Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
National Institute of Health, Maputo, Mozambique.
BMC Infect Dis. 2020 Aug 27;20(1):636. doi: 10.1186/s12879-020-05276-0.
Key populations - men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID) - are at high risk for sexually transmitted infections (STI) given their sexual risk behaviours along with social, legal and structural barriers to prevention, care and treatment services. The purpose of this secondary analysis is to assess the prevalence of self-reported STIs and to describe associated risk factors among participations of the first Biological Behavioural Surveillance (BBS) in Mozambique.
Responses from the first BBS surveys conducted in 2011-2014 were aggregated across survey-cities to produce pooled estimates for each population. Aggregate weighted estimates were computed to analyse self-reported STI prevalence. Unweighted pooled estimates were used in multivariable logistic regression to identify risk factors associated with self-reported STI.
The prevalence of self-reported STI was 11.9% (95% CI, 7.8-16.0), 33.6% (95% CI, 29.0-41.3), and 22.0% (95% CI, 17.0-27.0) among MSM, FSW and PWID, respectively. MSM who were circumcised, had HIV, reported drug use, reported receptive anal sex, and non-condom use with their last male partner had greater odds of STI self-report. STI-self report among FSW was associated with living in Beira, being married, employment aside from sex work, physical violence, sexual violence, drug use, access to comprehensive HIV prevention services, non-condom use with last client, and sexual relationship with a non-client romantic partner. Among PWID, risk factors for self-reported STI included living in Nampula/Nacala, access to HIV prevention services, and sex work.
The high-burden of STIs among survey participants requires integrated HIV and STI prevention, treatment, and harm reduction services that address overlapping risk behaviours, especially injection drug use and sex work. A robust public health response requires the creation of a national STI surveillance system for better screening and diagnostic procedures within these vulnerable populations.
由于性风险行为以及预防、护理和治疗服务方面存在社会、法律和结构性障碍，男男性行为者（MSM）、性工作者（FSW）和注射吸毒者（PWID）等重点人群面临较高的性传播感染（STI）风险。本二次分析旨在评估首次在莫桑比克进行的生物行为监测（BBS）参与者中自我报告的 STI 患病率，并描述相关的危险因素。
汇总了 2011-2014 年进行的首次 BBS 调查的回复，以产生每个群体的汇总估计值。对加权汇总估计值进行计算，以分析自我报告的 STI 患病率。使用未加权汇总估计值进行多变量逻辑回归，以确定与自我报告的 STI 相关的危险因素。
MSM、FSW 和 PWID 自我报告的 STI 患病率分别为 11.9%（95%CI，7.8-16.0）、33.6%（95%CI，29.0-41.3）和 22.0%（95%CI，17.0-27.0）。MSM 中，接受过割礼、感染 HIV、报告吸毒、报告接受肛交和与最近的男性性伴侣未使用安全套，自我报告 STI 的可能性更大。FSW 自我报告的 STI 与居住在贝拉、已婚、从事性工作以外的工作、身体暴力、性暴力、吸毒、获得全面的 HIV 预防服务、与最近的客户未使用安全套以及与非客户的浪漫伴侣发生性关系有关。PWID 中，自我报告 STI 的危险因素包括居住在楠普拉/纳卡拉、获得 HIV 预防服务和性工作。
调查参与者中 STI 负担沉重，需要综合的 HIV 和 STI 预防、治疗和减少伤害服务，以解决重叠的风险行为，特别是注射吸毒和性工作。强有力的公共卫生应对措施需要建立国家 STI 监测系统，以便在这些弱势群体中更好地进行筛查和诊断程序。
