Trends in Chlamydia Positivity among Asian and Native Hawaiian/Other Pacific Islander Women Age 15-24 in Region X Family Planning Clinics, 2000-2006

Tuesday, March 11, 2008: 10:15 AM
International Ballroom South
Wendy Nakatsukasa-Ono, MPH , Center for Health Training, Seattle, WA
David Fine, PhD , Center for Health Training, Seattle, WA

In 2000, the Census added “Native Hawaiian and Other Pacific Islander” (HAPI) as a new racial group, separate from “Asian." That year, the Region X Infertility Prevention Project (IPP) also began collecting data reflecting these changes.

1) Describe the epidemiology of and risk factors for chlamydia (CT) among Asian and HAPI women age 15-24 screened in family planning (FP) clinics in Region X from 2000-2006. 2) Identify potential implications for service delivery.

We analyzed CT positivity (CT+) among Asian and HAPI women age 15-24 screened at Region X FP clinics from 2000-2006. Trends in factors affecting CT+ were compared between non-Hispanic (NH) White, Asian and HAPI. Multivariate logistic regression was used to identify demographic, sexual risk behaviors and clinical findings associated with CT, overall and within races.

Of the 428,562 tests, 94.4% were NH White, 4.5% Asian and 1.1% HAPI. Overall, 46.8% were age 15-19. CT+ ranged from 5.0% for NH White to 6.7% Asian to 9.9% HAPI. In 2000-2006, unadjusted CT+ by race varied significantly: 4.4-5.2% for NH White; 7.5-6.1% for Asian; 9.4-11.2% for HAPI. After adjusting for age, test type, sexual risk behaviors and clinical findings, Asian (OR=1.23) and HAPI (OR=1.80) were at increased risk of CT compared to NH White.

Asian and HAPI women in Region X FP clinics had consistently higher levels of CT than NH White, even after adjusting for a wide range of factors. Significant CT differences were also found between Asian and HAPI women.

Findings confirm the importance of exploring racial/ethnic disparities in CT+, and analyzing data separately for Asian and HAPI women. They also support the need for better assessment of individual and community-level factors among Asian and HAPI women--including acculturation/generational issues--and support current interest in the role of sexual network dynamics.