Prevalence, risk factors, and perceptions of vaccination against reproductive tract infections among urban females in Delhi: a cross-sectional study.

BACKGROUND

Reproductive tract infections (RTIs) including sexually transmitted infections (STIs), endogenous and iatrogenic infections, are a major health concern globally, particularly among young females in developing nations. If untreated, they can lead to infertility, increased HIV susceptibility, and cervical cancer. This study examines prevalence of self-reported RTI symptoms, reproductive health status, health literacy, and associated risk factors and perception towards emerging STI vaccines among females in an urban setting.

METHODS

A cross-sectional study was conducted among 1,935 urban females, predominantly aged 18-25 years, from non-medical colleges located in Delhi using a structured questionnaire. Data from 15 participants were excluded due to incomplete information. The remaining data (N = 1,920) was analyzed using SPSS 20 following Chi-square tests, Fisher's exact tests, and Bonferroni corrections. Multinomial logistic regression (reference category: RTI-absent) identified risk factors for low- and high-risk RTIs. Additionally, a binary logistic regression was conducted to identify risk factors of STI/RTI vaccine acceptance.

RESULTS

Among total respondents, 1,241(64.6%) self-reported RTI symptoms, with 1,029 (83%) experiencing vaginal discharge and 974 (78.5%) vulval itching. Significant risk factors among high risk-RTIs, included, menstrual hygiene practices (OR = 3.183), awareness of contraceptive methods (OR = 1.919), family history of medical conditions (OR = 1.494) and prior RTI medication use (OR = 8.839). While, significant risk factors among low risk-RTIs, included, awareness of contraceptive methods (OR = 1.475), and prior RTI medication use (OR = 10.642). Approximately 8.2% and 25.9%, had been vaccinated against HPV and hepatitis B, respectively, while 54.3% and 79.5% of respondents were aware of these vaccines, respectively. Additionally, 1032 (53.8%) were hesitant about emerging RTI vaccines, citing safety concerns (36%, n = 372) and cost (18.6%, n = 192). However, 42.9% (n = 826) of participants reported that recommendations by healthcare providers positively influenced their willingness to receive vaccination.

CONCLUSION

The high prevalence of self-reported RTI symptoms highlights the urgent need for screening, healthcare services, literacy and awareness program to enhance RTI prevention and management.