Patient-led partner notification for syphilis: Strategies used by women accessing antenatal care in urban Bolivia.

Maternal syphilis adversely affects close to one million pregnancies worldwide every year with consequences that may include spontaneous abortion, stillbirth, neonatal death, premature birth, neurological impairment and bone deformities of the neonate. In Bolivia, the maternal syphilis rate has been estimated at 4.3% among women with live births and 26% among women with stillbirths. Partner notification is critical to the prevention of maternal re-infection and vertical transmission of syphilis. Patient-led partner notification, also known as patient referral, is the recommended starting point for partner notification programs in resource poor settings because it requires less infrastructure and provider involvement. Though patient referral requires a higher level of engagement on the part of individuals, few studies have examined, in depth, the process of patient-led notification. Further, we found no studies of this type conducted in Bolivia, a country where culturally acceptable and appropriate interventions are needed to control maternal syphilis. This study examined partner notification, for the first time, from the perspective of women accessing treatment for maternal syphilis in Bolivia. Semi-structured interviews were conducted with 18 women who had attempted or planned to attempt notifying their partner. The interview guide was designed to investigate the experience of patient-led partner notification for syphilis with particular emphasis on the strengths and capacities of the participants. Accordingly, we applied an existing theoretical model for individual empowerment in the analysis of the interviews with the participants. This emphasis on the positive, solution-finding capacities of the participants allowed us to investigate the ways in which participants took control over an aspect of concern to their health. More studies are needed which examine successful patient-led strategies for partner notification and their connections with long-term health outcomes.