Predictors of Sexually Transmitted Infection Risk Among Women Receiving Family Planning Services in Kisumu County, Kenya

Abstract

Background: Curable sexually transmitted infections prevalence continues to increase in the Sub- Saharan Africa, with women being the mostly affected compared to men. STIs lower the quality of life, increase HIV acquisition risk, and greatly contributes to adverse neonatal outcomes. In Kisumu County, chlamydia and Neisseria gonorrhoea are highly prevalent among women of reproductive age. Several studies have been conducted on predictors for specific STIs in Kenya however no effort has been made to identify general risk factors that can be predictive of STI risk. The aim of this study was to measure STI risk and assess socio-demographic and behavioral factors that increase STI risk among women of reproductive age who seeking family planning services in state facilities in Kisumu County. Methods: This was a baseline cross-sectional survey which was a subset of a quasi-label experimental project focusing on preparing and integrating PrEP services in family planning clinics in Kisumu County. STI risk was estimated from engaging unprotected sex with a partner of unknown or positive HIV status, engaging in sex for money/other favours, sharing needles during intravenous drug use and recent STI diagnosis/treatment. STI risk scores ranged from 0 to 4. Individuals falling at and below the median were classified to have low risk, while those above the median were categorized to high STI risk. Data was cleaned and analyzed using R Software. Median and inter-quartile range were reported for continuous variables while proportions were reported for categorical variables. Mixed-effects logistic regression was used to identify significant predictors of STI risk, where “enrolling facility” was included as a random effect. Results: A total of 650 women aged 15 − 49 years were enrolled in this study. Of these, 40.2%(𝑛 = 261) were aged below 25 years, 80.9%(𝑛 = 526) were married, and 87.9%(𝑛 = 409) had more than 1 partner. The prevalence of high STI risk was 17.8%(95%𝐶𝐼 ∶ 12.7%–36.7%). The associated factors of high STI risk included, having multiple partners (𝑎𝑂𝑅 ∶ 3.45, 95%𝐶𝐼 ∶ 1.58–7.53), alcohol consumption (𝑎𝑂𝑅 ∶ 2.15, 95%𝐶𝐼 ∶ 1.00–4.62), and having an uncircumcised partner (𝑎𝑂𝑅 ∶ 2.25, 95%𝐶𝐼 ∶ 1.06–4.75). Conclusion: High STI risk was common among women utilizing family planning services. Understanding demographic and behavioral factors associated with high STI risk can facilitate the identification of women at high risk for STIs. This will enable timely diagnostic screening, prompt initiation of treatment, better control of infection transmission, and improved disease outcomes