In 2005 about 340 million people globally acquired new infections of the four most common curable sexually transmitted infections (gonorrhoea, chlamydia, syphilis, and trichomoniasis) and 4.1 million acquired HIV.12 Partner notification is essential to prevent reinfection of index patients, decrease the pool of infectious people, and prevent the transmission of HIV.34

Provider referral, where health service personnel trace and notify partners, is practised in parts of the developed world. Patient referral, where index patients are encouraged to inform their partners of the need for treatment, is universal practice in the developing world, where provider referral is neither feasible nor affordable.

In this week's BMJ, Trelle and colleagues report a systematic review of strategies to improve patient referral,5 as observational studies and randomised controlled trials indicate that current patient referral practices fail to reach many partners of people with sexually transmitted diseases in …