Nearly half of adults with symptoms of sexually transmitted infections (STIs) did not seek clinical care

A population-based study of treatment-seeking behavior among adults in Rakai, Uganda

Bibliographic Data

ID19592059
AuthorsYasmin P Ogale (0000-0002-1882-6535, Johns Hopkins University, corresponding author), Caitlin E Kennedy (0000-0001-6820-063X, Johns Hopkins University, corresponding author), Fred Nalugoda (0000-0001-6119-9293, Rakai Health Sciences Program, corresponding author), Josephine Mpagazi (Rakai Health Sciences Program, corresponding author), Jade C Jackson (Johns Hopkins University, corresponding author), Ronald Galiwango (0000-0003-3702-5722, Rakai Health Sciences Program, corresponding author), Robert Ssekubugu (0000-0003-1245-4774, Rakai Health Sciences Program, corresponding author), Godfrey Kigozi (0009-0008-9142-6870, Rakai Health Sciences Program, corresponding author), Julie A Denison (0000-0002-4670-093X, Johns Hopkins University, corresponding author), Charlotte A Gaydos (0000-0002-1021-3195, Johns Hopkins University, corresponding author), Joseph Kagaayi (0000-0003-4101-3038, Rakai Health Sciences Program, corresponding author), M Kate Grabowski (0000-0002-4451-3436, Johns Hopkins University, corresponding author), M Kathryn Grabowski
EditorsPeter Bai James (0000-0002-6373-5704)
Year2023
Volume3
Issue5
Pagese0001626
Publication date2023-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001626
PMID37126490
OpenAlexW4367602051
LanguageEN
Citations received1
References cited51

Understanding treatment-seeking behavior is critical to the treatment and control of sexually transmitted infections (STIs), yet current data on STI treatment seeking in low-resource settings is rare. This population-based study aimed to describe STI treatment-seeking behavior and identify factors associated with seeking treatment at a clinic among adults with STI-related symptoms in rural Uganda. The STI prevalence study (STIPS) conducted a survey and STI testing among all consenting adults aged 18–49 in two communities in rural south-central Uganda. Of 1,825 participants, 962 individuals self-reported STI symptoms in the past six months; we present descriptive data on treatment seeking and STI prevalence among these individuals. We used multivariable Poisson regressions with robust variance to determine the sociodemographic and symptom-related factors independently associated with seeking STI treatment at a clinic and assessed the association with previous clinic treatment seeking and current STI diagnosis. Forty-three percent of adults who reported STI-related symptoms in the past six months said they did not seek any treatment. Among those who did, 58% sought treatment at a private clinic, 28% at a government clinic, 9% at a pharmacy/drug store, 3% at a traditional healer, 2% at a market/shop, and 5% at another location. Among both males and females, having multiple STI related symptoms was positively associated with clinic treatment seeking (males = PRR: 1.73, 95%CI: 1.36–2.21; females = PR: 1.41, 95%CI: 1.12–1.78). Approximately one-third of males and females who reported previously seeking clinic treatment for their symptoms were diagnosed with a curable STI at the time of the survey. In this setting, nearly half of adults with STI-related symptoms are not seeking clinical care and many who report having sought treatment for recent STI symptoms have curable STIs. Future studies should explore barriers to care-seeking and strategies to improve STI services

Descriptive statistics · Environmental health · Family medicine · Poisson regression · Population · Adolescent Sexual and Reproductive Health · Demography · HIV/AIDS Research and Interventions · Medicine · Syphilis Diagnosis and Treatment · Pharmacy