Intimate partner violence and syphilis risk among pregnant women in Bolivia

Introduction: Intimate partner violence (IPV) and sexually transmitted infections (STI) are co-occurring epidemics that disproportionately affect women. Purpose: This study determined the prevalence of IPV, specifically sexual and physical abuse, and the association between IPV and positive syphilis test among pregnant women attending antenatal clinics in four provinces in Bolivia. Methods: We administered structured questionnaires to women at the time of syphilis testing. We performed bi-variate and multivariate analyses to identify demographic risk factors for IPV and test the association between IPV and syphilis diagnosis. Results: In total, 7,386 women completed the questionnaire. Twenty-two percent of women (n=1,643) reported physical and/or sexual abuse in the past year. The prevalence of positive syphilis tests was twice as high among women who reported IPV (8%) compared to women who did not (4%). Having a positive syphilis test was significantly associated with reported IPV in multivariate analysis (aOR 1.55 95% CI 1.20-2.00) after controlling for social and demographic characteristics. In addition, low education (less than high school) among women (aOR 1.26 95% CI 1.09-1.46) and among partners (aOR 1.25 95% CI 1.07-1.46) remained independently associated with IPV in multivariate analysis. Conclusion: IPV and syphilis are urgent problems among pregnant women in Bolivia. Antenatal clinics may provide opportune settings to implement universal screening for these co-occurring epidemics in conjunction with strengthening appropriate follow-services for IPV.