Prevalence of Sexually Transmitted Infections among HIV Pre-Exposure Prophylaxis Users in Selected Health Facilities in Nairobi City County, Kenya
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Date
2024-02
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Sexually transmitted infections remain a significant public health problem mainly in low-income
countries including Kenya. Currently, approximately half a billion new cases occur worldwide
annually, and more than one million STIs are acquired per day. Of the estimated total of 357
million incident cases of the curable STIs world-wide, 131 million are from Chlamydia
trachomatis, 78 million are from Neisseria gonorrhea, 5.6 million are from syphilis and 143 million
are from Trichomonas vaginalis. In May 2017, the Kenya Ministry of Health, through the National
AIDS and STI Control Program rolled out pre-exposure prophylaxis nationally to individuals at
high risk of HIV acquisition. However, the roll out of HIV-PrEP by NASCOP has not been
assessed to establish the prevalence and behavioural risk factors of STIs among those on HIV-PrEP.
Additionally, attitudes toward HIV-PrEP, STIs related level of knowledge and health seeking
behaviour for STIs among HIV-PrEP users in Nairobi have not been investigated. The main aim of
this study therefore was to address the above gaps by assessing the prevalence of STIs among HIV PrEP users in Nairobi City County. This study employed an analytical cross-sectional research
design. The study targeted 3,330 HIV-PrEP users in Nairobi with a focus on five main health
facilities in Nairobi City County namely; Mbagathi District Hospital, Mama Lucy Level Five
Referral Hospital, Lang‘ata Health Centre, STC MOH-Casino Heath Centre (Comprehensive Care
Centre) and Sex Workers Outreach Program Kenya. Simple random sampling technique was
adopted to obtain a sample size of 357 respondents. The study used primary data which was
collected using structured questionnaire and secondary data (lab results). Descriptive and inferential
statistics were analyzed using Statistical Packages for Social Sciences version 26.0. Chi square test
and logistic regression was used to derive relationships between variables; results were considered
statistically significant with p value ≤0.05. The results were presented on tables and charts. The
study findings revealed that 45.8% of the PrEP users visiting health facilities in Nairobi City
County had at least one curable STI. The prevalence of STIs among this groups was; 13.4% for
Gonorrhea, 9.7% for Chlamydia, 7.4% for Syphilis, 6.0% for Trichomoniasis, 5.1% for Herpes
(Genital herpes), 3.7% for HIV and 0.5% for Genital warts. The study also found that most of the
HIV-PrEP users visiting health facilities in Nairobi City County were well informed and
knowledgeable about STIs occurrence and the benefits of HIV-PrEP. The findings furthermore
revealed a significant association between level of related knowledge on STIs and the prevalence of
STIs among HIV-PrEP users in the County, (
2
=62.280, p=0.033). The study further established
that HIV-PrEP users in Nairobi City County were engaging in risky sexual behaviours as most of
them were involved in the following behavioural risk activities: condomless sexual intercourse,
greater number of sex partners, etc... This was further confirmed by having STIs diagnosis. It was
shown that there existed a statistically significant association between behavioural risk factors of
STIs and the prevalence of STIs among HIV-PrEP users in Nairobi City County (
2
=31.170,
p=0.005<0.05). The study concludes that the adoption of HIV-PrEP is likely to influence sexual
behaviour causing a greater risk-taking tendency. The study thus recommends that there is need for
the County facilities offering HIV-PrEP services to implement a continuous comprehensive routine
screening tests for STIs for prompt identification and treatment of asymptomatic cases, to create
awareness about STIs for risky behaviour change, in order to lower the prevalence of STIs among
HIV-PrEP users.
Description
A Research Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University, February 2024.
Supervisor
1. Harun M. Kimani
2. George O. Orinda