(P4) PREVENTING CONGENITAL SYPHILIS: LESSONS LEARNED FROM THE PREGNANCY CONNECTIONS CLINIC PILOT PROGRAM

Background:
In the past decade, cases of congenital syphilis (CS), have risen sharply in the United States. CS is preventable with routine prenatal care, and thus is significantly associated with late or no care during pregnancy. CS is often seen among populations who are unstably housed and/or use substances, both of which pose barriers to prenatal care utilization. This qualitative study evaluated San Joaquin County’s Pregnancy Connections Clinic (PConn), which provides specialized care to populations with high rates of CS, including transportation assistance, referrals, appointment flexibility, and expanded communication with staff.

Methods:
From December 2022 through December 2023, interviews were conducted with a sample of providers (n=13), PConn patients (n=10), and women who would be eligible (due to unstable housing or substance use) but had not participated (n=14). Interviews were transcribed, coded, and analyzed to identify common themes and subthemes related to program successes, challenges, and lessons learned.

Results:
Results showed that most patients had overwhelmingly positive experiences at PConn, frequently mentioning the high quality of services and appreciation of staff who were communicative, non-judgmental, and responsive to their needs. Several staff and patients highlighted free transportation to and from the clinic, referrals to supportive services, longer appointment times, and patients having direct cellphone access to clinic staff as keys to the clinic’s success. Challenges identified by staff included appointment no-shows and issues with patient follow-up. No eligible non-participants were aware of the clinic, but expressed interest, highlighting the need for additional outreach and organizational referrals. Despite these challenges, this pilot program shows both a critical need for and interest in prenatal care services designed to specifically prevent CS.

Conclusion:
Tailored interventions such as PConn, with a focus on respectful, patient-centered care show promise for addressing CS. Dedicated outreach is needed to increase access to services for priority populations.