Answer to Case Study #1:

Explain that it is critical that his partners and his wife receive treatment. If they do not get treatment, he can get reinfected and keep transmitting the infection. STIs are often asymptomatic in women, so his partners may not know that they are infected. Also, untreated STIs can lead to serious complications in women, including PID and infertility. If any of his partners are pregnant, there is a risk that an untreated STI could be passed to a newborn.

After assuring him that your conversation with him is confidential and that notification of partners is voluntary, offer him options for notifying his partners:

1. He can tell his partners himself (offer to do role plays to practice communication skills, particularly focusing on his concern for his wife’s health and that of his other partners);
2. He can invite them to the clinic and tell them in your presence as you help facilitate the conversation;
3. You can contact his partners.

Emphasize that no matter which option he selects, it is of utmost importance that his partners get treatment and learn how to protect themselves. Finally, explore his knowledge of STIs, including HIV, and clarify any misinformation that he has. Explain the importance of adhering to treatment. Encourage him to use condoms, making sure that he knows how to use them correctly by practicing on a penis model. Support him to communicate with his wife about these sensitive issues. Ideally, he should use condoms with all partners, including his wife. Acknowledge that broaching condom use with his wife may be awkward. If he feels unable to do this, encourage him to use condoms consistently and correctly with his casual partners.

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