Sexually Transmitted Infections Symptoms Research Articles

The Effect of a Brief HIV Prevention Program on Risk Reduction Behaviors Among Thai Men Diagnosed With Sexually Transmitted Infections

Men diagnosed with sexually transmitted infections (STIs) are at greater risk for Human Immunodeficiency Virus (HIV) infection and STIs reinfection. This study aimed to test the effectiveness of a brief human immunodeficiency virus (B-HIV) prevention program on HIV and sexually transmitted infection (STI) knowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors, and reinfection rate among Thai men with STIs. A quasi-experimental design was conducted. Participants were selected from men with STIsymptoms. They were randomly assigned to a B-HIV prevention program or usual care, 100 each. The program consisted of 3 modules. Key messages for HIV prevention were sent weekly through Line. Outcomes were HIV and STIknowledge, perceived benefits of condom use, risk reduction self-efficacy, risk reduction behaviors (condom use, the number of sexual partners, and condomless sex), and STIreinfection rate. Independent t-test and binary logistic regression were performed. The B-HIV prevention program significantly increased HIV and STI knowledge and resulted in perception of greater benefits from condoms and greater risk reduction self-efficacy. Program participants used condoms more frequently with many types of partners, especially with casual partners and sex workers. The intervention group practiced condomless sex less frequently than the control group. The program did not improve participants' condom use with lovers/steady partners and did not decrease the number of sexual partners and STIreinfection rate at 3-month follow-up. A B-HIV prevention program could reduce the risk of HIV infection among male clients with current STIs by enhancing their condom use with casual partners and sex workers. Strategies to improve condom use with lovers/steady partners among this high-risk population is needed.

Medicinal plants used to manage sexually transmitted infections by Bapedi traditional health practitioners in the Blouberg area, South Africa

Sexually transmitted infections (STIs) are a major public health concern in developing countries with their transmission rate regarded as one of the highest in the world. A large proportion of the rural population in the Blouberg area of South Africa relies on traditional health practitioners and their practices of medicinal plants in order to meet their health care needs. The aim of the study was thus to gain insights into the way in which THPs manage the symptoms of STIs via the use of medicinal plants. Information was collected from 33 THPs using an interview schedule. Information recorded included ailments treated, diagnoses and gender treated. Further information regarding species used, growth forms harvested, plant parts used, as well as mode of preparation and administration of remedies was sought. Results showed that THPs manage only gonorrhoea, chalmydia and makgoma. Seventeen plant species belonging to 12 families are used to manage STIs. Herbs (41%), trees (35%) and shrubs (24%) were used. Roots (70%), bulbs (18%), as well as fruits and bark (6% each) were utilised. Remedies were prepared by boiling, powdering and pounding. The preferred method of administration was orally. The study found seven new species used by Bapedi THPs to manage STIs and related symptoms. This study reveals that local communities in the Blouberg area, still depend on THPs and traditional medicines for basic healthcare. Bapedi THPs in the Blouberg area play an important role in the management of STIs.

Heterosexual men who purchase sex and attended an STI clinic in Israel: characteristics and sexual behavior

BackgroundCommercial sex shares a role in HIV and sexually transmitted infections (STI) transmission. Men who pay for sex (MPS) may transmit HIV/STI to other populations which are low-risk. This study aimed to test our hypothesis that MPS engage in high-risk sexual behaviors associated with HIV/STI transmission more so than non-MPS.MethodsThis cross-sectional study included heterosexual men who attended an STI clinic between 2003 and 2010. Demographic, clinical, behavioral and laboratory data were compared between MPS and non-MPS to identify factors associated with high-risk sexual behavior and STI-burden.ResultsOf the first visits of 6156 heterosexual men who attended the STI-clinic during the study period, 1649 (26.7%) were MPS. MPS were more commonly older, married and non-Israeli born compared with non-MPS. MPS were more likely to engage in risk-behaviors associated with HIV/STI-transmission, including a greater number of lifetime sexual partners, substance use and previous STI diagnoses.Determinants associated with STI-diagnoses at the current visit included being non-Israeli born, presenting with STI symptoms, reporting a greater number of lifetime sexual partners and having sexual encounters with non-Israeli individuals.ConclusionsApproximately 25% of all men who attended the clinic were MPS. They were more likely to engage in risk-behaviors associated with HIV/STI transmission compared to non-MPS. These findings highlight the need to establish interventions for MPS that both continue to encourage condom use and address the potential perils pertaining to risky sexual behaviors.

