STI prevalence and associated factors among urban men in Pakistan.

OBJECTIVES

To measure the prevalence of selected sexually transmitted infections (STIs) among urban men in Pakistan and identify associated factors.

METHODS

A cross-sectional survey of 2400 urban men aged 16-45 years was carried out in six cities of Pakistan. Respondents were selected through a multistage systematic sampling design. After obtaining informed consent a structured behavioural questionnaire was administered. Blood and urine samples were also collected and tested for HIV (ELISA), HSV-2 (ELISA) syphilis (RPR and TPHA), chlamydia (PCR) and gonorrhoea (PCR).

RESULTS

Of the 2383 respondents whose results were received, 4.4% (n = 106) tested positive for at least one of the five STIs. The prevalence of the individual organisms was as follows: syphilis, 1.3%; HIV, 0.1%; HSV-2, 3.4%; gonorrhoea, 0.8% and chlamydia, no cases. City-wise, the highest prevalence was in Karachi (8.5%) followed by Lahore (5.3%), Faisalabad (4.0%) Quetta (4.3%), Rawalpindi (2.5%) and Peshawar (2.0%). At the univariate and multivariate level, older age, less schooling, and having more than four sexual partners were significantly associated with the presence of an STI. 92% of men who tested positive for any STI were asymptomatic.

CONCLUSIONS

HIV prevalence in Pakistan remains low, however, the emergence of genital herpes is a matter of concern as it could lead to a future conduit for HIV spread. Health education messages should target less educated segments of society and specifically advocate safe sex practices and early diagnosis.