Article Text
Abstract
Background Partner Notification (PN) has long been considered essential for sexually transmissible infection (STI) control, but both policies and methods of implementation vary between countries. Although the provision of sexual health services has improved in Chile, syphilis is one of the most commonly reported STIs. This is the first study to explore the role of PN in syphilis control in public health services in Chile.
Methods A qualitative multiple case study was designed, using two regional Health Services as cases. Different data collection methods were used: a qualitative document analysis, a syphilis management clinic review in 20 health services, and semi-structured interviews with 48 healthcare providers (HCPs) and 10 key informants. The data was analysed using an inductive approach, with both within-case and cross-case thematic analysis. Selected quotes were translated from Spanish-English.
Results Findings revealed that syphilis management has a well-organised approach in public health services, but little knowledge or understanding of the infection among patients leads to a lack of recognition of the importance of informing sexual partners. The management of partner(s) was acknowledged as critical for syphilis control in the guidelines and by HCPs, but no document provides comprehensive information about delivering PN. Patient referral was used most commonly; however, interviewees commented that index cases do not discuss their partners easily and PN delivery is further impacted by gender and the socio-cultural context. PN was perceived by HCPs as an exhausting, difficult and challenging process due to poor public understanding of syphilis, absence of practical recommendations and health system limitations.
Conclusion Understanding the state of current policies and practices are important for improving PN in Chile and Latin America. Lack of clear guidelines and resources, as well as the impact that gender and socio-cultural aspects have on STI risk perceptions, should be considered to strengthen STI control at the population level.
Disclosure No significant relationships.