High burden of Self-reported Sexually Transmitted Infections among Key Populations in Mozambique: The Urgent Need for an Integrated Surveillance System

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background: </jats:bold>Key populations - men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID) – are at high risk for sexually transmitted infections (STI) given their sexual risk behaviours along with social, legal and structural barriers to prevention, care and treatment services. The purpose of this secondary analysis is to assess the prevalence of self-reported STIs and describe associated risk factors among participations of the first Biological Behavioural Surveillance (BBS) in Mozambique.<jats:bold>Methods: </jats:bold>Responses from the first BBS surveys conducted in 2011-2014 were aggregated across survey-cities to produce pooled estimates for each population. Aggregate weighted estimates were computed to analyse self-reported STI prevalence. Unweighted pooled estimates were used in multivariable logistic regression to identify risk factors associated with self-reported STI. <jats:bold>Results: </jats:bold>The prevalence of self-reported STI was 11.9% (95% CI: 7.8-16.0), 33.6% (95% CI: 29.0-41.3), and 22.0% (95% CI: 17.0-27.0) among MSM, FSW and PWID, respectively. MSM who were circumcised, had HIV, reported drug use, reported receptive anal sex, and non-condom use with their last male partner had greater odds of STI self-report. STI-self report among FSW was associated with living in Beira, being married, employment aside from sex work, physical violence, sexual violence, drug use, access to comprehensive HIV prevention services, non-condom use with last client, and sexual relationship with a non-client romantic partner. Among PWID, risk factors for self-reported STI included living in Nampula/Nacala, access to HIV prevention services, and sex work.<jats:bold>Conclusion: </jats:bold>The high-burden of STIs among survey participants requires integrated HIV and STI prevention, treatment, and harm reduction services that address overlapping risk behaviours, especially injection drug use and sex work. A robust public health response requires the creation of a national STI surveillance system for better screening and diagnostic procedures within these vulnerable populations.</jats:p>

Recognizing the hidden: strengthening the HIV surveillance system among key and priority populations in Mozambique

“…There has been a systematic approach to the use and dissemination of data for the development of abstracts for international conferences and manuscripts for international peer-reviewed journals of both INS staff and students interested in using the BBS data for their thesis and dissertation work. To date, sixteen manuscripts have been published or are under review in peer-reviewed journals [13][14][15][16][17][34][35][36][37][38][39][40][41][42][43][44], and six students have used BBS data for their dissertations (undergraduate, masters, and doctorate). These abstracts and manuscripts have benefited from systematic and ongoing support from INS leadership and partner organizations.…”

Recognizing the hidden: Strengthening the HIV surveillance system among key and priority populations in Mozambique

“…There has been a systematic approach to the use and dissemination of data for the development of abstracts for international conferences and manuscripts for international peer-reviewed journals of both INS staff and students interested in using the BBS data for their thesis and dissertation work. To date, sixteen manuscripts have been published or are under review in peer-reviewed journals (13)(14)(15)(16)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45), and six students have used BBS data for their dissertations (undergraduate, masters, and doctorate). These abstracts and manuscripts have bene ted from systematic and ongoing support from INS leadership and partner organizations.…”