Semwogerere Michael, Dear Nicole, Tunnage Joshua, Reed Domonique, Kibuuka Hannah, Kiweewa Francis, Iroezindu Michael, Bahemana Emmanuel, Maswai Jonah, Owuoth John, Crowell Trevor A, Ake Julie A, Polyak Christina S, Esber Allahna
Makerere University Walter Reed Project, Kampala, Uganda.
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
BMC Public Health. 2021 Apr 16;21(1):738. doi: 10.1186/s12889-021-10762-4.
Sexually transmitted infections (STIs) are a major cause of morbidity. Understanding drivers of transmission can inform effective prevention programs. We describe STI prevalence and identify factors associated with STIs in four African countries.
The African Cohort Study is an ongoing, prospective cohort in Kenya, Nigeria, Tanzania and Uganda. At enrollment, a physical exam was conducted and STI diagnosis made by a clinician using a syndromic management approach. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for factors associated with an STI diagnosis.
As of June 2020, 3544 participants were enrolled. STI prevalence was 7.7% and did not differ by HIV status (p = 0.30). Prevalence differed by syndrome (3.5% vaginal discharge, 1.5% genital ulcer, 2.1% lower abdominal pain, 0.2% inguinal bubo). The odds of having an STI were higher at all sites compared to Kisumu West, Kenya, and among those with a primary level education or below compared to those with secondary or higher (aOR: 1.77; 95% CI: 1.32-2.38). The odds of an STI diagnosis was higher among participants 18-29 years (aOR: 2.29; 95% CI: 1.35-3.87), females (aOR: 2.64; 95% CI: 1.94-3.59), and those with depression (aOR: 1.78; 95% CI: 1.32-2.38). Among PLWH, similar factors were independently associated with an STI diagnosis. Viral suppression was protective against STIs (aOR: 2.05; 95% CI: 1.32-3.20).
Prevalence of STIs varied by site with young people and females most at risk for STIs. Mental health is a potential target area for intervention.
性传播感染（STIs）是发病的主要原因。了解传播驱动因素可为有效的预防计划提供依据。我们描述了四个非洲国家的性传播感染患病率，并确定与性传播感染相关的因素。
非洲队列研究是在肯尼亚、尼日利亚、坦桑尼亚和乌干达正在进行的一项前瞻性队列研究。在入组时，进行了体格检查，临床医生采用症状管理方法进行性传播感染诊断。多变量逻辑回归用于估计与性传播感染诊断相关因素的调整比值比（aORs）和95%置信区间（95% CIs）。
截至2020年6月，共有3544名参与者入组。性传播感染患病率为7.7%，在艾滋病毒感染状态方面无差异（p = 0.30）。患病率因综合征而异（阴道分泌物3.5%，生殖器溃疡1.5%，下腹部疼痛2.1%，腹股沟淋巴结炎0.2%）。与肯尼亚基苏木西部相比，所有地点感染性传播感染的几率更高；与接受过中等或更高教育的人相比，小学及以下教育水平的人感染性传播感染的几率更高（aOR：1.77；95% CI：1.32 - 2.38）。18 - 29岁的参与者（aOR：2.29；95% CI：1.35 - 3.87）、女性（aOR：2.64；95% CI：1.94 - 3.59）以及患有抑郁症的人（aOR：1.78；95% CI：1.32 - 2.38）性传播感染诊断的几率更高。在艾滋病毒感染者中，类似因素与性传播感染诊断独立相关。病毒抑制可预防性传播感染（aOR：2.05；95% CI：1.32 - 3.20）。
性传播感染患病率因地点而异，年轻人和女性感染性传播感染的风险最高。心理健康是一个潜在的干预目标领域。
