(P25) CONGENITAL SYPHILIS PREVENTION THROUGH AN OPEN ACESS, HARM-REDUCTION AND TRAUMA-INFORMED PRENATAL CARE CLINIC INTERVENTION

Background:
In California, congenital syphilis (CS) cases rose from 33 cases in 2012 to 528 cases in 2021, an increase of 1,500%. In statewide surveillance, birthing parents of Californian CS infants commonly reported delayed or no prenatal care, methamphetamine use, history of incarceration and homelessness. Timely prenatal diagnosis and treatment of syphilis is highly effective to prevent CS.

Methods:
From August 2021-present, the California Department of Public Health (CDPH), San Joaquin Health Center (SJHC) and San Joaquin Public Health Services (SJCPHS) co-created a prenatal clinic for patients with epidemiologic risk factors for syphilis, informed by local surveillance, consultation with a clinic serving unhoused pregnant patients in San Francisco, and key informant interviews conducted in San Joaquin County (SJC). The clinic was housed in SJHC’s family medicine clinic.

Results:
In January 2022, Pregnancy Connections Clinic (PCONN) was opened as an open-access prenatal clinic serving pregnant SJC residents who are unstably housed, using substances, have experienced incarceration, and/or have been diagnosed with syphilis. The clinic operates two half-days per week. Care is patient-centered and trauma-informed. PCONN offers clinical care via appointment or drop-in hours, transportation assistance, and in-depth case management. Between January 2022 and January 2024, 36 patients were enrolled, with 24 (71%) patients reporting previous or current experiences of unstable housing or homelessness, 26 (76%) reporting current or previous use of substances, and 1(3%) having experienced incarceration. Among 26 live births, 14 congenital syphilis cases were averted among 15 syphilis diagnoses during pregnancy.

Conclusion:
PCONN has been successfully implemented within an FQHC look-alike clinic. Such specialty clinics show promise for serving those at risk for prenatal syphilis, and for CS prevention.