Prevalence and associated factors of sexually transmitted infections among adolescents and young people attending general outpatient departments in the Teso subregion, Northeast Uganda. A cross-sectional study

Prevalence and associated factors of sexually transmitted infections among adolescents and young people attending general outpatient departments in the Teso subregion, Northeast Uganda. 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A cross-sectional study Hellen Akurut, Mary Abwola Olwedo, Fred Kirya, Emmanuel Ayikobua Tiyo, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6662550/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background. Globally, an estimated 374 million new cases of curable sexually transmitted infections (STIs) occur annually, with the highest rates among adolescents and young adults due to a combination of behavioral, biological, and social factors. Our study aimed to determine the prevalence and associated factors of sexually transmitted infections among adolescents and young people attending general outpatient departments (OPDs) in four selected health facilities in the Teso subregion of Northeast Uganda. Methods. A cross-sectional survey was conducted between February and June 2023 in four high volume health facilities in northeastern Uganda. A total of 400 participants were systematically selected and screened for STIs by adolescent counselors and a clinical team. Sociodemographic and risk factor data were collected using structured questionnaires administered by an interviewer, while blood-based samples were collected by trained laboratory technicians’ sterile procedures and equipment for testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis. Data entry and analysis were performed using Statistical Package (STATA), version 15.0. Crude and adjusted odds ratios with 95% confidence intervals (CIs) were computed to identify associated factors. Results The average age of the 400 participants was 20.3 (SD=2.7) years. The majority of theparticipants were females (89.5%, n=358) and had never married (65.5%, n=262). The overall prevalence of any STI (HIV, HBV or syphilis) was 6.5% (n=26, 95% CI, 4.4–9.4). The most prevalent STI among young people in Teso was hepatitis B, 3.1% (n=12/390, 95% CI, 1.8–5.4). After adjusting for each other, the factor that was significantly associated with STI prevalence among youth was having ever used illicit drugs (OR=3.16; 95% CI, 1.23--8.10). Conclusion STIs, especially hepatitis B, are common among adolescents and young people in the Teso subregion. There is a significant association between STI prevalence among youth who used illicit drugs. Adolescents and young people, especially those with a history of drug addiction, need to be prioritized for STI screening and management at outpatient departments (OPDs). Adolescents Young persons STIs HIV syphilis hepatitis B risk factors Teso region Background Sexually transmitted infections (STIs) are infections that are of public health concern and can be passed on from one person to another during unprotected sex and intimate skin-to-skin contact[ 1 ]. Many STIs do not have any symptoms. This means that an adolescent can have an STI without knowing it and pass it on to the partner during sex or close contact. These include gonorrhea, syphilis, HPV, herpes, genital warts, HIV, hepatitis B, and chlamydia. Most cases are easily treated, especially when they are discovered early. If left untreated, STIs can lead to serious health problems[ 1 ]. HBV, for example, causes 1.1 million deaths annually, mostly from liver cirrhosis and hepatocellular carcinoma, and 3.0 million new infections[ 2 ]. Sub-Saharan African (SSA) countries have the highest number of STI cases, accounting for approximately 93 million cases every year[ 3 ], with a reported prevalence of HBV and syphilis coinfections ranging from 10%-13%[ 4 ]. STI case rates are highest among adolescents and young people, with studies in some SSAs, such as Ethiopia, reporting a prevalence of 11.5% among young people[ 5 ], while the pooled self-reported STI prevalence among young women in Uganda was 26.0%[ 6 ]. While the STI case rate is highest in adolescents and young people, the most serious health outcomes occur later in life and are disproportionately borne by women and infants[ 1 ]. Adolescents are at particularly high risk for STIs due to a combination of behavioral, biological, and social factors, such as engaging in higher-risk sexual behaviors; thus, they lack access to sexual and reproductive health services or do not pursue STI testing due to confidentiality concerns[ 7 ]. The objective of this study was therefore to determine the prevalence and associated factors of sexually transmitted infections among adolescents and young people attending outpatient clinics in the Teso region of Uganda. Materials and methods Study design and study area This was a cross-sectional study conducted at health facility level from February to June 2023 among adolescents and young adults attending outpatient departments (OPDs) in four high-volume public health facilities. The Teso subregion comprises 10 districts: Soroti, Amuria, Kapelebyong, Katakwi, Bukedea, Kumi, Ngora, Serere, Kalaki, Kaberamaido and Soroti. The total number of health facilities providing STI screening, including HIV testing services, is 106 (1 RRH, 7 Hospitals, 10 HCIVs, 62 HCIII, 23 HCIIs and 3 special clinics)[ 11 ].The total population of the Teso subregion is 2,462,344[ 12 ], and the HIV prevalence is 4.2%[ 13 ]. Our study purposively selected four high-volume health facilities that served at least 200 adolescents and young adults per month in the preceding quarter. These included the Soroti regional referral hospital in Soroti City, Katakwi hospital in the Katakwi district, Kumi HCIV in the Kumi district and Serere HC IV in Serere district. Study population All adolescents and young people between the ages of 15–24 years, regardless of the presence or absence of STIs symptoms, who attended outpatient clinics at selected health facilities during the study period and were willing and able to provide informed consent and assent. The study excluded; participants who were mentally ill and those who were very sick and not able to participate in the study. Similarly, the adolescents and young people who were diagnosed with STIs and were undergoing treatment for STI were excluded. Sample size determination and sampling method. Regarding a sample size determination, a single proportion (N = Z 2 p(1-p)/d 2 ) was used. An STI prevalence of 19.1%[ 9 ] was applied, with 95% confidence level and a 5% margin of error, resulting in sample size of 237.To account for multiple study sites, a design effect of 1.5 was applied, increasing the size to 356. After adjusting for 10% nonresponse rate, the final sample size was determined to be 392 participants. In our final analysis, we included 400 participants distributed in the four facilities proportionate to the number of individuals served per facility. The total allocated sample sizes for the four study sites were as follows: Soroti RRH-120, Kumi HC IV-100, Serere HC IV-100 and Katakwi Hospital-80. A systematic random sampling method was applied for the selection of participants. Over a three months data collection period, approximately 2400 adolescents and young people were expected to visit the outpatient’s department, based the health facility’s projections and quarterly performance. This number was divided by the desired sample size (2400/400) to determine the sampling interval (K th value), which was 6. The first participant was randomly selected by the lottery method, and then every 6th client was invited to participate in the study until the target sample size was reached. Sociodemographic and behavioral data Sociodemographic and behavioral information was gathered through a structured questionnaire administered by the interviewer. Collected data participant’s sex, marital status, age, place of residence, level of education, religion, STI knowledge, substance and alcohol use, sexual behaviour and partners, sexual health knowledge and practices, prior STI screening and treatment, reasons for visiting the health facility, hepatitis B vaccination history and sources of income. Data collection tool and procedure The study team developed and utilised structured questionnaires that were pretested at Princes Diana HC IV. Adjustments were made to the questionnaire following the pretest and the Research Assistants (RAs) were identified, trained to provide health education and counseling and to administer the questionnaires in the OPD of the selected facilities. The RAs reviewed the ages of OPD patients and systematically sampled those within the age group of 15–24 years. The RAs held health education talks for adolescents and