Risk factors for curable sexually transmitted infections among youth: findings from the STICH population survey in Zimbabwe.

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES Sexually Transmitted Infections Pub Date : 2024-11-18 DOI:10.1136/sextrans-2024-056146

Kevin Martin, Ethel Dauya, Victoria Simms, Tsitsi Bandason, Steven Azizi, Anna Machiha, Tinei Shamu, Primrose Musiyandaka, Tinashe Mwaturura, Suzanna C Francis, Constance R S Mackworth-Young, Joanna Busza, Constancia Mavodza, Mandi Tembo, Richard J Hayes, Katharina Kranzer, Rashida A Ferrand, Chido Dziva Chikwari

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Abstract

Objectives: Youth are at high risk of sexually transmitted infections (STIs) in Africa. We aimed to determine the risk factors for curable STIs in youth in Zimbabwe.

Methods: A population-based survey was conducted among randomly selected 18-24 year-olds in 16 communities across two provinces in Zimbabwe to ascertain outcomes for a cluster randomised trial investigating the impact of community-based STI screening for youth on population prevalence of STIs. Participants underwent an interviewer-administered questionnaire, HIV testing and screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV). Risk factors for curable STIs were explored through multivariable logistic regression.

Results: Of the 5601 participants, 62.5% (n=3500) were female, and the median age was 20 (IQR 19-22) years. HIV prevalence was 6.3% (351/5556), and 55.4% (1939/3501) reported condomless sex at last intercourse. Only 7.2% (401/5599) reported STI symptoms, but CT/NG/TV prevalence was 19.8% (1107/5601). On multivariable analysis, factors associated with STI diagnosis included being aged 21-24 years (adjusted OR (aOR) 1.37, 95% CI 1.17 to 1.61); female sex (aOR 2.11, 95% CI 1.76 to 2.53); being unemployed/informally employed (compared with in education/formal employment) (aOR 1.35, 95% CI 1.13 to 1.61); increasing number of sexual partners in the preceding 12 months (one partner: aOR 2.23, 95% CI 1.73 to 2.88; two partners: aOR 2.39, 95% CI 1.69 to 3.39); living with HIV (aOR 1.44, 95% CI 1.07 to 1.94); and previous attempted suicide (aOR 1.58, 95% CI 1.08 to 2.32).

Conclusions: The prevalence of STIs among youth in Zimbabwe is high, particularly among those with HIV. In addition to moving away from syndromic STI management and strengthening implementation of existing prevention tools, there is a need for a more holistic focus on broader risk factors such as mental health and employment opportunities, and of integration of HIV and STI programming.

Trial registration number: ISRCTN15013425, NCT03719521.

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青年中可治愈性传播感染的风险因素：津巴布韦 STICH 人口调查的结果。

目标：在非洲，青少年是性传播感染（STI）的高发人群。我们的目的是确定津巴布韦青少年感染可治愈性传播疾病的风险因素：在津巴布韦两个省的 16 个社区中随机抽取了 18-24 岁的人群进行调查，以确定分组随机试验的结果，调查以社区为基础的青少年性传播感染筛查对性传播感染人群患病率的影响。参与者接受了由访谈者主持的问卷调查、HIV 检测以及沙眼衣原体 (CT)、淋病奈瑟菌 (NG) 和阴道毛滴虫 (TV) 筛查。通过多变量逻辑回归探讨了可治愈性传播感染的风险因素：在 5601 名参与者中，62.5%（n=3500）为女性，年龄中位数为 20（IQR 19-22）岁。HIV 感染率为 6.3%（351/5556），55.4%（1939/3501）的参与者在最后一次性交时未使用安全套。只有 7.2%（401/5599）报告了性传播感染症状，但 CT/NG/TV 感染率为 19.8%（1107/5601）。在多变量分析中，与性传播感染诊断相关的因素包括年龄在 21-24 岁（调整 OR (aOR) 1.37，95% CI 1.17 至 1.61）；性别为女性（aOR 2.11，95% CI 1.76 至 2.53）；失业/非正式就业（与受教育/正式就业相比）（aOR 1.35，95% CI 1.13至1.61）；在过去12个月中性伴侣数量增加（一个性伴侣：aOR为2.23，95% CI为1.73至2.88；两个性伴侣：aOR为2.39，95% CI为1.69至3.39）；HIV感染者（aOR为1.44，95% CI为1.07至1.94）；曾试图自杀（aOR为1.58，95% CI为1.08至2.32）：津巴布韦青少年性传播疾病的发病率很高，尤其是在艾滋病毒感染者中。除了摒弃综合征性传播感染管理和加强现有预防工具的实施外，还需要更全面地关注更广泛的风险因素，如心理健康和就业机会，以及整合艾滋病和性传播感染计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sexually Transmitted Infections 医学-传染病学

CiteScore

5.70

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.