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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.
Insights
Men with sexually transmitted diseases (STDs) frequently engage in high-risk sexual behaviors and delay seeking treatment. Culturally sensitive education is crucial to reduce STD transmission and improve timely healthcare seeking for men.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Sexually transmitted diseases (STDs) pose a significant public health challenge, particularly among men attending primary care.
- Understanding risk factors and health-seeking behaviors is essential for effective prevention and control strategies.
Purpose of the Study:
- To investigate the risk factors associated with STDs in men.
- To examine the health-seeking behaviors of men diagnosed with STDs in primary care settings.
Main Methods:
- An unmatched case-control study was conducted.
- 256 men with genital ulcer disease (GUD), 256 with other STDs, and 256 controls were recruited.
- Data were collected using a structured questionnaire.
Main Results:
- Men with STDs, including GUD, reported significantly higher rates of sexual intercourse with commercial sex workers and recent new sexual contacts.
- Condom use was reported by less than 30% of participants across all partner types.
- While 80% of STD cases sought treatment at primary care clinics, 35% experienced a delay of over 7 days.
Conclusions:
- Frequent engagement with commercial sex workers and new sexual contacts are key risk factors for STDs in men.
- Low condom use highlights a critical gap in prevention efforts.
- Delayed treatment seeking necessitates targeted interventions to improve timely healthcare access for STDs.
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.