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Background Human Papillomavirus (HPV) is common and is linked to cancer in both males and females. Efforts are underway to increase uptake of the vaccine (Gardasil) that is now recommended for youth and adults up to age 45. However, little is known about the role of gender identify on vaccination, particularly among youth at increased risk for contracting and spreading the virus. Methods We analyzed data (N=1070) from a longitudinal study of high-risk HIV negative youth and youth living with HIV aged 12–24. Data were collected in Los Angeles, CA and New Orleans, LA from clinic and community settings. We examined self-reports of HPV vaccination as well as predictors of vaccination. Results Cis-gender females (CGFs) had the highest proportion of youth reporting vaccination (52.7%) followed by transgender youth (45.9%), gender non-conforming youth (44.2%), and MSM (39.0%). Cis-gendered, heterosexual males (CGHMs) reported the lowest proportion (32.9%). However, 18.8% of youth did not know if they had received the vaccine. In our multivariate logistic model examining predictors of vaccination, gender identity was only significant for CGHMs. Other significant variables included age, some education higher than a high school diploma or completing higher education compared to less than high school, ever being tested for Hepatitis C, currently having a healthcare provider, always using condoms, and Latino or other race/ethnicity compared to African-American. Conclusion Results suggest that despite national efforts to increase the uptake of the vaccine, many youth at high-risk for HPV have not received it or did not know if they had. CGFs appear to have the highest uptake, but CGMs are a group for whom increased efforts targeting vaccination are needed. Demographic and health care factors may also impact vaccination rates. Research is needed on barriers to vaccination and new interventions that go beyond education and promotion such as policy initiatives. Disclosure No significant relationships.

Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) disproportionately affect adolescents, however, many adolescents receive infrequent sexually transmitted infection (STI) testing. Gay, bisexual, transgender, and homeless youth are at increased risk for STIs. Currently, the Centers for Disease Control and Prevention recommend only annual screening of CT/NG for all sexually active gay, bisexual, and other men who have sex with men (MSM). Methods We recruited adolescents aged 12–24 years from homeless shelters, lesbian, gay, bisexual, transgender, and queer (LGBTQ) organizations, and community health centers in Los Angeles, California and New Orleans, Louisiana from May 2017-January 2019. All participants received point-of-care pharyngeal, rectal, and urethral/vaginal CT/NG testing using the Cepheid GeneXpert (Sunnyvale, CA). We measured the proportion of participants with CT/NG infections every 4 months for 12 months. We compared the proportion of STI positivity at each time point to the baseline visit using a McNemar’s test. Results Overall, 156 participants received testing (53 MSM/transgender women, 56 heterosexual men, 47 heterosexual women). Baseline prevalence of CT/NG among MSM and transgender women was 18.9%. At the 4 month visit, prevalence was 5.7% (Δ = 13.2%, P-value = 0.04). At the 8 month visit, prevalence was 15.1% (Δ = 3.8%, P-value = 0.99). At the 12 month visit, prevalence of CT/NG was 3.8%, a 15.1% decrease from baseline (P-value = 0.02). There was no significant difference in prevalence among heterosexual men between their baseline visit (5.4%) and their 12-month visit (8.9%) (Δ = 3.5%, P-value = 0.82). There was no significant difference in prevalence among heterosexual women between their baseline visit (10.6%) and their 12-month visit (8.5%) (Δ = 2.1%, P-value = 0.99). Conclusion Providing regular testing among adolescent MSM and transgender women may be beneficial in reducing the prevalence of CT/NG infections. Reasons for failure to reduce prevalence among heterosexual men and women require further study. Disclosure No significant relationships.