Burden and Determinants of Syndromic Sexually Transmitted Infections among Key Populations on Combined HIV Prevention in Five Cameroonian Cities: A Cross-Sectional Study
Fardeau et Déterminants des Infections Sexuellement Transmissibles Syndromiques Au Sein des Populations Clés Sous Prévention Combinée du VIH dans Cinq Villes Camerounaises : Une Étude Transversale
DOI:
https://doi.org/10.5281/zenodo.20297565Keywords:
Sexually Transmitted Diseases, Sexual minorities, Risk Factors, Syndromic management, Pre-Exposure Prophylaxis, CameroonAbstract
ABSTRACT
Introduction. Sexually transmitted infections (STIs) remain a major burden among key populations in sub-Saharan Africa, yet data among men who have sex with men (MSM) and female sex workers (FSW) receiving combined HIV prevention including pre-exposure prophylaxis (PrEP) are scarce in Cameroon. The objective was to estimate the prevalence of syndromic STI and identify its independent correlates among MSM and FSW receiving combined HIV prevention in five Cameroonian cities. Methods. A cross-sectional study was conducted between 17 and 28 July 2023 in 14 community-based organisations in Yaoundé, Douala, Bafoussam, Bertoua and Bamenda. Eligible participants were MSM and FSW aged 21 years or older who had been receiving combined HIV prevention interventions, including PrEP for at least 12 months. Syndromic STI was defined according to World Health Organization algorithms based on self-reported symptoms over the preceding 12 months. Associations were estimated using modified (robust) Poisson regression; adjusted prevalence ratios (aPR) with 95% confidence intervals (95% CI) are reported. Results. Of 455 participants (202 MSM; 253 FSW), 44.6% of MSM and 73.1% of FSW reported at least one STI syndrome. Among FSW, residence in the Sawa area (aPR 0.73, 95% CI 0.61–0.88), regular alcohol consumption (aPR 1.25, 95% CI 1.02–1.52) and consistent condom use in the past six months (aPR 0.86, 95% CI 0.74–0.99) were independently associated with syndromic STI. Among MSM, consistent condom use was the only significant correlate (aPR 0.52, 95% CI 0.35–0.78). Conclusion. The syndromic STI burden remains high among key populations receiving combined HIV prevention in Cameroon. Reinforced condom promotion, the integration of alcohol-focused brief interventions for FSW and a progressive transition from syndromic to etiological STI screening within PrEP programmes are the priorities for action.
RÉSUMÉ
Introduction. Les infections sexuellement transmissibles (IST) demeurent un fardeau majeur au sein des populations clés en Afrique subsaharienne ; pourtant, les données concernant les hommes ayant des rapports sexuels avec des hommes (HSH) et les travailleuses du sexe (TS) bénéficiant d'une prévention combinée du VIH, incluant la prophylaxie pré-exposition (PrEP), sont rares au Cameroun. L’objectif était d’estimer la prévalence des IST syndromiques et identifier leurs corrélats indépendants chez les HSH et les TS bénéficiant de la prévention combinée du VIH dans cinq villes camerounaises. Méthodes. Une étude transversale a été menée entre le 17 et le 28 juillet 2023 au sein de 14 organisations communautaires à Yaoundé, Douala, Bafoussam, Bertoua et Bamenda. Les participants éligibles étaient des HSH et des TS âgés de 21 ans ou plus, bénéficiant d'interventions de prévention combinée du VIH, y compris la PrEP, depuis au moins 12 mois. Les IST syndromiques ont été définies selon les algorithmes de l'Organisation mondiale de la Santé, sur la base des symptômes auto-déclarés au cours des 12 mois précédents. Les associations ont été estimées à l'aide de la régression de Poisson modifiée (robuste) ; les ratios de prévalence ajustés (RPa) avec des intervalles de confiance à 95 % (IC à 95 %) sont présentés. Résultats. Sur 455 participants (202 HSH ; 253 TS), 44,6 % des HSH et 73,1 % des TS ont déclaré au moins un syndrome d'IST. Chez les TS, la résidence dans la zone Sawa (RPa 0,73, IC à 95 % 0,61–0,88), la consommation régulière d'alcool (RPa 1,25, IC à 95 % 1,02–1,52) et l'utilisation systématique du préservatif au cours des précedents six mois (RPa 0,86, IC à 95 % 0,74–0,99) étaient indépendamment associées aux IST syndromiques. Chez les HSH, l'utilisation systématique du préservatif était le seul corrélat significatif (RPa 0,52, IC à 95 % 0,35–0,78). Conclusion. Le fardeau des IST syndromiques reste élevé parmi les populations clés bénéficiant de la prévention combinée du VIH au Cameroun. Une promotion renforcée du préservatif, l'intégration d'interventions brèves axées sur la consommation d'alcool pour les TS, ainsi qu'une transition progressive du dépistage syndromique vers le dépistage étiologique des IST au sein des programmes de PrEP constituent les priorités d'action.
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Copyright (c) 2026 Nkoro Ombede Grace Anita, Rose Ekambi Kotto, Sonia Chiago, Berline Sigha, Jean-Pierre Yves Awono Noah, Justin Ndié, Emmanuelle Audrey Djeumi Sah, Francis Ateba Ndongo, Rogacien Kana Dongmo, Roger Alain Mbianda Yomi, Martial Gaël Bonyohe, Patrice Zanga Olinga, Jérôme Ateudjieu, Anne Cécile Zoung-Kanyi Bissek
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