medRxiv : the preprint server for health sciences · 2025
Associations with Prevalent Sexually Transmitted Infection Prevalence among Young Women Domestic Workers in Central Uganda.
СтатьяПрепринтНазвание и аннотация: Перевод в очереди
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Onzia Annet A, Mujugira Andrew, Nakate Vivian, Musaazi Joseph, Bukenya Justine, Sseggujja Eric, Ajeru Patricia A, Parkes-Ratanshi Rosalind, Melendez Johan H, Hamill Matthew M, Manabe Yukari C, Castelnuovo Barbara
Аннотация
OBJECTIVE: Our study aimed to determine the prevalence and correlates of sexually transmitted infections (STIs) among adolescent girls and young women (AGYW) employed as household domestic workers in Kampala, Uganda.
METHODS: Ugandan AGYW aged 14-24 participated in a community-based cross-sectional study in the Kampala Metropolitan Area from November 2023 to March 2024. Self-collected vaginal swabs were tested for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) using GeneXpert™. Testing for HIV and syphilis was performed using the Bioline™ HIV/syphilis Duo test. Correlates of STI prevalence were determined using modified Poisson regression.
RESULTS: Of 262 AGYW enrolled, the median age was 20 years (IQR 18-23), and 87 (33%) had an STI: Chlamydia trachomatis (27.5%), syphilis (5.7%), HIV (4.6%), and Neisseria gonorrhoea (1.5%). Overall, 14.9% had >1 STI. Of 12 AGYW with HIV, three (25%) were newly diagnosed, and 6/9 had detectable viral loads (≥1000 copies/ml). In the prior 12 months, 126 (48%) had received syndromic STI treatment, but only 35 (28%) notified their partners. Additionally, 102 (39%) had used emergency contraception, with 54% believing it was protective against STIs, including HIV. Factors associated with STI prevalence included receipt of non-cash (instead of salary) remuneration for domestic work (adjusted prevalence ratio [aPR] 2.26; 95% CI:1.04-4.92; P=0.040), lower education attainment (aPR 1.73; 95% CI: 1.16-2.57; P=0.007), alcohol consumption in past six months (aPR 1.72; 95% CI: 1.12-2.64; P=0.013) and transactional sex during the past six months (aPR 1.43; 95% CI: 1.01-2.04; P=0.045). Conversely, self-reported sexual abuse was negatively associated with STIs (aPR 0.48; 95% CI: 0.28-0.83; P=0.008).
CONCLUSION: The high prevalence of undiagnosed STIs and unsuppressed HIV among AGYW domestic workers in Kampala highlights the urgent need to increase HIV/STI prevention, testing and treatment coverage for these underserved and vulnerable young women. Targeted interventions are needed to mitigate STI/HIV acquisition in this population.
METHODS: Ugandan AGYW aged 14-24 participated in a community-based cross-sectional study in the Kampala Metropolitan Area from November 2023 to March 2024. Self-collected vaginal swabs were tested for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) using GeneXpert™. Testing for HIV and syphilis was performed using the Bioline™ HIV/syphilis Duo test. Correlates of STI prevalence were determined using modified Poisson regression.
RESULTS: Of 262 AGYW enrolled, the median age was 20 years (IQR 18-23), and 87 (33%) had an STI: Chlamydia trachomatis (27.5%), syphilis (5.7%), HIV (4.6%), and Neisseria gonorrhoea (1.5%). Overall, 14.9% had >1 STI. Of 12 AGYW with HIV, three (25%) were newly diagnosed, and 6/9 had detectable viral loads (≥1000 copies/ml). In the prior 12 months, 126 (48%) had received syndromic STI treatment, but only 35 (28%) notified their partners. Additionally, 102 (39%) had used emergency contraception, with 54% believing it was protective against STIs, including HIV. Factors associated with STI prevalence included receipt of non-cash (instead of salary) remuneration for domestic work (adjusted prevalence ratio [aPR] 2.26; 95% CI:1.04-4.92; P=0.040), lower education attainment (aPR 1.73; 95% CI: 1.16-2.57; P=0.007), alcohol consumption in past six months (aPR 1.72; 95% CI: 1.12-2.64; P=0.013) and transactional sex during the past six months (aPR 1.43; 95% CI: 1.01-2.04; P=0.045). Conversely, self-reported sexual abuse was negatively associated with STIs (aPR 0.48; 95% CI: 0.28-0.83; P=0.008).
CONCLUSION: The high prevalence of undiagnosed STIs and unsuppressed HIV among AGYW domestic workers in Kampala highlights the urgent need to increase HIV/STI prevention, testing and treatment coverage for these underserved and vulnerable young women. Targeted interventions are needed to mitigate STI/HIV acquisition in this population.