{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:20:45Z","timestamp":1781184045801,"version":"3.54.1"},"reference-count":15,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD103563"],"award-info":[{"award-number":["R01HD103563"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2024,10,15]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Better data on aetiological prevalence of sexually transmitted infections (STIs) among African men could greatly strengthen STI prevention efforts and convey benefits to women as well. In an ongoing study among men in Kenya, we analysed baseline STI prevalence and individual characteristics associated with STI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In Siaya County, Kenya, we recruited men aged 18\u201339 years who self-reported engagement in transactional sex and alcohol use. We administered a baseline questionnaire to participants and conducted testing for HIV, herpes simplex virus type 2 (HSV-2),<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) and<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG) infection. Characteristics associated with bacterial STIs were analysed using logistic regression and we estimated the positive and negative predictive values (PPV\/NPV) of syndromic management of these infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 1500 participants from July 2022 to March 2023. Participant mean age was 27.9 years, 62.2% were married\/cohabitating and 53.5% were heavy alcohol users (Alcohol Use Disorders Identification Test-Consumption\u22654). Participants reported a mean of 4.2 sexual partners and 3.5 transactional sex partners in the past 3 months. HIV prevalence was 9.5%, HSV-2 was 38.7%, CT was 14.3% and NG was 2.5%. Combined CT and\/or NG infection was detected in 16.1% of participants.<\/jats:p><jats:p>Compared with participants uninfected, those testing positive for CT and\/or NG were younger (p=0.001), had more sexual partners (p=0.027) and transactional sex partners (p=0.039), were less likely to have used a condom at last sex (p=0.015) and were more likely to self-report having an STI besides HIV in the past 12 months (p=0.002). The PPV and NPV for currently experiencing CT and\/or NG symptoms were 33.3% and 84.4%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among Kenyan men engaged in transactional sex and alcohol use, STI prevalence was high. These data fill an important gap about STI prevalence and risk factors in African men highlighting the risk of ongoing transmission and the need for targeted prevention programmes and expanded access to testing and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2024-056266","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T08:10:12Z","timestamp":1731053412000},"page":"183-186","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["High prevalence of STIs among men engaged in transactional sex and alcohol use in western Kenya: important implications for STI prevention interventions"],"prefix":"10.1136","volume":"101","clinical-trial-number":[{"clinical-trial-number":"nct04013295","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1146-8154","authenticated-orcid":false,"given":"Sue","family":"Napierala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth F","family":"Bair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ouma Dan","family":"Omollo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teniola I","family":"Egbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius Oduor","family":"Wesonga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha","family":"Rajaratnam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Celum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsha","family":"Thirumurthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kawango","family":"Agot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"2025041509500736000_101.3.183.1","unstructured":"World Health Organization . Sexually transmitted infections fact sheet. 2023. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/sexually-transmitted-infections-(stis)"},{"key":"2025041509500736000_101.3.183.2","unstructured":"WHO . Global progress report on hiv, viral hepatitis and sexually transmitted infections. Accountability for the global health sector strategies 2016\u201321: actions for impact; 2021."},{"key":"2025041509500736000_101.3.183.3","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/103452","article-title":"The Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Resource-Limited Settings","volume":"2014","author":"Ghebremichael","year":"2014","journal-title":"ISRN AIDS"},{"key":"2025041509500736000_101.3.183.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)30405-4"},{"key":"2025041509500736000_101.3.183.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002344","article-title":"Antimicrobial resistance in Neisseria gonorrhoeae: Global surveillance and a call for international collaborative action","volume":"14","author":"Wi","year":"2017","journal-title":"PLoS Med"},{"key":"2025041509500736000_101.3.183.6","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-022-06927-0","article-title":"A savings intervention to reduce men\u2019s engagement in HIV risk behaviors: study protocol for a randomized controlled trial","volume":"23","author":"Egbe","year":"2022","journal-title":"Trials"},{"key":"2025041509500736000_101.3.183.7","doi-asserted-by":"crossref","unstructured":"Bush K , Kivlahan DR , McDonell MB . The AUDIT Alcohol Consumption Questions (AUDIT-C) An Effective Brief Screening Test for Problem Drinking.. Arch Intern Med 1998;1789\u201395. doi:10.1001\/archinte.158.16.1789","DOI":"10.1001\/archinte.158.16.1789"},{"key":"2025041509500736000_101.3.183.8","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000093487.78664.3C"},{"key":"2025041509500736000_101.3.183.9","unstructured":"Republic of Kenya . National aids\/std control programme (nascop). algorithm for managing common sti syndromes. Nairobi, Kenya. Available: http:\/\/guidelines.health.go.ke:8000\/media\/Revised_ST1Chart_.pdf [Accessed 12 Sep 2024]."},{"key":"2025041509500736000_101.3.183.10","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00424-7"},{"key":"2025041509500736000_101.3.183.11","doi-asserted-by":"crossref","DOI":"10.7448\/IAS.19.1.21270","article-title":"High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria","volume":"19","author":"Keshinro","year":"2016","journal-title":"J Int AIDS Soc"},{"key":"2025041509500736000_101.3.183.12","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053613"},{"key":"2025041509500736000_101.3.183.13","unstructured":"National AIDS and STI Control Programme (NASCOP) . Kenya population-based hiv impact assessment (kenphia) 2018: final report. Nairobi: NASCOP NASCOP; 2022."},{"key":"2025041509500736000_101.3.183.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0005272","article-title":"Characteristics of HIV-1 Discordant Couples Enrolled in a Trial of HSV-2 Suppression to Reduce HIV-1 Transmission: The Partners Study","volume":"4","author":"Lingappa","year":"2009","journal-title":"PLoS ONE"},{"key":"2025041509500736000_101.3.183.15","article-title":"Syndromic versus Laboratory Diagnosis of Sexually Transmitted Infections in Men in Moshi District of Tanzania","volume":"2020","author":"Cheng","year":"2020","journal-title":"AIDS Res Treat"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2024-056266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T16:50:27Z","timestamp":1744735827000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2024-056266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,4,15]]},"published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1136\/sextrans-2024-056266"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2024-056266","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,7]]}}}