Prevalence of five curable sexually transmitted infections and associated risk factors among tertiary student men who have sex with men in Nairobi, Kenya: a respondent-driven sampling survey†

Samuel Waweru Mwaniki; Peter Mwenda Kaberia; Peter Mwangi Mugo; Thesla Palanee-Phillips

doi:10.1071/SH22114

RESEARCH ARTICLE (Open Access)

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Prevalence of five curable sexually transmitted infections and associated risk factors among tertiary student men who have sex with men in Nairobi, Kenya: a respondent-driven sampling survey^†

Samuel Waweru Mwaniki

^A ^B ^* , Peter Mwenda Kaberia ^C , Peter Mwangi Mugo ^D and Thesla Palanee-Phillips ^E ^F

+ Author Affiliations

- Author Affiliations

^A School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

^B University Health Services, Administration and Campus Support Services, University of Nairobi, Nairobi, Kenya.

^C Department of Mathematics, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya.

^D Kenya Medical Research Institute – Wellcome Trust Research Programme, Nairobi, Kenya.

^E Wits Reproductive Health and HIV Institute, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

^F Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.

^* Correspondence to: smwaniki@cartafrica.org

Handling Editor: Lei Zhang

Sexual Health 20(2) 105-117 https://doi.org/10.1071/SH22114
Submitted: 7 July 2022 Accepted: 21 December 2022 Published: 24 January 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background: Young men who have sex with men (MSM) are a key population at high risk of sexually transmitted infections (STIs). We conducted a respondent-driven sampling (RDS) bio-behavioural survey to estimate the prevalence of five curable STIs: chlamydia, gonorrhoea, syphilis, trichomoniasis and Mycoplasma genitalium infection, and associated risk factors among tertiary student MSM (TSMSM) in Nairobi, Kenya.

Methods: Between February and March 2021, we recruited 248 TSMSM aged ≥18 years who self-reported engaging in anal and/or oral sex with another man in the past year. Samples collected included urine, anorectal and oropharyngeal swabs for pooled Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae and Trichomonas vaginalis testing using multiplex nucleic acid amplification tests, and venous blood for serological Treponema pallidum screening and confirmation of current infection. Participants self-completed a behavioural survey on a REDCap digital platform. Data analysis was done using RDS-Analyst (v0.72) and Stata (v15). Differences in proportions were examined using the chi-squared (χ²) test, and unweighted multivariate logistic regression was used to assess factors associated with STI prevalence.

Results: RDS-adjusted prevalence rates of at least one of the five STIs, chlamydia, gonorrhoea, Mycoplasma genitalium infection, trichomoniasis and latent syphilis were 58.8%, 51.0%, 11.3%, 6.0%, 1.5% and 0.7%, respectively. Factors independently associated with STI prevalence were inconsistent condom use (adjusted odds ratio (AOR) = 1.89, 95% confidence interval (CI): 1.03–3.47, P = 0.038) and the last sex partner being a regular partner (AOR = 2.35, 95% CI: 1.12–4.92, P = 0.023).

Conclusion: STI prevalence among TSMSM in Nairobi, Kenya, is disturbingly high, demonstrating urgent need for tailored testing, treatment and prevention interventions for this population.

Keywords: condom use, digital health, nucleic acid amplification tests (NAATs), risk reduction counselling, sex partner, sexual behaviour, sexual minorities, Sub-Saharan Africa, young key populations, young men who have sex with men (YMSM).

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