P171 From trial to program: TTANGO2 scale-up and implementation sustains STI point-of-care testing in regional and remote Australian Aboriginal health services

Abstract

Background Chlamydia is a major cause of infertility, but its epidemiology among women of reproductive age remains unclear in China. This study investigated the prevalence of chlamydia and associated factors among Chinese women aged 18-44 years who were either 1) pregnant; 2) attending gynaecology clinics; or 3) subfertile. Methods We conducted a cross-sectional survey and recruited participants from obstetrics, gynaecology, and infertility clinics in Guangdong, between March to December, 2019. We collected information on individuals' socio-demographic characteristics, previous medical conditions, and sexual behaviours. First-pass urine and cervical swabs were tested using nucleic acid amplification testing. We calculated the prevalence in each population and subgroup by age, education, and age at first sex. Multivariable binomial regression models were used to identify factors associated with chlamydia prevalence. Results We recruited 1730 participants, including 881 pregnant women, 595 gynaecology clinic attendees, and 254 subfertile women. The overall prevalence was 6.7% (95% Confidence Interval (CI): 5.2%-8.5%), 8.2% (95%CI:6.2%-10.7%), 5.9% (95%CI: 3.5%-9.3%) for the above three populations, respectively. The subgroup-specific prevalence was highest among those who first had sex before 25 years and older pregnant women (>35 years). The proportion of asymptomatic chlamydia was 85%, 40%, and 60% among pregnant women, gynaecology clinic attendees, and subfertile women, respectively. Age at first sex (<25 years), multipara, and ever having more than one partner increased the risk of chlamydia. Conclusion Women of reproductive age in China have a high prevalence of chlamydia. As most women with chlamydia were asymptomatic, routine chlamydia screening is urgently needed in China.