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. 2021 Apr 16;21(1):738.
doi: 10.1186/s12889-021-10762-4.

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

Michael Semwogerere  1 , Nicole Dear  2   3 , Joshua Tunnage  2 , Domonique Reed  2   3 , Hannah Kibuuka  1 , Francis Kiweewa  4 , Michael Iroezindu  2   5 , Emmanuel Bahemana  2   6 , Jonah Maswai  2   7   8 , John Owuoth  2   7   9 , Trevor A Crowell  2   3 , Julie A Ake  2 , Christina S Polyak  2   3 , Allahna Esber  10   11 ; AFRICOS Study Group
Collaborators, Affiliations

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

Michael Semwogerere et al. BMC Public Health. .

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.

Keywords: People living with HIV; Sexually transmitted infections; Sub-Saharan Africa.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

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