young people who had come to the facility and identified those who were willing to be screened for STIs. We conducted questionnaire interviews with all eligible study participants who provided informed consent, parental informed consent and assent for minors to obtain information on previous STI screening access, acceptability and utilization of STI screening services, associated factors to STIs and provided screening services to those willing to be screened. We validated participant biodata and clinical characteristics from health facility outpatient registers and laboratory registers. STI screening, sample collection and analysis Qualified laboratory personnel collected 5 ml whole blood sample from each participant using a syringe at the OPD laboratory. HIV diagnosis was done according to the national HIV rapid diagnostic test algorithm (Determine, STAT PAK, SD-Bioline) to identify antibodies, with retesting conducted for all HIV-positive samples. Hepatitis B surface Antigen (HBsAg) was detected in the serum using a high quality, one-step rapid immunochromatographic test following the manufacturer’s instructions. Syphilis screening involved the detection of antibodies against syphilis antigen using Rapid Plasma Reagin (RPR) test and a one-step anti-TP rapid syphilis test based on the manufacturer’s protocol and Ministry of Health laboratory guidelines. Feedback was given to the study participants through the return of their laboratory results to the attending clinicians, and those testing positive for STIs were initiated on appropriate care and treatment at health facilities as per the national guidelines. The results were then entered into the online interview questionnaire by the RAs. Data Management and Analysis. Data was collected using predesigned forms in kobo collect software installed in android tablets, then exported to excel. The data was cleaned by checking for missing values, incomplete responses and inconsistences. After cleaning, the dataset was imported into STATA version 16.0 for further processing and analysis. Bivariable binary logistic regression was initially conducted to determine associations between the prevalence of STIs and independent variables. Variables with a p-value less than 0.20 in the bivariable analysis were included multivariable logistics regression analysis. Odds ratios, 95% confidence intervals, and p values were calculated to assess the strength of associations, with a statistical significance set at p < 0.05. Results Sociodemographic characteristics. The average age of the 400 participants was 20.3 (SD = 2.7) years. The majority of the participants were females (89.5%, n = 358), had never married (65.5%, n = 262) and were residing at home (85.0%, n = 340). Approximately half (n = 199) of the participants had come to the facility with STI symptoms, 15.5% (n = 62) reported experiencing sexual and gender-based violence, and 12.2% (n = 49) had ever used illicit drugs (Table 1 ). Table 1 Sociodemographic and behavioral characteristics of the participants Variable Frequency (n), N = 400 Proportions (%) Mean Age/years (SD) 20.3(2.7) Age Category 15–19 163 40.8 20–24 237 59.2 Sex Female 358 89.5 Male 42 10.5 Religion Catholics 165 41.3 Muslims 7 1.7 Pentecostal 46 11.5 Protestant 182 45.5 Education Level Never/Primary 194 48.5 Secondary 206 51.5 Marital Status Never married (Single) 262 65.5 **Ever Married 138 34.5 STI Screening setting At home/Self-test 58 14.5 At school 28 7.0 Hospital OPD/STI clinic 292 73.0 Private Laboratory 22 5.5 Visit reason-Have STI symptom No 201 50.2 Yes 199 49.8 Had Sex in 6 months No 90 22.5 Yes 310 77.5 Condom Use Always 8 2.0 N/A 74 18.5 No 217 54.3 Sometimes 101 25.2 Experienced SGBV No 338 84.5 Yes 62 15.5 Ever exchanged money for sex No 383 95.8 Yes 17 4.3 Ever used illicit drugs No 351 87.8 Yes 49 12.2 Hepatitis B vaccinated No 199 49.8 Yes 201 50.2 Ever screened for HIV No 75 18.7 Yes 325 81.3 Ever screened for Hepatitis B(n = 399) No 240 60.2 Yes 159 39.8 Ever Screened for Syphilis No 384 96.0 Yes 16 4.0 **Ever married = married/cohabiting/divorced/separated. STI prevalence among adolescents and young persons The overall prevalence (positivity) of any STI (HIV, HBV or syphilis) was 6.5% (n = 26, 95% CI, 4.4–9.4). The most prevalent STI among the young people in Teso was hepatitis B, 3.1% (n = 12/390, 95% CI, 1.8–5.4), followed by syphilis, 2.3% (n = 9/391, 95% CI, 1.0-4.1%), and HIV was the least prevalent, 1.5% (n = 6/390, 95% CI, 0.7–3.4) (Table 2 ). Table 2 STI prevalence STI TYPE NO. TESTED NO. POSITIVE PREVALENCE (%age Pos, 95%CI) HIV 390 6 1.5 (0.7–3.4) Hepatitis B 390 12 3.1 (1.8–5.4) Syphilis 391 9 2.3 (1.0-4.1) Overall 400 26 6.5 (4.4–9.4) Factors associated with STI prevalence. After adjusting for each other, the factor that was significantly associated with STI prevalence among youth was having ever used illicit drugs, aOR = 3.16(95%CI, 1.23–8.10). All other factors were not statistically significant. (Table 3 ). Table 3 Factors associated with STI prevalence. Variable Frequency, N = 400 Positive, n (%), n = 26 Negative, n (%), n = 373 Odds Ratio (OR) cOR aOR Age Category 15–19 163 10(6.1) 153(93.9) 1 1 20–24 237 16(6.8) 221(93.2) 1.09(0.49–2.43) 1.27(0.51–3.15) Sex Female 358 22(6.2) 336(93.8) 1 1 Male 42 4(9.5) 38(90.5) 1.75(0.60–5.07) 1.59(0.50–5.04) Education Level Never/Primary 194 15(7.7) 179(92.3) 1 1 Postprimary 206 11(5.3) 195(94.7) 0.68(0.31–1.50) 0.70(0.27–1.84) Marital Status Never married (Single) 262 19(7.3) 243(92.7) 1 1 **Ever Married 138 7(5.1) 131(94.9) 0.71(0.30–1.70) 0.31(0.24–1.63) Participants residence Home 340 25(7.4) 315(92.6) 1 1 Hostel/boarding school 60 1(1.7) 59(98.3) 0.31(0.06–1.66) 0.31(0.05–1.77) STI Symptoms No 201 7(4.5) 149(95.5) 1 Yes 199 4(7.8) 47(92.2) 1.64(0.74–3.65) 1.65(0.69–3.96) Symptoms-Bleeding No 395 25(6.3) 370(93.7) 1 1 Yes 5 1(20.0) 4(80.0) 4.84(0.73–32.09) 3.02(0.41–22.40) Symptoms-Blisters No 377 23(6.10) 354(93.9) 1 Yes 23 3(13.0) 20(87.0) 2.58(0.77–8.62) 1.82(0.50–6.70) Ever used illicit drugs No 351 19(5.4) 332(94.6) 1 1 Yes 49 7(14.3) 42(85.7) 3.01(1.22–7.41) 3.16(1.23–8.10) Hepatitis B vaccinated No 199 17(8.5) 182(91.5) 1 1 Yes 201 9(4.5) 192(95.5) 0.51(0.23–1.16) 0.58(0.24–1.39) Discussion This study determined the prevalence and associated factors of sexually transmitted infections (STIs) among adolescents and young adults attending OPD in four selected health facilities in the Teso subregion of Northeast Uganda. In our study, half of the participants reported to the facility with STI symptoms. The prevalence of self-reported STI symptoms is high in different settings, ranging from 19%-26% in Uganda[ 6 , 9 ] and 20% in Tanzania[ 14 ]. Young people are involved in risky sexual behaviors, which predisposes them to contract STIs[ 15 – 18 ]. We found that only 2% of our study participants used condoms consistently, and up to 54% reported no condom use at all. This puts them at increased risk of acquiring STIs. The overall prevalence (positivity) of any STI (HIV, Hep B or syphilis) was 6.5%, with the most prevalent STI being HBV (3.1%), followed by syphilis (2.3%) and HIV (1.5%). The only factor that was significantly associated with STI among participants was ever using illicit drugs. The lower rates of observed STIs in our study occurred because only a few STIs (3) were selected for testing. Studies that have tested more STIs have reported extremely high prevalence rates, with two studies among adolescents and young adults in Brazil reporting that 32–85% of the participants had at least one STI[ 19 , 20 ] and another in Eldoret, Kenya, reporting 28% STI positivity among adolescents and young adults[ 21 ]. A study conducted among youth-friendly service attendees in Ethiopia reported a higher prevalence of 4 STIs (Hepatitis B, HIV, syphilis and hepatitis C) at 11.5%[ 5 ], which was far above the one reported in our study. The STI prevalence rates reported in our study were comparable to those reported in previous studies. For example, the observed HIV prevalence of 1.5% was comparable to the Uganda population HIV impact assessment findings, which was 0.9% for adolescents aged 15–19 years and 2.9% for young adults aged 20–24 years[ 13 ]. On the other hand, active syphilis was previously reported in 0.9–1.5% of adolescents and young adults[ 22 ], which is slightly lower than what was observed in our study, whereas hepatitis B viral infection was previously reported in 3.7% and 4.5% of adolescents and young adults[ 22 ], which is slightly higher than what is currently reported. Hepatitis B specifically has been reported to be high at 6.5% among young adults in Ethiopia attending youth-friendly services[ 5 ] Elsewhere in Brazil, there was a zero (0%) prevalence of hepatitis B and HIV but a 1% prevalence of syphilis among adolescents[ 20 ] compared with hepatitis