Distribution on the Pattern, Incidence and  Determinants of Sexually Transmitted Infections Among Patients Attending Adari Hospital, Hawassa City,Sidama Region, Ethiopia

Distribution on the Pattern, Incidence and Determinants of Sexually Transmitted Infections Among Patients Attending Adari Hospital, Hawassa City,Sidama Region, Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Distribution on the Pattern, Incidence and Determinants of Sexually Transmitted Infections Among Patients Attending Adari Hospital, Hawassa City,Sidama Region, Ethiopia Melese Birmeka, Damtew Bekele This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3870052/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: Sexually transmitted infections cause series medical and psychological health problems in Ethiopia and vary in different localities. Thus, study was aimed to investigate pattern, status and the association of sexually transmitted infections and local risk factors on the patients attending Adari hospital. Methods: Institutional based cross-sectional study was carried out from September 2021 to June 2022.Systematic simple random sampling was used to select a total of 385 patients. In addition, a five years retrospective data were collected. Data were collected through blood test, urethral and vaginal discharge swabs, structured questionnaire, interview and observation. Variables with p-value less than 5% considered as significant. Results: The overall prevalence of sexually transmitted infections was 74.4%. The odds of STIs in patients who were urban, single, presence of two and above sexual partners, illiterate, sexual intercourse without using condom, and sex after drinking alcohol and chewing khat were more likely to be infected with STIs as compared with their counter parts. Conclusions: STIs were highly prevalent and one of health challenges of Hawassa city. Figures Figure 1 INTRODUCTION The burden of sexually transmitted infections (STIs) is globally large and ever increasing because many of them are asymptomatic infections; some of the most affected countries has no diagnostic techniques; and surveillance systems are very poor in many areas of the world (Moses et al. ,2002). The socio-cultural and economic contexts of low income nations impact the epidemiology of STIs, increase the transmission of HIV infection and help make them an important public health priority (Wasserheit,1989; Aral and Wasserheit ,1999). In developing countries like Ethiopia, high levels of STIs and high rates of complications result largely from inadequacies in health service provision and health care seeking (Aral and Wasserheit ,1999;WHO ,2001), poorly trained in STI case management care provider (Moses et al. ,2002),and the asymptomatic nature of many STIs. Incidence of STIs and their complications are usually higher among people living in urban areas, who are single and young, and the risk of becoming infected by one of these pathogens grows with the underutilization of preservatives and a higher number of sexual partners (WHO,2001;Upchurch et al .,2004; Pattman et al .,2005). Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with serious medical and psychological consequences to millions of men, women and infants health problem worldwide. Females are at a greater risk of contracting STIs and developing complications if infections go untreated, and do not present symptoms that lead to increased transmission and greater susceptibility to other types of infections (Upchurch et al .,2004). Microbial pathogens responsible for STIs include parasites, bacteria, viruses and fungi. Most are curable with treatment except STIs of viral origin, which range from mild presentation such as genital herpes to debilitating diseases like HIV/AIDS (WHO ,2013). The biology of STIs in Ethiopia has become more complex and reveals many characteristics of risk behavior where increasing poverty resulting delay of marriage, urbanization, socio-cultural change which, resulting in sexual behavior, and increasing unemployment of youth have contributed to earlier and often unprotected sex (Rozina, et al .,2017). Computing the incidence and burden of these infections is important for planning appropriate interventions and advocating for resources, as necessary. The uncertainties on global and regional STI estimates need to be reduced to obtain relevant data, as these have an important role to play in improving our understanding of the burden of these infections. They are also crucial in helping to improve the design and implementation of STI interventions. Although there are some studies conducted in Ethiopia, little is known about the prevalence and associated factors of STIs in the study area. Assessing the prevalence and factors associated with common STIs among study population provided better information for health planners to adopt strategies to manage the impacts of STIs on the local people. Materials and Methods Description of the study area The study was conducted in Hawassa city, which is located in Sidama region, 275km South east of Addis Ababa and found between 06º 58´– 07º 14´ N latitudes and 38º 22´–38 º 28´ E longitudes, and at altitude of 1685m above sea level (m.a.s.l). Hawassa city has two governmental hospital in addition to health centers and private clinics. Study design Health institution based cross-sectional study was conducted to collect data from September 2021 to June 2022 in Adari Hospital. Furthermore, five years retrospective data were collected from patients registered book, at Adari Hospital. The socio-demographic data (sex, age, residence, marital status and educational status and others) were collected using structured questionnaire, interview and observation. Sample size determination and sampling techniques Sample size determination The sample size was estimated using statistical formula developed by Yemane(1967) to consider the level of acceptable margin of error 5%. Hence,from the target population size in 2021(N = 10904 house hold) a total number of 179 samples was required to be drawn assuming 95% confidence level and 5% margin of error. Based on this the researcher decide to take the upper population size limit to get more valid sample size. If the population size (N) of a given study is known and its sampling error (e) is fixed by the researcher, then the total sample size (n) can be calculated by using the following formula. n = N/1 + N(e) 2 = 10904/1 + 10904(0.05) 2 =385 minimum sample size Sampling technique Systematic random sampling technique was applied to select samples from patients Data collection Data were collected by attending nurses who have prior experience in data collection.All data collectors and supervisors were trained for one day and performed practical excercises to be familiar with the questionnaire.Socio-demographic and sexual behavior data and,knowledge attitude and practice for STIs were collected through self-administered structured and pre-tested questionnaire. Laboratory data were collected using blood test,urethral and vaginal discharge swabs whereas retrospective data were obtained from document analysis. Data Analysis After data was checked for its completeness, and then analyzed by using the statistical software SPSS version 20. To determine the association of some potential risk factors with STI, logistic regression analyses were used. Odds ratios with their 95% confidence intervals were computed to identify the presence and strength of association, and statistical significance was declared if p < 0.05. Ethical considerations Ethical clearance was obtained from Institutional Ethical Committee Review Board. The objective of the study was