Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representative Surveys in Bangladesh.

Md Nazmul Huda,Md Bakhtiar Uddin,Jalal Uddin,Md Kamrul Hasan,Tinashe Moira Dune,Moin Uddin Ahmed

doi:10.3390/ijerph19031906

Abstract

Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no study examined the prevalence and risk factors of STI symptoms using a nationally representative sample. This study investigates the prevalence of STI symptoms among ever-married women in Bangladesh and the associations of STI symptoms with various demographic, socioeconomic, and behavioral risk factors using the most recent available data (2007, 2011, and 2014) of the Bangladesh Demographic and Health Surveys (BDHS). The BDHS employs a two-stage stratified sampling technique. The analytic sample comprised 41,777 women of reproductive age (15–49 years). Outcome variables included STI symptoms: abnormal genital discharge and genital sores/ulcers. Multivariate logistic regression was employed to find the adjusted odds ratio with a 95% confidence interval to assess the associations of outcome measures with explanatory variables. The study found that the prevalence of abnormal genital discharge and genital sores/ulcers among ever-married women aged 15–49 years was 10% and 6%, respectively. Multivariable analysis revealed that for women aged 25–34 years, those who used contraceptives and married earlier had an increased likelihood of STI symptoms. Furthermore, women from the wealthiest wealth quintile and couple’s joint decision-making were less likely to have STI symptoms. Findings have implications for interventions efforts aiming to improve women’s sexual and reproductive health in Bangladesh.

Highlights

Transmitted infections (STIs) are generally transmitted through sexual contact and can have some symptoms, representing a severe public health concern [1]
The current study provides a scientific understanding of the self-reported prevalence of Sexually transmitted infections (STI) symptoms and the demographic, socioeconomic, and behavioral risk factors of STI
We evaluated the associations of STI outcomes with demographic, socioeconomic, and behavioral risk factors using three separate logistic regression models containing variables with a p-value below 0.20 from the earlier set of chi-square tests [33]

Summary

Introduction

Transmitted infections (STIs) (e.g., gonorrhea, chlamydia, syphilis, and trichomonas) are generally transmitted through sexual contact and can have some symptoms (including abnormal genital discharge, genital sores/ulcers), representing a severe public health concern [1]. The STI symptoms can cause sexual and reproductive health (SRH) complications in women of reproductive age [1], infertility, and mother-to-child transmission if left untreated and undetected [2–5]. The prevalence of STIs is increasing globally [1]. More than 1 million men and women aged between 15 and 49 years manifest STI symptoms [2]. Heightened biological risk for contracting STIs [6], inadequate access to sexual health services [7], and limited agency to negotiate condom use with their partners [8] put women at increased risk for STIs [9]. The highest 40% of global STI burdens occurred in women in Sub-Saharan Africa, followed by the Southeast Asia region (20%) [10]. In Bangladesh, various studies report an ever-increasing rate of STI among women of reproductive age, ranging from 0.2% to 39.1% [11–14]. The increasing STIs burden remains a major public health concern in Bangladesh, especially among women

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