(P10) PREVENTION OF MOTHER-TO-CHILD TRANSMISSION (PMTCT) OF SYPHILIS IN THE CONTEXT OF MULTI-LEVEL BEHAVIORAL INTERVENTIONS IN A GLOBAL SETTING: A SCOPING REVIEW

Background:
Congenital syphilis (CS) is the second leading cause of preventable stillbirth globally. Maternal syphilis, when left untreated, poses risks of miscarriages, premature births, and low birth weight. Researchers propose behavioral interventions as practical prevention approaches to improve PMTCT of syphilis. However, few reviews have characterized these behavioral interventions and their behavioral outcomes.

Methods:
We conducted a scoping review to identify, summarize, and examine research on the characteristics and effectiveness of behavioral interventions (e.g., maternal health education and physician practice alert) contributing to the PMTCT of syphilis. Adhering to PRISMA-ScR guidelines, we searched articles published between 2010 and 2023 within PubMed, Medline Ovid, and Embase. Two researchers screened and charted articles independently by using Rayyan and Zotero. The articles must include one descriptive behavioral intervention regarding CS prevention.

Results:
Among the 3762 identified articles, 32 behavioral interventions were eligible and included in the final analysis. 40.6% (n=13) were published after 2020. Most studies were conducted in the USA (n=10) and Brazil (n=6). Majority of the interventions were multi-level, targeting more than two types of populations (e.g., pregnant women and their partners or providers and social workers). The top three targeted behavioral outcomes are pregnant women's CS treatment and screening behaviors (n=18), healthcare providers’ management of CS (n=12), and partner syphilis treatment behaviors (n=12). About 75% of the interventions (n=24) were conducted in hospitals and clinics. Other settings include home-based intervention, non-traditional prenatal care, and street consultation offices. Only six (21.4%) interventions included comparison groups to evaluate the intervention effectiveness, and only one was theory-based.

Conclusion:
Multi-level behavioral interventions targeting improvements in CS screening and treatment could reduce PMTCT of syphilis. More rigorous evaluations of theory-based PMTCT of syphilis interventions that include comparison groups is an essential next step in understanding the potential benefit of behavioral interventions on reducing CS rates and adverse pregnancy outcomes.