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Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya: Feasibility, Prevalence, and Correlates

Masese, Linnet N. MBChB, MPH, PhD*; Wanje, George BA, MPH; Kabare, Emmanuel BSc; Budambula, Valentine PhD; Mutuku, Francis PhD; Omoni, Grace MSc, PhD§; Baghazal, Anisa MBChB, MPH; Richardson, Barbra A. PhD∥**††; McClelland, R. Scott MD, MPH*†∥‡‡

doi: 10.1097/OLQ.0000000000000674
Original Studies

Introduction As adolescents and young women become sexually active, they are at risk of adverse reproductive health outcomes including sexually transmitted infections (STIs). We assessed feasibility and acceptability of STI screening among 15- to 24-year-old women in Mombasa, Kenya.

Methods After sensitization activities, participants were recruited from 3 high schools and 1 university. Study staff conducted informational sessions. Students interested in participating were given consent forms to take home, and invited to visit our clinic for STI screening. During clinic visits, participants completed a self-administered questionnaire and provided a urine specimen for STI testing using a nucleic acid amplification test.

Results Between August 2014 and March 2015, 463 high school and 165 university students collected consent forms. Of these, 293 (63%) from high schools versus 158 (95%) from university attended clinic for STI screening (P < 0.001). Of the 150 (33%) who reported any history of insertive vaginal sex, 78 (52.0%) reported condom use at the last sex act, 31 (20.7%) reported using modern nonbarrier contraceptive methods, and 37 (24.7%) reported not using any contraception at the last sex act. Twenty-six (5.8%) participants were diagnosed with STIs (7 [1.6%] Neisseria gonorrhoeae, 16 [3.6%] Chlamydia trachomatis, 3 [0.7%] Trichomonas vaginalis). In multivariable analyses, reporting receptive vaginal sex without a condom was associated with having a laboratory confirmed STI (odds ratio, 6.21; 95% confidence interval, 1.72–22.28).

Conclusions These findings support the need for reproductive health interventions to reduce the risk of STIs in a population of adolescent girls and young women in East Africa.

A study to assess the feasibility of sexually transmitted infection (STI) screening among adolescent girls and young women in Mombasa, Kenya, reported high STI testing uptake and overall STI prevalence of 5.8%.

From the *Department of Medicine, University of Washington, Seattle, WA; †University of Nairobi Institute of Tropical & Infectious Disease (UNITID), Nairobi; ‡Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa; §School of Nursing Sciences, University of Nairobi, Nairobi; ¶Mombasa County Department of Health, Mombasa, Kenya; ∥Department of Global Health, **Biostatistics, University of Washington; ††Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center; and ‡‡Department of Epidemiology, University of Washington, Seattle, WA

Acknowledgements: The authors would like to thank Mombasa County for working with us on this project. The authors appreciate the support that they received from the 4 institutions that allowed us to work with their students and staff. In particular, the authors thank the teachers and instructors who facilitated the study and the students who enthusiastically volunteered to participate.

Funding: This research was funded by a 2011 developmental grant from the University of Washington Global Center for Integrated Health of Women, Adolescents, and Children (Global WACh). One of the authors received training support from the Fogarty International Center (NIH 5D43-TW000007 to LM). Infrastructure and logistical support for the Mombasa Field Site were received from the University of Washington & Fred Hutchinson Cancer Research Center’s Center for AIDS Research (grant number P30-AI-27757). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

This work was presented in part at the World STI & HIV Congress 13-16th September, 2015, Brisbane, Australia. Poster P03.19.

Competing Interests: RSM receives research funding from Hologic Corporation, which is paid as a grant to the University of Washington.

Correspondence: Linnet Masese, MBChB, MPH, PhD, University of Washington, HMC Box 359909, 325 9th Avenue, Seattle, WA 98104-2499. E-mail:

Received for publication February 13, 2017, and accepted June 3, 2017.

© Copyright 2017 American Sexually Transmitted Diseases Association