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埃塞俄比亚女性性工作者中性传播感染的决定因素:计数回归模型方法。

Determinants of sexually transmitted infections among female sex workers in Ethiopia: a count regression model approach.

机构信息

Ethiopian Public Health Institute, Addis Ababa, Ethiopia.

College of Natural Sciences, Wollo University, Dessie, Ethiopia.

出版信息

Front Public Health. 2023 Aug 4;11:1190085. doi: 10.3389/fpubh.2023.1190085. eCollection 2023.


DOI:10.3389/fpubh.2023.1190085
PMID:37601188
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10437068/
Abstract

BACKGROUND: Sexually transmitted infections (STIs) remain a major public health problem worldwide, with the burden of these infections being high among female sex workers (FSWs), who are often not aware of their infection status. This study aimed to determine the factors that are associated with the number of STIs among FSWs in Ethiopia. METHODS: A cross-sectional bio-behavioral study involving respondent-driven sampling (RDS) was conducted among 6,085 FSWs in 16 towns in Ethiopia. The hurdle Poisson regression model was fitted using STATA Version 16.2. The incident rate ratio and adjusted odds ratio with a 95% confidence interval were employed to show the strength and direction of the association. A -value of ≤0.05 was used as a threshold for statistical significance. RESULTS: At least one STI was identified in 1,444 (23.64%) of the FSWs. Age group 35-49 years [IRR = 2.32; 95% CI (1.43, 3.74)], forced first sex [IRR = 1.32; 95% CI (1.01, 1.74)], condom breakage [IRR = 1.32; 95% CI (1.01, 1.74)], and a history of depression [IRR = 1.55; 95% CI (1.12, 2.18)] increase the number of STIs. FSWs aged 25-34 years [AOR = 2.99; % CI (2.54, 3.52)] and 35 = 59 years [AOR = 8.05; % CI (6.54, 9.91)], who were selling sex for 5-10 years [AOR = 1.30; 95% CI (1.1, 1.55)], and above 11 years [AOR = 1.21; 95% CI (1.03, 1.43)] were more likely to get STIs. CONCLUSION: STIs are common in Ethiopia. The covariates age, educational status, monthly income, condom failure, age at the first sexual encounter, and long duration of sexual practice are significant predictors of STIs. Health interventions among FSWs need to include awareness generation about the prevention and control of STIs and address the determinants identified in this analysis.

摘要

背景:性传播感染(STIs)仍然是全球一个主要的公共卫生问题,这些感染的负担在性工作者(FSWs)中很高,她们通常不知道自己的感染状况。本研究旨在确定与埃塞俄比亚 FSWs 中的 STI 数量相关的因素。

方法:在埃塞俄比亚的 16 个城镇中,进行了一项涉及应答驱动抽样(RDS)的横断面生物行为研究,共纳入 6085 名 FSWs。使用 STATA 版本 16.2 拟合了障碍泊松回归模型。使用发病率比和调整后的优势比(95%置信区间)来显示关联的强度和方向。使用 ≤0.05 的 值作为统计学显著性的阈值。

结果:至少有一种 STI 在 1444 名(23.64%)FSWs 中被发现。年龄组 35-49 岁[IRR = 2.32;95%CI(1.43,3.74)]、被迫首次性行为[IRR = 1.32;95%CI(1.01,1.74)]、避孕套破裂[IRR = 1.32;95%CI(1.01,1.74)]和抑郁症病史[IRR = 1.55;95%CI(1.12,2.18)]会增加 STI 的数量。25-34 岁的 FSWs [AOR = 2.99;%CI(2.54,3.52)]和 35-59 岁的 FSWs [AOR = 8.05;%CI(6.54,9.91)],性交易年限为 5-10 年[AOR = 1.30;95%CI(1.1,1.55)]和 11 年以上[AOR = 1.21;95%CI(1.03,1.43)]更有可能感染 STIs。

结论:STIs 在埃塞俄比亚很常见。年龄、教育程度、月收入、避孕套失败、首次性行为年龄和性活动时间等协变量是 STIs 的重要预测因素。针对 FSWs 的卫生干预措施需要包括提高对 STIs 的预防和控制的认识,并解决本分析中确定的决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e34/10437068/250734086d23/fpubh-11-1190085-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e34/10437068/5d2f3221aedc/fpubh-11-1190085-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e34/10437068/d60a23282c0d/fpubh-11-1190085-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e34/10437068/250734086d23/fpubh-11-1190085-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e34/10437068/5d2f3221aedc/fpubh-11-1190085-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e34/10437068/d60a23282c0d/fpubh-11-1190085-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e34/10437068/250734086d23/fpubh-11-1190085-g0003.jpg

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[2]
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[4]
Female sex workers' perceptions, concerns and acceptability of OraQuick HIV self-test in Woldia town, North Wollo, Ethiopia: a qualitative study.

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[5]
Prevalence and Factors Associated With Sexually Transmitted Infections Among Women of Reproductive Age in Tanzania: A Cross-Sectional Analysis of National Data.

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[6]
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本文引用的文献

[1]
Respondent-driven sampling: Advantages and disadvantages from a sampling method.

Medwave. 2022-1-3

[2]
Global burden and trends of sexually transmitted infections from 1990 to 2019: an observational trend study.

Lancet Infect Dis. 2022-4

[3]
Seroprevalence and Associated Factors of Human Immunodeficiency Virus, , Hepatitis B Virus, and Hepatitis C Virus among Female Sex Workers in Dessie City, Northeast Ethiopia.

Biomed Res Int. 2021

[4]
Too many zeros and/or highly skewed? A tutorial on modelling health behaviour as count data with Poisson and negative binomial regression.

Health Psychol Behav Med. 2021-5-6

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A New Regression Model for the Analysis of Overdispersed and Zero-Modified Count Data.

Entropy (Basel). 2021-5-21

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Determinants and consequences of heavy episodic drinking among female sex workers in Ethiopia: A respondent-driven sampling study.

PLoS One. 2021

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Sexually transmitted infections and factors associated with risky sexual practices among female sex workers: A cross sectional study in a large Andean city.

PLoS One. 2021

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Count Data in Medical Research: Poisson Regression and Negative Binomial Regression.

Anesth Analg. 2021-5-1

[9]
Effectiveness of Respondent-Driven Sampling for Conducting Health Studies Among Undocumented Immigrants at a Time of Heightened Immigration Enforcement.

J Immigr Minor Health. 2022-2

[10]
HIV Prevalence, Risk Factors for Infection, and Uptake of Prevention, Testing, and Treatment among Female Sex Workers in Namibia.

J Epidemiol Glob Health. 2020-12

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