Assessing the effectiveness of a patient-driven partner notification strategy among pregnant women infected with syphilis in Bolivia.

OBJECTIVE: Assess the feasibility and acceptability of a patient-led syphilis partner notification strategy among pregnant women with syphilis, their male partners and treatment completion in Bolivia. METHODS: In four provinces, women who had tested positive for syphilis while attending antenatal care visits were recruited to receive a partner notification (PN) intervention on how to notify partners of their positive diagnosis and encourage them to get tested/treated. All women who completed PN counselling and notified their male partners completed self-administered questionnaires regarding PN experiences. Sociodemographic characteristics associated with notification and partner treatment completion were assessed using bivariate and multivariate analyses. RESULTS: 144 women and 137 male partners participated; 78% women notified their partners. No women characteristics were significantly associated with PN. Significantly more male partners (85%) who were notified by women completed syphilis treatment (p<0.05) compared to those notified by providers (66%). In multivariate analysis, men notified by female partners had a threefold greater odds of treatment completion compared to men who had not been notified by partners or by someone else (ie, healthcare worker) (OR 3.45, 95% CI 1.21 to 9.90). 86% of women and 80% of men completed syphilis treatment. Our results suggest that lack of time was considered a barrier to care among men who did not complete treatment. CONCLUSION: A patient-led partner notification strategy for pregnant women and their male partners appears to be feasible and acceptable, providing evidence for larger-scale effectiveness studies to improve male partner treatment compliance.

Experiences and opinions of health-care professionals regarding legal abortion in Mexico City: a qualitative study.

This study examines the experiences and opinions of health-care professionals after the legalization of abortion in Mexico City in 2007. Sixty-four semistructured interviews were conducted between 1 December 2007 and 16 July 2008 with staff affiliated with abortion programs in 12 hospitals and 1 health center, including obstetricians/gynecologists, nurses, social workers, key decisionmakers at the Ministry of Health, and others. Findings suggest that program implementation was difficult because of the lack of personnel, space, and resources; a great number of conscientious objectors; and the enormous influx of women seeking services, which resulted in a work overload for participating professionals. The professionals interviewed indicate that the program improved significantly over time. They generally agree that legal abortion should be offered, despite serious concerns about repeat abortions. They recommend improving family planning campaigns and post-procedure contraceptive use, and they encourage the opening of primary health-care facilities dedicated to providing abortion services.