informed to the study participants and gave their consent to be participated in the study. Confidentiality was also maintained. RESULTS Socio-demographic and clinical characteristics of respondents Socio-demographic characteristics of respondents are summarized in Table 1 .A total of 385 respondents were participated in this study, of which 147(38.2%) were males and 238(61.8%) were females. Thirty (9%) participants were at age ≤ 15 years, 206(53.5%) were between age of 16–31 years. Eighty(20.8%) participants were between age of 32–47 years. Two hundred forty four (60.5%) participants of this study unmarried, 201(52.2%) were married. Most of the respondents were live in the rural, 201(52.2%). Two hundred twenty two (57.7%) respondents were uneducated, Two hundred eighty three (73.5%) respondents did not use condom during sexual intercourse. Most of the respondents, 267(69.4%) were doing sexual intercourse after drinking alcohol. Almost half, 201(52.2%) participants were doing Sex after Chewing khat (Table 1 ). Table 1 Socio-demographic characteristics of study participants, in Adari Hospital.2022. Characteristics Number Percent (%) Sex Male 193 47.9 Female 210 52.1 Age < 30 251 62.3 30–40 152 37.7 Marital status Single 244 60.5 Married 159 39.5 Residence Urban 272 67.5 Rural 131 32.5 Education status Illiterate 258 64 Literate 145 36 Condom use Yes 147 36.5 No 256 63.5 Occupation Public servant 120 29.8 Self employed 173 42.9 Private sector 67 16.6 Farmer 43 10.7 About 298/385(77.4%) of STIs suspected patients were STIs infected. Analyses of the potential risk factors explored for the STIs showed, 116(78.9%) of males, and 182(76.4%) of females had at least one STIs and statistically significant (P < 0.05) (Table 2 ). The odds of STIs in patients who were rural dwellers, 1.5 times higher than who lived in urban area. Similarly, patients who were single,1.5 times more likely to be infected with STIs. Moreover, patients who were illiterate 2 times more likely to be infected with STIs. Likewise,sex after drinking alcohol, and sex after chewing khat, sex without condum use, having good knowledge about STIs transmission were significantly associated with STIs transmission. Sexual intercourse without condum use was 1.8 times more likely to be infected with STIs. Furthermore, having good knowledge about STIs transmission and presence of only one sexual partner were protective from STIs transmission whereas presence of only one sexual partner were protective from STIs transmission and it showed reduction by 13% from STIs (Table 2 ). Table 2 Associations of potential risk factors for sexually transmitted infections among suspected patients, in Adari Hospital.2022. Variables STI positive No (%) COR(95% CI) p-value AOR(95%CI) p-value Sex Female 182(76.4) 1.871(1.4–2.64) 0.005 2.97(1.3–2.84) 0.005 Male 116(78.9) 1 1 Age 1–15 27(77) 1.64(2.13–3.16) 0.13 2.84(1.13–2.16) 0.24 16–31 156(75.7) 1.56(1.13–2.16) < 0.001 0.76(0.13–0.16) 48 55(85.9) 1 1 Residence Urban 142(77.1) 1 1 Rural 156(77.6) 1.63(1.15–2.3) < 0.001 1.47(1.5–1.7) < 0.001 Marriage Single 142(77.1) 1.63(1.15–2.3) < 0.001 1.47(1.5–1.7) < 0.001 Married 156(77.6 1 1 Education Illiterate 176(79.3) 1.43(1.03–2.10) < 0.001 2.13(1.02–2.6) 0.01 Literate 122(74.4) 1 Condom use Yes 75(73.5) 1 1 No 223(78.8) 1.89(1.23–2.96) < 0.001 1.80(1.43–2.76) < 0.001 Knowledge of STIs Good 155(77.8) 1 1 Poor 143(76.88) 1.54(2.03–5.16) < 0.001 2.54(2.53–4.13) < 0.001 Sexual partner One 145(79.2) 1 1 Two and above 153(75.7) 1.52(1.32–2.20) < 0.001 0.87(1.33–2.40) < 0.001 Sex after drinking alcohol Yes 205(76.8) 1.63(1.0-2.20) 0.02 1.43(1.0-2.31) 0.001 No 93(78.8) 1 1 Sex after Chewing khat Yes 142(77.2) 1.63(1.15–2.3) < 0.001 1.47(1.5–1.7) < 0.001 No 156(77.6) 1 1 *Calculated percentage value for the respective characteristic is from the total examined Trends of STIs incidence, 2016–2021 of the study participants A total of 1074 STIs patients were recorded from the year 2016 to 2021.Among these, 490 (45.6%) were males and 584 (54.4%) were females. As shown in Fig. 1 , the retrospective studies carried out on STI positive patients from 2016–2021 years showed the incidence of 92(8.6%) in 2016, 89(8.3%) in 2017, 198(18.4%) in 2018, 222(20.7%) in 2019, 232(21.6%) in 2020 and 241(22.4%) in 2021. The incidence of STDs increased from 2017 to 2021. Types and Frequency of Sexually Transmitted infections Gonorrhea had the highest percentage of infection occurrence, which accounts for 431(40.1%). Two hundred nineteen five (27.5%), 197(18.3%), 144(13.4%), and 7 (0.65%) of the patients were infected by hepatitis, HIV/AIDS, syphilis and chancroid respectively. HIV/AIDS, gonorrhea, hepatitis, and syphilis infections were higher on females and the age group < 30 years. Majority of the study participants (HIV, gonorrhea, hepatitis, syphilis and chancroid) patients were urban, unmarried and illiterate. Table 3 Frequency of STIs by demographic (n = 1074) with different characteristics at Adari Hospital Southern Ethiopia, (September 2016- June 2021) Variables Total HIV + ve Gonorrhea Hepatitis Syphilis Chancroid N(%) N(%) N(%) N(%) N(%) N(%) Sex Male 490 (45.6) 93(47) 194(45) 127(43) 69(48) 7(1.2) Female 584(54.4) 104(53) 237(55) 168(57) 75(52) 0(0) Age <30 560(52.1) 114(57.9 208(48.3) 167(56.6) 167(56.6 6(85.7) 30–45 374(34.8) 60(30.5) 158(36.7) 98(33.2) 55(39.3) 1(14.3) Above 45 140(13.1) 23(11.7) 65(15) 30(10) 20(13) 0(0) Residence Urban 921(85.8) 162(82.2 390(90.5) 240(81.4) 124(88.6 5(71.4) Rural 153(14.2) 35(17.8) 41(9.5) 55(18.6) 16(11.4) 2(28.6) Marital status Single 686(63.9) 143(72.5 254 (58.9) 184(62.4) 98 (70) 7(100) Married 388(36.1) 54( 27.5 177(41.1) 111(37.6) 42(30) 0(0) Educational status Illiterate 636(59.2) 119(60) 242(56) 171(58) 98(70) 6(86) Literate 438(40.8) 78(40) 189(44) 124(42) 42(30) 1(24) DISCUSSION Studies on STIs and their effects on health are low as compared to ever-increasing rate of sexually transmitted diseases in population. Due to absence of longitudinal studies, the pattern increment of sexually transmitted diseases may not be well justified (Garland et al.,2001). Although more efforts are needed to study on STIs and their effect on the health, some previous study indicated many significant psychological, medical/physiological and sociological negative impacts on the health of population (Gerberding, 2004). The STIs are believed to affect a large segment of the Ethiopian population, particularly the productive age group (Aster, 2014). Compared to what has been reported earlier from different regions of Ethiopia, the prevalence of STIs on health for the present study population were higher from some and lower from others. This could be explained by the differences in awareness about STIs transmission, sex after alcohol use, having multiple sexual partner and STIs non-testing contribute high prevalence of STIs in different regions or localities. Other investigators have also reported that the prevalence of STIs varies in different regions of Ethiopia (Aster, 2014).. STIs was higher in the age range 16–31 years. Hawassa is an emerging town and due to its attraction to tourists and investments, there are a lot of investments mainly hotels and industries. Due to such expansion of investments, high numbers of labor migrants dominantly young age groups who are most sexual active age group were moving from the surrounding districts to the town in search of job opportunities might contribute to the higher prevalence. This finding was in comparable with study done by (Olaniran et al .,2001; Aster, 2014). The overall proportion of HIV/AIDS within five years was (16.8%), which was higher than the prevalence rate reported in the study