1356. Association Between Marital Status and Pre-pregnancy STI Counseling Among Women Who Have Recently Given Birth: RI PRAMS 2016-2018

Abstract

Abstract Background As rates of sexually transmitted infections (STIs) continue to rise, all women of reproductive age can suffer from complications particularly during pregnancy which can lead to adverse neonatal outcomes. Currently, data on STI counseling among married women are limited. This study aims to assess differences in pre-pregnancy STI counseling based on marital status among women who have recently given birth. Methods We utilized the Rhode Island Pregnancy Risk Assessment Monitoring System (RI PRAMS) 2016-2018, a population-based survey of postpartum women. Mothers self-reported if they have received STI counseling for chlamydia, gonorrhea, and syphilis during any health care visit in the 12 months before becoming pregnant. Marital status was obtained from the birth certificate. Multivariable logistic regression analysis was performed adjusting for age, race, Hispanic ethnicity, education, insurance, income, and previous live birth. We accounted for weighting and complex survey design. Results Our analytic sample included 2,361 mothers. More than half of the women reported never having received pre-pregnancy STI counseling about the 3 most reported and curable STIs in the US. Among them, an estimated 78.9% (n=1,207) of married women did not receive pre-pregnancy STI counseling compared to 53.6% (n=429) of unmarried women (Table 1). Married women had 0.61 (95% CI: 0.46, 0.81) odds of receiving STI counseling before pregnancy compared to unmarried women (Figure 1). Other risk factors for not receiving STI counseling included having a college education or higher or having a previous live birth. Table 1. Characteristics of Women who have Recently Given Birth by Marital Status, RI PRAMS 2016-2018 (n=2,361) *Unknown/missing values for each category <10%.**Uninsured population <1% Figure 1: Adjusted Odds of Having Received Pre-pregnancy STI Counseling among Recent Mothers, RI PRAMS 2016-2018 (n=2,361) *P-value <0.05Reference Group; Marital Status: unmarried, Age: < 25 years old, Race: White, Hispanic: Non-Hispanic, Education: High school degree or less, Insurance: Public insurance, Income: < &24,000, Previous live birth: No previous live birth Conclusion Selective STI counseling creates gaps and missed opportunities to address STIs early before pregnancy. All women regardless of their perceived risk for STI or assumptions based on their marital status should receive proper STI counseling as all women are vulnerable and at higher risk of developing complications. Health care providers should increase efforts to address this gap and counsel all women about STIs during every visit irrespective of their marital status. Disclosures All Authors: No reported disclosures