(P56) IT’S DÉJÀ VU: EPIDEMIOLOGY OF CHLAMYDIA TRACHOMATIS AND REPEAT POSITIVITY IN NEW YORK STATE, 2015-2019

Background:
It’s well-known that persistent and/or repeat C. trachomatis (chlamydia) increases risk of health complications and perpetuate transmission. However, it’s unclear who are most likely to have laboratory-confirmed re-identification (repeat positivity) of chlamydia, hindering intervention planning. The aim of this study is to describe the epidemiology of chlamydia and repeat positivity among persons in New York State (NYS) outside of New York City from 2015-2019.

Methods:
Data were extracted from NYS’s Communicable Disease Electronic Surveillance System, a web-based surveillance system. Patient demographics and clinical factors were evaluated to describe reported chlamydia, from 2015-2019. Repeat positivity was defined as a second positive chlamydia test 31-365 days from the initial positive test during the study period. Analyses compared persons with single and repeat positivity, and sex-specific differences. Multivariable logistic regression models evaluated associations with repeat positivity.

Results:
Of the 176,273 persons with laboratory-confirmed chlamydia, the largest proportion were female (64.6%), non-Hispanic White (34.0%), ages 20-24 (38.0%), no gonorrhea coinfection (95.5%), no syphilis coinfection (99.7%), no HIV coinfection (98.9%), no prior STI (87.9%), urogenital infection site (97.4%), diagnosed by a private provider (49.6%), and reason for exam was “screening” (44.6%). Overall, 9.8% (n=17,253) had repeat positivity. There was an increased odds of repeat positivity among females [adjusted odds ratio (aOR)=1.46],  ages 13-19 (aOR=1.55), and non-Hispanic Black persons (aOR=1.38), individuals coinfected with HIV (aOR=1.45), having a prior STI (aOR=1.27), and extragenital infection (aOR=2.26). Notable differences were identified in sex-stratified models.

Conclusion:
While best practices for prevention remains adhering to federal screening and treatment recommendations, understanding populations most affected by single and repeat chlamydia positivity can better focus preventions, such as Expedited Partner Treatment, and sexual health education. Although not all infections/re-infections are reported, population-wide surveillance data identifies those known to have laboratory-confirmed chlamydia and provides an opportunity to tailor preventions to those most affected by repeat positivity.