Prevalence and determinants of genitalChlamydia trachomatisamong school-going, sexually experienced adolescents in urban and rural Indigenous regions of Panama

Abstract

ObjectivesTo determine the prevalence and risk factors of genital Chlamydia trachomatis (CT) among school-going sexually experienced male and female adolescents in Panama.MethodsWe conducted two multisite cross-sectional studies using two-stage cluster sampling to select adolescents aged 14–19 years attending urban public high schools (URB) in Panama City, San Miguelito, Colón and Panama Oeste from 2015 to 2018, and in the rural Indigenous Comarca Ngäbe-Buglé (CNB) from July–November 2018. CT testing was performed by real-time PCR on urine samples. Random-effects logistic regression accounting for sample clustering was used to identify risk factors.ResultsWe enrolled 3166 participants (54.3% females), median age 17 years (IQR: 15.9–18.1), with no difference by sex. Sexual experience was reported by 1954 (61.7%) participants. Combined CT prevalence was 15.8% (95% CI: 14.2 to 17.4), with no significant differences by region (URB=16.5%, 95% CI: 14.7% to 18.6%; CNB=13.6%, 95% CI: 10.9% to 16.8%; p=0.12). In an age-and-region-adjusted analysis, CT prevalence was higher among female participants compared with males (21.6% vs 9.1%, adjusted OR (AOR)=2.87, 95% CI: 1.62 to 5.10). Among sexually experienced females, CT prevalence was higher among those who reported ≥3 lifetime sex partners compared with one partner (33.5% vs 15.3%, AOR=2.20, 95% CI: 1.09 to 4.07); and among those reporting at least one pregnancy compared with nulligravidae participants (30.9% vs 13.8%, AOR=1.89, 95% CI: 1.05 to 3.43). In unadjusted analyses among males, CT was associated with older age (11.5% among those aged 18–19 years vs 3.4% among those aged 14–15 years, OR=3.69, 95% CI: 1.10 to 12.33).ConclusionsWe report high CT prevalence among sexually experienced, school-going adolescents in Panama. Female adolescents, particularly those with multiple sex partners and a history of pregnancy, were at highest risk. Adolescent-targeted CT screening should be implemented in Panama. Additionally, evidence-based comprehensive sexuality education will be imperative.

Adolescents’ World: Know One Tell One against Unsafe Sexual Behaviours, Teenage Pregnancies and Sexually Transmitted Infections Including Chlamydia

“…The increasing trend of chlamydia infection among young people including adolescents may be used as an alert to the respective authorities for special collaborative efforts to be given appropriate weight to reach them [71]. Tallying to the existing initiatives Adolescents' World: Know One Tell One against Unsafe Sexual Behaviours, Teenage Pregnancies... DOI: http://dx.doi.org/10.5772/intechopen.109048 against chlamydia infections among young people, mounting the scope of SRH preventive interventions such as screening programs, and education programs may be crucial to the proper development of the young generation towards a healthy adulthood [72].…”

How did COVID-19 measures impact sexual behaviour and access to HIV/STI services in Panama? Results from a national cross-sectional online survey

“…The HIV epidemic is concentrated among specific populations, particularly MSM and transwomen; STI prevalence is high among adolescents and unregistered female sex workers [4][5][6][7]. Regular testing of HIV/STI in these populations is considered to aid in controlling transmission.…”

“…HIV and other sexually transmitted infections (STIs) have been on the rise in Panama for the past several years [1], and groups including young adults [2] and Indigenous youth [3] are particularly affected. As of 2019, HIV prevalence nationwide was estimated at 0.6%, belying significant concentrated epidemics among men who have sex with men (MSM) (6.9%) and transwomen (29.6%) populations [1] Correspondingly, STI prevalence is more concentrated among MSM, female sex workers, and adolescents [4][5][6][7]. Higher HIV and STI prevalence in Panama is associated with engaging in sexual activity with new and casual partners, due to increased access to connected sexual networks and condomless sex soon after partnership initiation [1].…”

How did COVID-19 measures impact sexual behaviour and access to HIV/STI services in Panama? Results from a national cross-sectional online survey

“…1 Correspondingly, STI prevalence is more concentrated among MSM, female sex workers and adolescents. [3][4][5][6] The higher prevalence of HIV and STI in Panama is associated with engaging in sexual activity with new and casual partners due to increased access to connected sexual networks and condomless sex soon after partnership initiation. 1 The COVID-19 pandemic has brought several important changes relevant to sexual health and also created challenges for inperson data collection.…”