Prevalence of self-reported symptoms of sexually transmitted infections, knowledge and sexual behaviour among youth in semi-rural Tanzania in the period of adolescent friendly health services strategy implementation

BackgroundGlobal evidence shows that sexually transmitted infections (STIs) prevalence and sexual risk behaviours are high among youth, and knowledge about STIs is low. In Tanzania, there is limited recent evidence regarding these issues. The aim of this study was to describe the health seeking behaviour of youth reporting STI symptoms in semi-rural Tanzania and to evaluate the association of socio-demographic characteristics, STI knowledge and sexual risk behaviour with STI symptom reporting.MethodsThis was a cross-sectional study involving 2251 sexually experienced youth (15–24 years), who participated in a larger baseline survey of a cohort within Ifakara town. Interview data were electronically collected by trained field workers. Logistic regression analysis was used to identify factors that influence the risk of reporting STI symptoms within the past year, using Stata 12.1.ResultsThe prevalence of self-reported STI symptoms in the past year was 19.9%. Almost all of youth had heard of STIs and 32.7% of youth could mention at least one sign. 34.4% had sought care for their STI symptoms, the majority at private facilities. Only 20% of HIV-STI co-infected youth was aware of their HIV status.Youth with more knowledge of STI symptoms reported to have had symptoms more often (OR = 1.28; 95% CI 1.01–1.62), and those reporting having first sex at 16 or under were more likely to report STI symptoms than those who delayed to 17–19 years (OR 1.27; 95% CI 1.003–1.62).ConclusionThese findings highlight the need to improve the implementation of Adolescent Friendly Health Services available in Tanzania (especially in semi-rural areas). The inclusion of private facilities and pharmacies in AFHS scale-up would potentially raise the level of STI knowledge, lower the STI prevalence and reduce HIV incidence among youth.

Determinants of frequent and infrequent STI testing and STI diagnosis related to test frequency among men who have sex with men in the eastern part of the Netherlands: a 6-year retrospective study

ObjectiveMen who have sex with men (MSM) remain vulnerable to sexually transmitted infections (STIs) and are advised to be tested at least twice a year. The aim of this study...

Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia

BackgroundDespite policy actions and strategic efforts made to promote sexual and reproductive health service uptake of youths in Ethiopia, its utilization remains very low and little information was found on the extent to which school youths utilize available reproductive health services in Nekempt town. This study was aimed to assess utilization of Sexual and Reproduactive Health (SRH) services and its associated factors among secondary school students in Nekemte town, Ethiopia.MethodA school based cross-sectional study design was conducted from April 18 to 22, 2016. Multistage cluster sampling technique was used to select a total of 768 students who attended secondary schools. Sexual and reproductive health services utilization was measured using one item asking whether they had used either of sexual and reproductive health services components during the last one year or not. The data was entered using EpiData Manager with Entry Client and further analysis was done using SPSS version 21 software. Descriptive statistics, cross tabulations, biviarate and multivariate logistic regression analyses were used. All variables were set by p-values less than 0.05 and reported by Adjusted Odds Ratio with its 95%CI.ResultOut of the 768 study subjects, 739 participants underwent all the study components giving response rate of 96%. About 157 (21.2%) school youths reported that they utilized SRH services. On multivariable logistic regression analysis after adjusting for other variable, discussion with health workers (AOR 3.0, 95%CI [1.7–5.2]), previous history of perceived Sexually transmitted infections (STIs) symptoms (AOR 2.6, 95%CI [1.2–5.5]), being ever sexually experienced (AOR 5.9, 95%CI [3.4–10.2]) and exposure to information from school teachers (AOR 0.36, 95%CI [0.2–0.6]) were found to be independent determinants of sexual and reproductive services utilization among secondary school youths. Inconvenient times, lack of privacy, religion, culture, and parent prohibition were barriers to SRH service uptake cited by the school youths.ConclusionsThe overall utilization of sexual and reproductive services was low among school youths in the town. Discussion with health workers, history of perceived STIs symptoms, sexual experience and information were the association factors of sexual and reproductive service utilization among secondary school youths.

