4.5 Article

Congenital syphilis in East Baton Rouge parish, Louisiana: providers' and women's perspectives

Journal

BMC INFECTIOUS DISEASES
Volume 21, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12879-020-05753-6

Keywords

Syphilis; congenital; Prenatal care; Social determinants of health; Qualitative methods

Funding

  1. March of Dimes
  2. Centers for Disease Control and Prevention [U380T000199-05-00]

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Providers and community women in Baton Rouge identified delays in testing and care, lack of follow-through with partner testing, and the need for community connection as major contributors to rising rates of congenital syphilis. Women also faced difficulties in accessing Medicaid, leading to delayed prenatal care, lack of transportation for prenatal care, and lack of knowledge about testing and prevention for congenital syphilis.
Background: Congenital syphilis is completely preventable through screening and treatment, but rates have been rising in the United States. Certain areas are at particularly high risk. We aimed to assess attitudes, knowledge, and barriers around effective prevention of congenital syphilis among health care providers and community women potentially at risk. Methods: Two parallel studies were conducted: in-depth interviews with health care providers and focus groups with community women in the area of Baton Rouge, Louisiana. Each group was questioned about their experience in providing or seeking prenatal care, knowledge and attitudes about congenital syphilis, sources of information on testing and treatment, perceptions of risk, standards of and barriers to treatment. Results were transcribed into QSR NVivo V10, codes developed, and common themes identified and organized. Results: Providers identified delays in testing and care, lack of follow-through with partner testing, and need for community connection for prevention, as major contributors to higher rates of congenital syphilis. Women identified difficulties in accessing Medicaid contributing to delayed start of prenatal care, lack of transportation for prenatal care, and lack of knowledge about testing and prevention for congenital syphilis. Conclusions: Providers and community members were in broad agreement about factors contributing to higher rates of congenital syphilis, although some aspects were emphasized more by one group or another. Evidence-based interventions, likely at multiple levels, need to be tested and implemented to eliminate congenital syphilis.

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