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Congenital syphilis (CS); STI services; Medicaid program


Congenital syphilis (CS) is an infection acquired in utero that can lead to devastating outcomes, including stillbirth, infant death, or long-term health complications. Over the past decade, rising national rates of syphilis, including among women, have led to major increases in congenital syphilis cases and deaths.

CS is tragic and costly, but it is also preventable. With appropriate testing and treatment during prenatal care, syphilis in a pregnant woman can be identified and treated, and transmission to the fetus averted.

The Medicaid program is the payer for nearly half of all births in the U.S., making the program a crucial partner for efforts to better address syphilis in pregnancy and to prevent congenital syphilis. In 2018, more than half of all cases of CS in the U.S. occurred in the south, and mothers of infants with CS in the south were diagnosed at later stages of infection. This project explored challenges and opportunities for addressing congenital syphilis through the Medicaid program by focusing on seven southern states: Alabama, Georgia, Kentucky, Louisiana, North Carolina, South Carolina, and Tennessee.

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