Conference Proceeding

Prevalence and factors associated with self-reported STIs among HIV-positive individuals aged 15-49 years in Rwanda

Dr. Justine Umutesi,
University of Rwanda, Rwanda

Data shows a strong association between sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), with co-infection accelerating the progression of HIV and increasing the risk of HIV transmission.

Ms. Justine Umutesi is presently pursuing her Masters in field of Epidemiology and Laboratory Management at University of Rwanda. She completed her Bachelor’s Degree in Public Health at Saint Josephs University. She has membership in many professional bodies such as Member of Association of Nurses in AIDS care, Akron/Ohio. Member and secretary of Alumni Network of Field Epidemiologist of Rwanda. Her key qualifications are Field epidemiologist, Academic degree in public health, Academic Degree in Mid-Wifely etc.

Background: Data shows a strong association between sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), with co-infection accelerating the progression of HIV and increasing the risk of HIV transmission. Our objective was to determine the prevalence of STIs in HIV-positive individuals in Rwanda and to determine key risk factors for STIs in this population.
Methods: Our study was a cross-sectional analysis of the Rwanda Demographic and Health Survey (DHS) 2014-15 which included 380 HIV-infected people aged 15-49 years. We analyzed sociodemographic variables and conducted bivariate analysis to measure potential associations between covariates and STIs. Variables which were significant in bivariate models (p≤0.1) were entered into the multivariate model; p≤0.05 was considered significant. STI was defined as any self-reported STI, genital discharge, or genital sores within the last 12 months.
Results: A total of 380 respondents were HIV positive and approximately 67% were female. The mean age was 34.6 (±8.8). STIs were observed in 73 HIV+ people leading to a prevalence of 19.2% (95%CI 15.5-23.5). In bivariate analysis, people from Western and Eastern Provinces were more likely to have STIs compared by those in Kigali (OR 2.39 [95%CI 1.12-5.15] and 2.66 [1.27-5.62] respectively). Female gender (OR 1.59 [0.94-2.69]) and high risk partnership (OR 2.87 [1.50-5.50]) were associated with STIs infection. Conversely, people who attained secondary school education (OR 0.25[0.08-0.77]) and those aged 18 years and above were less likely to have STIs (OR 0.31 [0.18-0.54]). Surprisingly individuals who reported condom use were more likely to have STIs (OR 2.19[1.29-3.73]). In multivariate analysis, Eastern province (OR 3.56 [1.47-8.64]) and high risk partnership (OR 3.67 [1.31-10.24]) remained significantly associated with STIs, while secondary school attainment (OR 0.21 [0.06-0.80]) and age above 18 (OR 0.32 [0.17-0.64]) were protective.
Conclusion: Infection with an STI is very common in individuals infected with HIV in Rwanda. Strengthening STI education surrounding correct condom use, reduction of extramarital partnerships and delaying sexual activity initiation is necessary. Clear definition of condom use in the DHS is also needed for a better understanding of this important component in sexual and reproductive health.

Published: 05 May 2017