Risk Factors Associated with Syphilis Infection Among Men who Have Sex with Men in Nairobi City County, Kenya
Mwangi, Hellen Nyambura
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Syphilis is an infectious disease caused by the bacterium Treponema palladium. Globally, about 12 million people, majority of whom come from sub-saharan Africa and Asia have suffered from syphilis infections. This study therefore determined the prevalence and the risk factors for occurrence of syphilis among men who sex with men in SWOP/MSM clinic in Nairobi City County. The study adopted l crossectional study design which encompassed use of qualitative and quantitave data collection techniques. Structured questionnaires were used to collect quantitative data fromrespondents while Key Informant Interview schedules were used to qualitative data form healthcare workers in SWOP/MSM clinics. The study targeted a sample size of 257 MSMs attending clinical appointments in the facility. Systematic random sampling was used to select respondents using a predetermined interval of 2. The researcher obtained ethical clearance from the Kenyatta University Ethical Review Committee. Before interview each selected respondents, the study sought informed consent from respondents. Blood samples of 3mls were collected from respondents after each interview for VDRL screening. Postive VDRL specimens were subjected to a specific treponema test (Fluorescent treponema antibody absorption FTA-ABS) test for confirmatory diagnosis and treatment was given immediately by the clinical officer in the clinic. Data was then cleaned and entered into a Microsoft excel database for processing. This was later exported to SPSS version 22.0 for analysis. Descriptive data were presented using frequency tables, graphs and pie-charts. Inferential statistics were done using Chi-square to establish the relationship between variables. Qualitative data from KII was triangulated with quantitative data as direct quotes or narrations from respondents. The study found out that the prevalence of syphilis among MSMs in Nairobi stood at 18.9%. From Chi-Square analysis, the study revealed significant relationship between knowledge factors, risk factors and attitude towards syphilis infection. Transmission mode (p=0.001), frequency of syphilis testing (p=0.001), knowelege on syphilis reinfection (p=0.011), sexual orientation (p=0.005), number of sexual partners (p=0.001), isolation among MSMs (p=0.034), inconsistent use of condoms (p=0.001) and being afraid of syphilis infection (p=0.001) played a significant role in syphilis infection among respondents. These results will be presented to NASCOP and other NGOS and recommendations advised accordingly. These research findings would assist Key healthcare stakeholders to design strategic policies and initiatives to address the challenges faced by MSMs in acquiring healthcare services. This would in turn reduce the rising prevalence of syphilis infections among MSMs in Kenya.