(P50) DIFFERENCES IN THE PREVALENCE OF CHLAMYDIA TRACHOMATIS INFECTIONS AMONG FEMALES AGED 14-24 YEARS BY RACE/HISPANIC ETHNICITY: NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY, UNITED STATES 2011-2020

Background:
Non-Hispanic Black (NHB) adolescents and young adults experience disproportionately higher burden of Chlamydia trachomatis (CT) infections compared to their Non-Hispanic White counterparts (NHW) due to many factors. We explored this disparity overall, and whether it persisted in individual level risk factors stratified by race/ethnicity using data from the National Health and Nutrition Examination Survey (NHANES).

Methods:
We examined CT laboratory data from four NHANES cycles (2011-2020) to estimate the prevalence and 95% confidence intervals (CIs) of genital CT in sexually experienced females aged 14-24 years by race/Hispanic ethnicity (NHB, NHW, non-Hispanic Other [NHO], Hispanic). We estimated and compared race-specific CT prevalence by demographic and behavioral characteristics and reported the prevalence ratio (PR) comparing CT prevalence by race/Hispanic ethnicity.

Results:
Among 1,652 sexually experienced females aged 14-24 years, CT prevalence was 5.8% overall (95%CI: 4.5-7.3): 11.7% (95%CI: 8.7%-15.3%) among NHB, 10.5% (95%CI: 3.4%-22.2%) among NHO, 6.7% (95%CI: 4.4%-9.7%) among Hispanics, and 3.2% (95%CI: 1-7%-5.5%) among NHW. Compared to all other racial/Hispanic ethnicity groups, NHB had a CT prevalence ratio of 2.4 (95% CI: 1.6-3.6). This effect largely persisted across demographic and behavioral characteristics, with prevalence ratios higher for NHB females who sought healthcare in the past year (PR=2.52, 95%CI: 1.57-4.02), had a usual place for healthcare (PR=2.27, 95%CI: 1.46-3.50), or reported having only 1 sex partner in the past year (PR=2.02, 95%CI: 1.05-3.86).

Conclusion:
Consistent with recent surveillance data, these analyses demonstrate that genital CT infections continue to disproportionately affect NHB adolescents and young adults. This effect persisted across demographic and behavioral characteristics. This suggests that factors beyond the individual-level risk factors considered here might be increasing CT prevalence in NHB. Our findings lend further support for studies to examine ways in which network-level, in addition to individual-level behaviors, contribute to racial/ethnic differentials in exposure.