Knowledge and misconceptions of Saudi women about sexually transmitted infections.

Sexually transmitted infections (STIs) are increasingly becoming one of the most important health challenges , especially among women, as they bear long-term consequences such as infertility and cervical cancer owing to STIs. This study aimed to assess the knowledge and misconceptions of Saudi women about STIs. A descriptive study was conducted among adult women attending the dermatology clinic at King Saud University Medical City, Riyadh, Saudi Arabia, for reasons other than STIs. They were randomly approached and asked to complete an anonymous prevalidated questionnaire. Uneducated females were guided by an interviewer during the filling up of the survey questionnaire. Of 1150 women approached, 843 adult Saudi women responded to the survey (response rate: 73.3%). The mean age was 30.6±10.9 years. Knowledge of STIs was highest for HIV (85.9%) and lowest for genital warts (17.0%). Respondents believed that genital pruritus, foul discharge, and painful micturition are symptoms of STIs (71.1, 69.1, and 56.4%, respectively). A considerable percentage believed that STIs are transmitted by masturbation (54.8%), sleeping on contaminated beds (39.3%), and by eating and drinking from contaminated utensils (26.3%) whereas 8% believed that STIs are transmitted by shaking hands. Nearly two-thirds of women thought that condoms protect against STIs. Knowledge on the modes of transmission and symptoms of STIs was significantly correlated with younger age, higher level of education, and higher monthly income. Despite the huge campaigns and information about STIs seen on the internet and television by these women, there is still scarcity of knowledge on the more important aspects of STIs, especially the recognition of clinical features and modes of transmission/spread of STIs. There is still a need for health authorities to intensify information-dissemination campaigns about STIs to the grassroots level, particularly among women in Saudi Arabia.

Prevalence of Sexually Transmitted Infections and Their Risk Factors among Female Sex Workers in Isfahan, Iran: A Cross-Sectional Study.

Female sex workers (FSWs) are at high risk of sexually transmitted infections (STIs) and form a core group to facilitate STI spreading. We aimed to estimate the prevalence of STIs among FSWs who attended Female Harm Reduction Center of Isfahan, Iran, and to determine the association between risky behaviors and STIs. In a cross-sectional study, 99 FSWs were recruited and interviewed about demographic characteristics and risky behaviors. A trained midwife examined FSWs for genital ulcer, abnormal vaginal discharge, and cervicitis. Urine and genital specimens were collected and real-time polymerase chain reaction was performed to diagnose Neisseria gonorrhoeae, human papilloma virus (HPV), and Trichomonas Vaginalis. Data were analyzed via χ2 test and logistic regression in StataCorp software (version 11) with 95% confidence interval. Totally, 84.9% of FSWs reported STI symptoms, while 12.1% of them were infected with N gonorrhoeae, HPV, or T vaginalis. Human papilloma virus and gonorrhea prevalence rates were 5.7% and 8% in FSWs with STI-associated symptoms. Sexually transmitted infections showed significant association with duration of prostitution (odds ratio [OR]HPV = 1.009 [95% confidence interval [95% CI: 1.004-1.01]; ORgonorrhea = 1.01 [95% CI: 1.00-1.01]) and condom usage (ORHPV = 0.11 [95% CI: 0.012-0.98]; ORgonorrhea = 0.04 [95% CI: 0.005-0.33]). Due to the literature gap on the Iranian FSWs' sexual health and the intense stigma around this subject, in Iran, our results would be useful for developing an efficient intervention program. The prevalence of STIs in Isfahan FSWs can be controlled with programs such as consistent condom use and STI treatment. In addition, as just one-tenth of FSWs with an STI symptom were positive for an STI, symptomatic diagnosis of STIs might be insufficient.

