(P62) RACIAL AND ETHNIC INEQUITIES IN STI TESTING AND CASES AMONG GAY, BISEXUAL, AND OTHER MEN WHO HAVE SEX WITH MEN, 2012–2023

Background:
Racial and ethnic inequities in bacterial sexually transmitted infections (STI) exist among gay, bisexual, and other men who have sex with men (GBMSM), but it is unknown whether these inequities persist under routine STI screening during PrEP use.

Methods:
Using an open-source public health surveillance platform, we examined STI testing and cases among GBMSM from three Boston clinics during 2012–2023. We stratified person-time by PrEP use based on PrEP prescription dates. We estimated rates of gonorrhea, chlamydia, and syphilis tests and diagnoses by race and ethnicity.

Results:
Among 31,068 GBMSM, 11% were Black, 12% were Hispanic, 16% were another race or multiracial, and 61% were White. 9,334 (30%) GBMSM were ever prescribed PrEP. During PrEP use, rates of gonorrhea (17 cases per 100 person-years [PY]), chlamydia (19 per 100 PY), and syphilis (8 per 100 PY) were higher than during times of no PrEP use (5, 6, and 3 per 100 PY, respectively). Compared with White GBMSM, Black and Hispanic GBMSM, had a 1.6 and 1.7 crude incidence rate ratio (cIRR), respectively, of any STI while not using PrEP, and both had a 1.3 cIRR while using PrEP. Overall STI testing did not differ by race or ethnicity during PrEP use, but Black and Hispanic GBMSM were 0.7­–0.9 times as likely as White GBMSM to have a rectal STI test and up to 2.5 times more likely to have a pharyngeal STI test.

Conclusion:
Racial and ethnic inequities in STIs persisted but were less pronounced during PrEP use compared with periods of no PrEP use. Although overall STI testing did not differ by race or ethnicity during PrEP use, inequities in STI testing were present by anatomic site, which may impact the detection of asymptomatic STIs. Routine screening during PrEP use can help address inequities in STIs.