Digital partner notification is an online process where a person who is newly infected with a sexually transmitted infection can notify past sexual partners about potential exposure. Geospatial networking (GSN) app-based notification and other forms of digital notification have arisen to address challenges in alerting previously hard-to-reach partners. Notification is commonly required by law when the condition in question is a reportable disease. Partner notification, also called contact tracing, is not a new phenomenon and has been a STI control strategy in the United States since the early 20th century. A patient’s participation in partner notification programs is voluntary in all states except North Carolina and Indiana for cases of HIV.  

Partner notification laws play an important role in reducing transmission of STIs and HIV as well as ensuring impacted individuals receive treatment. There are challenges to partner notification tied to the rise in geosocial networking apps over the last decade. This shift particularly impacts gay, bisexual, and other men who have sex with men (MSM), who carry a large burden of HIV and STIs. Some of the challenges arise from patients not exchanging contact information with their partners, and partners then deleting profiles or changing profile names. This precludes health departments from carrying out standard practices for partner notification as they lack contact information for the partners.

Particularly among MSM population, studies have shown that receiving partner notification through these apps either from the patient or the health department, is generally accepted, but patients and partners still prefer traditional partner notification over digital options and the usefulness for health authorities is limited: One study utilizing anonymous ecards for self-referral partner notification found that 20-40% of ecards were never opened by the recipients. The same study had issues with the ecards being automatically marked as spam. Another limitation of digital partner notification is that recipients may doubt the authenticity of digital partner notification messages. While there is potential for partnerships between GSN apps and health departments to improve sexual health outcomes, very few apps explicitly allow DIS or other health specialists to use their sites for public health purposes. Health department policies — at the state or local levels — vary as to whether DIS can use GSN dating apps for partner notification purposes and to what extent they are allowed to use them. For example, DIS may be allowed to use the apps to gather partner information but not allowed to send partner notification messages through the apps.  

Digital partner notification may also be subject to heightened scrutiny over confidentiality concerns. Confidentiality is already a chief concern with traditional partner notification and adding a digital component raises added concerns of data storage and security. The efficacy of digital partner notification brings up concerns of non-maleficence as delayed or non-receipt of partner notification could lead to harm with the further transmission of the disease and delay in treatment.  

Another component to consider about digital partner notification is its conversion rate of recipients getting tested after being notified of their potential exposure. A study of DIS initiated HIV partner notification found that participants were more likely to test if they received traditional partner notification with 69% getting tested afterwards compared to just 34% using digital partner notification, including GSN app notifications. This again speaks to non-maleficence where digital partner notification has a much lower testing conversion rate compared to traditional methods so it could contribute to further transmission and delay in care. of DIS initiated HIV partner notification found that participants were more likely to test if they received traditional partner notification with 69% getting tested afterwards compared to just 34% using digital partner notification, including GSN app notifications. This again speaks to non-maleficence where digital partner notification has a much lower testing conversion rate compared to traditional methods so it could contribute to further transmission and delay in care.  

While digital partner notification is generally considered acceptable by patients and partners, the efficacy concerns surrounding it shows it should not yet replace traditional partner notification methods. With more research into improving efficacy and follow-up testing, digital partner notification could be a very useful tool in improving partner notification. Local jurisdictions should implement regulations allowing DIS workers to use GSN apps for partner notification and consider partnering with GSN apps to provide partner notification and referral services within the apps.  

Katie White is a second year law student at Wake Forest University School of Law. She earned her B.S. and Master of Public Health from the University of Alabama at Birmingham and worked as a public health professional for several years before law school.