School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and University Health Services, Administration and Campus Support Services, University of Nairobi, Nairobi, Kenya.
Department of Mathematics, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya.
Sex Health. 2023 Apr;20(2):105-117. doi: 10.1071/SH22114.
BACKGROUND: Young men who have sex with men (MSM) are a key population at high risk of sexually transmitted infections (STIs). We conducted a respondent-driven sampling (RDS) bio-behavioural survey to estimate the prevalence of five curable STIs: chlamydia, gonorrhoea, syphilis, trichomoniasis and Mycoplasma genitalium infection, and associated risk factors among tertiary student MSM (TSMSM) in Nairobi, Kenya. METHODS: Between February and March 2021, we recruited 248 TSMSM aged ≥18years who self-reported engaging in anal and/or oral sex with another man in the past year. Samples collected included urine, anorectal and oropharyngeal swabs for pooled Chlamydia trachomatis , Mycoplasma genitalium , Neisseria gonorrhoeae and Trichomonas vaginalis testing using multiplex nucleic acid amplification tests, and venous blood for serological Treponema pallidum screening and confirmation of current infection. Participants self-completed a behavioural survey on a REDCap digital platform. Data analysis was done using RDS-Analyst (v0.72) and Stata (v15). Differences in proportions were examined using the chi-squared (χ 2 ) test, and unweighted multivariate logistic regression was used to assess factors associated with STI prevalence. RESULTS: RDS-adjusted prevalence rates of at least one of the five STIs, chlamydia, gonorrhoea, Mycoplasma genitalium infection, trichomoniasis and latent syphilis were 58.8%, 51.0%, 11.3%, 6.0%, 1.5% and 0.7%, respectively. Factors independently associated with STI prevalence were inconsistent condom use (adjusted odds ratio (AOR)=1.89, 95% confidence interval (CI): 1.03-3.47, P =0.038) and the last sex partner being a regular partner (AOR=2.35, 95% CI: 1.12-4.92, P =0.023). CONCLUSION: STI prevalence among TSMSM in Nairobi, Kenya, is disturbingly high, demonstrating urgent need for tailored testing, treatment and prevention interventions for this population.
背景:男男性行为者(MSM)是性传播感染(STI)高危人群中的一个关键人群。我们进行了一项回应者驱动抽样(RDS)的生物行为调查,以估计五种可治愈的 STI(衣原体、淋病、梅毒、滴虫病和生殖支原体感染)在肯尼亚内罗毕的大学生男男性行为者(TSMSM)中的流行率,以及相关的危险因素。
方法:在 2021 年 2 月至 3 月期间,我们招募了 248 名年龄在 18 岁及以上的 TSMSM,他们自我报告在过去一年中与另一名男子进行了肛门和/或口腔性行为。收集的样本包括尿液、直肠和口腔拭子,用于使用多重核酸扩增试验检测沙眼衣原体、生殖支原体、淋病奈瑟菌和阴道毛滴虫的混合感染,以及静脉血进行梅毒血清学筛查和现症感染的确认。参与者使用 REDCap 数字平台自行完成行为调查。使用 RDS-Analyst(v0.72)和 Stata(v15)进行数据分析。使用卡方(χ 2 )检验检查比例差异,使用未加权多变量逻辑回归评估与 STI 流行率相关的因素。
结果:RDS 调整后的至少一种五种 STI(衣原体、淋病、生殖支原体感染、滴虫病和潜伏梅毒)的流行率分别为 58.8%、51.0%、11.3%、6.0%、1.5%和 0.7%。与 STI 流行率独立相关的因素是 condom 使用不一致(调整后的优势比(AOR)=1.89,95%置信区间(CI):1.03-3.47,P=0.038)和最近的性伴侣是固定伴侣(AOR=2.35,95% CI:1.12-4.92,P=0.023)。
结论:肯尼亚内罗毕 TSMSM 的 STI 流行率令人担忧地高,表明迫切需要为这一人群提供定制的检测、治疗和预防干预措施。
Ther Adv Reprod Health. 2024-12-19