B (3.1%), HIV (1.5%) and syphilis (2.3%) in our study. These findings indicate that young adults in Uganda are still at high risk of preventable STIs, probably due to limited access to healthcare and sexual health education; widespread poverty; cultural practices that promote risky sexual behavior; high rates of concurrent sexual partnerships; and inadequate screening and treatment programs in low- and middle-income countries[ 23 ], which contribute to a high prevalence of HIV, syphilis and hepatitis B. Although current guidelines in Uganda recommend testing all individuals between the ages of 13 and 64 years at least once a year for HIV, syphilis and HBV, this is not routinely done in OPD, except in antenatal care (ANC) for pregnant women, with the aim of preventing mother‒child transmission [ 24 , 25 ]. This leads to many missed opportunities for screening, early detection and treatment of STIs in adolescents and young adults. This calls for the prioritization of adolescents and youth in routine screening, particularly for hepatitis B, HIV and syphilis. The factor that was significantly associated with STI prevalence among adolescents and young adults in this study was having ever used illicit drugs. The use of alcohol and drugs reduces the perception of risk and tends toward unprotected sexual practices and STIs[ 26 , 27 ]. Other studies assessing the relationship between alcohol consumption and risky sexual behavior among adolescents and young adults reported similar findings that alcohol consumption is strongly associated with risky sexual behavior, including early sexual initiation, inconsistent condom use, and multiple sexual partners among adolescents and young adults[ 15 , 16 ]. These risky behaviors predispose adolescents and young people to STIs. Study strengths and limitations Our study had several limitations. As a facility-based study, some adolescents and young people who could have been sick and unable to visit the facility were missed, which may have led to underreporting of the STI prevalence among the adolescents. In addition, some minors who were eligible for the study were excluded because they did not come with their parents for consent. This could have also affected the results, as those who come along are most likely to have STI more than the minors who are escorted. Despite the above limitations, the study used four health facilities at different levels of care (Regional Referral Hospital, District Hospital, and Health Centre IVs), which included a mixture of participants, including urban and rural patients. Conclusions and recommendations In this study, the overall prevalence of sexually transmitted infections among adolescents and young people attending outpatients at selected health facilities in the Teso region was low. Most participants were positive for hepatitis B. The Ministry of Health and Key stakeholders should identify reasons for the high prevalence of hepatitis B despite the triple elimination campaign among pregnant women and consider prevention strategies, which may include strengthened vaccination and community sensitization. Research on strategies to prevent risky behavior that predisposes adolescents and young people to STIs is recommended. Abbreviations STIs Sexually transmitted infections HIV Human immunodeficiency Virus HBsAg Hepatitis B surface Antigen MOH Ministry of Health HPV Human Papilloma Virus CI Confidence Intervals REC Research Ethics Committee TASO The AIDS Support Organization OPD Outpatients Department ANC Antenatal care RA Research Assistant RPR Rapid Plasma Reagin OR Odds Ration SD Standard Deviation SUN RIF Soroti University Research and Innovation Fund. Declarations Ethical Consideration and Approval Our study adhered to the Declaration of Helsinki by ensuring primacy of adolescent and young people’s health and well-being and we offered care in the participant’s best interest. The protocol was submitted to the Busitema University Faculty of Health Sciences Research Ethics Committee (BUFHSREC), which reviewed and approved it, approval number BUFHS-2023-70, on 02/03/2023. The participants aged 18 years and above signed informed consent forms, whereas those aged 15-17 years signed informed assent, in addition to their parental informed consent. The objectives, purpose, benefits, risk of the study and their role in the study were briefed to them. To ensure participants anonymity and confidentiality, unique identifiers were assigned, pseudonyms were used in documentation and all electronic data were securely encrypted. The participants with both positive and negative test results from the laboratory, received health education and counselling services provided by health workers. However, those with positive result were referred and escorted for treatment at specialised clinics within the health facility. All research documents namely; questionnaires, the participants’ information sheets, and consent forms were translated to Ateso language to reduce communication barriers. Furthermore, the health workers and adolescent counselors respected participants opinions to withdrawal from the study and protected their rights. During the research design, potential adolescents and young persons were engaged and guided the team to focus on three disease conditions (HIV, syphilis, hepatitis B) that commonly affect the young people instead of assessing all sexually transmitted infections. Our study was conducted only by health care professionals with the appropriate ethics and scientific education, training and qualifications. A research team conducted facility-based trainings on the study protocol before data collection and selected qualified Nurses, Clinicians laboratory staff to screen participants for STIs.Supervsion was done by facility in charges who are medical officers and Soroti University staff who are qualified health professionals. The participants have been engaged in dissemination of results meetings at the study sites. Consent for publication All participants and parents to minors provided informed consent and minors provided informed assent to the study including consent for publication of anonymized data. The authors confirm that data presented in this manuscript do not contain any identifiable personal information and all findings are reported in confidentiality. Consent procedures were approved by Busitema University Faculty of Health Sciences Research Ethics Committee and the study was conducted according to relevant guidelines and regulations. The study was conducted in line with declaration of Helsinki on human subject participants. Availability of data and materials This study’s dataset and study materials are available from the corresponding author on request. Competing Interests The investigators of this study declare that they have no competing interests or conflicts of interest. All authors reviewed and consented to the publication of this article. Funding This study was funded by the Government of Uganda through the Soroti University Research and Innovation Fund, SUNRIF, Award No. SUN-RIF/2022/28 given to the Principal Investigator, Hellen Akurut. The funder did not have any role in the design and implementation of the project or in the decision to publish the work. The views expressed here do not represent those of the funder. Author Contributions Conceptualization: Hellen Akurut, Dr . Mary Abwola. Formal analysis: Hellen Akurut, Dr. Opito Ronald, Oluka Abraham. Investigation : Hellen Akurut , Ayikobua Emmanuel Tiyo, Dr. Mary Abwola, Dr. Opito Ronald, Dr. Kirya Fred, Hellen Nandudu, Dr. Kabwigu Samuel, Ataso Celina,Dr. Ariengu Athanasius. Methodology: Hellen Akurut , Ayikobua Emmanuel Tiyo, Dr. Mary Abwola, Dr . Opito Ronald, Dr . Kabwigu Samuel. Project administration: Hellen Akurut. Supervision: Hellen Akurut, Dr. Mary Abwola, Ayikobua Emmanuel Tiyo, Dr . Opito Ronald. Writing – original draft: Hellen Akurut, Dr Opito Ronald. Writing – review & editing: All authors Acknowledgment. Appreciation goes to all the study participants for their willingness to take part in this study. We thank all health workers and adolescent counsellors of the participating health facilities (Soroti RRH, Katakwi Hospital, Kumi HC IV, Serere HC IV) for their assistance during data collection and for managing those who were diagnosed with STIs. We also thank Soroti University Administration, Directorate of Soroti University Research and Innovation, staff of Soroti University, Ministry of Health, Administration, Soroti Regional Referral Hospital, and district authorities (Katakwi, Serere & Kumi). Operational definition Sexually transmitted infection (STI) . These infections can be passed on during unprotected sex and intimate skin-to-skin contact. In this study, STIs are defined as positive for either a single infection or a combination of infections specific to HIV, hepatitis B and syphilis . Adolescents and young people ; These are people who were 15-24 years old were included in this study. 