Ahinkorah Bright Opoku, Aboagye Richard Gyan, Donkoh Irene Esi, Okyere Joshua, Yaya Sanni
Faculty of Health and Medical Sciences The University of Adelaide Adelaide Australia.
Department of Family and Community Health Fred N. Binka School of Public Health University of Health and Allied Sciences Hohoe Ghana.
Public Health Chall. 2025 Aug 18;4(3):e70088. doi: 10.1002/puh2.70088. eCollection 2025 Sep.
In sub-Saharan Africa (SSA), less than 10% of men, compared to 50%-80% of women, are affected by sexually transmitted infections (STIs). Untreated STIs can lead to severe reproductive health complications, including infertility, pelvic inflammatory disease, and increased susceptibility to HIV. Understanding the determinants of healthcare-seeking behaviour for STIs is crucial for informing policies and interventions aimed at improving access to timely and appropriate care. This study examined the healthcare-seeking behaviours of adolescent girls and young women (AGYW) with STIs in SSA.
Our study utilised data from the Demographic and Health Surveys of 20 countries in SSA. We used a forest plot to present the results on the prevalence of healthcare seeking for STIs among AGYW in SSA. Additionally, we examined the predictors of healthcare seeking for STIs using a multilevel binary logistic regression analysis.
The results showed that 54.31% (95% confidence interval [CI]: 53.48-55.14) of AGYW in SSA sought healthcare for STIs. This ranged from as low as 26.98% (95% CI: 23.44-30.52) in Ethiopia to as high as 82.50% (95% CI: 78.38-86.62) in Liberia. AGYW aged 20-24 (adjusted odds ratio [aOR] = 1.49, 95% CI: 1.31-1.71), those who were cohabiting (aOR = 1.40, 95% CI: 1.10-1.79), those with secondary [aOR = 1.49, 95% CI: 1.20-1.85] or higher education [aOR = 1.68, 95% CI: 1.08-2.61], those who were working at the time of the survey [aOR = 1.23, 95% CI: 1.07-1.40], those who were covered by health insurance [aOR = 1.45, 95% CI: 1.09-1.93], and those in richest wealth quintiles [aOR = 2.18, 95% CI: 1.62-2.92] were more likely to seek healthcare for STIs.
Our study has shown that the proportion of AGYW who sought healthcare for their STIs is relatively low, with country-level variations. Several factors were found to be associated with healthcare seeking for STIs. Focused interventions are required to enhance access to healthcare treatments for STIs among the vulnerable sub-populations.
在撒哈拉以南非洲地区（SSA），感染性传播感染（STIs）的男性比例不到10%，而女性比例为50%-80%。未经治疗的性传播感染可导致严重的生殖健康并发症，包括不孕、盆腔炎以及感染艾滋病毒的易感性增加。了解寻求性传播感染医疗服务行为的决定因素对于制定旨在改善及时获得适当护理的政策和干预措施至关重要。本研究调查了撒哈拉以南非洲地区感染性传播感染的少女和年轻女性（AGYW）的就医行为。
我们的研究利用了撒哈拉以南非洲20个国家的人口与健康调查数据。我们使用森林图展示撒哈拉以南非洲地区AGYW寻求性传播感染医疗服务的患病率结果。此外，我们使用多水平二元逻辑回归分析来研究寻求性传播感染医疗服务的预测因素。
结果显示，撒哈拉以南非洲地区54.31%（95%置信区间[CI]：53.48-55.14）的AGYW因性传播感染寻求医疗服务。这一比例在埃塞俄比亚低至26.98%（95%CI：23.44-30.52），在利比里亚高达82.50%（95%CI：78.38-86.62）。20-24岁的AGYW（调整优势比[aOR]=1.49，95%CI：1.31-1.71）、同居者（aOR=1.40，95%CI：1.10-1.79）、接受过中等教育[aOR=1.49，95%CI：1.20-1.85]或高等教育[aOR=1.68，95%CI：1.08-2.61]者、调查时正在工作的人[aOR=1.23，95%CI：1.0-1.40]、有医疗保险覆盖的人[aOR=1.45，95%CI：1.09-1.93]以及最富裕财富五分位数人群[aOR=2.18，95%CI：1.62-2.92]更有可能因性传播感染寻求医疗服务。
我们的研究表明，因性传播感染寻求医疗服务的AGYW比例相对较低，且存在国家层面的差异。发现有几个因素与因性传播感染寻求医疗服务有关。需要有针对性的干预措施，以增加弱势群体获得性传播感染医疗治疗的机会。
