P3.334 Social Geography of Diagnosed and Undiagnosed STIs: Preliminary Results

Abstract

Background Geographic propinquity affects the number and types of sexual partners available as well as sexual network connexions. Geographic location also affects the pervasiveness of STI screening and the availability of STI treatment. This presentation explores the geographic clustering of diagnosed and undiagnosed STIs and STI-risk factors in CityplaceBaltimore, StateMD. Methods The 2006–2009 Monitoring STIs Survey Program (MSSP) tracked trends in three STIs (trichomoniasis, chlamydia, gonorrhoea) in probability samples of the population ages 15 to 35 in CityplaceBaltimore, StateMD. 2,936 participants reported on previously diagnosed STIs and STI-risk behaviours, and 2,136 participants provided biospecimens for STI testing. Census tract codes and socio-demographic characteristics of these tracts were appended to the MSSP data. Investigators are exploring the social geography of the distribution of diagnosed and undiagnosed STIs and STI-risk factors using this database. Results Preliminary analyses suggest that: (1) the estimated prevalence of undiagnosed infections is elevated among Black respondents living in census tracts with high levels of median income; (2) the estimated prevalence of diagnosed infections is elevated among Black respondents living in census tracts with low levels of median income; (3) the estimated prevalence of undiagnosed infections among non-Blacks is highest among non-Blacks living in Census tracts with more than 80% Black residents; (4) the estimated prevalence of undiagnosed infection among Black women has a curvilinear relationship with the percentage of residents in a Census tract who are Black. (Higher infection prevalences are found in Census tracts with lower and higher proportions of Black residents.) Conclusion These results invite provocative conclusions. It appears, for example, that inadequate screening resources may be targeted on Black respondents residing in wealthier neighbourhoods resulting in an elevated prevalence of undiagnosed infection in this subpopulation. A rigorous examination of this and related preliminary results will be presented at the conference.