conducted in Hawassa University (10.6%) (Getu,2013). Gondar, Ethiopia (14.5%) (Rozina et al .,2017). However, the overall HIV/AIDS prevalence rate observed in this study was lower than the prevalence rate observed in the study done in Malawi (. Behets et al .,1995),which was 44.2%. The differences might be due to the time in which the research was conducted and differences in locality. This study revealed that, the prevalence of gonorrhea relative to other STIs within five years was 40.1%. This was higher than those reported from Gondar (20.8%) (Rozina et al.,2017), Mozambique (22.5%) (Apalat et al.,2009). Egypt (26%), (Ali et al.,1995). Southwestern Nigeria (25%) (Okonko et al.,2012). Mongolia (11%) (Garland et al.,2001).The reason behind the prevalence difference might be due to time of the study, environmental differences, cultural context in which the people live and knowledge about the transmission of the disease. In this study, the prevalence of Hepatitis A, (26.8%) was higher than the prevalence rate observed in Jigjiga, Ethiopia (19%) (Melese and Tesfaye,2016). Addis Ababa, Ethiopia (7.3%) (Desalegn et al.,2016). The study also revealed that, syphilis had 13.96% mean prevalence rate within five- year retrospective study. This was lower than the study conducted in Gondar, Ethiopia (30%) (Rozina et al.,2017). Yirgalem Hospital Southern Ethiopia (39%) (Anteneh et al.,2018). This might be due to differences in the study period, differences in locality, in socio-economic cultural differences. The findings of the study showed that, the overall prevalence of sexually transmitted diseases in 385 study subjects was 77.40%. This was comparatively similar to the prevalence in Gondar town, Ethiopia (74.1%) (Rozina et al.,2017).and lower than Nigeria (85%) (Okonko et al.,2012). On the contrary,it was higher than study done in Addis Ababa, Ethiopia (Desalegn et al.,2016), which reported an STI prevalence rate of 47.9% and studies reported in Malawi (4.2%) (Behets et al.,1995). and Mozambique (41%) (Apalat et al.,2009).The probable reason for this prevalence discrepancy might be due to difference in the duration of the study, the interventions used for the target group, difference in sample size, as the current study was conducted only in a single town or hospital where as the other studies were done at national level on a large scale, due to the socio-cultural and economic context in which the person live, knowledge difference between the person about how to protect themselves from, environment, different attitudes of the community for having sexual attraction with similar gender and national laws towards homosexuality. In this study, literates were more likely to protect STIs as compared to illiterates (AOR = 2.13, 95% CI; 1.02, 2.6). This finding was almost similar with the study conducted in Brazil and showed that illiterates had developed high prevalence rate as compared to their counterparts (AOR = 1.09, 95% CI; 1.31,4.73) (Mariade et al.,2007). In this study, residence and STIs prevalence were highly associated. This means those patients who came from urban areas were more likely to develop STIs as compared to patients who reside in rural areas. This is consistent with a previous study; patients from urban areas attending in the health facility had significantly higher STIs prevalence compared to patients from rural areas (Ramose et al.,2008; Dangisso et al.,2014). It has been suggested that patients from urban areas may be due to the possibility to have two or more sexual partners and urbanization could contribute to higher prevalence rate. In this study, STIs prevalence was also less frequent among married than single. The reason for high occurrence of STIs in single patients may be due to STIs non-testing, condom non-use and the presence of multiple sexual partners. This finding is contrary to other studies done in Gondar, Northern Ethiopia (Rozina et al.,2017). The trend of STIs gradually increased from 2017 to 2021,which is similar to study done by(Rozina et al.,2017; Aster,2014 ).This might be due to increment of unprotected sex through time, the presence of more than one sexual partner and sex after alcohol use contribute to high prevalence of STIs. Conclusions This study revealed that, the prevalence of sexually transmitted infections in the study area was relatively high as compared to findings documented in some parts of the country, and its prevalence was 77.4%. An increasing trend was observed in STIs prevalence rate in the past five-years from (8.6%- 22.4%) 2016–2021. The most prevalent STIs were gonorrhea and the most affected age group was below 16–31 years in both sexes. Moreover, the prevalence rate had significant association with marital status; residence, condom use, educational status, number of sexual partner, sex after drinking alcohol and sex after Chewing khat of the study participants. In general, it was observed that those individuals who were not married, urban residence, sexual intercourse without using condom, sexual intercourse after drinking alcohol, sexual intercourse after chewing khat and illiterate were more likely to develop risk of STIs as compared to their counterparts. Declarations Ethics approval and consent to participate Approval for this study was done by ethical institutional review board (IRB), Hawassa university. The purpose, benefits, confidentiality and the voluntary nature of participation were explained and informed consent was obtained from participants. Competing of interests The author participated in the manuscript confirms that I have no competing interests. Author Contribution MB conceived the project idea, designed the study protocol, collected the data, Both MB and DB analyzed the data, interpreted and drafted the manuscript. Acknowledgments We thank Hawassa University for giving laboratory room to conduct laboratory work. We would like to acknowledge technical staffs of Adari hospital for their unfailing cooperation during the survey. We would like to acknowledge the technical staff of Medical Parasitology Unit of the Hawassa University, for their technical assistance. We would thank to the study participants for their willingness to be part of this study. References Ali F, Aziz AA, Helmy MF, Mobdy AA. and Darwish M. Prevalence of certain sexually transmitted diseases in Egypt. Egypt Public Health Assoc.1995; 71 (5-6):553-575. Anteneh Abebe, Getachew Feleke and Demissie Alemu. High sero prevalence of syphilis infection in Yirgalem Hospital Southern Ethiopia. 2018. Apalat T, Zimba TF, Sturm WA and Moodley P. 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Upchurch DM, Mason WM, Kusunoki Y. and Kriechbaum MJ. Social and Behavioral determinants of self-reported STD among adolescents. Perspectives on Sexual and Reproductive Health.2004; 36(6), 276-287. doi: 10.1363/3627604. Wasserheit JN. “The Significance and Scope of Reproductive Tract Infections amongThird World Women.” International Journal of Gynecology and Obstetrics 3 (Suppl).1989; 145–68. WHO. Family planning. {Online} Available at http:// www.Who.int/ media center/ factsheets/ fs 351/en/ 2013. WHO. Global prevalenceand incidence of selected curable sexuallytransmitted infections. Overview and estimates.Geneva: World Health Organization. 2001. Yemane Y. Mathematical formulae for sample size determination, 1967 Additional Declarations No competing interests reported. 