4.0 Article

Prevalence of five curable sexually transmitted infections and associated risk factors among tertiary student men who have sex with men in Nairobi, Kenya: a respondent-driven sampling survey

Journal

SEXUAL HEALTH
Volume 20, Issue 2, Pages 105-117

Publisher

CSIRO PUBLISHING
DOI: 10.1071/SH22114

Keywords

condom use; digital health; nucleic acid amplification tests (NAATs); risk reduction counselling; sex partner; sexual behaviour; sexual minorities; Sub-Saharan Africa; young key populations; young men who have sex with men (YMSM)

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This study aimed to estimate the prevalence of curable sexually transmitted infections (STIs) among tertiary student MSM in Nairobi, Kenya, and investigate associated risk factors. The results showed a high prevalence of at least one of the five STIs among tertiary student MSM in Nairobi, highlighting the urgent need for tailored testing, treatment, and prevention interventions for this population.
Background. Young men who have sex with men (MSM) are a key population at high risk of sexually transmitted infections (STIs). We conducted a respondent-driven sampling (RDS) bio-behavioural survey to estimate the prevalence of five curable STIs: chlamydia, gonorrhoea, syphilis, trichomoniasis and Mycoplasma genitalium infection, and associated risk factors among tertiary student MSM (TSMSM) in Nairobi, Kenya. Methods. Between February and March 2021, we recruited 248 TSMSM aged >= 18 years who self-reported engaging in anal and/or oral sex with another man in the past year. Samples collected included urine, anorectal and oropharyngeal swabs for pooled Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae and Trichomonas vaginalis testing using multiplex nucleic acid amplification tests, and venous blood for serological Treponema pallidum screening and confirmation of current infection. Participants self-completed a behavioural survey on a REDCap digital platform. Data analysis was done using RDS-Analyst (v0.72) and Stata (v15). Differences in proportions were examined using the chi-squared (chi(2)) test, and unweighted multivariate logistic regression was used to assess factors associated with STI prevalence. Results. RDS-adjusted prevalence rates of at least one of the five STIs, chlamydia, gonorrhoea, Mycoplasma genitalium infection, trichomoniasis and latent syphilis were 58.8%, 51.0%, 11.3%, 6.0%, 1.5% and 0.7%, respectively. Factors independently associated with STI prevalence were inconsistent condom use (adjusted odds ratio (AOR) = 1.89, 95% confidence interval (CI): 1.03-3.47, P = 0.038) and the last sex partner being a regular partner (AOR = 2.35, 95% CI: 1.12-4.92, P = 0.023). Conclusion. STI prevalence among TSMSM in Nairobi, Kenya, is disturbingly high, demonstrating urgent need for tailored testing, treatment and prevention interventions for this population.

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