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Perspectives on male partner notification and treatment for syphilis among antenatal women and their partners in Kampala and Wakiso districts, Uganda.
BMC Infect Dis. 2019 Feb 06; 19(1):124.BI

Abstract

BACKGROUND

Syphilis screening can be successfully integrated into antenatal clinics, and potentially avert significant morbidity and mortality to unborn infants. A minority of male partners report for testing and treatment, increasing the likelihood of reinfection. We conducted a qualitative study to understand factors influencing male partners to seek treatment after syphilis notification by their pregnant partners.

METHODS

A purposeful sample of 54 adults who participated in the STOP (Syphilis Treatment of Partners) study was stratified by gender (24 women, 30 male partners) and enrolled for in-depth interviews which were audio recorded, transcribed, and analyzed using the thematic approach.

RESULTS

The participants' median age (IQR) was 32 years (25-44), 87% were married, and 57.4% (31/74) had attained secondary education. Fourteen of 22 (63%) female participants reported that they sometimes experienced domestic violence. Male participant's knowledge of syphilis and their perception of their valued role as responsible fathers of an unborn baby facilitated return. Female's fear of partner's violence and poor communication between partners, were barriers against delivery of the notification forms to partners and subsequent treatment of partners. For men, fear of injection pain, perceptions of syphilis as a genetic disease and as a woman's problem, busy work schedules, poor access to good STD services, shared facilities with women in clinics, as well as HIV-related stigma were important barrier factors.

CONCLUSIONS

The return to the clinic for treatment of male partners after partner notification by infected pregnant women, was low due to limited knowledge about syphilis, fear of painful injection, fears of domestic violence, lack of communication skills (individual characteristics) and syphilis disease characteristics such as signs and symptoms. This, combined with health services characteristics such as structural barriers that hinder male partner treatment, low access, low capacity, work/time challenges, inadequate laboratory services and low clinic personnel capacity; threatens efforts to eliminate mother-to-child infection of syphilis. Improved public messaging about syphilis, better services, legal and policy frameworks supporting STD notification and treatment in resource-constrained settings are needed for effective STD control.

TRIAL REGISTRATION

Clinicaltrials.gov NCT02262390 ., Date Registered October 8 2014.

Authors+Show Affiliations

School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda. edith.nakkujoloba@gmail.com. STD Clinic/Ward 12, Mulago Hospital, Kampala, Uganda. edith.nakkujoloba@gmail.com.School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.STD Clinic/Ward 12, Mulago Hospital, Kampala, Uganda. Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK.Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA.Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda. Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

30727950

Citation

Nakku-Joloba, Edith, et al. "Perspectives On Male Partner Notification and Treatment for Syphilis Among Antenatal Women and Their Partners in Kampala and Wakiso Districts, Uganda." BMC Infectious Diseases, vol. 19, no. 1, 2019, p. 124.
Nakku-Joloba E, Kiguli J, Kayemba CN, et al. Perspectives on male partner notification and treatment for syphilis among antenatal women and their partners in Kampala and Wakiso districts, Uganda. BMC Infect Dis. 2019;19(1):124.
Nakku-Joloba, E., Kiguli, J., Kayemba, C. N., Twimukye, A., Mbazira, J. K., Parkes-Ratanshi, R., Birungi, M., Kyenkya, J., Byamugisha, J., Gaydos, C., & Manabe, Y. C. (2019). Perspectives on male partner notification and treatment for syphilis among antenatal women and their partners in Kampala and Wakiso districts, Uganda. BMC Infectious Diseases, 19(1), 124. https://doi.org/10.1186/s12879-019-3695-y
Nakku-Joloba E, et al. Perspectives On Male Partner Notification and Treatment for Syphilis Among Antenatal Women and Their Partners in Kampala and Wakiso Districts, Uganda. BMC Infect Dis. 2019 Feb 6;19(1):124. PubMed PMID: 30727950.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perspectives on male partner notification and treatment for syphilis among antenatal women and their partners in Kampala and Wakiso districts, Uganda. AU - Nakku-Joloba,Edith, AU - Kiguli,Juliet, AU - Kayemba,Christine Nalwadda, AU - Twimukye,Adeline, AU - Mbazira,Joshua Kimeze, AU - Parkes-Ratanshi,Rosalind, AU - Birungi,Monica, AU - Kyenkya,Joshua, AU - Byamugisha,Josaphat, AU - Gaydos,Charlotte, AU - Manabe,Yukari C, Y1 - 2019/02/06/ PY - 2017/09/07/received PY - 2019/01/09/accepted PY - 2019/2/8/entrez PY - 2019/2/8/pubmed PY - 2019/5/30/medline KW - Maternal syphilis KW - Partner notification KW - Resource constrained settings KW - Socio-cultural factors SP - 124 EP - 124 JF - BMC infectious diseases JO - BMC Infect Dis VL - 19 IS - 1 N2 - BACKGROUND: Syphilis screening can be successfully integrated into antenatal clinics, and potentially avert significant morbidity and mortality to unborn infants. A minority of male partners report for testing and treatment, increasing the likelihood of reinfection. We conducted a qualitative study to understand factors influencing male partners to seek treatment after syphilis notification by their pregnant partners. METHODS: A purposeful sample of 54 adults who participated in the STOP (Syphilis Treatment of Partners) study was stratified by gender (24 women, 30 male partners) and enrolled for in-depth interviews which were audio recorded, transcribed, and analyzed using the thematic approach. RESULTS: The participants' median age (IQR) was 32 years (25-44), 87% were married, and 57.4% (31/74) had attained secondary education. Fourteen of 22 (63%) female participants reported that they sometimes experienced domestic violence. Male participant's knowledge of syphilis and their perception of their valued role as responsible fathers of an unborn baby facilitated return. Female's fear of partner's violence and poor communication between partners, were barriers against delivery of the notification forms to partners and subsequent treatment of partners. For men, fear of injection pain, perceptions of syphilis as a genetic disease and as a woman's problem, busy work schedules, poor access to good STD services, shared facilities with women in clinics, as well as HIV-related stigma were important barrier factors. CONCLUSIONS: The return to the clinic for treatment of male partners after partner notification by infected pregnant women, was low due to limited knowledge about syphilis, fear of painful injection, fears of domestic violence, lack of communication skills (individual characteristics) and syphilis disease characteristics such as signs and symptoms. This, combined with health services characteristics such as structural barriers that hinder male partner treatment, low access, low capacity, work/time challenges, inadequate laboratory services and low clinic personnel capacity; threatens efforts to eliminate mother-to-child infection of syphilis. Improved public messaging about syphilis, better services, legal and policy frameworks supporting STD notification and treatment in resource-constrained settings are needed for effective STD control. TRIAL REGISTRATION: Clinicaltrials.gov NCT02262390 ., Date Registered October 8 2014. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/30727950/Perspectives_on_male_partner_notification_and_treatment_for_syphilis_among_antenatal_women_and_their_partners_in_Kampala_and_Wakiso_districts_Uganda_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-3695-y DB - PRIME DP - Unbound Medicine ER -