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

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

1) Describe 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 in Region X FP clinics from 2000-2006. Trends 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.

Of 428,562 tests, 94.4% were NH White, 4.5% Asian and 1.1% HAPI. CT+ ranged from 5.0% for NH White to 6.7% Asian to 9.9% HAPI. 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 had consistently higher levels of CT than NH White, even after adjusting for other factors. Significant differences were also found between Asian and HAPI.

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 and support interest in the role of sexual networks.