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A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California

Congenital syphilis is the result of placental transmission from mother to fetus of Treponema pallidum. Although congenital syphilis is preventable through timely treatment, the rate of new infections in the United States (US) has increased each year since 2013, and is increasing at a noticeably gre...

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Autores principales: Chan, Elaine Y. L., Smullin, Carolyn, Clavijo, Stephanie, Papp-Green, Melissa, Park, Eunhee, Nelson, Marlene, Giarratano, Gloria, Wagman, Jennifer A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016223/
https://www.ncbi.nlm.nih.gov/pubmed/33793630
http://dx.doi.org/10.1371/journal.pone.0249419
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author Chan, Elaine Y. L.
Smullin, Carolyn
Clavijo, Stephanie
Papp-Green, Melissa
Park, Eunhee
Nelson, Marlene
Giarratano, Gloria
Wagman, Jennifer A.
author_facet Chan, Elaine Y. L.
Smullin, Carolyn
Clavijo, Stephanie
Papp-Green, Melissa
Park, Eunhee
Nelson, Marlene
Giarratano, Gloria
Wagman, Jennifer A.
author_sort Chan, Elaine Y. L.
collection PubMed
description Congenital syphilis is the result of placental transmission from mother to fetus of Treponema pallidum. Although congenital syphilis is preventable through timely treatment, the rate of new infections in the United States (US) has increased each year since 2013, and is increasing at a noticeably greater pace in California (CA). Most research into congenital syphilis has focused on individual psychosocial and behavioral factors that contribute to maternal vulnerability for syphilis. The aim of this study was to evaluate structural barriers to prenatal care access and utilization and congenital syphilis prevention in Kern County, CA. Transcripts from 8 in-depth interviews with prenatal care providers and 5 focus group discussions with 42 pregnant and postpartum persons were examined using thematic analysis. Structural barriers experienced by pregnant and postpartum persons to prenatal care access and utilization included (1) burdens of poverty; (2) stigma around substance use in pregnancy; (3) citizenship status; (4) lack of healthcare coverage; (5) low sexual health literacy; and (6) gender inequality Structural barriers experienced by prenatal care providers in congenital syphilis prevention included (1) limited guidance on clinical management of syphilis in pregnancy; (2) decay in public health infrastructure; and (3) inadequate support for managing patients’ social comorbidities. The response to congenital syphilis prevention will require an examination of the complex context of social determinants of health in which persons diagnosed with syphilis live in.
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spelling pubmed-80162232021-04-08 A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California Chan, Elaine Y. L. Smullin, Carolyn Clavijo, Stephanie Papp-Green, Melissa Park, Eunhee Nelson, Marlene Giarratano, Gloria Wagman, Jennifer A. PLoS One Research Article Congenital syphilis is the result of placental transmission from mother to fetus of Treponema pallidum. Although congenital syphilis is preventable through timely treatment, the rate of new infections in the United States (US) has increased each year since 2013, and is increasing at a noticeably greater pace in California (CA). Most research into congenital syphilis has focused on individual psychosocial and behavioral factors that contribute to maternal vulnerability for syphilis. The aim of this study was to evaluate structural barriers to prenatal care access and utilization and congenital syphilis prevention in Kern County, CA. Transcripts from 8 in-depth interviews with prenatal care providers and 5 focus group discussions with 42 pregnant and postpartum persons were examined using thematic analysis. Structural barriers experienced by pregnant and postpartum persons to prenatal care access and utilization included (1) burdens of poverty; (2) stigma around substance use in pregnancy; (3) citizenship status; (4) lack of healthcare coverage; (5) low sexual health literacy; and (6) gender inequality Structural barriers experienced by prenatal care providers in congenital syphilis prevention included (1) limited guidance on clinical management of syphilis in pregnancy; (2) decay in public health infrastructure; and (3) inadequate support for managing patients’ social comorbidities. The response to congenital syphilis prevention will require an examination of the complex context of social determinants of health in which persons diagnosed with syphilis live in. Public Library of Science 2021-04-01 /pmc/articles/PMC8016223/ /pubmed/33793630 http://dx.doi.org/10.1371/journal.pone.0249419 Text en © 2021 Chan et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chan, Elaine Y. L.
Smullin, Carolyn
Clavijo, Stephanie
Papp-Green, Melissa
Park, Eunhee
Nelson, Marlene
Giarratano, Gloria
Wagman, Jennifer A.
A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California
title A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California
title_full A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California
title_fullStr A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California
title_full_unstemmed A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California
title_short A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California
title_sort qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in kern county, california
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016223/
https://www.ncbi.nlm.nih.gov/pubmed/33793630
http://dx.doi.org/10.1371/journal.pone.0249419
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