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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-3870052","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":267630798,"identity":"dd2ec3ae-990a-4068-8faa-3f1bfdbcf06f","order_by":0,"name":"Melese Birmeka","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYFAC5gYgcYAHxGJgqGBgMCCshRFZyxkStIDtY2BsI0KLbntj48MfFXdkzKcdPmzwc95heXP25gMMPyq24dRiduZgszHPmWc8MrfTkhN7tx023NlzLIGx58xt3FpuJLZJM7Yd5pGQzjE+wLvtMOOGGzkGzIxteLTcf9j+8+c/kJb8zwf/zjlsT1jLDaCXeRvAtjAnAxmJhLWcSWyW5jn2DKglzdhY5lh68oYzxxIO4vXL8cMHP/6ouWMvIZ38WPJNjbXthuPNBx/8qMCtBR00g8kDRKsHgjpSFI+CUTAKRsEIAQDofmAss1ci3AAAAABJRU5ErkJggg==","orcid":"","institution":"Hawassa University","correspondingAuthor":true,"prefix":"","firstName":"Melese","middleName":"","lastName":"Birmeka","suffix":""},{"id":267630799,"identity":"920ce0fe-33ac-41b4-8217-647fc1920775","order_by":1,"name":"Damtew Bekele","email":"","orcid":"","institution":"Ambo University","correspondingAuthor":false,"prefix":"","firstName":"Damtew","middleName":"","lastName":"Bekele","suffix":""}],"badges":[],"createdAt":"2024-01-16 14:14:46","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3870052/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3870052/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49893734,"identity":"967fb731-eb31-49c2-82d5-0ed0829f01b6","added_by":"auto","created_at":"2024-01-19 21:16:39","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":23387,"visible":true,"origin":"","legend":"\u003cp\u003eTrends of STI incidence in (2016-2021) among Patients in Adari hospital.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3870052/v1/f2e8f4563e8d9bb48f3d9918.png"},{"id":49936820,"identity":"ebcd3837-cac3-4e6a-82e3-3716e248c105","added_by":"auto","created_at":"2024-01-21 20:37:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":389010,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3870052/v1/114a3f57-de83-4b5b-88c2-c116398486fd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Distribution on the Pattern, Incidence and Determinants of Sexually Transmitted Infections Among Patients Attending Adari Hospital, Hawassa City,Sidama Region, Ethiopia","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe burden of sexually transmitted infections (STIs) is globally large and ever increasing because many of them are asymptomatic infections; some of the most affected countries has no diagnostic techniques; and surveillance systems are very poor in many areas of the world (Moses \u003cem\u003eet al.\u003c/em\u003e,2002).\u003c/p\u003e \u003cp\u003eThe socio-cultural and economic contexts of low income nations impact the epidemiology of STIs, increase the transmission of HIV infection and help make them an important public health priority (Wasserheit,1989; Aral and Wasserheit ,1999).\u003c/p\u003e \u003cp\u003eIn developing countries like Ethiopia, high levels of STIs and high rates of complications result largely from inadequacies in health service provision and health care seeking (Aral and Wasserheit ,1999;WHO ,2001), poorly trained in STI case management care provider (Moses \u003cem\u003eet al.\u003c/em\u003e,2002),and the asymptomatic nature of many STIs.\u003c/p\u003e \u003cp\u003eIncidence of STIs and their complications are usually higher among people living in urban areas, who are single and young, and the risk of becoming infected by one of these pathogens grows with the underutilization of preservatives and a higher number of sexual partners (WHO,2001;Upchurch \u003cem\u003eet al\u003c/em\u003e.,2004; Pattman \u003cem\u003eet al\u003c/em\u003e.,2005).\u003c/p\u003e \u003cp\u003eSexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with serious medical and psychological consequences to millions of men, women and infants health problem worldwide. Females are at a greater risk of contracting STIs and developing complications if infections go untreated, and do not present symptoms that lead to increased transmission and greater susceptibility to other types of infections (Upchurch \u003cem\u003eet al\u003c/em\u003e.,2004).\u003c/p\u003e \u003cp\u003eMicrobial pathogens responsible for STIs include parasites, bacteria, viruses and fungi. Most are curable with treatment except STIs of viral origin, which range from mild presentation such as genital herpes to debilitating diseases like HIV/AIDS (WHO ,2013).\u003c/p\u003e \u003cp\u003eThe biology of STIs in Ethiopia has become more complex and reveals many characteristics of risk behavior where increasing poverty resulting delay of marriage, urbanization, socio-cultural change which, resulting in sexual behavior, and increasing unemployment of youth have contributed to earlier and often unprotected sex (Rozina,\u003cem\u003eet al\u003c/em\u003e.,2017).\u003c/p\u003e \u003cp\u003eComputing the incidence and burden of these infections is important for planning appropriate interventions and advocating for resources, as necessary. The uncertainties on global and regional STI estimates need to be reduced to obtain relevant data, as these have an important role to play in improving our understanding of the burden of these infections. They are also crucial in helping to improve the design and implementation of STI interventions. Although there are some studies conducted in Ethiopia, little is known about the prevalence and associated factors of STIs in the study area. Assessing the prevalence and factors associated with common STIs among study population provided better information for health planners to adopt strategies to manage the impacts of STIs on the local people.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDescription of the study area\u003c/h2\u003e \u003cp\u003eThe study was conducted in Hawassa city, which is located in Sidama region, 275km South east of Addis Ababa and found between 06\u0026ordm; 58\u0026acute;\u0026ndash; 07\u0026ordm; 14\u0026acute; N latitudes and 38\u0026ordm; 22\u0026acute;\u0026ndash;38 \u0026ordm; 28\u0026acute; E longitudes, and at altitude of 1685m above sea level (m.a.s.l). Hawassa city has two governmental hospital in addition to health centers and private clinics.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eHealth institution based cross-sectional study was conducted to collect data from September 2021 to June 2022 in Adari Hospital. Furthermore, five years retrospective data were collected from patients registered book, at Adari Hospital. The socio-demographic data (sex, age, residence, marital status and educational status and others) were collected using structured questionnaire, interview and observation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSample size determination and sampling techniques\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003eSample size determination\u003c/h2\u003e \u003cp\u003eThe sample size was estimated using statistical formula developed by Yemane(1967) to consider the level of acceptable margin of error 5%. Hence,from the target population size in 2021(N\u0026thinsp;=\u0026thinsp;10904 house hold) a total number of 179 samples was required to be drawn assuming 95% confidence level and 5% margin of error. Based on this the researcher decide to take the upper population size limit to get more valid sample size. If the population size (N) of a given study is known and its sampling error (e) is fixed by the researcher, then the total sample size (n) can be calculated by using the following formula.