Background: From 2002-2007,
Objectives: In March 2009, a rapid ethnographic assessment was conducted to better understand community and structural level factors potentially contributing to persistent high rates of CS among Latinas.
Methods: Key informant interviews were conducted with 42 providers from state and local STD/HIV programs, community based organizations and health facilities. Providers were asked their perceptions of STD awareness and risk behaviors, sexual and reproductive health seeking, and barriers to using STD and prenatal care services among Latinos. Data were analyzed using NVivo7.
Results:Non-English speaking women without legal status were identified as a vulnerable population for congenital syphilis, due to low levels of STD knowledge/awareness, reluctance to use services because of fear of deportation, lack of insurance coverage for prenatal care, and high cost of services for pregnancy and delivery. Some women delay care because they are unaware of the benefits of prenatal care. Screening of pregnant women for syphilis is not routine in ERs.
Conclusions:Continued focus on providers to increase 3rd trimester screening and screening in ERs is warranted. Interventions to reach pregnant women through social institutions and networks also are needed. Activities to address CS require collaboration among state and local health departments and stakeholders.
Implications for Programs, Policy, and/or Research: Barriers to using prenatal care services exist at community, structural and policy levels, and are contributing to adverse pregnancy outcomes among Latinas in Maricopa County.