Ações de prevenção da transmissão vertical da sífilis congênita: um estudo de avaliabilidade num município do Estado da Bahia

Abstract

Background: Syphilis is a Sexually Transmitted Infection that can be transmitted through sexual intercourse without using a condom or from a woman to her fetus. Thus, Congenital Syphilis (CS) occurs as a result of the hematogenous dissemination of the bacteria in an infected pregnant woman who, untreated or inadequately treated, infects her fetus, transplacentally, at any stage of pregnancy or clinical phase of the disease. Although diagnosis and treatment are easily accessible and low-cost, this condition continues to be a public health problem. It appears that there are municipalities in Bahia that exceed the average of the State's epidemiological indicators, such as Camaçari. The persistence of high incidence of the disease and high rates of vertical transmission indicate that the quality of care offered or elements external to health care need to be known and considered. The hypothesis of insufficient participation of men in prenatal care, and consequent low adherence to treatment, seems to be a factor that contributes to the maintenance of this scenario. Thus, we sought to answer what approach should be made to the partners of pregnant women with syphilis in prenatal care, and whether it contributes (or not) to the prevention of congenital syphilis. Objective: This study carried out a pre-assessment of actions to prevent vertical transmission of syphilis, with an emphasis on the approach to sexual partners. Methodology: This was an evaluability study of actions to prevent mother-to-child transmission of syphilis with emphasis on the approach to the sexual partner of women diagnosed with syphilis in prenatal care, with the following steps: review of literature and normative documents on actions to prevent mother-to-child transmission; the elaboration of the logical model of the program; interviews with users (pregnant women and partners), professionals and managers. The data analysis was categorized through the narratives, under Bardin's light, according to the reality presented. Results: The thematic content analysis on the approach to sexual partners occurs in an unsystematic way in Camaçari and has the pregnant woman as the main link for this adherence, but due to the asymmetrical gender relations, fear and insecurities in the disclosure of the diagnosis can occur important conflicts in their affective relationship, at the delicate moment of pregnancy. Health professionals admit the absence of a large portion of partners in prenatal care and revealed little investment by management in training and campaigns alluding to the theme. Conclusion: Creative strategies in the direct approach to the sexual partner, training of professionals in topics involving sexuality, gender and health, and new studies that are dedicated to power relations and inequalities between genders and their effects on health are recommended. The planning and evaluation actions of the program, considering the participation and treatment of men, the partner of pregnant women diagnosed in prenatal care, are fundamental for preventing vertical transmission of congenital syphilis.