\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;N/1\u0026thinsp;+\u0026thinsp;N(e)\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e=\u0026thinsp;10904/1\u0026thinsp;+\u0026thinsp;10904(0.05)\u003csup\u003e2\u003c/sup\u003e =385 minimum sample size\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003eSampling technique\u003c/h2\u003e \u003cp\u003eSystematic random sampling technique was applied to select samples from patients\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eData were collected by attending nurses who have prior experience in data collection.All data collectors and supervisors were trained for one day and performed practical excercises to be familiar with the questionnaire.Socio-demographic and sexual behavior data and,knowledge attitude and practice for STIs were collected through self-administered structured and pre-tested questionnaire. Laboratory data were collected using blood test,urethral and vaginal discharge swabs whereas retrospective data were obtained from document analysis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eAfter data was checked for its completeness, and then analyzed by using the statistical software SPSS version 20. To determine the association of some potential risk factors with STI, logistic regression analyses were used. Odds ratios with their 95% confidence intervals were computed to identify the presence and strength of association, and statistical significance was declared if p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations\u003c/h2\u003e \u003cp\u003e Ethical clearance was obtained from Institutional Ethical Committee Review Board. The objective of the study was informed to the study participants and gave their consent to be participated in the study. Confidentiality was also maintained.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic and clinical characteristics of respondents\u003c/h2\u003e \u003cp\u003eSocio-demographic characteristics of respondents are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.A total of 385 respondents were participated in this study, of which 147(38.2%) were males and 238(61.8%) were females. Thirty (9%) participants were at age\u0026thinsp;\u0026le;\u0026thinsp;15 years, 206(53.5%) were between age of 16\u0026ndash;31 years. Eighty(20.8%) participants were between age of 32\u0026ndash;47 years. Two hundred forty four (60.5%) participants of this study unmarried, 201(52.2%) were married. Most of the respondents were live in the rural, 201(52.2%). Two hundred twenty two (57.7%) respondents were uneducated, Two hundred eighty three (73.5%) respondents did not use condom during sexual intercourse. Most of the respondents, 267(69.4%) were doing sexual intercourse after drinking alcohol. Almost half, 201(52.2%) participants were doing Sex after Chewing khat (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\u003eSocio-demographic characteristics of study participants, in Adari Hospital.2022.\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=\"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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\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\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.9\u003c/p\u003e \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\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\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\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\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\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e244\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidence\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\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation status\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\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCondom use\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\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.5\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=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation\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\u003ePublic servant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e173\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate sector\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.7\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\u003eAbout 298/385(77.4%) of STIs suspected patients were STIs infected. Analyses of the potential risk factors explored for the STIs showed, 116(78.9%) of males, and 182(76.4%) of females had at least one STIs and statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The odds of STIs in patients who were rural dwellers, 1.5 times higher than who lived in urban area. Similarly, patients who were single,1.5 times more likely to be infected with STIs. Moreover, patients who were illiterate 2 times more likely to be infected with STIs. Likewise,sex after drinking alcohol, and sex after chewing khat, sex without condum use, having good knowledge about STIs transmission were significantly associated with STIs transmission.\u003c/p\u003e \u003cp\u003eSexual intercourse without condum use was 1.8 times more likely to be infected with STIs. Furthermore, having good knowledge about STIs transmission and presence of only one sexual partner were protective from STIs transmission whereas presence of only one sexual partner were protective from STIs transmission and it showed reduction by 13% from STIs (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\u003eAssociations of potential risk factors for sexually transmitted infections among suspected patients, in Adari Hospital.2022.\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=\"left\" 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=\"char\" char=\".\" 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=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSTI positive\u003c/p\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCOR(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\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\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 \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\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e182(76.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.871(1.4\u0026ndash;2.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.97(1.3\u0026ndash;2.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.005\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\u003e116(78.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003e\u003cb\u003eAge\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\u003e1\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27(77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.64(2.13\u0026ndash;3.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.84(1.13\u0026ndash;2.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u0026ndash;31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156(75.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.56(1.13\u0026ndash;2.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.76(0.13\u0026ndash;0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e32\u0026ndash;47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60(75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.75(1.01\u0026ndash;2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.65(0.01\u0026ndash;0.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55(85.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003e\u003cb\u003eResidence\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\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e142(77.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156(77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.63(1.15\u0026ndash;2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.47(1.5\u0026ndash;1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarriage\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\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e142(77.