Factors contributing to the upsurge of sexually transmitted infections in Gaborone, Botswana

Abstract

Background: Sexually Transmitted Infections (STIs) remain a major public health problem in subsaharan African countries, particularly Botswana. In Gaborone, STIs increased from 24 272 in 2015 to 28 106 in 2016 (16%), despite intense advocacy for behavior change by stakeholders to reduce HIV and AIDS prevalence. This study aimed to establish the risk factors associated with STIs.

Materials and Methods: A case-control design was used to study 90 cases and 153 controls (Mean age= 28; SD= ± 6.48; age range= 18 – 60 years) enrolled from two health facilities. Data were collected through interviewer-administered questionnaires and participants were selected using simple random sampling. Data were captured and analyzed using SPSS statistical software (version 25).

Results: Traveling long distances to access condoms from clinics or pharmacies was a risk factor for contracting STIs among males [Adjusted Odds Ratio (AOR) = 3.46; 95% CI 1.37-8.73]. Negative attitudes, for instance, reduction of quality of sex (pleasure) caused by condom use, was found to be a risk factor among females (AOR= 4.15; 95% CI 1.71-10.08). Additionally, belonging to a particular religion, that is, Pentecostal, was a deterrent to contracting STIs for both genders (AOR=0.27; 95% CI 0.11-0.68).

Conclusions: Knowledge of the deleterious effects of STIs was not sufficient to curb contracting any of the infections. Barriers to easy access of condoms such as traveling long distances and negative attitudes towards condom use are obstacles to maintaining healthy behaviors. Stakeholders should increase condom collection points and change negative attitudes through the use of cost-benefit analysis in the AIDS era.

Keywords: STIs, Precede-Proceed model, condom use, risky behavior, negative attitudes