High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection

Knowledge of the risk factors of individuals with an asymptomatic sexually transmitted infection (STI) is essential for implementation of targeted STI screening strategies. Between June 2015 and January 2017, an STI screening was offered to all participants in the Zurich Primary human immunodeficiency virus (HIV)-1 Infection study. Patients were tested for gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV). Of 214 participants, 174 (81%) were screened at least once. Most patients were men who have sex with men (MSM) (87.4%). Presenting with a primary HIV infection was associated with higher odds for later risky sexual behavior, as compared with presenting in the chronic phase (odds ratio [OR], 5.58; 95% confidence interval [CI], 3.68-8.8). In total, 79 STIs were detected, reflecting a high period prevalence of 33.3% (58 of 174 patients). Sixty-six percent of patients (52 of 79) were asymptomatic. Most common STIs were chlamydia (50.6%; 40 of 79 patients), gonorrhea (25.3%; 20 of 79), and syphilis (19%; 15 of 79). In a multivariable model, engaging in insertive (OR, 6.48; 95% CI, 1.14-36.76) or both insertive and receptive (4.61; 1.01-20.96) anal intercourse, STI symptoms (3.4; 1.68-6.89), and condomless sex (2.06; 1.14-3.74) were positively correlated with a positive screening result. The hazard of an incident STI increased with the presence of STI symptoms (hazard ratio, 3.03; 95% CI, 1.17-7.84) and any recent drug use (2.63; 1-6.9). A trimonthly STI screening including asymptomatic individuals should be considered in this population, particularly in MSM who report sexual risk behavior. NCT 00537966.

Awareness of sexually transmitted infections and cervical cancer among husbands in urban slums of Mumbai, India

Background: Cervical cancer is the most common cancer among women, 80 percent of cervical cancer cases present with an advanced stage of the disease when cure is impossible. This may be due to lack of awareness and knowledge, lack of access to proper treatment including screening facility. Cervical cancer does not always cause symptoms during initial stage. Pap smear test helps in early diagnosis of cervical cancer and hence is successful in treatment. In recent years, there has been a growing interest in involving men into reproductive health to improve health outcomes as often husband is the leading decision maker in almost all the areas. The present paper examines the knowledge, attitude, practice and health seeking behaviour about sexually transmitted infections (STIs) and cervical cancer among husbands in a slum community of Mumbai. Methods: Baseline data from an intervention study entitled “Enhancing knowledge and promoting health seeking behaviour of couples on sexually transmitted infections and cervical cancer in urban slums of Mumbai” is used for this article. This data was collected from a random sample of 1958 husbands whose wives age was between 18-49 years, through a semi-structured interview schedule from two urban slums of Mumbai. Information was collected on socio-economic and demographic characters, awareness and symptoms of STIs and Cervical cancer, and health seeking behaviour. Results: About 76 percent husbands heard about the infections transmitted through sexual intercourse, 95.4 percent were aware of cancer whereas only 8.5 percent husbands were aware of cervical cancer and 0.3 percent were aware of Pap smear to detect the cervical cancer. About 3 percent husbands experienced at least one symptom of STIs six months prior to survey, 7.3 percent husbands reported of having sexual partner other than spouse. Most husbands were not aware of STIs symptoms specific to wives. Conclusions: There is a need for disseminating knowledge regarding STI symptoms, cervical cancer and Pap smear test for early detection of cervical cancer as well as promoting better health seeking behaviour with respect to cervical cancer and STIs. Considering sensitivity of the topic it is necessary to design separate programmes for men.