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Available from: https://www.sciencedirect.com/science/article/pii/S1054139X16000938 Uganda Ministry of Health. Consolidated guidelines for the prevention and treatment of hiv and aids in uganda. 2022. Uganda Ministry of Health. Uganda guidelines for prevention, testing, care and treatment of Hepatitis B and C virus infection. 2019. Evers YJ, Liere AFS, Van, Hoebe CJPA, Nicole H. Chemsex among men who have sex with men living outside major cities and associations with sexually transmitted infections: A cross- sectional study in the Netherlands. 2019;1–15. Haider MR, Kingori C, Brown MJ, Battle-Fisher M, Chertok IA. Illicit drug use and sexually transmitted infections among young adults in the US: evidence from a nationally representative survey. Int J STD AIDS. 2020;31(13):1238–46. Additional Declarations No competing interests reported. Supplementary Files AppendixIXQuestionnaireSTIFINAL28May2025.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6662550","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":467247649,"identity":"68034b82-bead-491f-9f12-fa12af4cc9dc","order_by":0,"name":"Hellen Akurut","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxElEQVRIiWNgGAWjYBACAwY2MC1HshYDY9K1JDYQrcWc/ViadGXbn/T5M3IPMPyoYUic70BAi2VP2jHJs20GuRtu5CUw9hxjSNx4gJDDDqS3STaCtEjkGDDwNgC1EHKiwfnnYC3p8jNyDBj/EqXlBtBhQC0JDDdyDJhBtswnoAOo5VmyZcM5Y8MNZ94YHJY5JmG8gaCW82mGNxvK5OTl23MMH76psZGdT8hhKOAAA4MEMEBI0QIG8iTZMgpGwSgYBSMBAADuvz+1Hw7WNwAAAABJRU5ErkJggg==","orcid":"","institution":"Soroti University","correspondingAuthor":true,"prefix":"","firstName":"Hellen","middleName":"","lastName":"Akurut","suffix":""},{"id":467247650,"identity":"23467cbb-47ca-464a-8b9a-00a5cc55291f","order_by":1,"name":"Mary Abwola Olwedo","email":"","orcid":"","institution":"Soroti University","correspondingAuthor":false,"prefix":"","firstName":"Mary","middleName":"Abwola","lastName":"Olwedo","suffix":""},{"id":467247651,"identity":"12e70818-1427-4c2f-a959-4249e5c97a94","order_by":2,"name":"Fred Kirya","email":"","orcid":"","institution":"Soroti University","correspondingAuthor":false,"prefix":"","firstName":"Fred","middleName":"","lastName":"Kirya","suffix":""},{"id":467247652,"identity":"ffd5d062-2f04-4f7b-8b57-ec0bf35c1fc3","order_by":3,"name":"Emmanuel Ayikobua Tiyo","email":"","orcid":"","institution":"Soroti University","correspondingAuthor":false,"prefix":"","firstName":"Emmanuel","middleName":"Ayikobua","lastName":"Tiyo","suffix":""},{"id":467247653,"identity":"7384d6a6-fc7c-4ec1-b0cf-5318d0449e95","order_by":4,"name":"Hellen Nandudu","email":"","orcid":"","institution":"The AIDS Support Organization","correspondingAuthor":false,"prefix":"","firstName":"Hellen","middleName":"","lastName":"Nandudu","suffix":""},{"id":467247654,"identity":"ab6fa1bf-c654-4853-bf68-5b599066112d","order_by":5,"name":"Samuel Kabwigu","email":"","orcid":"","institution":"Soroti University","correspondingAuthor":false,"prefix":"","firstName":"Samuel","middleName":"","lastName":"Kabwigu","suffix":""},{"id":467247655,"identity":"268b5dd8-1065-4e37-856e-1aadb3e9aef1","order_by":6,"name":"Ariengu Athanasius","email":"","orcid":"","institution":"Soroti Regional Referral Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ariengu","middleName":"","lastName":"Athanasius","suffix":""},{"id":467247656,"identity":"2494741d-228e-4ab2-b9bf-4f69215818fd","order_by":7,"name":"Oluka Abraham","email":"","orcid":"","institution":"AIDS Information Centre","correspondingAuthor":false,"prefix":"","firstName":"Oluka","middleName":"","lastName":"Abraham","suffix":""},{"id":467247657,"identity":"772296cf-a854-482d-8911-fd86de1435d1","order_by":8,"name":"Ataso Celina","email":"","orcid":"","institution":"Soroti University","correspondingAuthor":false,"prefix":"","firstName":"Ataso","middleName":"","lastName":"Celina","suffix":""},{"id":467247658,"identity":"b09d351f-31b5-4389-8cea-3143dc5daedc","order_by":9,"name":"Ronald Opito","email":"","orcid":"","institution":"Soroti University","correspondingAuthor":false,"prefix":"","firstName":"Ronald","middleName":"","lastName":"Opito","suffix":""}],"badges":[],"createdAt":"2025-05-14 09:23:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6662550/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6662550/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102962830,"identity":"043f6d71-f0bb-488b-8650-80774f82b4ac","added_by":"auto","created_at":"2026-02-19 04:11:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1369414,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6662550/v1/e2cec760-4888-4b4e-b263-cb7e933b4e2b.pdf"},{"id":84099833,"identity":"124aa62b-0204-4d1c-937b-3e49fdf5b042","added_by":"auto","created_at":"2025-06-06 18:52:02","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":169701,"visible":true,"origin":"","legend":"","description":"","filename":"AppendixIXQuestionnaireSTIFINAL28May2025.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6662550/v1/0c09c1b616cac89b3f0f0a9f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and associated factors of sexually transmitted infections among adolescents and young people attending general outpatient departments in the Teso subregion, Northeast Uganda. A cross-sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003eSexually transmitted infections (STIs) are infections that are of public health concern and can be passed on from one person to another during unprotected sex and intimate skin-to-skin contact[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Many STIs do not have any symptoms. This means that an adolescent can have an STI without knowing it and pass it on to the partner during sex or close contact. These include gonorrhea, syphilis, HPV, herpes, genital warts, HIV, hepatitis B, and chlamydia. Most cases are easily treated, especially when they are discovered early. If left untreated, STIs can lead to serious health problems[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. HBV, for example, causes 1.1\u0026nbsp;million deaths annually, mostly from liver cirrhosis and hepatocellular carcinoma, and 3.0\u0026nbsp;million new infections[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSub-Saharan African (SSA) countries have the highest number of STI cases, accounting for approximately 93\u0026nbsp;million cases every year[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], with a reported prevalence of HBV and syphilis coinfections ranging from 10%-13%[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. STI case rates are highest among adolescents and young people, with studies in some SSAs, such as Ethiopia, reporting a prevalence of 11.5% among young people[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], while the pooled self-reported STI prevalence among young women in Uganda was 26.0%[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile the STI case rate is highest in adolescents and young people, the most serious health outcomes occur later in life and are disproportionately borne by women and infants[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Adolescents are at particularly high risk for STIs due to a combination of behavioral, biological, and social factors, such as engaging in higher-risk sexual behaviors; thus, they lack access to sexual and reproductive health services or do not pursue STI testing due to confidentiality concerns[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe objective of this study was therefore to determine the prevalence and associated factors of sexually transmitted infections among adolescents and young people attending outpatient clinics in the Teso region of Uganda.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and study area\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional study conducted at health facility level from February to June 2023 among adolescents and young adults attending outpatient departments (OPDs) in four high-volume public health facilities. The Teso subregion comprises 10 districts: Soroti, Amuria, Kapelebyong, Katakwi, Bukedea, Kumi, Ngora, Serere, Kalaki, Kaberamaido and Soroti. The total number of health facilities providing STI screening, including HIV testing services, is 106 (1 RRH, 7 Hospitals, 10 HCIVs, 62 HCIII, 23 HCIIs and 3 special clinics)[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].The total population of the Teso subregion is 2,462,344[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], and the HIV prevalence is 4.2%[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur study purposively selected four high-volume health facilities that served at least 200 adolescents and young adults per month in the preceding quarter. These included the Soroti regional referral hospital in Soroti City, Katakwi hospital in the Katakwi district, Kumi HCIV in the Kumi district and Serere HC IV in Serere district.