Maternal syphilis and intimate partner violence in Bolivia: a gender-based analysis of implications for partner notification and universal screening.

OBJECTIVES Use a gender perspective to analyze a partner notification study conducted in antenatal clinics in Bolivia to assess the association between intimate partner violence (IPV) and partner notification. GOAL Guide the implementation of a safe, feasible, and culturally appropriate partner notification strategy in Bolivia in order to reduce the potential of IPV. STUDY DESIGN We conducted a cross-sectional survey with women (n = 209) and their notified partners (n = 137) and structured interviews with a subsample of participants. RESULTS Nearly 40% of women reported IPV in the past year and 28% mentioned fear of violence as a barrier to notifying their partners. Overall, 65% of women reported that they had notified their partners about their positive syphilis test results. Women who did not perceive violence as a barrier had greater odds of notifying their partner of their syphilis status (OR = 1.82; CI [0.93-3.60]; P <0.08). Women who could not protect themselves against partners' syphilis had a lower odds of notifying their partner (OR = 0.06; CI [0.049-0.656]; P <0.0001). Women who notified their partners said it was a favorable experience. Most men said they responded well to their partner's disclosure but could understand other men acting violently, especially when infidelity was involved. CONCLUSIONS The majority of women who participated were able to notify male partners of their positive syphilis diagnosis but also reported high levels of domestic violence. The data suggest that public health practitioners should concomitantly screen for IPV and syphilis during pregnancy and assist women in abusive relationships on how to communicate sensitive disclosure information to partners.