Awareness about Sexually Transmitted Infections and Human Immunodeficiency Virus Infection among Patients with Genital Symptoms

Introduction: Sexually transmitted infections (STIs) are a major cause of public health problem. In developing countries, human immunodeficiency virus (HIV) infection is spreading rapidly, with sexually transmitted infections acting as a cofactor for the spread of HIV. Yet adequate awareness regarding these infections is lacking.Objective: To explore the knowledge and awareness about STIs and HIV infection in patients visiting Dermatology and Venereology Clinic of Institute of Medicine, Tribhuvan University Teaching Hospital (TUTH) with genital symptoms.Material and Methods: A cross sectional descriptive study was carried out in the department of dermato-venereology, TUTH for a period of one year. Total of 130 consecutive cases were enrolled. After taking consent and assuring confidentiality they were interviewed regarding awareness of STIs and HIV/AIDS.Results: Out of 130 cases, 95% and 98.5% had heard of an STI and HIV/AIDS respectively. Only 43.8% could mention discharge from genitalia as a symptom of STI whereas 38.5% could mention none. Most (91.5%) knew about the sexual mode of transmission of both STIs and HIV. None could mention about mother to child transmission of an STI, whereas 15% knew that an infected mother can transmit HIV to her baby. About 58% were aware that condoms could protect them from acquiring an STI, 63% perceived this as best method of prevention from HIV. When only 26% knew that being faithful to one partner is the best mode of prevention from an STI, 45% mentioned avoiding contact with multiple partners could prevent them from HIV transmission.Conclusions: Awareness programme on STIs as a whole could improve knowledge and awareness on HIV and STIs and hence prevent both.

Transactional Sex between Men and Its Implications on HIV and Sexually Transmitted Infections in Nigeria.

Introduction Men who have transactional sex with men (MTSM) are known to be at higher risk for HIV and sexually transmitted infections (STIs). This study explored the risk factors associated with STI symptoms and HIV prevalence among men who have transactional sex with men in Nigeria. Methods In 2014, a cross-sectional study, using respondent driven sampling technique, was carried out to recruit 3,172 MSM across eight states in Nigeria. Relevant information on sociodemographic characteristics, sexual behaviors, and self-reported symptoms of STI was obtained. Bivariate and multivariate analysis was performed to identify risk factors for STI symptoms and HIV. Results 38.2% of the MSM were involved in transactional sex. Prevalence of self-reported STI symptoms was higher among MTSM than other MSM, while HIV prevalence was higher among other MSM than MTSM. Identified factors associated with STI symptoms and HIV among MSTM were being single, alcohol consumption, oral sex, and history of rape by a male partner. Conclusion Sexually transmitted infections are a significant challenge to men who have transactional sex with men. Adolescents and single men are more at risk of these infections. Youth empowerment needs to be invested on to avoid increased risk among these groups of people.

Understanding sexual healthcare seeking behaviour: why a broader research perspective is needed

BackgroundDespite effective and accessible treatments, many sexually transmitted infections (STIs) in high-income countries go untreated, causing poor sexual health for individuals and their partners. Research into STI care has tended to focus on biomedical aspects of infections using patient samples and prioritised attendance at healthcare services. This approach overlooks the broader social context of STIs and healthcare-seeking behaviours, which are important to better understand the issue of untreated infections.Main bodyThis paper is structured around three main arguments to improve understanding of help-seeking behaviour for STIs in order to help reduce the burden of untreated STIs for both individuals and public health. Firstly, biomedical perspectives must be combined with sociological approaches to align individual priorities with clinical insights. More research attention on understanding the subjective experiences of STI symptoms and links to healthcare-seeking behaviour is also needed. Secondly, a focus on non-attendance at healthcare services is required to address the patient-centric focus of STI research and to understand the reasons why individuals do not seek care. Finally, research using non-patient samples recruited from outside medical contexts is vital to accurately reflect the range of behaviours, beliefs and health issues within the population to ensure appropriate and effective service provision. We suggest piggy-backing other research on to existing studies as an effective way to recruit participants not defined by their patient status, and use a study recruiting a purposive non-patient sample from an existing dataset – Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) as an illustrative example.ConclusionSTIs are common but treatable, however a range of social and cultural factors prevent access to healthcare services and contribute to the burden of untreated infection. Different conceptual and empirical approaches are needed to better understand care-seeking behaviour and reduce the gap between social and biomedical advancements in managing untreated infection.