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003e All adolescents and young people between the ages of 15\u0026ndash;24 years, regardless of the presence or absence of STIs symptoms, who attended outpatient clinics at selected health facilities during the study period and were willing and able to provide informed consent and assent. The study excluded; participants who were mentally ill and those who were very sick and not able to participate in the study. Similarly, the adolescents and young people who were diagnosed with STIs and were undergoing treatment for STI were excluded.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSample size determination and sampling method.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eRegarding a sample size determination, a single proportion (N\u0026thinsp;=\u0026thinsp;Z\u003csup\u003e2\u003c/sup\u003ep(1-p)/d\u003csup\u003e2\u003c/sup\u003e) was used. An STI prevalence of 19.1%[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] was applied, with 95% confidence level and a 5% margin of error, resulting in sample size of 237.To account for multiple study sites, a design effect of 1.5 was applied, increasing the size to 356. After adjusting for 10% nonresponse rate, the final sample size was determined to be 392 participants. In our final analysis, we included 400 participants distributed in the four facilities proportionate to the number of individuals served per facility. The total allocated sample sizes for the four study sites were as follows: Soroti RRH-120, Kumi HC IV-100, Serere HC IV-100 and Katakwi Hospital-80.\u003c/p\u003e \u003cp\u003eA systematic random sampling method was applied for the selection of participants. Over a three months data collection period, approximately 2400 adolescents and young people were expected to visit the outpatient\u0026rsquo;s department, based the health facility\u0026rsquo;s projections and quarterly performance. This number was divided by the desired sample size (2400/400) to determine the sampling interval (K\u003csup\u003eth\u003c/sup\u003e value), which was 6. The first participant was randomly selected by the lottery method, and then every 6th client was invited to participate in the study until the target sample size was reached.\u003c/p\u003e\n\u003ch3\u003eSociodemographic and behavioral data\u003c/h3\u003e\n\u003cp\u003eSociodemographic and behavioral information was gathered through a structured questionnaire administered by the interviewer. Collected data participant\u0026rsquo;s sex, marital status, age, place of residence, level of education, religion, STI knowledge, substance and alcohol use, sexual behaviour and partners, sexual health knowledge and practices, prior STI screening and treatment, reasons for visiting the health facility, hepatitis B vaccination history and sources of income.\u003c/p\u003e\n\u003ch3\u003eData collection tool and procedure\u003c/h3\u003e\n\u003cp\u003eThe study team developed and utilised structured questionnaires that were pretested at Princes Diana HC IV. Adjustments were made to the questionnaire following the pretest and the Research Assistants (RAs) were identified, trained to provide health education and counseling and to administer the questionnaires in the OPD of the selected facilities. The RAs reviewed the ages of OPD patients and systematically sampled those within the age group of 15\u0026ndash;24 years. The RAs held health education talks for adolescents and young people who had come to the facility and identified those who were willing to be screened for STIs. We conducted questionnaire interviews with all eligible study participants who provided informed consent, parental informed consent and assent for minors to obtain information on previous STI screening access, acceptability and utilization of STI screening services, associated factors to STIs and provided screening services to those willing to be screened. We validated participant biodata and clinical characteristics from health facility outpatient registers and laboratory registers.\u003c/p\u003e\n\u003ch3\u003eSTI screening, sample collection and analysis\u003c/h3\u003e\n\u003cp\u003e Qualified laboratory personnel collected 5 ml whole blood sample from each participant using a syringe at the OPD laboratory. HIV diagnosis was done according to the national HIV rapid diagnostic test algorithm (Determine, STAT PAK, SD-Bioline) to identify antibodies, with retesting conducted for all HIV-positive samples. Hepatitis B surface Antigen (HBsAg) was detected in the serum using a high quality, one-step rapid immunochromatographic test following the manufacturer\u0026rsquo;s instructions. Syphilis screening involved the detection of antibodies against syphilis antigen using Rapid Plasma Reagin (RPR) test and a one-step anti-TP rapid syphilis test based on the manufacturer\u0026rsquo;s protocol and Ministry of Health laboratory guidelines. Feedback was given to the study participants through the return of their laboratory results to the attending clinicians, and those testing positive for STIs were initiated on appropriate care and treatment at health facilities as per the national guidelines. The results were then entered into the online interview questionnaire by the RAs.\u003c/p\u003e \u003cp\u003e \u003cb\u003eData Management and Analysis.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eData was collected using predesigned forms in kobo collect software installed in android tablets, then exported to excel. The data was cleaned by checking for missing values, incomplete responses and inconsistences. After cleaning, the dataset was imported into STATA version 16.0 for further processing and analysis. Bivariable binary logistic regression was initially conducted to determine associations between the prevalence of STIs and independent variables. Variables with a p-value less than 0.20 in the bivariable analysis were included multivariable logistics regression analysis. Odds ratios, 95% confidence intervals, and p values were calculated to assess the strength of associations, with a statistical significance set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003eSociodemographic characteristics.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe average age of the 400 participants was 20.3 (SD\u0026thinsp;=\u0026thinsp;2.7) years. The majority of the participants were females (89.5%, n\u0026thinsp;=\u0026thinsp;358), had never married (65.5%, n\u0026thinsp;=\u0026thinsp;262) and were residing at home (85.0%, n\u0026thinsp;=\u0026thinsp;340). Approximately half (n\u0026thinsp;=\u0026thinsp;199) of the participants had come to the facility with STI symptoms, 15.5% (n\u0026thinsp;=\u0026thinsp;62) reported experiencing sexual and gender-based violence, and 12.2% (n\u0026thinsp;=\u0026thinsp;49) had ever used illicit drugs (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic and behavioral characteristics of the participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n), N\u0026thinsp;=\u0026thinsp;400\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProportions (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMean Age/years (SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.3(2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Category\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCatholics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuslims\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePentecostal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation Level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever/Primary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever married (Single)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e**Ever Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSTI Screening setting\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt home/Self-test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital OPD/STI clinic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e292\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate Laboratory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVisit reason-Have STI symptom\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHad Sex in 6 months\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCondom Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExperienced SGBV\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e84.