Factors associated with sexually transmitted infections among care-seeking adults in the African Cohort Study

Abstract

Objectives Sexually transmitted infections (STIs) are a major cause of morbidity. Understanding drivers of transmission can inform effective prevention programs. We describe STI prevalence and identify factors associated with STIs in four African countries. Methods The African Cohort Study is an ongoing, prospective cohort in Kenya, Nigeria, Tanzania and Uganda. At enrollment, a physical exam was conducted and STI diagnosis made by a clinician using a syndromic management approach. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for factors associated with an STI diagnosis. Results As of June 2020, 3544 participants were enrolled. STI prevalence was 7.7% and did not differ by HIV status (p = 0.30). Prevalence differed by syndrome (3.5% vaginal discharge, 1.5% genital ulcer, 2.1% lower abdominal pain, 0.2% inguinal bubo). The odds of having an STI were higher at all sites compared to Kisumu West, Kenya, and among those with a primary level education or below compared to those with secondary or higher (aOR: 1.77; 95% CI: 1.32–2.38). The odds of an STI diagnosis was higher among participants 18–29 years (aOR: 2.29; 95% CI: 1.35–3.87), females (aOR: 2.64; 95% CI: 1.94–3.59), and those with depression (aOR: 1.78; 95% CI: 1.32–2.38). Among PLWH, similar factors were independently associated with an STI diagnosis. Viral suppression was protective against STIs (aOR: 2.05; 95% CI: 1.32–3.20). Conclusions Prevalence of STIs varied by site with young people and females most at risk for STIs. Mental health is a potential target area for intervention.

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection and associated factors among asymptomatic pregnant women in Botswana

“…7 Younger age, lower education level, and unmarried as opposed to married relationship status have all been shown to be associated with increased STI risk in other studies. 6,9,17,21 Further, in our study, 41% of women in the testing arm were enrolled at Old Naledi Clinic which is located in a neighbourhood with poorer socioeconomic conditions, compared to the other recruitment sites. Although we could not compare income level with the previous studies conducted in Botswana, due to lack of income data reported, these social and economic factors could explain the higher STI prevalence observed in our study.…”

“…7 Younger age, lower education level, and unmarried as opposed to married relationship status have all been shown to be associated with increased STI risk in other studies. 6,9,17,21 Further, in our study, 41% of women in the testing arm were enrolled at Old Naledi Clinic which is located in a neighbourhood with poorer socioeconomic conditions, compared to the other recruitment sites.…”

Clinical factors and outcomes associated with immune non-response among virally suppressed adults with HIV from Africa and the United States

“…All AFRICOS participants received the standard of care associated with their PEPFAR-supported site. The details of this study, as well as the characteristics of each study site, have also been previously described 20 , 21 . The NHS has been approved centrally by the Uniformed Services University (USU) Institutional Review Board (IRB) and at each participating site.…”

Sexually transmitted infections related care-seeking behavior and associated factors among reproductive age women in East Africa: a multilevel analysis of demographic and health surveys

“…Several studies showed that health care-seeking behavior is affected or influenced by different factors like lack of money, distance from the health facility, age, educational status, residence, occupation, age at first sex, number of sexual partners, use of a condom, being tested for HIV, media exposure, wealth index cultural beliefs and practices are some of the identified factors which affect the health care seeking behavior of women [ 13 – 18 ].…”