Sexually transmitted diseases · 2025
Dynamics of Gender Identity With STI Diagnoses and Behavioral Outcomes Among Seattle Sexual Health Clinic Attendees, 2016-2023.
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Lang John Chang, Cannon Chase A, Manhart Lisa E, Berzkalns Anna, Kerani Roxanne P
Аннотация
BACKGROUND: Nonbinary/genderqueer (NB/GQ) individuals represent a distinct population with unique sexual health care needs. We characterize trends in clinic attendance, sociodemographics, sexually transmitted infection (STI), and drug use among NB/GQ patients at an urban sexual health clinic (SHC).
METHODS: We analyzed Public Health, Seattle & King County, Seattle (PHSKC) SHC visit data collected between January 2016 and October 2023. We used the Cochran-Armitage trend test to identify trends in reported gender identity and χ 2 tests to identify sociodemographic characteristics associated with cisgender, transgender, and NB/GQ. We evaluated the associations between gender identity and the prevalence of syphilis, urogenital gonorrhea, rectal chlamydia infection, methamphetamine, and nonprescribed injection drug use using generalized estimating equations.
RESULTS: Of 82,384 visits, 1672 (2.0%), 867 (1.1%), and 79,845 (96.9%) were NB/GQ, transgender, and cisgender patients, respectively. From 2016 to 2023, the proportion of visits among NB/GQ and transgender patients increased from 0.7% to 3.5% and 0.7% to 1.7%, respectively ( p trend<0.001). NB/GQ identity was more common among patients assigned female versus male sex at birth (3.2% vs 1.8%, P < 0.001), younger vs older patients (14-25 years: 3.1% vs >46: 0.2%, P < 0.001), and white versus black patients (2.3% vs 1.0%, P < 0.001). Compared with MSM, NB/GQ patients had significantly lower odds of urogenital gonorrhea (adjusted odds ratio [aOR], 0.50; 95% confidence interval [CI], 0.32-0.80). The differences in rectal chlamydia (aOR, 0.78; 95% CI, 0.59-1.02) and syphilis (aOR, 0.96; 95% CI, 0.87-1.06) were not statistically significant. There were no significant differences between the NB/GQ and transgender visits.
CONCLUSIONS: Gender diversity among SHC attendees increased significantly over the 8 years. Continued monitoring is essential for tailoring STI/HIV prevention strategies.
METHODS: We analyzed Public Health, Seattle & King County, Seattle (PHSKC) SHC visit data collected between January 2016 and October 2023. We used the Cochran-Armitage trend test to identify trends in reported gender identity and χ 2 tests to identify sociodemographic characteristics associated with cisgender, transgender, and NB/GQ. We evaluated the associations between gender identity and the prevalence of syphilis, urogenital gonorrhea, rectal chlamydia infection, methamphetamine, and nonprescribed injection drug use using generalized estimating equations.
RESULTS: Of 82,384 visits, 1672 (2.0%), 867 (1.1%), and 79,845 (96.9%) were NB/GQ, transgender, and cisgender patients, respectively. From 2016 to 2023, the proportion of visits among NB/GQ and transgender patients increased from 0.7% to 3.5% and 0.7% to 1.7%, respectively ( p trend<0.001). NB/GQ identity was more common among patients assigned female versus male sex at birth (3.2% vs 1.8%, P < 0.001), younger vs older patients (14-25 years: 3.1% vs >46: 0.2%, P < 0.001), and white versus black patients (2.3% vs 1.0%, P < 0.001). Compared with MSM, NB/GQ patients had significantly lower odds of urogenital gonorrhea (adjusted odds ratio [aOR], 0.50; 95% confidence interval [CI], 0.32-0.80). The differences in rectal chlamydia (aOR, 0.78; 95% CI, 0.59-1.02) and syphilis (aOR, 0.96; 95% CI, 0.87-1.06) were not statistically significant. There were no significant differences between the NB/GQ and transgender visits.
CONCLUSIONS: Gender diversity among SHC attendees increased significantly over the 8 years. Continued monitoring is essential for tailoring STI/HIV prevention strategies.