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver exchanged money for sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e383\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver used illicit drugs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHepatitis B vaccinated\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver screened for HIV\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e325\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver screened for Hepatitis B(n\u0026thinsp;=\u0026thinsp;399)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver Screened for Syphilis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e**Ever married\u0026thinsp;=\u0026thinsp;married/cohabiting/divorced/separated.\u003c/p\u003e\n\u003ch3\u003eSTI prevalence among adolescents and young persons\u003c/h3\u003e\n\u003cp\u003eThe overall prevalence (positivity) of any STI (HIV, HBV or syphilis) was 6.5% (n\u0026thinsp;=\u0026thinsp;26, 95% CI, 4.4\u0026ndash;9.4). The most prevalent STI among the young people in Teso was hepatitis B, 3.1% (n\u0026thinsp;=\u0026thinsp;12/390, 95% CI, 1.8\u0026ndash;5.4), followed by syphilis, 2.3% (n\u0026thinsp;=\u0026thinsp;9/391, 95% CI, 1.0-4.1%), and HIV was the least prevalent, 1.5% (n\u0026thinsp;=\u0026thinsp;6/390, 95% CI, 0.7\u0026ndash;3.4) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSTI prevalence\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTI TYPE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO. TESTED\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNO. POSITIVE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePREVALENCE (%age Pos, 95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.5 (0.7\u0026ndash;3.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHepatitis B\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.1 (1.8\u0026ndash;5.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSyphilis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e391\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.3 (1.0-4.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.5 (4.4\u0026ndash;9.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eFactors associated with STI prevalence.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAfter adjusting for each other, the factor that was significantly associated with STI prevalence among youth was having ever used illicit drugs, aOR\u0026thinsp;=\u0026thinsp;3.16(95%CI, 1.23\u0026ndash;8.10). All other factors were not statistically significant. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors associated with STI prevalence.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFrequency, N\u0026thinsp;=\u0026thinsp;400\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePositive, n (%), n\u0026thinsp;=\u0026thinsp;26\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNegative, n (%), n\u0026thinsp;=\u0026thinsp;373\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eOdds Ratio (OR)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ecOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eaOR\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Category\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(6.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e153(93.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e221(93.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.09(0.49\u0026ndash;2.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.27(0.51\u0026ndash;3.15)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22(6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e336(93.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38(90.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.75(0.60\u0026ndash;5.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.59(0.50\u0026ndash;5.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation Level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever/Primary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(7.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e179(92.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostprimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e195(94.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.68(0.31\u0026ndash;1.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.70(0.27\u0026ndash;1.84)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever married (Single)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(7.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e243(92.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e**Ever Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e131(94.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.71(0.30\u0026ndash;1.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.31(0.24\u0026ndash;1.63)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParticipants residence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e315(92.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHostel/boarding school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59(98.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.31(0.06\u0026ndash;1.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.31(0.05\u0026ndash;1.77)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTI Symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e149(95.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47(92.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.64(0.74\u0026ndash;3.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.65(0.69\u0026ndash;3.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSymptoms-Bleeding\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e395\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e370(93.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(80.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.84(0.73\u0026ndash;32.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.02(0.41\u0026ndash;22.40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSymptoms-Blisters\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(6.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e354(93.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(87.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.58(0.77\u0026ndash;8.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.82(0.50\u0026ndash;6.70)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver used illicit drugs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e332(94.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(85.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e3.01(1.22\u0026ndash;7.41)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e3.16(1.23\u0026ndash;8.10)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHepatitis B vaccinated\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17(8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e182(91.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e192(95.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.51(0.23\u0026ndash;1.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.58(0.24\u0026ndash;1.39)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study determined the prevalence and associated factors of sexually transmitted infections (STIs) among adolescents and young adults attending OPD in four selected health facilities in the Teso subregion of Northeast Uganda.\u003c/p\u003e \u003cp\u003eIn our study, half of the participants reported to the facility with STI symptoms. The prevalence of self-reported STI symptoms is high in different settings, ranging from 19%-26% in Uganda[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] and 20% in Tanzania[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Young people are involved in risky sexual behaviors, which predisposes them to contract STIs[\u003cspan additionalcitationids=\"CR16 CR17\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. We found that only 2% of our study participants used condoms consistently, and up to 54% reported no condom use at all. This puts them at increased risk of acquiring STIs.\u003c/p\u003e \u003cp\u003eThe overall prevalence (positivity) of any STI (HIV, Hep B or syphilis) was 6.5%, with the most prevalent STI being HBV (3.1%), followed by syphilis (2.3%) and HIV (1.5%). The only factor that was significantly associated with STI among participants was ever using illicit drugs.\u003c/p\u003e \u003cp\u003eThe lower rates of observed STIs in our study occurred because only a few STIs (3) were selected for testing. Studies that have tested more STIs have reported extremely high prevalence rates, with two studies among adolescents and young adults in Brazil reporting that 32\u0026ndash;85% of the participants had at least one STI[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and another in Eldoret, Kenya, reporting 28% STI positivity among adolescents and young adults[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. A study conducted among youth-friendly service attendees in Ethiopia reported a higher prevalence of 4 STIs (Hepatitis B, HIV, syphilis and hepatitis C) at 11.5%[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], which was far above the one reported in our study.