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Risk factors for sexually transmitted disease in Harare: a case-control study
M Wellington1, F Ndowa, L Mbengeranwa
1City Health Department, Harare, Zimbabwe.
Objective:
To obtain information on risk factors and health-seeking behavior of men with sexually transmitted diseases (STDs) attending primary care clinics.
Study Design:
Unmatched case-control.
Methods:
Cases consisted of 256 consecutive men with genital ulcer disease (GUD) and 256 with other STDs. Control subjects (N = 256) were recruited from every third man with non-STD-related complaints. All subjects were at least 15 years of age. A structured questionnaire was administered.
Results:
Genital ulcer disease cases reported more frequent sexual intercourse with a commercial sex worker (odds ratio [OR] = 17.4; 95% confidence intervals [CI] = 7.8-40.0) and a recent new sexual contact (OR = 6.7; CI = 3.3-14.1). Similarly, STD cases reported more frequent sexual contact with a commercial sex worker (OR = 3.4; CI = 2.0-5.6) and a recent new sexual contact (OR = 7.9; CI = 3.9-16.3). Reported condom use was less than 30% with all partner types. Of all STD cases, 80% sought treatment at the primary care clinics, with 35% delaying more than 7 days before seeking treatment.
Conclusions:
Culturally appropriate behavioral educational programs are advocated to reduce the risk of transmission and the period for seeking treatment for all STDs.