Barriers and Facilitators of Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya: A Qualitative Study

Abstract

ObjectiveYoung women bear the greatest burden of sexually transmitted infections (STIs), so it is important to identify and address barriers to STI screening in this population. We conducted a qualitative study to explore the feasibility of STI screening among adolescent girls and young women in Mombasa, Kenya.MethodsWe conducted 17 in-depth interviews (IDIs) (8 with adolescent girls and 9 with young women) and 6 focus group discussions (FGDs) (4 with adolescent girls and 2 with young women, total 55 participants). The audio recordings for the IDIs and FGDs were translated and transcribed into English. Transcripts were independently reviewed by two researchers, and a set of codes was designed to help analyze the data using the content analysis approach. Data content was then analyzed manually and digitally using ATLAS.ti, and consensus was reached on central and specific emergent themes discussed by the research team.ResultsAdolescent girls and young women in Mombasa, Kenya expressed willingness to participate in STI screening. A major incentive for screening was participants’ desire to know their STI status, especially following perceived high-risk sexual behavior. Lack of symptoms and fear of positive test results were identified as barriers to STI screening at the individual level, while parental notification and stigmatization from parents, family members and the community were identified as barriers at the community level. Uncomfortable or embarrassing methods of specimen collection were an additional barrier. Thus, urine-based screening was felt to be the most acceptable.ConclusionKenyan adolescent girls and young women seem willing to participate in screening for STIs using urine testing. Addressing stigmatization by parents, health care workers and the community could further facilitate STI screening in this population.

Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya: Feasibility, Prevalence, and Correlates

“…However, due to confidentiality concerns, girls participating in this formative work felt strongly that they would prefer to receive services at the clinic. 14 …”

“…14 At the beginning of the STI screening phase, study staff visited the institutions to introduce the study and answer questions from students. After these information sessions, interested students were given the informed assent/consent forms to take home.…”

Sexually Transmitted Infections in the PReP Era. Are Family Doctors Ready to Give Advice?

“…As Avuvika et al [19], sexually transmitted infections (STIs) represent a public health concern due to their wide distribution and potential to lead to serious health conditions. STIs are preventable, diagnosable, and treatable.…”

Self-Sampling Interventions for Sexually Transmitted Infections in Women: A Scoping Review Protocol

“…However, asymptomatic infections remain undiagnosed and untreated (10). Other barriers include stigmatization and judgement associated with issues of sexual ill-health (8,20). Moreover, some women nd invasive genital examinations embarrassing and uncomfortable and as such procrastinate seeking medical assistance, and as such risk disease complications (11,14).…”

“…The challenge with syndromic management is that asymptomatically infected individuals are often missed and excluded. Other challenges include procrastination and reluctance of individuals to seek medical assistance due to social stigma; attitudes and perceptions associated with STIs; and discomfort of pelvic examinations (6,8,13). Furthermore, in resource-limited settings where access to healthcare facilities is limited, this approach places these populations at a disadvantage (6).…”