医疗保健利用和性传播感染治疗寻求：乌干达维多利亚湖难以接触的渔业社区的一项混合方法横断面调查。

Healthcare use and sexually transmitted infections treatment-seeking: a mixed methods cross-sectional survey among hard-to-reach fishing communities of Lake Victoria, Uganda.

机构信息

Uganda Virus Research Institute (UVRI), International AIDS Vaccine Initiative (IAVI), HIV Vaccine Program Limited, Entebbe, Uganda.

Human Vaccines Project, New York, United States of America.

出版信息

Pan Afr Med J. 2024 Jul 24;48:134. doi: 10.11604/pamj.2024.48.134.27244. eCollection 2024.

DOI:10.11604/pamj.2024.48.134.27244

PMID:39554263

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11567908/

Abstract

INTRODUCTION

Uganda´s fishing communities experience a high burden of sexually transmitted infections (STIs) including human immunodeficiency virus (HIV), with limited access to healthcare. Knowledge on healthcare use and treatment seeking will help identify unmet needs and facilitate appropriate allocation of resources.

METHODS

between 2014-2015, a mixed methods cross-sectional survey was conducted in four fishing communities on Lake Victoria, Uganda, as part of preparedness for HIV trials. The goal was to understand health problems (having any illness, medical condition, or injury in the past 12 months), perceptions of healthcare, health services use, and factors associated with seeking STI care. Data were collected from participants aged 13-49 years; quantitatively using a structured questionnaire and qualitatively via focus group discussions (FGDs) and key informant interviews (KIIs). Information covered recent health problems, health services use, and healthcare perceptions. Multivariable logistic regression modeling was used to determine factors associated with seeking care for STIs.

RESULTS

participants´ median (interquartile range) age was 29 (23-35) years, more than half (51.9%, 763/1,469), were females, and the majority (60.4%, 888/1,469) had up to seven years of formal education. Most participants reported having had health problems (76%, 1,117/1,469). The most frequently reported health issues were STI symptoms (52.6%, 587/1,117). Lack of health services was mentioned as one of the reasons for not seeking care during the FDGs and KIIs. Adolescents, 13-19 were less likely to seek care for STIs symptoms than adults of 20 or more years (aOR= 0.5 (95% CI 0.3-0.9)). Females were more likely to seek STI treatment (aOR= 1.4 (95% CI 1.0-2.1)), as were participants who worked mainly in bars, restaurants or lodges (aOR= 2.0 (95% CI 1.1-3.6)).

CONCLUSION

in these communities, adolescents have low treatment seeking for STIs symptoms.

摘要

引言

乌干达的渔业社区感染性传播疾病（STIs）的负担很重，包括人类免疫缺陷病毒（HIV），但获得医疗保健的机会有限。了解医疗保健的使用和治疗寻求情况将有助于确定未满足的需求，并促进资源的合理分配。

方法

2014-2015 年，在乌干达维多利亚湖的四个渔业社区进行了一项混合方法的横断面调查，这是 HIV 试验准备工作的一部分。目的是了解健康问题（在过去 12 个月中患有任何疾病、身体状况或受伤）、对医疗保健的看法、卫生服务的使用以及与寻求性传播感染护理相关的因素。数据来自年龄在 13-49 岁的参与者；使用结构化问卷进行定量收集，并通过焦点小组讨论（FGD）和关键知情人访谈（KII）进行定性收集。信息涵盖最近的健康问题、卫生服务的使用和医疗保健的看法。多变量逻辑回归模型用于确定与寻求性传播感染护理相关的因素。

结果

参与者的中位（四分位距）年龄为 29 岁（23-35 岁），超过一半（51.9%，763/1469）为女性，大多数（60.4%，888/1469）接受了长达七年的正规教育。大多数参与者报告有健康问题（76%，1117/1469）。报告最多的健康问题是性传播感染症状（52.6%，587/1117）。在 FGD 和 KII 中，缺乏卫生服务被提到是未寻求治疗的原因之一。青少年（13-19 岁）比 20 岁或以上的成年人更不可能因性传播感染症状寻求治疗（调整后比值比（aOR）=0.5（95%置信区间 0.3-0.9））。女性更有可能寻求性传播感染治疗（aOR=1.4（95%置信区间 1.0-2.1）），主要在酒吧、餐馆或旅馆工作的参与者也更有可能寻求治疗（aOR=2.0（95%置信区间 1.1-3.6））。