Introduction Partner Notification (PN) has long been considered an essential strategy for sexually transmitted infection (STI) control, but both policies and methods of implementation vary between countries. In Chile, syphilis is the most commonly reported STI in the general population; however, congenital syphilis is close to being eliminated. In this study, we explore the challenges faced by healthcare providers (HCP) when they perform PN for syphilis in public health services in Chile.
Methods To identify the nuances of delivering PN, semi-structured face-to-face interviews were conducted with HCP. A third of the interviews were transcribed verbatim and translated from Spanish to English for thematic analysis, which followed an inductive approach based on grounded theory. Following the identification of themes, remaining interviews were coded utilising constant comparison.
Results 48 HCP were interviewed in PHC centres and sexual health units. The primary challenge revealed by HCP in this study was the low level of awareness about STI risk and potential long-term implications for patients. HCP recognised that a significant lack of recognition of PN for the value of STI control, and consequently it is not undertaken routinely. Index patients are reluctant to reveal partner information, likely to avoid perceived stigma. Furthermore, HCP identified several limitations within the Chilean system, such as lack of available counselling for patients, absence of resources for provider referral, and insufficient training and specialist support for effective PN.
Conclusion Improvements in syphilis management have achieved a significant reduction in congenital syphilis. However, our findings suggest syphilis elimination could be assisted by improved PN. Hence, it is vital to develop clear referral pathways for HCP to perform PN at the grassroots level.
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