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.63(1.15\u0026ndash;2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.47(1.5\u0026ndash;1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156(77.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003eEducation\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\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e176(79.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.43(1.03\u0026ndash;2.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.13(1.02\u0026ndash;2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122(74.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\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\u003eCondom use\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\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75(73.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e223(78.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.89(1.23\u0026ndash;2.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.80(1.43\u0026ndash;2.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge of STIs\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\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e155(77.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e143(76.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.54(2.03\u0026ndash;5.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.54(2.53\u0026ndash;4.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual partner\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\u003eOne\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e145(79.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003eTwo and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e153(75.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.52(1.32\u0026ndash;2.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.87(1.33\u0026ndash;2.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex after drinking alcohol\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\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e205(76.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.63(1.0-2.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.43(1.0-2.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.001\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\u003e93(78.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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\u003eSex after Chewing khat\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\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e142(77.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.63(1.15\u0026ndash;2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.47(1.5\u0026ndash;1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\u003e156(77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\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 \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e*Calculated percentage value for the respective characteristic is from the total examined\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eTrends of STIs incidence, 2016\u0026ndash;2021 of the study participants\u003c/h2\u003e \u003cp\u003eA total of 1074 STIs patients were recorded from the year 2016 to 2021.Among these, 490 (45.6%) were males and 584 (54.4%) were females. As shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, the retrospective studies carried out on STI positive patients from 2016\u0026ndash;2021 years showed the incidence of 92(8.6%) in 2016, 89(8.3%) in 2017, 198(18.4%) in 2018, 222(20.7%) in 2019, 232(21.6%) in 2020 and 241(22.4%) in 2021. The incidence of STDs increased from 2017 to 2021.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eTypes and Frequency of Sexually Transmitted infections\u003c/h2\u003e \u003cp\u003eGonorrhea had the highest percentage of infection occurrence, which accounts for 431(40.1%). Two hundred nineteen five (27.5%), 197(18.3%), 144(13.4%), and 7 (0.65%) of the patients were infected by hepatitis, HIV/AIDS, syphilis and chancroid respectively. HIV/AIDS, gonorrhea, hepatitis, and syphilis infections were higher on females and the age group\u0026thinsp;\u0026lt;\u0026thinsp;30 years. Majority of the study participants (HIV, gonorrhea, hepatitis, syphilis and chancroid) patients were urban, unmarried and illiterate.\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\u003eFrequency of STIs by demographic (n\u0026thinsp;=\u0026thinsp;1074) with different characteristics at Adari Hospital Southern Ethiopia, (September 2016- June 2021)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\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=\"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 \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eTotal\u003c/span\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV\u0026thinsp;+\u0026thinsp;ve\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGonorrhea\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHepatitis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSyphilis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eChancroid\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN(%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex Male\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e490 (45.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93(47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e194(45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e127(43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69(48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7(1.2)\u003c/p\u003e \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\u003e584(54.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e104(53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e237(55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e168(57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75(52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge \u0026lt;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e560(52.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114(57.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e208(48.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e167(56.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e167(56.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6(85.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e374(34.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(30.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158(36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e98(33.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e55(39.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(14.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbove 45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140(13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(11.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65(15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30(10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20(13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResidence Urban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e921(85.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e162(82.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e390(90.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e240(81.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e124(88.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5(71.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e153(14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(9.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55(18.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16(11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2(28.