Prevalence of Chlamydia trachomatis Genital Infection Among Sexually Experienced Females Aged 14 to 24 Years by Race/Ethnicity, United States: 2011 to March 2020.

BACKGROUND

Since 2013, national trends in behavioral factors that increase sexually transmitted infection risk among adolescent and young adult (A/YA) females have been mixed (e.g., fewer sex partners, lower condom use). We used data from a national sample of A/YA females to examine racial disparities in Chlamydia trachomatis (CT) prevalence considering these trends.

METHODS

Using 2011-March 2020 National Health and Nutrition Examination Survey data, we estimated the prevalence, and unadjusted and adjusted prevalence ratios of a positive CT urine test result among sexually experienced non-Hispanic Black (Black), Hispanic, non-Hispanic Other race (NHO), and non-Hispanic White (White) A/YA females. Percentages were categorized by race/ethnicity, and each was compared with the average of the other race/ethnic groups (e.g., Black vs. Hispanic, NHO, and White). Covariates included age group, health insurance coverage, number of sex partners, and condom use (both past year).

RESULTS

Overall, the prevalence of CT infection among A/YA females was 5.8% (95% confidence interval [CI], 4.5%-7.3%). The prevalence of CT was higher among Black females (vs. Hispanic, NHO, and White; 11.7%; 95% CI, 8.7%-15.2%) and lower among White females (vs. Black, Hispanic, and NHO; 3.2%; 95% CI, 1.7%-5.5%). Compared with the average CT prevalence for Hispanic, NHO, and White females, Black females had a higher adjusted CT prevalence (adjusted prevalence ratio, 2.48; 95% CI, 1.63-3.75).

CONCLUSIONS

Nationally, CT prevalence was 2.5 times as high among Black A/YA females than the average prevalence for Hispanic, NHO, and White females. Inclusion of behavioral sexually transmitted infection risk factors did not attenuate this association. Research incorporating sexual network-level factors associated with CT transmission may provide additional insights.