Baseline STD prevalence in a community intervention trial of the female condom in Kenya

Abstract

Objective: We present baseline sexually transmitted disease (STD) prevalence rates from an ongoing intervention trial at Kenyan agricultural sites. Methods: After gaining the cooperation of management, we identified six matched pairs of tea, coVee, and flower plantations and enrolled approximately 160 women at each site. Six intervention sites received an information programme and distributed female and male condoms, while six control sites received male condoms only and similar information about them. At clinic visits, we tested participants for cervical gonorrhoea (GC) and Chlamydia trachomatis (CT) by ligase chain reaction on urine specimens, and Trichomonas vaginalis (TV) by culture. The study has 80% power to detect a 10% prevalence diVerence during follow up, assuming a combined STD prevalence of 20%, 25% loss to follow up and intracluster correlation coeYcient (ICC) of 0.03. Results: Participants at intervention and control sites (total 1929) were similar at baseline. Mean age was 33 years, the majority were married, more than half currently used family planning, 78% had never used male condoms, and 9% reported more than one sexual partner in the 3 months before the study. Prevalences of GC, CT, and TV were 2.6%, 3.2%, and 20.4% respectively (23.9% overall), and were similar at intervention and control sites. The ICC for STD prevalence was 0.0011. Baseline STD was associated with unmarried status, non-use of family planning, alcohol use, and more than one recent sexual partner, but the highest odds ratio was 1.5. Conclusions: Baseline results confirm a high prevalence of trichomoniasis and bacterial STD at these Kenyan rural sites. Improved STD management is urgently needed there. Our ongoing female condom intervention trial is feasible as designed. (Sex Transm Inf 2000;76:454-456)

Aetiology of sexually transmitted infections and response to syndromic treatment in southwest Uganda

“…12 Even this figure from the Masaka Intervention Trial is low compared with other reports from the region: 3.8% in a population based study in the Rakai district of Uganda 15 ; 9% in a clinic population in Nairobi, Kenya 28 ; and 3.2% in a study of women recruited from agricultural plantations in western Kenya. 29 The prevalence of NG was 7% in women with FGD compared with 0.9% in 13-39 year olds in Masaka District. 12 This is within range of other studies: 1.6% in a population based study in the Rakai district of Uganda 15 to 7% in a Nairobi clinic population.…”

Alcohol Use and Sexual Risks for HIV/AIDS in Sub-Saharan Africa: Systematic Review of Empirical Findings

“…Sexually transmitted infection (STI) clinic patients who are also at high risk for HIV commonly report drinking before sex (Simbayi et al, 2004a). Alcohol use is also associated with testing positive for an STI among women employed in Kenyan plantations (Feldblum et al, 2000), and daily alcohol use predicts incident STI diagnoses among Kenyan commercial sex workers (Yadav et al, 2005).…”

Treatment outcomes of a stage 1 cognitive–behavioral trial to reduce alcohol use among human immunodeficiency virus‐infected out‐patients in western Kenya

“…Alcohol use displays a dose-response association with imperfect adherence to antiretrovirals (ARVs) (6), with comorbid medical diseases and AIDS-defining conditions (7) and has been associated with increased risk of unprotected sex (8;9). In Kenya, alcohol use correlates with HIV infection (10;11) and with risk of sexually transmitted infections (12;13). There is growing evidence in both the U.S. and Africa that heavy drinking limits the success of HIV prevention efforts (14–16).…”