\u003c/p\u003e \u003cp\u003eThe STI prevalence rates reported in our study were comparable to those reported in previous studies. For example, the observed HIV prevalence of 1.5% was comparable to the Uganda population HIV impact assessment findings, which was 0.9% for adolescents aged 15\u0026ndash;19 years and 2.9% for young adults aged 20\u0026ndash;24 years[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. On the other hand, active syphilis was previously reported in 0.9\u0026ndash;1.5% of adolescents and young adults[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], which is slightly lower than what was observed in our study, whereas hepatitis B viral infection was previously reported in 3.7% and 4.5% of adolescents and young adults[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], which is slightly higher than what is currently reported. Hepatitis B specifically has been reported to be high at 6.5% among young adults in Ethiopia attending youth-friendly services[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eElsewhere in Brazil, there was a zero (0%) prevalence of hepatitis B and HIV but a 1% prevalence of syphilis among adolescents[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] compared with hepatitis B (3.1%), HIV (1.5%) and syphilis (2.3%) in our study. These findings indicate that young adults in Uganda are still at high risk of preventable STIs, probably due to limited access to healthcare and sexual health education; widespread poverty; cultural practices that promote risky sexual behavior; high rates of concurrent sexual partnerships; and inadequate screening and treatment programs in low- and middle-income countries[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], which contribute to a high prevalence of HIV, syphilis and hepatitis B.\u003c/p\u003e \u003cp\u003eAlthough current guidelines in Uganda recommend testing all individuals between the ages of 13 and 64 years at least once a year for HIV, syphilis and HBV, this is not routinely done in OPD, except in antenatal care (ANC) for pregnant women, with the aim of preventing mother‒child transmission [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. This leads to many missed opportunities for screening, early detection and treatment of STIs in adolescents and young adults. This calls for the prioritization of adolescents and youth in routine screening, particularly for hepatitis B, HIV and syphilis.\u003c/p\u003e \u003cp\u003eThe factor that was significantly associated with STI prevalence among adolescents and young adults in this study was having ever used illicit drugs. The use of alcohol and drugs reduces the perception of risk and tends toward unprotected sexual practices and STIs[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Other studies assessing the relationship between alcohol consumption and risky sexual behavior among adolescents and young adults reported similar findings that alcohol consumption is strongly associated with risky sexual behavior, including early sexual initiation, inconsistent condom use, and multiple sexual partners among adolescents and young adults[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These risky behaviors predispose adolescents and young people to STIs.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStudy strengths and limitations\u003c/h2\u003e \u003cp\u003eOur study had several limitations. As a facility-based study, some adolescents and young people who could have been sick and unable to visit the facility were missed, which may have led to underreporting of the STI prevalence among the adolescents. In addition, some minors who were eligible for the study were excluded because they did not come with their parents for consent. This could have also affected the results, as those who come along are most likely to have STI more than the minors who are escorted.\u003c/p\u003e \u003cp\u003eDespite the above limitations, the study used four health facilities at different levels of care (Regional Referral Hospital, District Hospital, and Health Centre IVs), which included a mixture of participants, including urban and rural patients.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions and recommendations","content":" \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003cp\u003eIn this study, the overall prevalence of sexually transmitted infections among adolescents and young people attending outpatients at selected health facilities in the Teso region was low. Most participants were positive for hepatitis B. The Ministry of Health and Key stakeholders should identify reasons for the high prevalence of hepatitis B despite the triple elimination campaign among pregnant women and consider prevention strategies, which may include strengthened vaccination and community sensitization. Research on strategies to prevent risky behavior that predisposes adolescents and young people to STIs is recommended.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eSTIs \u0026nbsp; \u0026nbsp; \u0026nbsp; Sexually transmitted infections\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;HIV \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Human immunodeficiency Virus\u003c/p\u003e\n\u003cp\u003eHBsAg \u0026nbsp;\u0026nbsp;Hepatitis B surface Antigen\u003c/p\u003e\n\u003cp\u003eMOH \u0026nbsp; \u0026nbsp; \u0026nbsp;Ministry of Health\u003c/p\u003e\n\u003cp\u003eHPV \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Human Papilloma Virus\u003c/p\u003e\n\u003cp\u003eCI \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Confidence Intervals\u003c/p\u003e\n\u003cp\u003eREC \u0026nbsp; \u0026nbsp; \u0026nbsp;Research Ethics Committee\u003c/p\u003e\n\u003cp\u003eTASO \u0026nbsp; \u0026nbsp;The AIDS Support Organization\u003c/p\u003e\n\u003cp\u003eOPD \u0026nbsp; \u0026nbsp; \u0026nbsp; Outpatients Department\u003c/p\u003e\n\u003cp\u003eANC \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Antenatal care\u003c/p\u003e\n\u003cp\u003eRA \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Research Assistant\u003c/p\u003e\n\u003cp\u003eRPR \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Rapid Plasma Reagin\u003c/p\u003e\n\u003cp\u003eOR \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Odds Ration\u003c/p\u003e\n\u003cp\u003eSD \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Standard Deviation\u003c/p\u003e\n\u003cp\u003eSUN RIF \u0026nbsp;Soroti University Research and Innovation Fund.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Consideration and Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study adhered to the Declaration of Helsinki by ensuring primacy of adolescent and young people\u0026rsquo;s health and well-being and we offered care in the participant\u0026rsquo;s best interest. The protocol was submitted to the Busitema University Faculty of Health Sciences Research Ethics Committee (BUFHSREC), which reviewed and approved it, approval number BUFHS-2023-70, on 02/03/2023. The participants aged 18 years and above signed informed consent forms, whereas those aged 15-17 years signed informed assent, in addition to their parental informed consent. The objectives, purpose, benefits, risk of the study and their role in the study were briefed to them.\u003c/p\u003e\n\u003cp\u003eTo ensure participants anonymity and confidentiality, unique identifiers were assigned, pseudonyms were used in documentation and all electronic data were securely encrypted. The participants with both positive and negative test results from the laboratory, received health education and counselling services provided by health workers. However, those with positive result were referred and escorted for treatment at specialised clinics within the health facility. \u0026nbsp;All research documents namely; questionnaires, the participants\u0026rsquo; information sheets, and consent forms were translated to Ateso language to reduce communication barriers.\u003c/p\u003e\n\u003cp\u003eFurthermore, the health workers and adolescent counselors respected participants opinions to withdrawal from the study and protected their rights.\u003c/p\u003e\n\u003cp\u003eDuring the research design, potential adolescents and young persons were engaged and guided the team to focus on three disease conditions (HIV, syphilis, hepatitis B) that commonly affect the young people instead of assessing all sexually transmitted infections.