Differences in Chlamydia trachomatis seroprevalence between ethnic groups cannot be fully explained by socioeconomic status, sexual healthcare seeking behavior or sexual risk behavior: a cross-sectional analysis in the HEalthy LIfe in an Urban Setting (HELIUS) study

BMC Infect Dis. 2018 Dec 3;18(1):612. doi: 10.1186/s12879-018-3533-7.


Background: In the Netherlands, there are strong disparities in Chlamydia trachomatis (CT) prevalence between ethnic groups. The current study aims to identify whether socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior may explain differences in CT seroprevalence between ethnic groups.

Methods: We used 2011-2014 baseline data of the HELIUS (HEalthy LIfe in an Urban Setting) study, a multi-ethnic population-based cohort study in Amsterdam, the Netherlands, including participants from Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Moroccan and Turkish origin. For this analysis, we selected sexually active, heterosexual participants aged 18-34 years old. CT seroprevalence was determined using a multiplex serology assay. The CT seroprevalence ratios between different ethnicities are calculated and adjusted for potential indicators of socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior.

Results: The study population consisted of 2001 individuals (52.8% female) with a median age of 28 years (IQR 24-31). CT seropositivity differed by ethnicities and ranged from 71.6% (African Surinamese), and 67.9% (Ghanaian) to 31.1% (Turkish). The CT seroprevalence ratio of African Surinamese was 1.72 (95% CI 1.43-2.06) and 1.52 (95% CI 1.16-1.99) of Ghanaian as compared to the Dutch reference group, after adjustment for socioeconomic status, sexual risk behavior and sexual healthcare seeking behavior.

Conclusions: Indicators of socioeconomic status, sexual risk behavior, and sexual health seeking behavior could not explain the higher CT seroprevalence among African Surinamese and Ghanaian residents of Amsterdam.

Keywords: Chlamydia trachomatis; Ethnicity; Sexual healthcare seeking behavior; Sexual risk behavior; Socioeconomic status.

MeSH terms

  • Adolescent
  • Adult
  • Asia / ethnology
  • Chlamydia Infections / blood
  • Chlamydia Infections / epidemiology*
  • Chlamydia Infections / ethnology
  • Chlamydia trachomatis* / immunology
  • Chlamydia trachomatis* / isolation & purification
  • Cohort Studies
  • Cross-Sectional Studies
  • Ethnicity / statistics & numerical data*
  • Female
  • Ghana / ethnology
  • Health Behavior* / ethnology
  • Heterosexuality / statistics & numerical data
  • Humans
  • Male
  • Morocco / ethnology
  • Netherlands / epidemiology
  • Risk-Taking*
  • Seroepidemiologic Studies
  • Sexual Behavior* / ethnology
  • Sexual Behavior* / statistics & numerical data
  • Social Class
  • Suriname / ethnology
  • Turkey / ethnology
  • Urban Population / statistics & numerical data*
  • Young Adult