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status Single\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e686(63.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e143(72.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e254 (58.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e184(62.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e98 (70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7(100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e388(36.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54( 27.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e177(41.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e111(37.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42(30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational status Illiterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e636(59.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119(60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e242(56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e171(58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e98(70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6(86)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e438(40.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78(40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e189(44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e124(42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42(30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eStudies on STIs and their effects on health are low as compared to ever-increasing rate of sexually transmitted diseases in population. Due to absence of longitudinal studies, the pattern increment of sexually transmitted diseases may not be well justified (Garland et al.,2001).\u003c/p\u003e \u003cp\u003eAlthough more efforts are needed to study on STIs and their effect on the health, some previous study indicated many significant psychological, medical/physiological and sociological negative impacts on the health of population (Gerberding, 2004). The STIs are believed to affect a large segment of the Ethiopian population, particularly the productive age group (Aster, 2014).\u003c/p\u003e \u003cp\u003eCompared to what has been reported earlier from different regions of Ethiopia, the prevalence of STIs on health for the present study population were higher from some and lower from others. This could be explained by the differences in awareness about STIs transmission, sex after alcohol use, having multiple sexual partner and STIs non-testing contribute high prevalence of STIs in different regions or localities. Other investigators have also reported that the prevalence of STIs varies in different regions of Ethiopia (Aster, 2014)..\u003c/p\u003e \u003cp\u003eSTIs was higher in the age range 16\u0026ndash;31 years. Hawassa is an emerging town and due to its attraction to tourists and investments, there are a lot of investments mainly hotels and industries. Due to such expansion of investments, high numbers of labor migrants dominantly young age groups who are most sexual active age group were moving from the surrounding districts to the town in search of job opportunities might contribute to the higher prevalence. This finding was in comparable with study done by (Olaniran \u003cem\u003eet al\u003c/em\u003e.,2001; Aster, 2014).\u003c/p\u003e \u003cp\u003eThe overall proportion of HIV/AIDS within five years was (16.8%), which was higher than the prevalence rate reported in the study conducted in Hawassa University (10.6%) (Getu,2013). Gondar, Ethiopia (14.5%) (Rozina \u003cem\u003eet al\u003c/em\u003e.,2017). However, the overall HIV/AIDS prevalence rate observed in this study was lower than the prevalence rate observed in the study done in Malawi (. Behets \u003cem\u003eet al\u003c/em\u003e.,1995),which was 44.2%. The differences might be due to the time in which the research was conducted and differences in locality.\u003c/p\u003e \u003cp\u003eThis study revealed that, the prevalence of gonorrhea relative to other STIs within five years was 40.1%. This was higher than those reported from Gondar (20.8%) (Rozina et al.,2017), Mozambique (22.5%) (Apalat et al.,2009). Egypt (26%), (Ali et al.,1995). Southwestern Nigeria (25%) (Okonko et al.,2012). Mongolia (11%) (Garland et al.,2001).The reason behind the prevalence difference might be due to time of the study, environmental differences, cultural context in which the people live and knowledge about the transmission of the disease.\u003c/p\u003e \u003cp\u003eIn this study, the prevalence of Hepatitis A, (26.8%) was higher than the prevalence rate observed in Jigjiga, Ethiopia (19%) (Melese and Tesfaye,2016). Addis Ababa, Ethiopia (7.3%) (Desalegn et al.,2016). The study also revealed that, syphilis had 13.96% mean prevalence rate within five- year retrospective study. This was lower than the study conducted in Gondar, Ethiopia (30%) (Rozina et al.,2017). Yirgalem Hospital Southern Ethiopia (39%) (Anteneh et al.,2018). This might be due to differences in the study period, differences in locality, in socio-economic cultural differences.\u003c/p\u003e \u003cp\u003eThe findings of the study showed that, the overall prevalence of sexually transmitted diseases in 385 study subjects was 77.40%. This was comparatively similar to the prevalence in Gondar town, Ethiopia (74.1%) (Rozina et al.,2017).and lower than Nigeria (85%) (Okonko et al.,2012). On the contrary,it was higher than study done in Addis Ababa, Ethiopia (Desalegn et al.,2016), which reported an STI prevalence rate of 47.9% and studies reported in Malawi (4.2%) (Behets et al.,1995). and Mozambique (41%) (Apalat et al.,2009).The probable reason for this prevalence discrepancy might be due to difference in the duration of the study, the interventions used for the target group, difference in sample size, as the current study was conducted only in a single town or hospital where as the other studies were done at national level on a large scale, due to the socio-cultural and economic context in which the person live, knowledge difference between the person about how to protect themselves from, environment, different attitudes of the community for having sexual attraction with similar gender and national laws towards homosexuality.\u003c/p\u003e \u003cp\u003eIn this study, literates were more likely to protect STIs as compared to illiterates (AOR\u0026thinsp;=\u0026thinsp;2.13, 95% CI; 1.02, 2.6). This finding was almost similar with the study conducted in Brazil and showed that illiterates had developed high prevalence rate as compared to their counterparts (AOR\u0026thinsp;=\u0026thinsp;1.09, 95% CI; 1.31,4.73) (Mariade et al.,2007).\u003c/p\u003e \u003cp\u003eIn this study, residence and STIs prevalence were highly associated. This means those patients who came from urban areas were more likely to develop STIs as compared to patients who reside in rural areas. This is consistent with a previous study; patients from urban areas attending in the health facility had significantly higher STIs prevalence compared to patients from rural areas (Ramose et al.,2008; Dangisso et al.,2014). It has been suggested that patients from urban areas may be due to the possibility to have two or more sexual partners and urbanization could contribute to higher prevalence rate.\u003c/p\u003e \u003cp\u003eIn this study, STIs prevalence was also less frequent among married than single. The reason for high occurrence of STIs in single patients may be due to STIs non-testing, condom non-use and the presence of multiple sexual partners. This finding is contrary to other studies done in Gondar, Northern Ethiopia (Rozina et al.,2017).