Patterns of Sexually Transmitted Infections Cases Presenting In Key Population Friendly Health Facilities in Oyo State South-West Nigeria

Authors: Titus Michael Olubunmi1, Bako John Chukwudi1, Odulaja Adebusola1, Ogungbenro Tunde1, Oyedeji Segun1, Omoregie Godpower1, Adetunji Adebola1, Ayinde Olubunmi2

Conference: 19th International Conference on AIDS and STIs in Africa (ICASA 2017) to be held in Côte d’Ivoire 4 – 9 December 2017

Presentation Date: Thursday, 7 December 2017

Abstract Number: THPDCI38

Issues: Sexually transmitted infections (STIs) have a profound impact on sexual and reproductive health worldwide leading to considerable morbidity, mortality and stigma. More than 1 million STIs are acquired every day worldwide each year and increases the risk of HIV acquisition three-fold or more. A syndrome-based approach to the management of STI patients was developed and promoted by WHO for developing countries who lack laboratory equipment or skills required for aetiological diagnosis of STI.

Descriptions: In a bid to increase access and uptake of STI treatment by Key Populations (KP) and their sexual partners who accounted for 45% of all new HIV infections in 2015, the Society for Family Health, with funding from the Global Fund, selected 5 Health care workers (HCWs) each in 3 government-owned and 3 private owned ART health facilities. The selected HCWs were trained on comprehensive sexuality education, STI and HIV pre- and post-test counselling; safer sex/risk-reduction counselling, condom promotion, and interventions targeted at key populations (FSW, MSM and PWID). Mobile HIV Counsellor Testers were also trained to screen KP and clients of KP for STIs (including HIV) and referred to these friendly health facilities for provision of STI Syndromic Management services and free drugs. This paper is a retrospective review of data from the health facilities between April 2016 and May 2017.

Lessons learned: HCWs are now KP friendly which has led to more KPs visiting the health facilities. The HCWs are now conversant in identification of presenting STI cases therefore leading to increased STI cases seen. 304 (254KP, 312 clients of KP) visited and 832 STI cases presented during the period. Generally, the most common presenting STI cases were abnormal vaginal discharge 287 (34.5%), lower abdominal pain 287 (33.9%), male urethral discharge 128 (15.4%), genital ulcers 98 (11.8%), scrotal swelling 13 (1.6%) and genital warts 12 (1.4%). Among KP, most common presenting cases were lower abdominal pain 152 (38.7%), abnormal vaginal discharge 117 (29.8%), genital ulcers 54 (13.7%), male urethral discharge 52 (13.2%), while least cases were genital warts 8 (2%), scrotal swelling 7 (1.8%), inguinal swelling 2 (0.5%) and postpartum vaginal discharge 1 (0.3%).

Next steps: More health facilities and HCWs should be trained on provision of KP friendly STI syndromic management. More interventions to reduce STI and also treat partners should be encouraged.

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