(P67) FACES-NOT-CASES: CHARACTERISTICS OF INDIVIDUALS WITH REPEATED BACTERIAL STIS, MASSACHUSETTS, 2018-2022.

Background:
Reported cases of bacterial STIs have increased recently, but total case counts do not accurately reflect the true number of individuals impacted, as STIs can be reacquired. We assessed factors associated with STI reacquisition over a five-year period.

Methods:
Using 2018-2022 Massachusetts STI surveillance datasets, reported cases of chlamydia, gonorrhea, and infectious syphilis were matched based on unique identifiers. Demographic, social, and behavioral characteristics were described for those with ≥10 STIs; demographics were compared to those with only one reported infection on or before March 1, 2021, the date the last person with ≥10 STIs entered the dataset.

Results:
Among 184 individuals with ≥10 STIs, all had ≥1 chlamydia infection (avg. 5.4), 183 (99.5%) had ≥1 gonococcal infection (avg. 5.6), and 120 (65.2%) had ≥1 infectious syphilis case (avg. 1.3). Average age at first diagnosis was 30.5 years; 160 (87.0%) identified as male, 147 (79.9%) reported same sex male partners, and 35 (19.0%) reported methamphetamine and/or opioid use. Fifty-three (28.8%) were HIV-positive at entry date; 10 (5.4%) acquired HIV during the study period. Seventy-two (39.1%) had no contact with MA Division of STD Prevention (DSTDP) from 2018-2022. Males were significantly more likely than females to be older (30.1 vs. 19.1 years), HIV-positive (38.1% vs. 8.3%), have a rectal STI (86.9% vs. 8.3%) and more STI diagnoses (12 vs. 11). Compared to 64,881 individuals with one STI, those with ≥10 were older (28.1 vs. 25.6 years, p= <.0001) and more likely to be male (87.0% vs. 41.6%, p= <.0001).

Conclusion:
Among individuals with ≥10 STIs, merely 60.9% experienced contact with DSTDP; as outreach is predominantly conducted for infectious syphilis, limited information is available for those diagnosed with only chlamydia and/or gonorrhea. Follow-up counseling and biomedical prevention interventions could be explored for populations, particularly females <25 years with multiple chlamydia and gonococcal infections.