• Paul Lanier, Susan Kennedy, Angela Snyder, Jessica Smith, Eric Napierala, Jeffrey Talbert, Lindsey Hammerslag, Larry Humble, Eddy Myers, Anna Austin, Thomas Blount, Shannon Dowler, Victoria Mobley, FedeAna Lòpez-DeALInstitute for Families in Society, University of South Carolina, Columbia, South Carolina., Hoa Nguyen, Jean Bruce, Carlos G Grijalva, Sunita Krishnan, Caitlin Otter, Katie Horton, Naomi Seiler, John Majors, and William S Pearson.
• School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: planier@unc.edu.
• Am J Prev Med. 2022 May 1; 62 (5): 770-776.

IntroductionThe rates of syphilis among pregnant women and infants have increased in recent years, particularly in the U.S. South. Although state policies require prenatal syphilis testing, recent screening rates comparable across Southern states are not known. The purpose of this study is to measure syphilis screening among Medicaid enrollees with delivery in states in the U.S. South.MethodsA total of 6 state-university research partnerships in the U.S. South developed a distributed research network to analyze Medicaid claims data using a common analytic approach for enrollees with delivery in fiscal years 2017-2018 and 2018-2019 (combined N=504,943). In 2020-2021, each state calculated the percentage of enrollees with delivery with a syphilis screen test during the first trimester, third trimester, and at any point during pregnancy. Percentages for those with first-trimester enrollment were compared with the percentages of those who enrolled in Medicaid later in pregnancy.ResultsPrenatal syphilis screening during pregnancy ranged from 56% to 91%. Screening was higher among those enrolled in Medicaid during the first trimester than in those enrolled later in pregnancy.ConclusionsDespite state laws requiring syphilis screening during pregnancy, screening was much lower than 100%, and states varied in syphilis screening rates among Medicaid enrollees. Findings indicate that access to Medicaid in the first trimester is associated with higher rates of syphilis screening and that efforts to improve access to screening in practice settings are needed.Copyright © 2021 American Journal of Preventive Medicine. All rights reserved.

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