Knowledge, Attitude, Practice and Barriers Regarding Safe Sex and Contraceptive Use in Rural Women in Fiji

<p><strong>Background:</strong> Fiji has a low contraceptive uptake rate and high rates of unplanned pregnancy and sexually transmitted infections (STIs). In this paper we report the result of a study on Knowledge, Attitude, Practice and Barriers (KAPB) to safe sex and contraceptive use, conducted on 1494 rural women aged between 18 to 75 years in Fiji.</p><p><strong>Objectives:</strong> To explore the knowledge, attitudes, practice and barriers regarding safe sex and contraceptive use in rural women of Ba, Lautoka and Nadi, in Fiji.</p><p><strong>Methods:</strong> Structured questionnaires were administered to women presenting to rural outreach Sexual and Reproductive Health (SRH) education sessions and clinics conducted by trained health educators and clinicians.</p><p><strong>Results: </strong>Knowledge on how pregnancy occurred and how to avoid pregnancies was high<strong> </strong>(86% and 83% respectively); but when it came to practice 43% of women had never used a contraceptive. Despite 81% of women having completed either secondary or tertiary education, 88% were not aware of emergency contraception. Fifty three percent of respondents were unaware that condom use provided protection against both pregnancy and STIs. Sixty three percent knew how an STI is contracted but 48% were unaware of any of the symptoms of STIs. Women offered ‘lack of knowledge’ (53%), ‘being married’ (17%), ‘difficulty accessing’ (10%) or ‘partner disagrees’ (7%) as the common barriers to condom use. Forty percent of women were unable to articulate a barrier to contraceptive use and said they did not know whereas 21% said ‘fear’, 15% said ‘partner objecting’ and 5% said ‘religion’ were barriers.</p><p><strong>Conclusion: </strong>While a high percentage of women had some knowledge of how to avoid pregnancies and how STIs were contracted, this did not translate to practice of safe sex or use of contraceptives.<strong> </strong>Review of current education and health programs is necessary to ensure that misinformation and false perceptions do not act as barriers. The influence of the partner needs further research.<strong></strong></p>

Marital violence and sexually transmitted infections among women in post-revolution Egypt

ObjectivesTo explore the relationship between past year physical or sexual partner violence against women and women’s self-report of sexually transmitted infection (STI) symptoms in post-revolution Egypt; and to examine the effects of men’s and women’s risky sexual behavioural characteristics and structural dimensions of poverty and gender inequality on this relationship. Study designThis study uses the nationally representative cross-sectional demographic and health survey data conducted in 2014. Multivariate logistic regression was used to assess the relationship between past year partner violence and self-report of STI symptoms among currently married women. Main outcome measureswomen’s self-report of STI was based on their responses to three questions; whether in the past year they had: got a disease through sexual contact?, a genital sore or ulcer?, or a bad smelling abnormal genital discharge? Women who gave an affirmative response to one or more of these questions were assumed to self-report STI. ResultsAlmost one-third of women self-reported symptoms of STI. Fourteen percent of women reported they had experienced physical or sexual violence by a male partner in the past 12months. Abused women had a 2.76 times higher odds of self-reported STI symptoms (95% CI 2.25–3.38). The significant relationship between self-reported STI and past year partner violence against women did not alter when adjusting for men’s and women’s behavioural characteristics and factors related to poverty and gender inequality. ConclusionsPublic health interventions that address women’s sexual and reproductive health need to consider violence response and prevention strategies.

