Prevalence and Associated Factors of Syndromic STIs Among Young Key Populations Lacking Combined Prevention in Cameroon
Prévalence et Facteurs Associés aux IST Syndromiques Chez les Jeunes Populations Clés Sans Accès À la Prévention Combinée au Cameroun
DOI:
https://doi.org/10.5281/zenodo.19681727Keywords:
Sexually Transmitted Infections, Men Who Have Sex with Men, Female Sex Workers, Cameroon, Syndromic managementAbstract
ABSTRACT
Introduction. Sexually transmitted infections (STIs) are a major global health concern, with young Cameroonian MSM and FSW bearing a disproportionate burden; however, data remains scarce for those not receiving combined prevention. This study aimed to determine the prevalence of STIs diagnosed using a syndromic approach and to identify associated factors among young MSM and FSW not receiving combined prevention in Cameroon. Methodology. This cross-sectional study, conducted in July 2023 across 14 community organizations in five Cameroonian cities, assessed STI syndromes among MSM and FSW aged 18–24 years. Researchers used WHO algorithms to identify STI symptoms in participants active for at least 12 months and not on PrEP. Factors associated with having at least one STI syndrome were identified using multivariable robust Poisson regression, with results reported as adjusted prevalence ratios (aPR). Results. Of 393 participants (157 MSM, 236 FSW; median age 22–23), STI prevalence reached 45.9% in MSM and 74.2% in FSW. Leading syndromes were vaginal (52.5%) and urethral (38.6%) discharge for FSW, and urethral discharge (19.1%) and anorectal symptoms (10.2%) for MSM. Multivariable analysis showed no significant associations for MSM. For FSW, residing in Grassfield (aPR=0.75; 95% CI: 0.60–0.93) or Sawa (aPR=0.76; 95% CI: 0.63–0.93) areas correlated with lower prevalence versus Fang Béti, while high perceived HIV risk (aPR=1.20; 95% CI: 1.03–1.41) correlated with higher prevalence. Conclusion. Syndromic STI prevalence is alarmingly high among young, PrEP-naive MSM and FSW in Cameroon, especially among FSW. Linked to geographic disparities and risk perception, these results highlight the urgent need for integrated, youth-friendly STI services within HIV prevention programs for key populations.
RÉSUMÉ
Introduction. Bien que les infections sexuellement transmissibles (IST) constituent une menace majeure pour la santé mondiale, les données sur leur prévalence chez les jeunes populations clés du Cameroun non couvertes par la prévention combinée restent limitées. Méthodologie. Cette étude transversale, menée en juillet 2023 dans cinq villes auprès de 393 participants (157 HSH et 236 TS) âgés de 18 à 24 ans et naïfs de PrEP, a utilisé les algorithmes de l'OMS et une régression de Poisson multivariée pour évaluer la prévalence syndromique et les facteurs associés. Résultats. Sur un total de 393 participants (157 HSH, 236 TS ; âge médian 22-23 ans), la prévalence des IST a atteint 45,9 % chez les HSH et 74,2 % chez les TS. Les principaux syndromes étaient les pertes vaginales (52,5 %) et l'écoulement urétral (38,6 %) chez les TS, tandis que l'écoulement urétral (19,1 %) et les symptômes anorectaux (10,2 %) prédominaient chez les HSH. L'analyse multivariée n'a montré aucune association significative pour les HSH. Pour les TS, la résidence dans les zones Grassfield (RPa = 0,75 ; IC 95 % : 0,60–0,93) ou Sawa (RPa = 0,76 ; IC 95 % : 0,63–0,93) était corrélée à une prévalence plus faible par rapport à la zone Fang-Béti, tandis qu'une perception élevée du risque de VIH (RPa = 1,20 ; IC 95 % : 1,03–1,41) était corrélée à une prévalence plus élevée. Conclusion. La prévalence syndromique des IST est alarmante chez les jeunes HSH et TS naïfs de PrEP au Cameroun, particulièrement chez les travailleuses du sexe. Liés aux disparités géographiques et à la perception du risque, ces résultats soulignent l'urgence d'intégrer des services de prise en charge des IST adaptés aux jeunes au sein des programmes de prévention du VIH ciblant les populations clés.
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Copyright (c) 2026 Nkoro Grâce Anita, Justin Ndié, Jean-Pierre Yves Awono Noah, Sigha Odette Berline, Ekambi Kotto Rose, Francis Ateba Ndongo, Martial Gaël Bonyohe, Patrice Zanga Olinga, Jérôme Ateudjieu, Anne Cécile Zoung-Kanyi Bissek
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