Abstract
To identify factors associated with a history of sexually transmitted infections in Ghanaian women 15 - 24 years. The study was a cross-sectional data analysis of 1280 sexually experienced females from the 2003 Ghana Demographic Health Survey. Using chi square and t-test, those with a history or symptoms of STI were compared with those denying such a history on demographic, individual and partner level variables. Significant variables were entered into logistic regression to identify variables associated with STI. The STI group comprised 12% of the study population. Compared to those denying a history of STI, the STI group was less likely to know where to get condoms (37% vs 23%, p=.001) but more likely to use a condom at their last sexual encounter (27% vs 17%, p=.003). Women in the STI group were significantly less likely to discuss family planning with their partners but more likely to have 2 or more partners in the preceding 12 months. Logistic regression showed that factors associated with STI among sexually active Ghanaian female youth included not knowing where to get condoms and not discussing family planning with partner. Majority of sexually experienced Ghanaian female youth do not know where to get condoms. Lack of knowledge of source of condoms was identified as a risk factor for STI for these women.
Highlights
Transmitted infections (STI) are a significant cause of morbidity among adolescents with multiple consequences. 1 In addition to some Sexually transmitted infections (STI) increasing the risk of HIV transmission, problematic is the long term sequelae which include infertility, tubal pregnancy, chronic pain in the pelvis and cervical cancer.1-4Adolescents, especially female adolescents, are vulnerable to the acquisition of STI because of biological, cognitive and socio-cultural factors. 5-7 For several STI, adolescents have been reported to have the highest age-specific risk.1One out of eight sexually experienced 15 to 24 year old women self-reported STI and symptoms of STI in the 2003 Ghana Democratic Health Survey (GDHS).8 These rates represent the highest prevalence recorded among all the age groups surveyed
While the prevalence of STI (12%) in the present study sample was higher than the 8% recorded for sexually experienced Ghanaian female youth in other studies, the age of onset of sexual intercourse was consistent with what others have reported. 20-21 The difference in STI rates may be attributable to the comparative studies involving unmarried 12 -24 year olds while the present study focused on 15 to 24 year olds some of whom were married
9 Again the current study sample included married respondents who have been found to be less likely to report using condoms for last sexual intercourse compared to single women
Summary
Transmitted infections (STI) are a significant cause of morbidity among adolescents with multiple consequences. 1 In addition to some STI increasing the risk of HIV transmission, problematic is the long term sequelae which include infertility, tubal pregnancy, chronic pain in the pelvis and cervical cancer.. One out of eight sexually experienced 15 to 24 year old women self-reported STI and symptoms of STI in the 2003 Ghana Democratic Health Survey (GDHS).8 These rates represent the highest prevalence recorded among all the age groups surveyed. Factors associated with the individual include early age at initiation of sexual activity, alcohol and drug use before sex, having multiple sexual partners and condom availability and use.. The index and control groups were compared on individual and partner level factors with the hypothesis that youth with selfreported STI will be more likely to report factors found from previous studies to be associated with STI including alcohol use before sex, older age of sexual partner, younger age at first intercourse and multiple sexual partners
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