\u003c/p\u003e\n\u003cp\u003eOur study was conducted only by health care professionals with the appropriate ethics and scientific education, training and qualifications. A research team conducted facility-based trainings on the study protocol before data collection and selected qualified Nurses, Clinicians laboratory staff to screen participants for STIs.Supervsion was done by facility in charges who are medical officers and Soroti University staff who are qualified health professionals. The participants have been engaged in dissemination of results meetings at the study sites.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants and parents to minors provided informed consent and minors provided informed assent to the study including consent for publication of anonymized data. The authors confirm that data presented in this manuscript do not contain any identifiable personal information and all findings are reported in confidentiality. Consent procedures were approved by Busitema University Faculty of Health Sciences Research Ethics Committee and the study was conducted according to relevant guidelines and regulations. The study was conducted in line with declaration of Helsinki on human subject participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study\u0026rsquo;s dataset and study materials are available from the corresponding author on request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe investigators of this study declare that they have no competing interests or conflicts of interest. All authors reviewed and consented to the publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Government of Uganda through the Soroti University Research and Innovation Fund, SUNRIF, Award No. SUN-RIF/2022/28 given to the Principal Investigator, Hellen Akurut. The funder did not have any role in the design and implementation of the project or in the decision to publish the work. The views expressed here do not represent those of the funder.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConceptualization:\u0026nbsp;\u003c/strong\u003eHellen Akurut, Dr\u003cins cite=\"mailto:Editor%202\" datetime=\"2025-05-12T10:54\"\u003e.\u003c/ins\u003e Mary Abwola. \u003cstrong\u003eFormal analysis:\u0026nbsp;\u003c/strong\u003eHellen Akurut, Dr. Opito Ronald, Oluka Abraham. \u003cstrong\u003eInvestigation\u003c/strong\u003e: Hellen Akurut\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003eAyikobua Emmanuel Tiyo, Dr.\u0026nbsp;Mary Abwola, Dr.\u0026nbsp;Opito Ronald, Dr. Kirya Fred, Hellen Nandudu, Dr. Kabwigu Samuel, Ataso Celina,Dr. Ariengu Athanasius. \u003cstrong\u003eMethodology:\u0026nbsp;\u003c/strong\u003eHellen Akurut\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003eAyikobua Emmanuel Tiyo, Dr. Mary Abwola, Dr\u003cins cite=\"mailto:Editor%202\" datetime=\"2025-05-12T10:54\"\u003e.\u003c/ins\u003e Opito Ronald, Dr\u003cins cite=\"mailto:Editor%202\" datetime=\"2025-05-12T10:54\"\u003e.\u003c/ins\u003e Kabwigu Samuel. \u003cstrong\u003eProject administration:\u0026nbsp;\u003c/strong\u003eHellen Akurut. \u003cstrong\u003eSupervision:\u0026nbsp;\u003c/strong\u003eHellen Akurut, Dr. Mary Abwola,\u0026nbsp;Ayikobua Emmanuel Tiyo, Dr\u003cins cite=\"mailto:Editor%202\" datetime=\"2025-05-12T10:54\"\u003e.\u003c/ins\u003e Opito Ronald.\u0026nbsp;\u003cstrong\u003eWriting \u0026ndash; original draft:\u0026nbsp;\u003c/strong\u003eHellen Akurut, Dr Opito Ronald. \u003cstrong\u003eWriting \u0026ndash; review \u0026amp; editing:\u0026nbsp;\u003c/strong\u003eAll authors\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAppreciation goes to\u0026nbsp;all the study participants for their willingness to take part in this study. We thank all health workers and adolescent counsellors of the participating health facilities (Soroti RRH, Katakwi Hospital, Kumi HC IV, Serere HC IV) for their assistance during data collection and for managing those who were diagnosed with STIs.\u003c/p\u003e\n\u003cp\u003eWe also thank \u0026nbsp;Soroti University Administration, Directorate of Soroti University Research and Innovation, staff of Soroti University, Ministry of Health, Administration, Soroti Regional Referral Hospital, and district authorities (Katakwi, Serere \u0026amp; Kumi).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperational definition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSexually\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003etransmitted\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;infection\u003c/strong\u003e \u003cstrong\u003e(STI)\u003c/strong\u003e. These infections can be passed on during unprotected sex and intimate skin-to-skin contact. In this study,\u0026nbsp;\u003cstrong\u003eSTIs\u003c/strong\u003e are defined as positive\u0026nbsp;for\u0026nbsp;either a single\u0026nbsp;infection\u0026nbsp;or a combination of infections specific to HIV, hepatitis B and syphilis\u003cins cite=\"mailto:Editor%202\" datetime=\"2025-05-12T10:54\"\u003e.\u003c/ins\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdolescents and young people\u003c/strong\u003e; These are people\u0026nbsp;who were 15-24 years\u0026nbsp;old were included in\u0026nbsp;this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSexually transmitted\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003einfection\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;screening:\u0026nbsp;\u003c/strong\u003eThis involves risk assessment and laboratory procedures where blood is drawn and analyzed using different testing kits.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKamb ML, Garcia PJ. 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Int J STD AIDS. 2020;31(13):1238\u0026ndash;46.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Adolescents, Young persons, STIs, HIV, syphilis, hepatitis B, risk factors, Teso region","lastPublishedDoi":"10.21203/rs.3.rs-6662550/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6662550/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGlobally, an estimated 374 million new cases of curable sexually transmitted infections (STIs) occur annually, with the highest rates among adolescents and young adults due to a combination of behavioral, biological, and social factors. Our study aimed to determine the prevalence and associated factors of sexually transmitted infections among adolescents and young people attending general outpatient departments (OPDs) in four selected health facilities in the Teso subregion of Northeast Uganda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods. \u003c/strong\u003eA cross-sectional survey was conducted between February and June 2023 in four high volume health facilities in northeastern Uganda. A total of 400 participants were systematically selected and screened for STIs by adolescent counselors and a clinical team. Sociodemographic and risk factor data were collected using structured questionnaires administered by an interviewer, while blood-based samples were collected by trained laboratory technicians’ sterile procedures and equipment for testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis. Data entry and analysis were performed using Statistical Package (STATA), version 15.0. Crude and adjusted odds ratios with 95% confidence intervals (CIs) were computed to identify associated factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe average age of the 400 participants was 20.3 (SD=2.7) years. The majority of theparticipants were females (89.5%, n=358) and had never married (65.5%, n=262). The overall prevalence of any STI (HIV, HBV or syphilis) was 6.5% (n=26, 95% CI, 4.4–9.4). The most prevalent STI among young people in Teso was hepatitis B, 3.1% (n=12/390, 95% CI, 1.8–5.4). After adjusting for each other, the factor that was significantly associated with STI prevalence among youth was having ever used illicit drugs (OR=3.16; 95% CI, 1.23--8.10).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSTIs, especially hepatitis B, are common among adolescents and young people in the Teso subregion. There is a significant association between STI prevalence among youth who used illicit drugs. Adolescents and young people, especially those with a history of drug addiction, need to be prioritized for STI screening and management at outpatient departments (OPDs).\u003c/p\u003e","manuscriptTitle":"Prevalence and associated factors of sexually transmitted infections among adolescents and young people attending general outpatient departments in the Teso subregion, Northeast Uganda. A cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-06 18:51:58","doi":"10.21203/rs.3.rs-6662550/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c298bb0b-61d5-4ced-8b21-ddf15174904d","owner":[],"postedDate":"June 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-17T09:10:59+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-06 18:51:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6662550","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6662550","identity":"rs-6662550","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}