{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:33:15Z","timestamp":1791379995983,"version":"4.3.3"},"reference-count":30,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"unspecified","delay-in-days":82,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,4,30]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Little is known about the burden of sexually transmitted infections (STIs) among adolescent girls and young women (AGYW) employed as domestic workers in Ugandan households.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a community-based cross-sectional study from November 2023 to March 2024 to determine the prevalence and correlates of STIs among Ugandan AGYW aged 14\u201324 in the Kampala Metropolitan Area. Self-collected vaginal swabs were tested for\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      (NG) and\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      (CT) using GeneXpert. HIV and syphilis testing were performed using the Bioline HIV\/syphilis Duo test. Correlates of STI prevalence were determined using modified Poisson regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 262 AGYW, median age was 20 years (IQR 18\u201323) and 87 (33%) had an STI: CT (27.5%), syphilis (5.7%), HIV (4.6%) and NG (1.5%). Overall, 14.9% had &gt;1\u2009STI. Of 12 AGYW with HIV, 3 (25%) were newly diagnosed and 6\/9 had detectable viral loads (\u22651000 copies\/mL). In the prior 12 months, 126 (48%) had received syndromic STI treatment, but only 35 (28%) notified their partners. Additionally, 102 (39%) had used emergency contraception and 54% believed it was protective against STIs, including HIV. Factors associated with STI prevalence included non-cash compensation for domestic work (adjusted prevalence ratio (aPR) 2.26; 95%\u2009CI 1.04 to 4.92; p=0.040), lower educational attainment (aPR 1.73; 95%\u2009CI 1.16 to 2.57; p=0.007), alcohol consumption in the past 6\u2009months (aPR 1.72; 95%\u2009CI 1.12 to 2.64; p=0.013) and transactional sex during the past 6\u2009months (aPR 1.43; 95%\u2009CI 1.01 to 2.04; p=0.045). Conversely, self-reported sexual abuse was negatively associated with STIs (aPR 0.48; 95%\u2009CI 0.28 to 0.83; p=0.008).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The high prevalence of undiagnosed STIs and unsuppressed HIV among AGYW domestic workers in Central Uganda highlights the urgent need to increase STI\/HIV prevention, testing and treatment coverage for these underserved and vulnerable young women. Targeted interventions are needed to mitigate STI\/HIV acquisition in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003618","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:00:30Z","timestamp":1782194430000},"page":"e003618","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and correlates of prevalent sexually transmitted infections among young women employed as domestic workers in Central Uganda: a community-based cross-sectional study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6741-1512","authenticated-orcid":false,"given":"Annet","family":"Onzia","sequence":"first","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Mujugira","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Nakate","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Musaazi","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7732-1019","authenticated-orcid":false,"given":"Eric","family":"Ssegujja","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Bukenya","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalind Parkes","family":"Ratanshi","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"},{"name":"Public Health, Queen\u2019s University Belfast Faculty of Medicine Health and Life Sciences, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A","family":"Ajeru","sequence":"additional","affiliation":[{"name":"Medicine, Kampala International University - Western Campus, Bushenyi, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6586-051X","authenticated-orcid":false,"given":"Johan H","family":"Melendez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-819X","authenticated-orcid":false,"given":"Matthew M","family":"Hamill","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8619-5598","authenticated-orcid":false,"given":"Yukari Carol","family":"Manabe","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Castelnuovo","sequence":"additional","affiliation":[{"name":"Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"2026062223001946000_4.2.e003618.1","unstructured":"UNAIDS . 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