(P252) Prevalence of urogenital Mycoplasma genitalium and associated factors in a sample of US Army service members and their dependents

Background: Mycoplasma genitalium (MG) is an emerging cause of sexually transmitted infections (STIs). However, its burden is not well characterized in the US military, which is highly affected by STIs. The objective of these analyses was to examine the epidemiology of MG in a US Army population.

Methods: We conducted a cross-sectional analysis of data from personnel on active duty in the US Army and their medical beneficiaries upon enrollment in a trial of a group based STI/HIV behavioral intervention. Inclusion criteria included being age 18–30 years and having an STI diagnosis or a clinical indication for STI screening in the past 6 months. Urogenital MG infection was determined by nucleic acid amplification testing (NAAT) of voided urine. Additional STI screening included NAAT for Chlamydia trachomatis and Neisseria gonorrhoeae in urine, anorectal, and oropharyngeal specimens, and serology for Treponema pallidum. We used multivariable robust Poisson regression to compute adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) to assess associations with MG.

Results: Among 427 participants enrolled between November 2020 and December 2022, 94.9% were on active duty in the US Army. The median age was 23 years (interquartile range: 21-25), 60.9% were male, 40.3% were non-Hispanic (NH) Black, 57.6% had an education level of some college or higher, 71.7% were single, and 76.8% were heterosexual. Overall, 42 (9.9%) had a urine specimen positive for MG, of whom 13 (31.0%) had another concurrent bacterial STI. In the multivariable model, female sex (aPR 1.94, 95% CI: 1.10­­­–3.43), NH Black race/ethnicity (vs. NH White; aPR 2.34, 95% CI: 1.02–5.33), not attending college (aPR 1.81, 95% CI: 1.02–3.21), and not being in a committed relationship (aPR 3.53, 95% CI: 1.29–9.68) were associated with significantly higher prevalence of MG.

Conclusion: We documented a substantial burden of urogenital MG in a sample of US Army service members and their dependents, with disparities by sex and race/ethnicity. The associations with education level and relationship status emphasize the importance of examining underlying social and behavioral determinants, which may be amenable to targeted interventions to reduce the burden of MG in this population.