Trends in Associations between Maternal Methamphetamine Use and Congenital Syphilis in Los Angeles County, 2011 through 2020

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PROJECT SUMMARY/ABSTRACT The purpose of the Predoctoral Individual National Research Service Award (F31) is to provide the candidate with mentoring and research experiences that will promote candidate’s development as an independent researcher, with particular emphasis in spatial-temporal trend and longitudinal analysis as well as multi-level modeling in maternal and child health among populations diagnosed with syphilis. Objectives of the training are to develop knowledge and skills to: 1) gain research experience using state-of-the-art methods using a large longitudinal surveillance dataset and publish the research findings as the first author; 2) advance epidemiological training focused on knowledge of the epidemiology of substance abuse and sexually transmitted infections and gain statistical skills for mediation and longitudinal analyses; and 3) obtain Skills for a successful academic career and professional development, including ethics, the dissemination of research findings, and the development of collaborative scientific relationships. Training activities will include didactic coursework and specific workshops, directed readings and one-on-one tutorials with mentors, and instruction in the responsible conduct of research. The candidate will receive mentorship from a Training Committee comprised of nationally renowned experts in the fields of substance use, maternal and child health, sexually transmitted diseases (STDs), and longitudinal data analysis at the University of California, Los Angeles. The specific aims of the proposed research are to: 1) measure spatial-temporal trends in methamphetamine (meth) use incidence rates among women of reproductive age (15-44 years old), pregnant women, and congenital syphilis (CS) case mothers who are diagnosed with syphilis in Los Angeles County between 2011 and 2020; 2) determine whether temporal trends in prenatal care visits, syphilis treatment during pregnancy, and delivery of infants with CS among pregnant women diagnosed with syphilis differ by meth use; and 3) apply syndemic theory to examine meth use, high-risk sexual behaviors, homelessness, and social vulnerabilities that co-occur and test how the co-occurrence of these factors are associated with no prenatal care and CS incidents among pregnant women diagnosed with syphilis. The research aims will be accomplished by conducting spatial- temporal trend analysis and advanced statistics such as structural equation modeling and cross-legged panel modeling. Quantitative data will come from STD surveillance system and sample size will be determined by the number of women at reproductive age diagnosed with syphilis (N=6,014) and infants born with syphilis (N=426) in Los Angeles County between 2011 and 2020. Findings from the proposed research will position the candidate to propose a F32 or K01 proposal to pilot test a theoretically-driven, mixed methods intervention that addresses the multiplicity of risks among meth using women in the context of STDs and access to reproductive health.