STI-prevalence and differences in social background and sexual behavior among urban and rural young women in Uganda.

BACKGROUND

Adolescents in Uganda carry a heavy burden of reproductive health problems. Different environment creates different problems.

OBJECTIVES

To study the prevalence of STI and to compare social and behavioral risk factors for Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) among sexually experienced young women in one urban and one rural area in Uganda.

METHODS

Consenting, sexually experienced women, below 20 years, visiting two different youth clinics were asked about social background, genital symptoms and sexual experiences. Vaginal samples were taken for NG and CT and analyzed by PCR.

RESULTS

The prevalence of NG and/or CT was 20 (6.8%) in the urban and 23 (7.8%) in the rural study site, a non-significant difference. The rural women were often in marital union, 25.3% compared to 12.2% of the urban women (OR 2.4, 95% CI 1.6-3.8) and had experienced more pregnancies and had more children. Their partners were often more than 10 years older. More urban women (42.2%) knew their HIV status compared to rural women (16.2%), OR 2.1 (1.6-2.7), reported more condom use and more sexual partners.

CONCLUSIONS

Marital status and few sexual partners does not appear to protect young rural women from sexually transmitted infections (STIs), implying that male sexual behavior may have an important impact on women's risk to be infected.