Department of Midwifery, Ambo University, Ambo, Ethiopia.
Departments of Midwifery, Hawassa University, Hawassa, Ethiopia.
BMC Public Health. 2020 Apr 3;20(1):434. doi: 10.1186/s12889-020-08584-x.
Lack of knowledge about sexual violence, its consequences, substance use and homelessness are major problems that make street dwellers susceptible to sexually transmitted diseases. Hence, this study assessed knowledge, attitudes and treatment-seeking behaviors related to sexually transmitted diseases among street dwellers in southern Ethiopia.
An explanatory sequential mixed-methods study design was conducted among 842 respondents. A simple random sampling technique was used to select seven cities among fourteen major cities of the region. The sample was allocated proportionally to each selected city. In order to identify and fill in the required sample size, a snowball sampling technique was used. A pre-tested and structured interviewer-administered questionnaire was used to collect quantitative data. The collected data were entered using Epidata and exported to SPSS version 23.0 for further analysis. Unstructured questionnaires were also used to collect 21 in-depth interviews and 10 key informants' interviews. Respondents for in-depth interviews were selected purposively during quantitative data collection.
Most street dwellers were aware of (86.7%) and had a favourable attitude towards (84.4%) prevention and management of sexually transmitted diseases. A portion of respondents experienced bad-smelling genital discharge (13.8%), genital ulcers (11.2%) and a burning sensation (14.5%) during urination, in the previous year. Among those who experienced symptoms of sexually transmitted disease, only 15.3% of them received treatment from a health care provider. Fear of questions raised by providers was one of the reasons for not seeking care according to our qualitative findings.
In this study, a significant number of street dwellers reported experiencing symptoms of a sexually transmitted disease. Despite having awareness about sexually transmitted diseases, seeking treatment from a health center was found to be low based on both quantitative and qualitative findings. We recommend that health care providers should undergo special training to address the sexual and reproductive health problems of street dwellers.
缺乏性暴力、其后果、物质使用和无家可归方面的知识是使街头居民易感染性传播疾病的主要问题。因此，本研究评估了埃塞俄比亚南部街头居民与性传播疾病相关的知识、态度和寻求治疗行为。
在 842 名受访者中进行了一项解释性顺序混合方法研究设计。采用简单随机抽样技术从该地区的 14 个主要城市中选择了 7 个城市。样本按比例分配给每个选定的城市。为了确定并填补所需的样本量，使用了滚雪球抽样技术。使用经过预测试和结构化访谈员管理的问卷收集定量数据。收集的数据使用 Epidata 输入，并导出到 SPSS 版本 23.0 进行进一步分析。还使用了非结构化问卷收集 21 次深入访谈和 10 次关键知情人访谈。在定量数据收集期间，有目的地选择了深入访谈的受访者。
大多数街头居民都意识到（86.7%）并对性传播疾病的预防和管理持有利态度（84.4%）。在过去一年中，一部分受访者经历了生殖器分泌物有异味（13.8%）、生殖器溃疡（11.2%）和排尿时烧灼感（14.5%）。在那些出现性传播疾病症状的人中，只有 15.3%的人从医疗保健提供者那里接受了治疗。根据我们的定性发现，害怕提供者提出的问题是他们不寻求治疗的原因之一。
在这项研究中，相当数量的街头居民报告说出现了性传播疾病的症状。尽管对性传播疾病有一定的认识，但根据定量和定性结果，发现从医疗中心寻求治疗的比例较低。我们建议医疗保健提供者应接受特殊培训，以解决街头居民的性健康和生殖健康问题。
