Objectives: Better data on aetiological prevalence of sexually transmitted infections (STIs) among African men could greatly strengthen STI prevention efforts and convey benefits to women as well. In an ongoing study among men in Kenya, we analysed baseline STI prevalence and individual characteristics associated with STI.
Methods: In Siaya County, Kenya, we recruited men aged 18-39 years who self-reported engagement in transactional sex and alcohol use. We administered a baseline questionnaire to participants and conducted testing for HIV, herpes simplex virus type 2 (HSV-2), (CT) and (NG) infection. Characteristics associated with bacterial STIs were analysed using logistic regression and we estimated the positive and negative predictive values (PPV/NPV) of syndromic management of these infections.
Results: We enrolled 1500 participants from July 2022 to March 2023. Participant mean age was 27.9 years, 62.2% were married/cohabitating and 53.5% were heavy alcohol users (Alcohol Use Disorders Identification Test-Consumption≥4). Participants reported a mean of 4.2 sexual partners and 3.5 transactional sex partners in the past 3 months. HIV prevalence was 9.5%, HSV-2 was 38.7%, CT was 14.3% and NG was 2.5%. Combined CT and/or NG infection was detected in 16.1% of participants.Compared with participants uninfected, those testing positive for CT and/or NG were younger (p=0.001), had more sexual partners (p=0.027) and transactional sex partners (p=0.039), were less likely to have used a condom at last sex (p=0.015) and were more likely to self-report having an STI besides HIV in the past 12 months (p=0.002). The PPV and NPV for currently experiencing CT and/or NG symptoms were 33.3% and 84.4%, respectively.
Conclusions: Among Kenyan men engaged in transactional sex and alcohol use, STI prevalence was high. These data fill an important gap about STI prevalence and risk factors in African men highlighting the risk of ongoing transmission and the need for targeted prevention programmes and expanded access to testing and treatment.
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http://dx.doi.org/10.1136/sextrans-2024-056266 | DOI Listing |
JAMA Netw Open
January 2025
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Importance: Women who use heroin in sub-Saharan Africa face elevated HIV risk linked to structural vulnerability including frequent incarceration. However, little is known about the association between incarceration and drug use and HIV outcomes among women who use heroin in Africa.
Objective: To estimate associations between incarceration and adverse HIV-related and drug use-related outcomes among women who used heroin.
AIDS
January 2025
Centre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Busia, Kenya.
Background: Transactional sexual relations in the absence of condom use is a well-established behaviour that strongly contributes to HIV transmission if the infected person is not virally suppressed. In this study, we determined the trends and factors associated with VLNS among treatment-experienced FSWs in Kenya.
Methods: This retrospective cohort study used data collected from 7-sex workers outreach clinics between 2015 and 2022.
AIDS Behav
December 2024
Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, USA.
This brief report presents findings on informal, non-prescribed PrEP use among an online sample of gay, bisexual and other men who have sex with men (n = 196). Mean age was 33.4.
View Article and Find Full Text PDFReprod Health
December 2024
Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Plot 51-59, Nakiwogo Road, Entebbe, Uganda.
Background: HIV prevention trials usually require that women of childbearing potential use an effective method of contraception. This is because the effect of most investigational products on unborn babies is unknown. We assessed contraceptive use, prevalence and incidence of pregnancy and associated factors among women in a HIV vaccine preparedness study in Masaka, Uganda.
View Article and Find Full Text PDFTher Adv Infect Dis
December 2024
Section of Infectious Diseases & Global Health, University of Chicago Medicine, 5841 S. Maryland Avenue, MC5065, Chicago, IL 60637, USA.
Introduction: Despite escalating rates of sexually transmitted infections (STIs) in the United States (US), there has been progressive divestment of sexual health services leading to the reliance on emergency departments (EDs) for sexual healthcare, particularly among vulnerable populations. The Sexual Wellness Clinic (SWC), a novel care delivery model operating in collaboration with the ED, offers comprehensive sexual health services.
Objectives: This study aims to analyze the demographics, STI positivity, and HIV Pre-Exposure Prophylaxis (PrEP) uptake among patients accessing the SWC.
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