O15.5 Prevalence and risk factors for chlamydia and gonorrhea among transgender women in 2019–20 in São Paulo, Brazil

Transgender women (TGW) in Brazil are disproportionately affected by HIV, but knowledge about others STIs is scarce. We estimated the prevalence of chlamydia and gonorrhea infections and investigated risk factors associated with infection in TGW in São Paulo, a part of a national survey. TransOdara is a cross-sectional study which included TGW ≥ 18 years, recruited at CRT DST/AIDS in São Paulo, Brazil, from December 2019-October 2020. Participants were recruited from an ongoing cohort study, originally assembled using RDS. A structured interview collecting socio-demographic and behavioral information was followed by triple-anatomical site STI testingand an HIV test. Risk factors were assessed using multivariable logistic regression. The study was supported by Brazilian MOH and PAHO. 403 TGW participated; 52.1% were aged 18–33 years; mean 34.4 (SD ±9.6); 57.6% had ≥ 12 years of formal education; 70% identified as black/mixed race; 25.8% declared sex work as main source of income and 48.1% that their monthly income was below or equal to the Brazilian minimum wage. Prevalence of chlamydia and gonorrhea was, respectively, 10.2% (41/403) and 8.2% (33/403); coinfection was 2.4% (10/403). Most TGW testing positive had anal infections: 90.2% for chlamydia and 66.7%, gonorrhea. Prevalence of chlamydia or gonorrhea was slightly higher among individuals living with HIV (18% vs 15% among HIV-negative individuals, OR 1.21; 95% CI 0.67 – 2.19). After adjusting for schooling, sex work as main source of income, and monthly income, young age remained a risk factor for a chlamydia (aOR 2.78; 95% CI 1.34 – 5.74) and gonorrhea (aOR 2.21; 95% CI 1.02 – 4.79) diagnosis. Chlamydia and gonorrhoea prevalence is high among Brazilian TGW, especially amongst the young. Comprehensive care and prevention programs, including sexual education and screening polices directed at TGW are urgently needed to reduce STI burden and to interrupt STI/HIV transmission.