O17.6 Risk factors for STI versus testing rates in a Dutch multicultural area: opportunities for increasing sexual health care accessibility?

Background We aimed to compare sexually transmitted infection (STI)-related risk profiles and STI testing rates by geographical area to determine areas for improvement of access to sexual health care (SHC). This could aid in optimizing and targeting interventions or service allocation. Methods Five-year (2015–2019) individual population registry data were used (15–45yr), and matched with laboratory-based chlamydia (CT) and gonorrhea (NG) testing data of general practitioners (GPs) and the only sexual health clinic (SH-CLIN) in the multicultural greater Rotterdam area, the Netherlands. CT/NG data were used as proxy for STI consultation. Per four-digit postal code (PC) area we calculated STI-related risk scores (based on age, non-western migratory background, education level and urbanization) and testing rates. Three PC clusters were identified: 1) high risk score with low testing rate; 2) high risk score with high testing rate; 3) low risk score, independently of testing rate. Multivariable logistic regression analysis was used to compare individual and area characteristics in cluster 1 and cluster 2. Results The greater Rotterdam area consists of approximately 525,000 residents between 15–45yr. Around 27,000 CT/NG tests per year were reported. The PC area testing rate ranged from 2.2 to 116.1 tests per 1,000 residents. Around 45% of all residents belonged to cluster 1 and 30% to cluster 2. Characteristics associated with individuals in cluster 1 are low education, Turkish, Moroccan, residing outside the dense urban area, living in less ethnic diverse area and more distant from both GP and SH-CLIN. Conclusion This study combines individual population data and data of the two main SHC providers. Several determinants are associated with high STI-related risk scores and low testing rates. The next step is to develop strategies to improve SHC access for this group. Opportunities for further exploration include for example GP education, community-based testing and service (re)allocation.