Chitneni Pooja, Owembabazi Moran, Kanini Eunice, Mwima Simon, Bwana Mwebesa Bosco, Psaros Christina, Muyindike Winnie R, Haberer Jessica E, Matthews Lynn T
Division of General Internal Medicine and Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
Harvard Medical School, Boston, Massachusetts, United States of America.
PLOS Glob Public Health. 2024 Jan 30;4(1):e0002817. doi: 10.1371/journal.pgph.0002817. eCollection 2024.
Globally, over one million people acquire curable sexually transmitted infections (STI) each day. Understanding how people think about STIs is key to building culturally appropriate STI prevention and treatment programs. We explored STI knowledge and perceptions in rural, southwestern Uganda to inform future interventions. From August 2020 to December 2020, we conducted individual in-depth interviews among adult men and women (≥18 years) with recent or current personal or partner pregnancy, a history of an STI diagnosis and treatment, and membership in an HIV-sero-different relationship. Interviews explored STI knowledge, perceptions, and barriers and facilitators to engaging in STI care. We used inductive and deductive approaches to generate a codebook guided by the healthcare literacy skills framework in a thematic analysis. Ten men with STI, five of their female partners, eighteen women with STI, and four of their male partners participated in individual in-depth interviews. The median age was 41 (range 27-50) for men and 29 (range 22-40) for women. Sixteen (43%) participants were with HIV. Significant themes include: 1) Participants obtained STI knowledge and information from the community (friends, family members, acquaintances) and medical professionals; 2) While participants knew STIs were transmitted sexually, they also believed transmission occurred via non-sexual mechanisms. 3) Participants associated different connotations and amounts of stigma with each STI, for example, participants reported that syphilis was passed down "genetically" from parent to child. 4) Participants reported uncertainty about whether STIs affected pregnancy outcomes and whether antenatal STI treatment was safe. The complicated nature of STIs has led to understandable confusion in settings without formal sexual healthcare education. Robust counseling and education prior to sexual debut will help allow men and women to understand the signs, symptoms, and treatments necessary for STI cure and to navigate often complicated and overburdened healthcare systems.
在全球范围内，每天有超过100万人感染可治愈的性传播感染（STI）。了解人们对性传播感染的看法是建立符合文化背景的性传播感染预防和治疗项目的关键。我们在乌干达西南部农村地区探索了性传播感染的知识和认知，以为未来的干预措施提供信息。2020年8月至2020年12月，我们对成年男性和女性（≥18岁）进行了个人深入访谈，这些人近期或当前有个人或伴侣怀孕情况、有性传播感染诊断和治疗史，并且处于HIV血清学不同的关系中。访谈探讨了性传播感染的知识、认知以及参与性传播感染护理的障碍和促进因素。我们采用归纳和演绎方法，在主题分析中生成了一个以医疗保健素养技能框架为指导的编码手册。10名患有性传播感染的男性、他们的5名女性伴侣、18名患有性传播感染的女性以及他们的4名男性伴侣参与了个人深入访谈。男性的年龄中位数为41岁（范围27 - 50岁），女性为29岁（范围22 - 40岁）。16名（43%）参与者感染了艾滋病毒。重要主题包括：1）参与者从社区（朋友、家庭成员、熟人）和医疗专业人员那里获得性传播感染的知识和信息；2）虽然参与者知道性传播感染是通过性传播的，但他们也认为传播会通过非性机制发生。3）参与者将不同的耻辱内涵和程度与每种性传播感染联系起来，例如，参与者报告梅毒是从父母“遗传”给孩子的。4）参与者报告对性传播感染是否会影响妊娠结局以及产前性传播感染治疗是否安全存在不确定性。性传播感染的复杂性在没有正规性健康保健教育的环境中导致了可以理解的困惑。在首次性行为之前进行强有力的咨询和教育将有助于男性和女性了解性传播感染治愈所需的体征、症状和治疗方法，并应对通常复杂且负担过重的医疗保健系统。
