Please provide a brief description of the intervention (with name, if possible).
Congenital syphilis (CS) can be prevented with timely prenatal care, and syphilis screening and treatment of the patient and their sex partners. Reviews of CS cases in New York City (NYC) have indicated healthcare access and other psychosocial factors have played a role. In 2017, NYC Bureau of Sexually Transmitted Infections started an intervention to provide social work (SW) services to pregnant people with syphilis, with the goal of improving outcomes and care among pregnant person with syphilis (Social Work CS Prevention program). For each pregnant person diagnosed with any stage of syphilis, SW staff identify and navigate potential barriers to prenatal care, assure third trimester syphilis screening, and provide psychosocial support to patients beyond standard STI case investigation and partner services. Specifically, SW staff review case investigation records of eligible patients, reach out to eligible persons and offer support throughout the duration of pregnancy via phone, and provide intensive case management, connecting patients to syphilis treatment, prenatal care, encouraging retesting for syphilis at 28 weeks, and linking to social resources (Cribs for Kids, Nurse Family Partnership, etc.) where appropriate.
Who was/is involved in implementing the intervention (e.g., staff titles, partner organizations, etc.)?
The idea for this intervention came from the Assistant Commissioner of the Bureau of STI during a CS workgroup meeting. It was designed and executed by the Director of Behavioral Health, Social Work team, Director of Surveillance and Field Operations, Director of Case Investigation and Partner Services, and a Medical Director with OBGYN training.
If other, please describe.
Pregnant people with syphilis in NYC
What were/are the primary objectives/goals of this intervention?
The Social Work CS Prevention program aims to improve outcomes, care, and access to resources – including receipt of third trimester syphilis screening, and continued access to prenatal care—among pregnant persons with syphilis, in order to reduce Congenital Syphilis.
What were the outcomes of the intervention?
Please provide specific outcomes if possible, such as # or people served, # or % of reaching XYZ outcome, etc.
Between Jan-Dec 2019, among 69 pregnant persons with syphilis, 54 (78%) received third trimester syphilis screening (+1.3% relative improvement from previous year). Between Jan-Dec 2019, among 69 pregnant persons with a new case of syphilis, 42 (61%) engaged in the social worker follow-up; of those, 35/42 (83%) completed follow-up. All those completing follow-up were informed of the need for third trimester syphilis screening.
If other, please describe.
Staff turnover, language barriers, reluctance of clients to engage
If other, please describe.
Leadership priority, centralized coordination
What else would you recommend or advise to other counties considering this intervention/activity?
The STI program in NYC has Social Workers on staff who primarily work in the Sexual Health Clinics, and this intervention was added to their responsibilities. We did not hire SW for this project. Other counties considering such a program might need to partner with other parts of their health departments, or CBOs to implement a similar program.