Thursday, March 11, 2010: 8:45 AM
Grand Ballroom A (M4) (Omni Hotel)
Robert Kirkcaldy, MD, MPH1, John Su, MD, PhD
2, Melanie Taylor, MD, MPH
3, Tom Mickey
4, Michelle Winscott, MD, MPH
5, Kerry Kenney
5, Hillard Weinstock, MD, MPH
2 and Emilia Koumans, MD, MPH
2, 1Office of Workforce Development and Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 2Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 3Office of HIV, STD, and Hepatitis Services, Arizona Department of Health Services, Phoenix, AZ, 4STD Program, Maricopa County Department of Public Health, Phoenix, AZ, 5STD Control Program, Arizona Department of Health Services, Phoenix, AZ
Background:
Since 1998, early syphilis rates declined among women in Maricopa County, Arizona but congenital syphilis (CS) rates did not decline and remained among the highest in the United States (32 per 100,000 live births, 2007), disproportionately affecting Hispanic infants. Objectives:
Describe characteristics of Hispanic women in Maricopa County with early syphilis (primary, secondary and early latent), their partners, and mothers of infants with CS. Methods:
Women’s syphilis case-reports were reviewed for demographic, clinical, and behavioral characteristics and linked to male sex partner and CS data. Results:
During 2004–2008, 339 early syphilis cases among women were reported. Of these women, 34.5% were non-Hispanic white, 10.3% were non-Hispanic black, 11.2% were American Indian, and 43.4% were Hispanic (Hispanics comprise 30% of the county population). Of Hispanic women with early syphilis, 62% reported US citizenship. Few Hispanic women with early syphilis reported risk behaviors: compared with white women, Hispanic women less often reported anonymous sex (25.2% vs. 45.2%, p=0.001), commercial sex work (10.1% vs. 26.5%, p<0.001), and > 1 partner (44.9% vs. 61.5%, p=0.007). Hispanic women with early syphilis were more often pregnant at the time of syphilis diagnosis than white women (33.6% vs. 15.3%, p=0.003). While mothers of infants with CS were disproportionately Hispanic (66.2%), pregnant women with syphilis overall were also disproportionately Hispanic (64.6%). Similar proportions of pregnant Hispanic and white women with syphilis reported at least 1 prenatal care visit (82.1% vs. 71.9%, p=0.189). Conclusions:
Increased fertility rates among Hispanic women with syphilis may account for disparities in CS rates among infants of Hispanic mothers. Differences in access to prenatal care by ethnicity were not detected, although substantial numbers of pregnant women reported no prenatal care. Implications for Programs, Policy, and/or Research:
Further research is needed to understand factors linking increased fertility and prenatal syphilis acquisition among Hispanic women.
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