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Patterns of uptake of treatment for self reported sexually transmitted infection symptoms in rural Zimbabwe
  1. J J C Lewis1,
  2. G P Garnett1,
  3. C A Nyamukapa1,2,
  4. C A Donnelly1,
  5. P R Mason2,
  6. S Gregson1,2
  1. 1Department of Infectious Disease Epidemiology, Imperial College London, Faculty of Medicine, St Mary’s Campus, Norfolk Place, London W2 1PG, UK
  2. 2Biomedical Research and Training Institute, University of Zimbabwe Campus, PO Box CY 1753, Causeway, Harare, Zimbabwe
  1. Correspondence to:
 James J C Lewis
 Department of Infectious Disease Epidemiology, Imperial College London, Faculty of Medicine, St Mary’s Campus, Norfolk Place, London W2 1PG, UK;


Objectives: To determine the extent of self reported symptoms perceived to be related to sexually transmitted infections and the patterns of subsequent treatment seeking behaviour in a predominantly rural population of Zimbabwe.

Methods: A population based survey of 4331 men and 5149 women was conducted in rural Zimbabwe during 1998–2000. Structured confidential interviews collected data on self reported sexually transmitted infection symptoms, treatment seeking behaviour, sociodemographic characteristics, and sexual behaviour.

Results: 25% of men aged 17–54 years report experiencing genital sores and 25% of men report experiencing urethral discharge; 30% of women aged 15–44 years report experiencing vaginal discharge. The lifetime number of sexual partners, age, and years of sexual activity were all significant predictors of symptoms for both men and women (all p values <0.001). 92% of men and 62% of women had sought treatment for their symptoms in the past year (p value <0.001). Men and women were equally likely to have sought treatment at a local hospital or clinic, but women were much less likely than men to have sought treatment at a different hospital or clinic. Among those who had sought treatment, men sought treatment faster than women and were more likely to report being “very satisfied” with their treatment than women.

Conclusions: The gender differences in treatment seeking are of major concern for control efforts and further work on determining the reasons for these should be a priority. This would inform the likely impact of both increasing availability of local services and further reducing the stigma faced by those wishing to access such services.

  • HSV-2, herpes simplex virus type 2
  • ICVI, informal, confidential voting interview
  • STIs, sexually transmitted infections
  • sexually transmitted infection
  • Zimbabwe

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  • Conflicts of interest: Funding from Medical Research Council, UK; the Wellcome Trust; CDC; the Royal Society; UNAIDS.

  • Ethical approvals: Previous ethical approval for the study was obtained from the Research Council of Zimbabwe (Number 02187) and from the St Mary’s local research ethics committee, London (HIV/GUM EC no 03.66 R&D 03/SB/004E).