Syphilis in pregnancy: a qualitative investigation of healthcare provider perspectives on barriers to syphilis screening during pregnancy in south-east Queensland
Sarah Warzywoda
A * , James A. Fowler A , Clare Nourse B C , Mandy Wu B D , Sumudu Britton B E , Diane Rowling F , Paul Griffin B G , Mattea Lazarou A D , Zoe Hamilton A and Judith A. Dean A
+ Author Affiliations
- Author Affiliations
A The University of Queensland, Faculty of Medicine, School of Public Health, 288 Herston Road, Herston, Qld 4006, Australia.
B The University of Queensland, Faculty of Medicine, School of Medicine, 288 Herston Road, Herston, Qld 4006, Australia.
C Infection Management and Prevention Service, Queensland Children’s Hospital, Children’s Health Queensland Hospital and Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia.
D Queensland Children’s Hospital, Children’s Health Queensland Hospital and Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia.
E Department of Infectious Diseases, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, 7 Butterfield Street, Herston, Qld 4029, Australia.
F Metro North Public Health Unit, Metro North Hospital and Health Service, Bryden Street, Windsor, Qld 4030, Australia.
G Mater Health Brisbane, Raymond Terrace, South Brisbane, Qld 4101, Australia.
Sexual Health 20(4) 330-338 https://doi.org/10.1071/SH22193
Submitted: 7 December 2022 Accepted: 8 May 2023 Published: 29 May 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Increasing rates of syphilis in pregnancy (SiP) in Australia and other high-income countries, has led to the resurgence of congenital syphilis. Suboptimal syphilis screening during pregnancy has been identified as a key contributing factor.
Methods: This study aimed to explore, from the perspective of multidisciplinary healthcare providers (HCPs), the barriers to optimal screening during the antenatal care (ANC) pathway. Semi-structured interviews conducted with 34 HCPs across multiple disciplines practising in south-east Queensland (SEQ) were analysed through a process of reflexive thematic analysis.
Results: Barriers were found to occur at the system level of ANC, through difficulties in patient engagement in care, limitations in the current model of health care delivery and limitations in the communication pathways across health care disciplines; and at the individual HCP level, through HCP knowledge and awareness of epidemiological changes in syphilis in SEQ, and adequately assessing patient risk.
Conclusion: It is imperative that the healthcare systems and HCPs involved in ANC address these barriers to improve screening in order to optimise management of women and prevent congenital syphilis cases in SEQ.
Keywords: congenital syphilis, healthcare provider, infectious syphilis, pregnancy, qualitative, sexually transmitted infection, syphilis, syphilis in pregnancy.
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