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

Background:
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.

Objective:
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.

Method:
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.

Result:
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.

Conclusion:
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.

Implications:
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.