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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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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. |
format | Online Article Text |
id | pubmed-8016223 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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