The notification and treatment of sexual partner(s) is a key element in the prevention and
control of sexually transmitted infections (STIs). Partner notification interrupts the chain of
STI transmission, prevents STI complications and long-term sequelae in the sexual partner(s),
and also prevents re-infection of the treated index patient. Partner notification is a recognized
component of the syndromic management of STIs in Namibia and yet the partner notification
rates in the country remain low - as low as 7% in the district of Windhoek currently. In this
district, which has the highest number of STIs cases in Namibia, the specific factors that
hinder partner notification have not yet been documented.
This study sought to investigate the perceived and experienced barriers to partner notification
amongst STI patients attending an urban primary health center in the district. An explorative,
qualitative study with eight patients (four males and four females), aged 16 years and over,
who presented with a new/recurrent episode or a STI follow up was conducted. The
participants were purposively selected with the aid of the deputy nurse in charge of the health
center after agreeing to take part in the study. The patients were asked about what they felt
were personal, partner-relationship and health services related factors that hindered partner
notification. Three health workers working at the health center served as key informants and
were asked about barriers to partner notification based on their experience of delivering
preventative and curative STI - related services over the past three or more years. Interviews
with both patients and key informants were conducted in the health facility, recorded and later
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transcribed. Content analysis of the transcribed data was conducted to identify recurring
themes across the different interviews.
The results of the study suggest that the partner notification strategy was not functioning
optimally as a result of a number of inter-twined factors. The factors can be categorized into
personal barriers, partner-relationship dynamics and health services related barriers. The study
found that participants considered there were barriers to partner notification across all these
three categories. Commonly reported barriers included the stigma associated with STIs and
the cultural and religious norms that do not promote discussion of topics related to sex and
sexuality in general. Other barriers such as gender inequality, the fear of a partner‟s reaction
to the notification, feelings of guilt associated with infidelity, the lack of communication
between partners and the inability to locate partner(s) were highlighted by participants.
Barriers associated with the health services included the lack of health education about the
importance of partner notification, the absence of thorough risk reduction counseling, the
current method of partner notification that is being utilized and the negative attitudes of health
workers.
It is suggested that having a greater understanding of these barriers and how to work with
them in a health education or counseling sessions will allow health workers to address them
more directly with their patients and in turn, hopefully improve the management and
outcomes of partner notification strategies in the STI prevention and control program in the
Windhoek district and potentially other districts in Namibia.