Sociodemographic factors and STIs associated with Chlamydia trachomatis and Neisseria gonorrhoeae infections in Zambian female sex workers and single mothers

Author:

Connolly Sarah12ORCID,Wall Kristin M23,Parker Rachel34,Kilembe William4,Inambao Mubiana4,Visoiu Ana-Maria4,Sharkey Tyronza4,Hunter Eric13,Allen Susan234ORCID

Affiliation:

1. Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA

2. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

3. Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA

4. Zambia–Emory HIV Research Project, Lusaka, Zambia

Abstract

Sexually transmitted infections (STIs) in women caused by Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG) are epidemiologically distinct. In this study, associations with sociodemographic and clinical risk factors are explored separately for CT and NG. Multivariate logistic regression (MLR) models quantify associations between potential CT and/or NG risk factors within a cross-sectional study of high-risk women in two Zambian cities, Lusaka and Ndola. CT was associated with living in Lusaka, younger age, and literacy. Long-acting reversible contraception (LARC) was predictive of CT in Ndola, but protective in Lusaka. In Lusaka only, CT was associated with lower education and reported unprotected sex. NG was associated with younger age, lower education, concurrent Trichomonas vaginalis, bacterial vaginosis, and incident syphilis infection. Signs and symptoms were rare and not associated with either infection. CT was more prevalent, nearly 11%, compared to NG, 6.8%. The higher prevalence of CT could explain the lack of association with other STIs. The associations observed with NG could be the result of high-risk sexual networks or lack of protective immunity. Risk factors for CT and NG are distinct and may differ geographically, which should be considered when developing diagnostic tools or guiding presumptive treatment in specific populations.

Funder

National Institute of Mental Health

National Institute of Allergy and Infectious Diseases

The AIDS International Training and Research Program Fogarty International Center

International AIDS Vaccine Initiative

United States Agency for International Development

Emory Global Health Institute

National Institute of Child Health and Human Development

Emory Center for AIDS Research

Burroughs Wellcome Fund

Publisher

SAGE Publications

Subject

Infectious Diseases,Pharmacology (medical),Public Health, Environmental and Occupational Health,Dermatology

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