P204 A junior doctor-led programme is effective in educating young people about sexually transmitted infections and their local sexual health clinic

IntroductionIt is well recognised that people aged 15–24 have the highest rates of sexually transmitted infections (STIs). In an area failing to meet national targets on chlamydia detection in this age group and overall HIV testing, junior doctors are delivering sessions to educate young people. The project aims to increase attendance at sexual health clinics and improve sexual health in this high-risk group.MethodsSince 2012 junior doctors have been visiting secondary schools locally to deliver a 50-minute teaching session to 14–16 year olds covering condom application, symptoms of STIs and accessing their local sexual health clinics. The sessions have received positive feedback from teachers and students. This year a questionnaire has been introduced to quantify pre and post teaching knowledge.Results188 children completed the questionnaire. Pre-teaching scores included 25.9% on STI symptoms, 34.9% on where the local clinic is and 27% awareness of what happens there. The post-teaching scores showed an improvement of 49.8%. 89% students reported feeling more comfortable discussing STIs following the session.DiscussionWe have highlighted that there is a need to provide more information to 14–16 year-olds about the symptoms of STIs and their local sexual health clinic. We have also demonstrated that a junior doctor led programme is an efficacious method of delivering this. Education from a young age could contribute towards increasing screening and reducing STI rates.

A community-based survey on Syrian refugee women’s health and its predictors in Şanliurfa, Turkey

ABSTRACTReproductive characteristics, mental health symptoms, micronutrient deficiencies, and symptoms of sexually transmitted infections (STIs) were determined among married Syrian refugee women aged 15–49 years who were living outside of camps in 2015, using probability sampling. Of the 458 participants, 51.3 percent married before the age of 18 years. Early-age marriages and number of desired children increased after the war. In multivariable analyses, education (adjusted odds ratio [aOR] = 1.2; 95% confidence interval [CI] = 1.2–1.3) and length of stay in Şanlıurfa (aOR = 1.2; 95% CI = 1.1–1.2) were independently associated with early marriage. Approximately 16 percent of women were pregnant, and 26.7 percent of them had not received prenatal care; 47.7 percent had had a pregnancy loss; 50.8 percent reported symptoms of STIs. Of those who were sexually active, 37.8 percent were not using contraception. The prevalence of iron, B12, and folic acid deficiencies was 50 percent, 45.6 percent, and 10.5 percent, respectively. Early marriage (aOR = 2.2; 95% CI = 1.4–3.5) and number of desired children (aOR = 5.03; 95% CI = 3.2–7.9) were associated with not using contraception. Most (89.7 percent) women reported at least two mental health symptoms; lack of social support (aOR = 2.6; 95% CI = 1.3–5.3), language barrier (aOR = 2.3; 95% CI = 1.01–5.2), and B12 deficiency (aOR = 1.8; 95% CI = 1.01–3.4) were associated with such symptoms. The findings demonstrate the need for reproductive health and psychosocial services.

Sexual and reproductive health behaviors of female sex workers in Dhaka, Bangladesh.

ObjectivesThe objective of this study was to document sexual and reproductive health (SRH) practices among female sex workers (FSWs) including abortion, pregnancy, use of maternal healthcare services and sexually transmitted infections (STIs) with the aim of developing recommendations for action.MethodsA total of 731 FSWs aged between 15 and 49 years were surveyed using a stratified sampling in Dhaka, Bangladesh. A workshop with 23 participants consisted of policy makers, researchers, program implementers was conducted to formulate recommendations.ResultsAbout 61.3% of 731 FSWs reported SRH-related experiences in the past one year, including abortion (15.5%), ongoing pregnancy (9.0%), childbirth (8.3%) or any symptoms of STIs (41.6%). Among FSWs who had an abortion (n = 113), the most common methods included menstrual regulation through manual vacuum aspiration (47.8%), followed by Dilation and Curettage procedure (31%) and oral medicine from pharmacies (35.4%). About 57.5% of 113 cases reported post abortion complications. Among FSWs with delivery in the past year (n = 61), 27.7% attended the recommended four or more antenatal care visits and more than half did not have any postnatal visit. Adopting sustainable and effective strategies to provide accessible and adequate SRH services for FSWs was prioritized by workshop participants.ConclusionThere was substantial unmet need for SRH care among FSWs in urban areas in Dhaka, Bangladesh. Therefore, it is important to integrate SRH services for FSWs in the formal healthcare system or integration of abortion and maternal healthcare services within existing HIV prevention services.

High prevalence of curable sexually transmitted infections among pregnant women in a rural county hospital in Kilifi, Kenya.

