics during a randomised controlled trial of PN; (4) application of the Theoretical Domains Framework (TDF) to identify index patients' willingness to engage in PN for each partner type.


Five main partner types emerged from the evidence synthesis and consultation: 'established partner', 'new partner', 'occasional partner', 'one-off partner' and 'sex worker'. The types differed across several dimensions, including likely perceptions of sexual exclusivity, likelihood of sex reoccurring between index patient and sex partner. Sexual health professionals found the classification easy to operationalise. During the trial, they assigned all 3288 partners described by 2223 index patients to a category. The TDF analysis suggested that the partner types might be associated with different risks of STI reinfection, onward transmission and index patients' engagement with PN.


We developed an evidence-informed, useable classification of five sexual partner types to underpin PN practice and other STI prevention interventions. Analysis of biomedical, psychological and social factors that distinguish different partner types shows how each could warrant a tailored PN approach. This classification could facilitate the use of partner-centred outcomes. Additional studies are needed to determine the utility of the classification to improve measurement of the impact of PN strategies and help focus resources.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Low, Nicola


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




BMJ Publishing Group




Andrea Flükiger-Flückiger

Date Deposited:

07 May 2021 14:55

Last Modified:

05 Dec 2022 15:51

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

HIV chlamydia infections contact tracing gonorrhea sexual health





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