PT - JOURNAL ARTICLE AU - Alexiou, Zoïe Willemijn AU - van Aar, Fleur AU - Hoenderboom, Bernice Maria AU - Morre, Servaas Antonie AU - Heijne, Janneke Cornelia Maria TI - Trends in <em>Chlamydia trachomatis</em> IgG seroprevalence in the general population of the Netherlands over 20 years AID - 10.1136/sextrans-2023-055888 DP - 2024 Feb 01 TA - Sexually Transmitted Infections PG - 31--38 VI - 100 IP - 1 4099 - http://sti.bmj.com/content/100/1/31.short 4100 - http://sti.bmj.com/content/100/1/31.full SO - Sex Transm Infect2024 Feb 01; 100 AB - Objectives To report sex and age-specific Chlamydia trachomatis (Ct) seroprevalence estimates in the general population of the Netherlands between 1996 and 2017 and identify risk factors associated with Ct seropositivity.Methods Participants (n=5158, aged 15–59 years) were included from three independent nationwide population-based serosurveillance studies in 1996, 2007 and 2017. Participants completed a questionnaire on demographics and sexual behaviour. Serum antibodies were analysed using Medac Ct IgG ELISA test. Census weights were assigned to achieve seroprevalence estimates representative of the general Dutch population. Weighted seroprevalence estimates were stratified by gender, age and birth cohort. Trends and risk factors in men and women were identified using multivariable logistic regression.Results Weighted overall Ct seroprevalence was 10.5% (95% CI: 9.2% to 12.0%) in women and 5.8% (95% CI: 4.7% to 7.0%) in men. Among women &lt;25 years, there was a non-significant increase in seroprevalence from 5.9% (95% CI 3.7% to 9.2%) in 1996, to 7.6% (95% CI 5.1% to 11.1%) in 2007 and 8.8% (95% CI 5.5% to 13.9%) in 2017. Among women ≥25 years, the seroprevalence significantly decreased from 15.6% (95% CI: 12.2% to 19.7%) in 1996 to 9.5% (95% CI: 7.2% to 12.4%) in 2007 but did not further drop (11.2% (95% CI 8.1% to 15.3%) in 2017). In men, we did not observe trends between study rounds. In both men and women, having a non-Western migration background was a risk factor for seropositivity. In women, having had a prior sexually transmitted infection and ≥2 recent sex partners were risk factors for seropositivity as well.Conclusions We have not found evidence for a decrease in population seroprevalence in those under 25 years old despite decades of intensified testing-and-treatment efforts in the Netherlands. This suggests further monitoring of Ct burden in the general population is needed. If serum banks are used for this, specifically individuals &lt;25 years old and with diverse migration backgrounds should be included.Data are available upon reasonable request.