Abstract
BackgroundIn the Netherlands, there are strong disparities in Chlamydia trachomatis (CT) prevalence between ethnic groups. The current study aims to identify whether socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior may explain differences in CT seroprevalence between ethnic groups.MethodsWe used 2011–2014 baseline data of the HELIUS (HEalthy LIfe in an Urban Setting) study, a multi-ethnic population-based cohort study in Amsterdam, the Netherlands, including participants from Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Moroccan and Turkish origin. For this analysis, we selected sexually active, heterosexual participants aged 18–34 years old. CT seroprevalence was determined using a multiplex serology assay. The CT seroprevalence ratios between different ethnicities are calculated and adjusted for potential indicators of socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior.ResultsThe study population consisted of 2001 individuals (52.8% female) with a median age of 28 years (IQR 24–31). CT seropositivity differed by ethnicities and ranged from 71.6% (African Surinamese), and 67.9% (Ghanaian) to 31.1% (Turkish). The CT seroprevalence ratio of African Surinamese was 1.72 (95% CI 1.43–2.06) and 1.52 (95% CI 1.16–1.99) of Ghanaian as compared to the Dutch reference group, after adjustment for socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior.ConclusionsIndicators of socioeconomic status, sexual risk behavior, and sexual health seeking behavior could not explain the higher CT seroprevalence among African Surinamese and Ghanaian residents of Amsterdam.
Highlights
In the Netherlands, there are strong disparities in Chlamydia trachomatis (CT) prevalence between ethnic groups
Short summary A multi-ethnic cohort in Amsterdam, the Netherlands, showed that the disparate Chlamydia trachomatis seroprevalence between ethnic groups was not explained by socioeconomic status, sexual healthcare seeking behavior and sexual behavior
We examined whether socioeconomic status (SES), sexual risk behavior (SRB) and sexual healthcare seeking behavior (sHSB) could explain the difference in heterosexual CT seroprevalence between ethnic groups in Amsterdam, the Netherlands
Summary
In the Netherlands, there are strong disparities in Chlamydia trachomatis (CT) prevalence between ethnic groups. The current study aims to identify whether socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior may explain differences in CT seroprevalence between ethnic groups. Evidence from several population-based and STI clinic studies in the Netherlands suggested that sexual healthcare seeking behavior (sHSB) may play an important role in explaining the ethnic differences in CT infection rates [4]. Especially asymptomatic, CT infections may be delayed by reduced sHSB, prolonging the time during which CT transmission is possible. This might lead to a higher CT prevalence in (sub)populations where members are characterized by low sHSB, high risk of CT infection, and have sex predominantly with members of the same group. In another study the uptake of CT screening tests was different between individuals with different ethnic backgrounds [4]
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