(P366) Pilot implementation of the National Service for C. trachomatis, N. gonorrhoeae, T. vaginalis, and M. genitalium molecular tests: Preliminary prevalence and Risk Factors Among Pregnant Women in Brazil

Background: Chlamydia trachomatis(CT), Neisseria gonorrhoeae(NG), Trichomonas vaginalis(TV), and Mycoplasma genitalium(MG) are not notifiable infections in Brazil. We assessed the preliminary prevalence and risk factors associated with CT/NG/MG/TV infection among pregnant women included in the pilot implementation of the National Service for molecular diagnosis of CT/NG/MG/TV.

Methods: We obtained Ministry of Health surveillance data from the pilot network encompassing pregnant women 15-49yo assisted in public antenatal clinics in the country. A vaginal swab specimen was collected from each participant using Aptima Collection Kit (HOLOGIC) and was shipped to the reference laboratory for testing using Aptima Assays(HOLOGIC) for CT/NG/MG/TV detection. Risk factors for being diagnosed with any pathogen were assessed regarding demographic, behavioral, and clinical data using logistic regression.

Results: Between January-December(2022), 2,591 pregnant women were assisted by the pilot network. The mean age was 27yr (Standard Deviation=6.7), the majority were black/brown(57.9%), 41.5% had eight years or more of formal education, and 75.9% reported family income < 4 minimum wages. Of the participants, 24.5% reported having first sexual intercourse < 15yo, and 61.8% had more than one sexual partner in lifetime. Most pregnant women were asymptomatic for any sexually transmitted infection (STI) (73.4%), 0.4% were HIV-positive, 2.2% and 1.1% reported having syphilis or other STI in the previous year, respectively. Around 20% had an abortion history. In this preliminary analysis, the national prevalence of CT infection was 10.0%(259), NG was 0.62%(16), MG was 7.8%(200), and TV was 6,9%(180). For any infection, the prevalence was 21.2% (549), with the highest and lowest prevalence in the Southeast (23.58%) and Center-West (15.4%) regions, respectively. Women with detection test for any pathogen were younger (15–24yo vs. 25-47yo) (AOR=1.87; 95%CI:1.53-2.29); reported not living maritally with their partners (AOR= 1.89, 95%CI:1.51-2.37), and had more than one sexual partner in lifetime (AOR=1.97, 95%CI: 1.45-2.71) (Table).

Conclusions: This first national combined screening for CT/NG/MG/TV infections in pregnant women in Brazil showed high prevalence. National surveillance data is necessary to support the development of public policies for STIs. Besides the importance of STI molecular testing implementation, the results also highlight the need to deliver strategies for STI prevention and sexual health education focusing on young people.