Sexually transmitted infections: knowledge, attitudes, practises and health-seeking behaviour among patients in a special treatment centre in Nairobi, Kenya

Abstract

Despite an apparent recent decline in the global incidence of the most prevalent STIs namely Chlamydia trachomatis and Neisseria gonorrhoea infections in many countries, sexually transmitted infections (STIs) remain a major public health concern because of their association with the possible transmission of HIV infection, Pelvic Inflammatory Disease (PID), infertility and ectopic pregnancy. Cultural and socio-economic factors have been implicated as obstacles to peoples' acquisition of knowledge on STUHIV/AIDS, negative attitudes, treatment seeking options and this may contribute to delays in seeking treatment. The aims of this study were to examine the knowledge, attitudes, practices and the health-seeking behaviour of patients with STIs in a special treatment centre in Nairobi. Data for the study was drawn from a cross-sectional survey of patients in this clinic from November 2001 to April 2002. The data were collected using self-administered questionnaires; interviews and Focus Group Discussions (FGDs) The patients were selected by purposive sampling. For each interview, the patients appeared in a face-to face session in a private room in the clinic premises. The collected data were scored, cleaned and analysed using the SPSS statistical package. Survey questions included information on STUHIV/AIDS regarding knowledge, attitudes, sexual history and health-seeking behaviour. Chi-square tests were done to establish the association between knowledge and other categorical variables. It was noted from the study interview that the respondents were aware of STIs, but not knowledgeable on the specific STIs. The most commonly known STI was syphilis (36.5%), followed by gonorrhea (36.1%), HIV/AIDS with 23.3%, and Hepatitis B only known to 0.1%. Despite the observation that the 25-31 years age group was the most knowledgeable, they were also the most infected with STIs. The study results showed that 70.9% of the patients had their first sexual encounter by the age of 20 years and an overwhelming percentage (73%) had sexual intercourse with their unmarried partners within the first six months of their relationship. Furthermore, 29% of the participants had exchanged sex for money and that 76% of these were with older partners. Approximately 70% of the participants had been infected with STIs before and 51.8% among them had sought treatment from a private practitioner before going to a public health facility. Similarly 77.1% of these patients never finished their previous treatment appointments. Although 73.7% of all the study subjects had positive attitudes with regard to the attitude test, in some questions the negative attitudes scored highest The results of this study could be used to promote relevant behavioural changes to control the spread of STIs. The information will also be useful in designing proper intervention strategies against the transmission of HIV/AIDS.