Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
BMC Public Health. 2020 Dec 7;20(1):1884. doi: 10.1186/s12889-020-09996-5.
Despite the importance of self-reporting health in sexually transmitted infections (STIs) control, studies on self-reported sexually transmitted infections (SR-STIs) are scanty, especially in sub-Saharan Africa (SSA). This study assessed the prevalence and factors associated with SR-STIs among sexually active men (SAM) in SSA.
Analysis was done based on the current Demographic and Health Survey of 27 countries in SSA conducted between 2010 and 2018. A total of 130,916 SAM were included in the analysis. The outcome variable was SR-STI. Descriptive and inferential statistics were performed with a statistical significance set at p < 0.05.
On the average, the prevalence of STIs among SAM in SSA was 3.8%, which ranged from 13.5% in Liberia to 0.4% in Niger. Sexually-active men aged 25-34 (AOR = 1.77, CI:1.6-1.95) were more likely to report STIs, compared to those aged 45 or more years. Respondents who were working (AOR = 1.24, CI: 1.12-1.38) and those who had their first sex at ages below 20 (AOR = 1.20, CI:1.11-1.29) were more likely to report STIs, compared to those who were not working and those who had their first sex when they were 20 years and above. Also, SAM who were not using condom had higher odds of STIs (AOR = 1.35, CI: 1.25-1.46), compared to those who were using condom. Further, SAM with no comprehensive HIV and AIDS knowledge had higher odds (AOR = 1.43, CI: 1.08-1.22) of STIs, compared to those who reported to have HIV/AIDS knowledge. Conversely, the odds of reporting STIs was lower among residents of rural areas (AOR = 0.93, CI: 0.88-0.99) compared to their counterparts in urban areas, respondents who had no other sexual partner (AOR = 0.32, CI: 0.29-0.35) compared to those who had 2 or more sexual partners excluding their spouses, those who reported not paying for sex (AOR = 0.55, CI: 0.51-0.59) compared to those who paid for sex, and those who did not read newspapers (AOR = 0.93, CI: 0.86-0.99) compared to those who read.
STIs prevalence across the selected countries in SSA showed distinct cross-country variations. Current findings suggest that STIs intervention priorities must be given across countries with high prevalence. Several socio-demographic factors predicted SR-STIs. To reduce the prevalence of STIs among SAM in SSA, it is prudent to take these factors (e.g., age, condom use, employment status, HIV/AIDS knowledge) into consideration when planning health education and STIs prevention strategies among SAM.
尽管自我报告的健康状况在性传播感染（STI）控制中非常重要，但关于性传播感染（SR-STI）的自我报告的研究却很少，尤其是在撒哈拉以南非洲（SSA）。本研究评估了 SSA 中活跃性伴侣（SAM）的 SR-STI 的流行率及其相关因素。
分析基于 2010 年至 2018 年期间在 SSA 进行的当前人口与健康调查。共有 130916 名 SAM 被纳入分析。结局变量为 SR-STI。采用具有统计学意义的 p < 0.05 进行描述性和推断性统计分析。
SSA 中 SAM 的 STI 患病率平均为 3.8%，范围从利比里亚的 13.5%到尼日尔的 0.4%。与年龄在 45 岁或以上的 SAM 相比，年龄在 25-34 岁的 SAM（AOR = 1.77，CI：1.6-1.95）更有可能报告 STI。与未工作的 SAM 相比，从事工作的 SAM（AOR = 1.24，CI：1.12-1.38）和首次性行为发生在 20 岁以下的 SAM（AOR = 1.20，CI：1.11-1.29）更有可能报告 STI。与使用避孕套的 SAM 相比，未使用避孕套的 SAM 更有可能发生 STI（AOR = 1.35，CI：1.25-1.46）。此外，与报告具有 HIV/AIDS 知识的 SAM 相比，对 HIV/AIDS 知识缺乏全面了解的 SAM 发生 STI 的可能性更高（AOR = 1.43，CI：1.08-1.22）。相反，与城市地区的 SAM 相比，农村地区的 SAM 报告 STI 的可能性较低（AOR = 0.93，CI：0.88-0.99），与报告有 2 个或更多性伴侣（不包括配偶）的 SAM 相比，性伴侣较少的 SAM （AOR = 0.32，CI：0.29-0.35）更有可能报告 STI。与支付性行为费用的 SAM 相比，不支付性行为费用的 SAM（AOR = 0.55，CI：0.51-0.59）更有可能报告 STI，与阅读报纸的 SAM 相比，不阅读报纸的 SAM（AOR = 0.93，CI：0.86-0.99）更有可能报告 STI。
SSA 选定国家的 STI 流行率显示出明显的国家间差异。目前的研究结果表明，必须在高流行率国家优先考虑 STI 干预措施。一些社会人口因素预测了 SR-STI。为了降低 SSA 中 SAM 的 STI 流行率，在规划 SAM 的健康教育和 STI 预防策略时，应考虑这些因素（例如年龄、避孕套使用、就业状况、HIV/AIDS 知识）。
