P476 Prevalence of chlamydia and gonorrhea among youth in los angeles and new orleans receiving frequent testing

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Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) disproportionately affect adolescents, however, many adolescents receive infrequent sexually transmitted infection (STI) testing. Gay, bisexual, transgender, and homeless youth are at increased risk for STIs. Currently, the Centers for Disease Control and Prevention recommend only annual screening of CT/NG for all sexually active gay, bisexual, and other men who have sex with men (MSM). Methods We recruited adolescents aged 12–24 years from homeless shelters, lesbian, gay, bisexual, transgender, and queer (LGBTQ) organizations, and community health centers in Los Angeles, California and New Orleans, Louisiana from May 2017-January 2019. All participants received point-of-care pharyngeal, rectal, and urethral/vaginal CT/NG testing using the Cepheid GeneXpert (Sunnyvale, CA). We measured the proportion of participants with CT/NG infections every 4 months for 12 months. We compared the proportion of STI positivity at each time point to the baseline visit using a McNemar’s test. Results Overall, 156 participants received testing (53 MSM/transgender women, 56 heterosexual men, 47 heterosexual women). Baseline prevalence of CT/NG among MSM and transgender women was 18.9%. At the 4 month visit, prevalence was 5.7% (Δ = 13.2%, P-value = 0.04). At the 8 month visit, prevalence was 15.1% (Δ = 3.8%, P-value = 0.99). At the 12 month visit, prevalence of CT/NG was 3.8%, a 15.1% decrease from baseline (P-value = 0.02). There was no significant difference in prevalence among heterosexual men between their baseline visit (5.4%) and their 12-month visit (8.9%) (Δ = 3.5%, P-value = 0.82). There was no significant difference in prevalence among heterosexual women between their baseline visit (10.6%) and their 12-month visit (8.5%) (Δ = 2.1%, P-value = 0.99). Conclusion Providing regular testing among adolescent MSM and transgender women may be beneficial in reducing the prevalence of CT/NG infections. Reasons for failure to reduce prevalence among heterosexual men and women require further study. Disclosure No significant relationships.

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