PDF(Pubmed)
Abstract：
BACKGROUND: Syphilis and congenital syphilis rates have increased sharply in Colorado in the past 5 years. Congenital syphilis is passed during pregnancy in utero and can cause lifelong physical, developmental, and neurologic problems for the child, or can lead to miscarriage, stillbirth, or early infant death. Congenital syphilis is easily prevented if the mother receives timely testing, treatment, and prenatal care. Providers can play a key role in preventing congenital syphilis for women with social vulnerabilities, who have a higher likelihood of syphilis and/or congenital syphilis infection.
METHODS: We surveyed 23 and interviewed 4 health care providers in southern Colorado in 2022 to record their experiences in providing sexual health care services. We asked providers with direct care experience about perceived barriers in effectively treating syphilis.
RESULTS: The most significant barriers reported in the survey were the cost of treatment (26%) and the loss to follow-up (22%). Interviews revealed further challenges, including discretionary testing procedures, delays in screening results, treatment referral issues, and stigma around substance use and sexual activity.
CONCLUSIONS: Elevated syphilis and congenital syphilis rates pose significant public health challenges. Coordinated interventions are necessary to effectively reduce the transmission of syphilis and congenital syphilis among women with upstream barriers. Potential care solutions include expanding rapid, point-of care testing and treatment options, supporting bicillin delivery or web-based inventory systems, offering anti-stigma training for providers, offering mental and behavioral health resources at providers\' clinics, and expanding partnerships with syringe access programs.
METHODS: We surveyed 23 and interviewed 4 health care providers in southern Colorado in 2022 to record their experiences in providing sexual health care services. We asked providers with direct care experience about perceived barriers in effectively treating syphilis.
RESULTS: The most significant barriers reported in the survey were the cost of treatment (26%) and the loss to follow-up (22%). Interviews revealed further challenges, including discretionary testing procedures, delays in screening results, treatment referral issues, and stigma around substance use and sexual activity.
CONCLUSIONS: Elevated syphilis and congenital syphilis rates pose significant public health challenges. Coordinated interventions are necessary to effectively reduce the transmission of syphilis and congenital syphilis among women with upstream barriers. Potential care solutions include expanding rapid, point-of care testing and treatment options, supporting bicillin delivery or web-based inventory systems, offering anti-stigma training for providers, offering mental and behavioral health resources at providers\' clinics, and expanding partnerships with syringe access programs.
摘要：
背景：在过去的5年中，科罗拉多州的梅毒和先天性梅毒发病率急剧上升。先天性梅毒在怀孕期间在子宫内传播，并可导致终身体检，发展,和孩子的神经系统问题，或者可能导致流产，死产,或婴儿早逝。如果母亲及时接受检测，先天性梅毒很容易预防，治疗,和产前护理。提供者可以在预防有社会脆弱性的女性的先天性梅毒方面发挥关键作用，梅毒和/或先天性梅毒感染的可能性更高。
方法：我们于2022年对科罗拉多州南部的23位医疗保健提供者进行了调查，并采访了4位医疗保健提供者，以记录他们在提供性保健服务方面的经验。我们向有直接护理经验的提供者询问了有效治疗梅毒的感知障碍。
结果：调查报告中最重要的障碍是治疗费用（26％）和随访损失（22％）。采访揭示了进一步的挑战，包括自由裁量的测试程序，筛查结果的延迟，治疗转诊问题，以及围绕物质使用和性活动的耻辱。
结论：梅毒和先天梅毒的发病率升高对公共卫生构成了重大挑战。必须采取协调一致的干预措施，以有效减少梅毒和先天性梅毒在有上游障碍的妇女中的传播。潜在的护理解决方案包括快速扩展、点护理测试和治疗方案，支持bicillin交付或基于网络的库存系统，为提供者提供反污名培训，在提供者诊所提供精神和行为健康资源，并扩大与注射器访问计划的伙伴关系。
方法：我们于2022年对科罗拉多州南部的23位医疗保健提供者进行了调查，并采访了4位医疗保健提供者，以记录他们在提供性保健服务方面的经验。我们向有直接护理经验的提供者询问了有效治疗梅毒的感知障碍。
结果：调查报告中最重要的障碍是治疗费用（26％）和随访损失（22％）。采访揭示了进一步的挑战，包括自由裁量的测试程序，筛查结果的延迟，治疗转诊问题，以及围绕物质使用和性活动的耻辱。
结论：梅毒和先天梅毒的发病率升高对公共卫生构成了重大挑战。必须采取协调一致的干预措施，以有效减少梅毒和先天性梅毒在有上游障碍的妇女中的传播。潜在的护理解决方案包括快速扩展、点护理测试和治疗方案，支持bicillin交付或基于网络的库存系统，为提供者提供反污名培训，在提供者诊所提供精神和行为健康资源，并扩大与注射器访问计划的伙伴关系。
