STI prevalence and associated factors among urban men in Pakistan
- Dr Ali Mohammad Mir, Population Council, House 7, Street 62, F-6/3, Islamabad, Pakistan;
- Accepted 30 January 2009
- Published Online First 11 February 2009
Objectives: To measure the prevalence of selected sexually transmitted infections (STIs) among urban men in Pakistan and identify associated factors.
Methods: A cross-sectional survey of 2400 urban men aged 16–45 years was carried out in six cities of Pakistan. Respondents were selected through a multistage systematic sampling design. After obtaining informed consent a structured behavioural questionnaire was administered. Blood and urine samples were also collected and tested for HIV (ELISA), HSV-2 (ELISA) syphilis (RPR and TPHA), chlamydia (PCR) and gonorrhoea (PCR).
Results: Of the 2383 respondents whose results were received, 4.4% (n = 106) tested positive for at least one of the five STIs. The prevalence of the individual organisms was as follows: syphilis, 1.3%; HIV, 0.1%; HSV-2, 3.4%; gonorrhoea, 0.8% and chlamydia, no cases. City-wise, the highest prevalence was in Karachi (8.5%) followed by Lahore (5.3%), Faisalabad (4.0%) Quetta (4.3%), Rawalpindi (2.5%) and Peshawar (2.0%). At the univariate and multivariate level, older age, less schooling, and having more than four sexual partners were significantly associated with the presence of an STI. 92% of men who tested positive for any STI were asymptomatic.
Conclusions: HIV prevalence in Pakistan remains low, however, the emergence of genital herpes is a matter of concern as it could lead to a future conduit for HIV spread. Health education messages should target less educated segments of society and specifically advocate safe sex practices and early diagnosis.
An appendix of the methodology is published online only at http://sti.bmj.com/content/vol85/issue3
Funding: Funding was provided by Department for International Development (DFID), UK. DFID had no role beyond that in the creation of this paper.
Competing interests: None.
Contributors: AMM was principal investigator on the project, conceived this paper and took primary responsibility in its writing. AW was deputy principal investigator on the project, organised and conducted the statistical analyses reported here, as well as taking part in the writing and editing of the paper. LR was consultant on the project and took part in writing and editing the paper. MK was the field data coordinator on the project and helped in writing the paper.