\u003c/p\u003e \u003cp\u003eThe trend of STIs gradually increased from 2017 to 2021,which is similar to study done by(Rozina et al.,2017; Aster,2014 ).This might be due to increment of unprotected sex through time, the presence of more than one sexual partner and sex after alcohol use contribute to high prevalence of STIs.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study revealed that, the prevalence of sexually transmitted infections in the study area was relatively high as compared to findings documented in some parts of the country, and its prevalence was 77.4%. An increasing trend was observed in STIs prevalence rate in the past five-years from (8.6%- 22.4%) 2016\u0026ndash;2021. The most prevalent STIs were gonorrhea and the most affected age group was below 16\u0026ndash;31 years in both sexes. Moreover, the prevalence rate had significant association with marital status; residence, condom use, educational status, number of sexual partner, sex after drinking alcohol and sex after Chewing khat of the study participants. In general, it was observed that those individuals who were not married, urban residence, sexual intercourse without using condom, sexual intercourse after drinking alcohol, sexual intercourse after chewing khat and illiterate were more likely to develop risk of STIs as compared to their counterparts.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e \u003cp\u003e Approval for this study was done by ethical institutional review board (IRB), Hawassa university. The purpose, benefits, confidentiality and the voluntary nature of participation were explained and informed consent was obtained from participants.\u003c/p\u003e \u003ch2\u003eCompeting of interests\u003c/h2\u003e \u003cp\u003eThe author participated in the manuscript confirms that I have no competing interests.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eMB conceived the project idea, designed the study protocol, collected the data, Both MB and DB analyzed the data, interpreted and drafted the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgments\u003c/h2\u003e \u003cp\u003eWe thank Hawassa University for giving laboratory room to conduct laboratory work. We would like to acknowledge technical staffs of Adari hospital for their unfailing cooperation during the survey. We would like to acknowledge the technical staff of Medical Parasitology Unit of the Hawassa University, for their technical assistance. We would thank to the study participants for their willingness to be part of this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAli F, Aziz AA, Helmy MF, Mobdy AA. and Darwish M. Prevalence of certain sexually transmitted diseases in Egypt. Egypt Public Health Assoc.1995; 71 (5-6):553-575.\u003c/li\u003e\n\u003cli\u003eAnteneh Abebe, Getachew Feleke and Demissie Alemu. High sero prevalence of syphilis infection in Yirgalem Hospital Southern Ethiopia. 2018.\u003c/li\u003e\n\u003cli\u003eApalat T, Zimba TF, Sturm WA and Moodley P. Antimicrobial susceptibility profile of gonorrhea isolated from patients attending STD facility in Maputo, Mozambique. Sex Transm. Dis.2009; 36(6): 341-343.\u003c/li\u003e\n\u003cli\u003eAral SO. and Wasserheit J N. \u0026ldquo;STD-Related Health Care Seeking and Health Service Delivery.\u0026rdquo; In \u003cem\u003eSexually Transmitted Diseases\u003c/em\u003e, 3rd ed.,ed. K. K. Holmes, P. F. Sparling, P.-A. Mardh, S. 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Prevalence of Tuberculosis among HIV/AIDS Patients in Obafemi Awolowo University Teaching Hospital Complex. \u003cem\u003eInt J Biol Med Res.\u003c/em\u003e2001;\u003cem\u003e \u003c/em\u003e\u003cstrong\u003e2\u003c/strong\u003e(4): 874 -877.\u003c/li\u003e\n\u003cli\u003ePattman R, Snow M, Handy P, Sankar KN, Elawad B. Oxford Handbook of genitourinary medicine, HIV, and AIDS. Oxford: Oxford Univertity Press.2005.\u003c/li\u003e\n\u003cli\u003eRamose JM, Reyes F. and Facin R. Surgical lymph biopsies in a rural Ethiopian Hospital: histopathologic diagnoses and clinical characteristics. Ethiop Med J. 2008; 46:173\u0026ndash;178.Pmid: 21309207.\u003c/li\u003e\n\u003cli\u003eRozina Ambachew, Beyene Moges, Abate Assefa, Mngistu Endris and Addisu Gize.The prevalence of Sexually Transmitted Infections and associated factors among symptomatic patients attending Gondar town Hospitals and Health centers.2017.\u003c/li\u003e\n\u003cli\u003eUpchurch DM, Mason WM, Kusunoki Y. and Kriechbaum MJ. Social and Behavioral determinants of self-reported STD among adolescents. Perspectives on Sexual and Reproductive Health.2004; 36(6), 276-287. doi: 10.1363/3627604.\u003c/li\u003e\n\u003cli\u003eWasserheit JN. \u0026ldquo;The Significance and Scope of Reproductive Tract Infections amongThird World Women.\u0026rdquo; \u003cem\u003eInternational Journal of Gynecology and Obstetrics \u003c/em\u003e3 (Suppl).1989; 145\u0026ndash;68.\u003c/li\u003e\n\u003cli\u003eWHO. Family planning. {Online} Available at \u003cu\u003ehttp://\u003c/u\u003e www.Who.int/ media center/ factsheets/ fs 351/en/ 2013.\u003c/li\u003e\n\u003cli\u003eWHO. Global prevalenceand incidence of selected curable sexuallytransmitted infections. Overview and estimates.Geneva: World Health Organization. 2001.\u003c/li\u003e\n\u003cli\u003eYemane Y. Mathematical formulae for sample size determination, 1967\u003c/li\u003e\n\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":"","lastPublishedDoi":"10.21203/rs.3.rs-3870052/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3870052/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Sexually transmitted infections cause series medical and psychological health problems in Ethiopia and vary in different localities. Thus, study was aimed to investigate pattern, status and the association of sexually transmitted infections and local risk factors on the patients attending Adari hospital.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: Institutional based cross-sectional study was carried out from September 2021 to June 2022.Systematic simple random sampling was used to select a total of 385 patients. In addition, a five years retrospective data were collected. Data were collected through blood test, urethral and vaginal discharge swabs, structured questionnaire, interview and observation. Variables with p-value less than 5% considered as significant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: The overall prevalence of sexually transmitted infections was 74.4%. The odds of STIs in patients who were urban, single, presence of two and above sexual partners, illiterate, sexual intercourse without using condom, and sex after drinking alcohol and chewing khat were more likely to be infected with STIs as compared with their counter parts.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions: STIs were highly prevalent and one of health challenges of Hawassa city.\u003c/p\u003e","manuscriptTitle":"Distribution on the Pattern, Incidence and Determinants of Sexually Transmitted Infections Among Patients Attending Adari Hospital, Hawassa City,Sidama Region, Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-19 21:16:34","doi":"10.21203/rs.3.rs-3870052/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":"eeae038c-21c7-465b-a84d-7070fe7f4641","owner":[],"postedDate":"January 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-01-21T20:29:20+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-19 21:16:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3870052","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3870052","identity":"rs-3870052","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}