In sexual health nursing, so much of our work is supporting people through a sexually transmitted infection (STI) diagnosis and helping them reduce their risk of acquiring another. Over time, I’ve realised that the most meaningful change doesn’t come from tests or treatments but often through the conversations we have.

Partner notification (PN) and motivational interviewing (MI) are two of the most powerful tools I use in sexual health nursing. They’re not flashy or new, and they don’t always get the attention they deserve, but I see how these skilled conversations can help individuals and quietly deliver some of the most effective public health outcomes in the NHS. 

Before exploring why PN and MI matter so much today, it’s important to acknowledge where this work began – because its history shows how far we’ve come. 

Looking back

In the 1700s and 1800s, STI’s were managed by policing and social control rather than public health. The Contagious Diseases Act (1864, 1866, 1869) targeted women, not infection. Josephine Butler’s activism challenged this injustice and pushed the system towards a more humane, rights-based approach. 

During the First World War, Colonel Harrison discovered that when patients were encouraged to inform their partners, outcomes were far better than when the police were involved, which shifted PN from surveillance to collaboration. 

Before the NHS was created in 1948, the UK already had a state funded sexual health service which was one of the earliest examples of a national public health service.  

The 20th century saw PN become a recognised professional practice. Contact tracers were employed, training and courses on PN followed in 1981 and national standards were published in 2004. 
What began as a policing tool has evolved into a skilled, person-centred public health intervention – and a core part of sexual health nursing. 

Why Partner Notification still matters 

When I support someone through PN, I’m reminded of how this can break the chains of infection, prevent reinfection, and protect people who have no idea they may have been exposed. Evidence shows that PN is far more cost-effective at case-finding than screening for STIs. Yet, despite how effective PN is, I’ve watched it diminish through years of disinvestment, and increasing clinical pressures. In some services, sexual health advisers - pivotal to PN and outbreak management - have disappeared entirely. It’s no surprise that syphilis rates are now the highest recorded since the 1940s. 

This is not a criticism of staff, but a reflection of a system that is stretched so thin that one of the most historic public health tools has been quietly ignored. Still, I hope that through passion, influence, and activism, PN will once again be restored to the powerful intervention it has always been. 

Motivational interviewing and the conversations that matter

When I discovered MI, it changed my practice. When someone is anxious or ashamed, MI gives me a structure to help them move from those feelings and ambivalence to a plan. I think it respects autonomy, builds trust, and recognises that behavioural change doesn’t just happen because we tell people what to do. It happens because we create the conditions for them to choose it. 
PN conversations can be emotionally charged, with people worrying about blame, rejection, or stigma. Without a person-centred approach, these conversations can shut down quickly. MI allows me to explore barriers gently through open questions, affirmations, reflections, and summaries, guiding them towards a decision that feels right for them.  

MI goes far beyond PN. I use it to support risk reduction, medication concordance, chemsex and recreational drug use harm reduction, contraceptive choices, and safer sex. These conversations require patience, and MI gives me the tools to help people express what matters to them and identify their own motivation for change. 

Why public health needs more of this

PN and MI aren’t skills to be used just in sexual health - they’re tools that public health says it wants to prioritise. We talk a lot of prevention, early diagnosis, reducing inequalities, and supporting informed choices, but these ambitions only become real through the quality of the conversations we have. 

Sexual Health nursing has been delivering this for decades. We’re used to working with complex scenarios and helping people navigate risk, relationships, identity, and behavioural change. MI and PN show that public health impact doesn’t always come from large programmes or high-tech interventions. Sometimes it comes from skilled conversations that helps someone understand their risk, notify a partner, take treatment, or make a safer choice. 

My hope is that as public health continues to move into the future, we make and hold space for these approaches, not just in sexual health, but in wider public health.