P441: If You Build It, They Will Come: Access, not Distance, Predicts STI testing among Genderqueer Adults.

Background: Compared to their cisgender counterparts, genderqueer adults have significantly higher rates of sexually transmitted infections (STIs). Screening guidelines suggest that sexually active genderqueer adults should be screened for STIs annually, yet those living in rural or under resourced areas may be less likely to do so. Methods: Using social media, 438 genderqueer adults were recruited from a five-state region in the mid-Atlantic United States. To participate, adults were required to be 18+ and identify as transgender, genderqueer, nonbinary, or as a gender different than their assigned sex at birth. Via an online survey in REDCap, participants were asked about their history of STI testing and access to routine healthcare. Using log binomial regression, we evaluated the relationship between access to routine healthcare and STI testing. Results: Among participants who had ever had sex (n=354), 50% lived in a rural county, the majority (84%) were aged 18-34, 74% identified as White, and 21% identified as Black. 39% reported being tested for STIs in the past year. 14% reported having no routine care provider, 8% reported having to travel 50+ miles to receive routine care, 13% reported travelling 25-49 miles, and 49% reported < 25 miles. Unadjusted and adjusted log binomial regression revealed that those without a routine care provider were significantly less likely to report STI testing compared to those who travel less than 25 miles. However, those who travel further (25-49,50+ miles) were not significantly different than those reporting a < 25-mile distance. Conclusion: Only participants who reported not having a routine healthcare provider were significantly less likely to have been tested for STIs, while distance to provider was not a significant predictor. These findings suggest that connecting genderqueer populations to routine healthcare providers is of critical importance, regardless of distance. Given the shortage of healthcare providers cognizant of transgender-specific needs in many areas, immediate efforts can be made to ensure that genderqueer adults are connected to healthcare in neighboring communities and regions. [ABSTRACT FROM AUTHOR]