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. 2025 May 22;25(1):734.
doi: 10.1186/s12879-025-11138-4.

Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018-2024 demographic and health survey data

Getachew Teshale  1 , Melak Jejaw  2 , Kaleb Assegid Demissie  2 , Nebebe Demis Baykemagn  3 , Tirualem Zeleke Yehuala  3 , Jenberu Mekurianew Kelkay  4
Affiliations

Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018-2024 demographic and health survey data

Getachew Teshale et al. BMC Infect Dis. .

Abstract

Introduction: Sexually transmitted infections (STIs) represent a significant global public health concern, contributing substantially to illness and mortality, particularly in Sub-Saharan Africa (SSA). Women of reproductive age who initiated sexual intercourse at an early age are at high risk of acquiring STIs. However, comprehensive data on their care-seeking behaviors in SSA are lacking. This study determines the prevalence of STI-related care-seeking behavior and identifies associated factors among these women.

Method: This study utilized data from the most recent Demographic and Health Surveys (DHS) conducted in 22 SSA countries between 2018 and 2024. A weighted sample of 54,425 reproductive-age women who initiated sexual intercourse at an early age and reported STIs or related symptoms in the past year was analyzed. A multilevel mixed-effects logistic regression model identified individual and community-level factors, with statistical significance set at *p* < 0.05. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated.

Results: The pooled prevalence of STI-related care-seeking behavior among women initiated sexual intercourse at early age in SSA countries was 39.18% (95% CI: 33.25%, 45.03%). Multilevel analysis revealed significant associations with age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, community education, media exposure, and poverty.

Conclusion: STI-related care-seeking behavior remains lower in this population compared to other studies. Associated factors include age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, and community-level factors such as education, media exposure, and poverty. Public health efforts should prioritize socioeconomically disadvantaged women by strengthening counseling and awareness during cervical cancer screenings and antenatal visits. Policies to improve healthcare access and financial support for these women are essential.

Keywords: DHS; Early age sexual intercourse; Healthcare seeking; STI; Sub-Saharan.

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Conflict of interest statement

Declarations. Ethical consideration: Since we used secondary data and had no direct interaction with the study participants, ethical clearance was not required for this study. The DHS Study administered written informed consent to study participants. We submitted an online request to have permission to access the data. The data was obtained from the DHS program’s measure at http://www.dhsprogram.com .The details of the ethical approval for the DHS program make it possible to approve the download of survey data. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Prevalence of care seeking behavior for STI among women having early sexual intercourse in the sub-Saharan countries
See this image and copyright information in PMC

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References

    1. Workowski KA, Bolan GA. Control CfD, Prevention. Sexually transmitted diseases treatment guidelines, 2015. 2015. - PubMed
    1. Elendu C, Amaechi DC, Elendu ID, Elendu TC, Amaechi EC, Usoro EU, et al. Global perspectives on the burden of sexually transmitted diseases: A narrative review. Medicine. 2024;103(20):e38199. - PMC - PubMed
    1. Organization WH. Report on global sexually transmitted infection surveillance, 2018, Availlable at https://www.who.int
    1. Van Gerwen OT, Muzny CA, Marrazzo JM. Sexually transmitted infections and female reproductive health. Nat Microbiol. 2022;7(8):1116–26. - PMC - PubMed
    1. Shrier LA. Bacterial sexually transmitted infections: gonorrhea, chlamydia, pelvic inflammatory disease, and syphilis. Pediatric and adolescent gynecology. 5th ed. Philadelphia: Lippincott, Williams and Wilkins; 2005. pp. 565–614.