Factors associated with sexually transmitted infections among care-seeking adults in the African Cohort Study
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
BMC public health
Abstract
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.
Description
Keywords
Sexually transmitted infections, Sub-Saharan Africa, People living with HIV
Citation
Semwogerere, M., Dear, N., Tunnage, J., Reed, D., Kibuuka, H., Kiweewa, F., ... & Esber, A. (2021). Factors associated with sexually transmitted infections among care-seeking adults in the African Cohort Study. BMC public health, 21(1), 1-11. https://doi.org/10.1186/s12889-021-10762-4