Evaluation of a community-based aetiological approach for sexually transmitted infections management for youth in Zimbabwe: intervention findings from the STICH cluster randomised trial.
HIV
Integration
STI testing
Youth
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
18
04
2023
revised:
02
07
2023
accepted:
17
07
2023
medline:
18
8
2023
pubmed:
18
8
2023
entrez:
18
8
2023
Statut:
epublish
Résumé
Young people are at high risk of sexually transmitted infections (STIs). We report STI testing uptake, prevalence and incidence within a community-based integrated HIV and sexual and reproductive health service for youth, being evaluated in a cluster randomised trial in Zimbabwe. This paper reports the intervention findings of the cluster randomised trial whereby STI testing was offered to all service attendees (16-24 years) in 12 intervention clusters over 12 months between October 5, 2020, and December 17, 2021, in Zimbabwe. Testing for Overall, 8549/9891 (86.1%) eligible youth accepted CT/NG testing. Prevalence of CT and NG was 14.7% (95% CI 13.6-15.8) and 2.8% (95% CI 2.2-3.6) respectively. Combined prevalence of CT, NG or TV in women was 23.2% (95% CI 21.5-25.0). After adjusting for cluster, age and sex, the odds of NG were increased in those living with HIV (aOR 3.14, 95% CI 2.21-4.47). The incidence rate among those who initially tested negative for CT or NG was 25.6/100PY (95% CI 20.6-31.8). CT/NG treatment uptake was 924/1526 (60.6%). TV treatment uptake was 483/489 (98.8%). A partner returned for treatment for 103/1807 clients (5.7%). Our findings show high acceptability of STI testing among youth. STI prevalence was high particularly among females and youth with HIV, underscoring the need for integration of HIV and STI services. MRC/ESRC/DFID/NIHR (MR/T040327/1) and Wellcome Trust (206316/Z/17/Z).
Sections du résumé
Background
UNASSIGNED
Young people are at high risk of sexually transmitted infections (STIs). We report STI testing uptake, prevalence and incidence within a community-based integrated HIV and sexual and reproductive health service for youth, being evaluated in a cluster randomised trial in Zimbabwe.
Methods
UNASSIGNED
This paper reports the intervention findings of the cluster randomised trial whereby STI testing was offered to all service attendees (16-24 years) in 12 intervention clusters over 12 months between October 5, 2020, and December 17, 2021, in Zimbabwe. Testing for
Findings
UNASSIGNED
Overall, 8549/9891 (86.1%) eligible youth accepted CT/NG testing. Prevalence of CT and NG was 14.7% (95% CI 13.6-15.8) and 2.8% (95% CI 2.2-3.6) respectively. Combined prevalence of CT, NG or TV in women was 23.2% (95% CI 21.5-25.0). After adjusting for cluster, age and sex, the odds of NG were increased in those living with HIV (aOR 3.14, 95% CI 2.21-4.47). The incidence rate among those who initially tested negative for CT or NG was 25.6/100PY (95% CI 20.6-31.8). CT/NG treatment uptake was 924/1526 (60.6%). TV treatment uptake was 483/489 (98.8%). A partner returned for treatment for 103/1807 clients (5.7%).
Interpretation
UNASSIGNED
Our findings show high acceptability of STI testing among youth. STI prevalence was high particularly among females and youth with HIV, underscoring the need for integration of HIV and STI services.
Funding
UNASSIGNED
MRC/ESRC/DFID/NIHR (MR/T040327/1) and Wellcome Trust (206316/Z/17/Z).
Identifiants
pubmed: 37593222
doi: 10.1016/j.eclinm.2023.102125
pii: S2589-5370(23)00302-4
pmc: PMC10430193
doi:
Types de publication
Journal Article
Langues
eng
Pagination
102125Subventions
Organisme : Wellcome Trust
ID : 206316/Z/17/Z
Pays : United Kingdom
Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
Authors declare no competing interests.
Références
Sex Transm Infect. 2015 Nov;91(7):473-8
pubmed: 25834122
Lancet Child Adolesc Health. 2021 Feb;5(2):122-132
pubmed: 33417838
J Adolesc Health. 2016 Jul;59(1):7-16
pubmed: 27338664
Open AIDS J. 2016 Apr 08;10:34-48
pubmed: 27347270
Sex Transm Infect. 2011 Dec;87 Suppl 2:ii34-6
pubmed: 22110152
Sex Transm Infect. 2019 May;95(3):219-227
pubmed: 30518620
Clin Microbiol Infect. 2019 Jul;25(7):865-871
pubmed: 30391581
ISRN AIDS. 2014 Mar 05;2014:103452
pubmed: 24729919
Cochrane Database Syst Rev. 2013 Oct 03;(10):CD002843
pubmed: 24092529
J Adolesc Health. 2015 Jan;56(1 Suppl):S22-41
pubmed: 25528977
BMJ Glob Health. 2020 Oct;5(10):
pubmed: 33051283
Can Fam Physician. 2018 Jun;64(6):448
pubmed: 29898936
Sex Transm Infect. 2019 Dec;95(8):569-574
pubmed: 31175210
Nat Microbiol. 2022 Aug;7(8):1116-1126
pubmed: 35918418
J Int AIDS Soc. 2019 Aug;22 Suppl 6:e25343
pubmed: 31468679
Glob Health Sci Pract. 2019 Sep 26;7(3):435-446
pubmed: 31558599
Lancet Infect Dis. 2022 Apr;22(4):541-551
pubmed: 34942091
Curr Opin Pediatr. 2018 Feb;30(1):137-143
pubmed: 29315111
Cult Health Sex. 2015;17 Suppl 2:S190-205
pubmed: 25953243
Sex Health. 2022 Aug;19(4):265-277
pubmed: 35705518
Int Health. 2022 Nov 1;14(6):545-553
pubmed: 35134172