BackgroundWomen attending antenatal care (ANC) in resource-limited countries are frequently screened for syphilis and HIV, but rarely for other sexually transmitted infections (STIs). We assessed the prevalence of curable STIs, defined as infection with either Chlamydia trachomatis or Neisseria gonorrhoeae or Trichomonas vaginalis, from July to September 2015.MethodsIn a cross-sectional study, women attending ANC at the Kilifi County Hospital, Kenya, had a urine sample tested for C. trachomatis/N. gonorrhoeae by GeneXpert® and a vaginal swab for T. vaginalis by culture. Bacterial vaginosis (BV) was defined as a Nugent score of 7–10 of the Gram stain of a vaginal smear in combination with self-reported vaginal discharge. Genital ulcers were observed during collection of vaginal swabs. All women responded to questions on socio-demographics and sexual health and clinical symptoms of STIs. Predictors for curable STIs were assessed in multivariable logistic regression.ResultsA total of 42/202 (20.8%, 95% confidence interval (CI):15.4–27.0) women had a curable STI. The prevalence was 14.9% for C. trachomatis (95% CI:10.2–20.5), 1.0% for N. gonorrhoeae (95% CI: 0.1–3.5), 7.4% for T. vaginalis (95% CI:4.2–12.0), 19.3% for BV (95% CI: 14.1–25.4) and 2.5% for genital ulcers (95% CI: 0.8–5.7). Predictors for infection with curable STIs included women with a genital ulcer (adjusted odds ratio (AOR) = 35.0, 95% CI: 2.7–461.6) compared to women without a genital ulcer, women who used water for cleaning after visiting the toilet compared to those who used toilet paper or other solid means (AOR = 4.1, 95% CI:1.5–11.3), women who reported having sexual debut ≤ 17 years compared to women having sexual debut ≥18 years (AOR = 2.7, 95% CI:1.1–6.6), and BV-positive women (AOR = 2.7, 95% CI:1.1–6.6) compared to BV-negative women.ConclusionOne in five women attending ANC had a curable STI. These infections were associated with genital ulcers, hygiene practices, early sexual debut and bacterial vaginosis.

Knowledge and Attitude About Sexually Transmitted Infections Amongst Truck Drivers in Southern Punjab, Pakistan.

IntroductionThere is very limited knowledge about sexually transmitted infections (STIs) transmission and prevention present amongst high-risk groups such as truck drivers in Pakistan because of lack of awareness and understanding about barrier techniques.ObjectiveThe aim of this study was to collect and access the data gathered from truck drivers about symptoms of STIs, their attitude towards hazards of multiple sexual partners, homosexuality, transmission and consequences of STIs, and their perception about preventing it using condoms and other barrier methods.MethodsThis study was conducted at small roadside tea stalls and local rest areas on Karachi road, Lodhran near the city of Bahawalpur in Southern Punjab, Pakistan. A structured questionnaire was designed, and 50 willing truck drivers of the city of Bahawalpur were included and interviewed. It was a cross-sectional study. Data was collected on knowledge about the STIs and use of barrier methods like condoms. Quantitative data was assessed and analyzed using SPSS version 23.0 (IBM, NY, USA).ResultsFifty truck drivers of Bahawalpur were interviewed via standardized questionnaire in this study. All of them provided answers about their knowledge of STIs. Twenty drivers (40%) reported burning micturition, and only two (four percent) knew the real cause of it. Thirty-two (64%) of them were well aware of the use of condoms. Thirty-eight (76%) truck drivers had the knowledge about the adverse effects of multiple sex partners.ConclusionThe truck drivers of Bahawalpur city are quite vulnerable to STIs and this demonstrates the importance of prevention programs that can target this particular group. A significant number of the respondents had serious gaps in their knowledge about STIs like acquired immunodeficiency syndrome (AIDS), especially its modes of transmission, signs, and symptoms. The knowledge of other routes of human immunodeficiency virus (HIV) transmission like needle sharing and blood transfusion, and precautionary steps should be given due respect in HIV/AIDS awareness programs.