{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:06:32Z","timestamp":1788930392105,"version":"build-2803163510"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Gonorrhea caused by <jats:italic>Neisseria gonorrhoeae<\/jats:italic> is the second most prevalent curable sexually transmitted infection worldwide. Female Sex Workers (FSWs) are at a higher risk of contracting gonorrhea due to their risky sexual behaviors like inconsistent condom use and multiple sexual partners. We determined the prevalence and risk factors associated with gonorrhea and its antimicrobial susceptibility pattern among symptomatic FSWs attending Sexual Workers Outreach Program (SWOP) city clinic in Nairobi, Kenya.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using convenience sampling, we recruited 379 female sex workers from SWOP City clinic in Nairobi County. We administered a semi-structured questionnaire to collect data on socio-demographics and behavioral risk factors associated with gonorrhea. We also conducted three focus groups. Two endocervical swabs were collected from each participant by the attending physician for the laboratory identification of <jats:italic>Neisseria gonorrhoeae<\/jats:italic>. An antimicrobial susceptibility test was performed using the disc diffusion method.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Twenty-four out of 379 (6.3%) participants tested positive for gonorrhea by PCR. The significant risk factors associated with gonorrhea were having multiple sexual partners in the previous two weeks, primary education, and being in the age group of 38\u201349 years (p &lt; 0.05).<\/jats:p>\n<jats:p>From the qualitative data, sex work disclosure, and difficulty in engaging protected sex with their partner, and unprotected sex with their clients due to more money from the client, PREP, and alcohol use made the female sex workers vulnerable to gonorrhea exposure and or risky sexual behavior. The culture-positive sample result yielded complete (100%) resistance to all the antimicrobials used.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p><jats:italic>Neisseria gonorrhoeae<\/jats:italic> infection is prevalent among symptomatic FSWs in Nairobi. Multiple sexual partners, being in age group 38\u201349 years and having primary education were the factors associated with gonorrhea among the study participants. Based on our identification of a highly resistant isolate, we strongly recommend increasing capacity for culture-based diagnosis and susceptibility testing.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0263531","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T19:03:46Z","timestamp":1645815826000},"page":"e0263531","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Neisseria gonorrhoeae infection in female sex workers in an STI clinic in Nairobi, Kenya"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7635-5199","authenticated-orcid":true,"given":"Amina","family":"Abdullahi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samson Muuo","family":"Nzou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Kikuvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilu","family":"Mwau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"pone.0263531.ref001","unstructured":"Organization, W.H., Report on global sexually transmitted infection surveillance 2018. 2018."},{"key":"pone.0263531.ref002","unstructured":"Organization, W.H., WHO guidelines for the treatment of Neisseria gonorrhoeae. 2016. 2016."},{"issue":"12","key":"pone.0263531.ref003","first-page":"e0143304","volume":"10","author":"L. Newman","year":"2015","journal-title":"Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting"},{"key":"pone.0263531.ref004","author":"W.H. Organization","year":"2012","journal-title":"Global incidence and prevalence of selected curable sexually transmitted infections-2008"},{"issue":"1","key":"pone.0263531.ref005","first-page":"10","volume":"343","author":"E.W.J.T.A.j.o.t.m.s Hook","year":"2012","journal-title":"Gender differences in risk for sexually transmitted diseases"},{"issue":"1","key":"pone.0263531.ref006","first-page":"1","volume":"9","author":"A.N. Maina","year":"2016","journal-title":"Prevalence and risk factors of three curable sexually transmitted infections among women in Nairobi, Kenya"},{"issue":"7","key":"pone.0263531.ref007","first-page":"417","volume":"27","author":"K. 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Luo","year":"2015","journal-title":"Neisseria gonorrhoeae prevalence, incidence and associated risk factors among female sex workers in a high HIV-prevalence area of China"},{"issue":"6","key":"pone.0263531.ref016","first-page":"608","volume":"16","author":"M. Nasirian","year":"2017","journal-title":"Prevalence of sexually transmitted infections and their risk factors among female sex workers in Isfahan, Iran: a cross-sectional study"},{"issue":"6","key":"pone.0263531.ref017","first-page":"398","volume":"95","author":"E.P. Chow","year":"2019","journal-title":"Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015\u20132017: need for oropharyngeal testing"},{"issue":"1","key":"pone.0263531.ref018","first-page":"1","volume":"19","author":"A. Tadele","year":"2019","journal-title":"Prevalence and associated factors of Chlamydia trachomatis and Neisseria gonorrhoeae among female commercial sex workers in Hawassa City, Southern Ethiopia"},{"issue":"1","key":"pone.0263531.ref019","first-page":"46","volume":"19","author":"H. Musyoki","year":"2015","journal-title":"Prevalence of HIVsexually transmitted infections, and risk behaviours among female sex workers in Nairobi, Kenya: results of a respondent driven sampling study"},{"key":"pone.0263531.ref020","volume":"2011","author":"A. Das","year":"2011","journal-title":"Prevalence and assessment of clinical management of sexually transmitted infections among female sex workers in two cities of India"},{"issue":"1","key":"pone.0263531.ref021","first-page":"1","article-title":"Risk factors associated with gonorrhea and chlamydia transmission in selected health facilities in Ghana","volume":"19","author":"H. Dela","year":"2019"},{"issue":"1","key":"pone.0263531.ref022","first-page":"1","volume":"8","author":"H. Sopheab","year":"2008","journal-title":"Sustained high prevalence of sexually transmitted infections among female sex workers in Cambodia: high turnover seriously challenges the 100% Condom Use Programme"},{"key":"pone.0263531.ref023","author":"S. Duncan","year":"2011","journal-title":"High prevalence of quinolone resistance in Neisseria gonorrhoeae in coastal Kenya"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263531","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T19:03:46Z","timestamp":1645815826000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0263531"}},"subtitle":[],"editor":[{"given":"Caroline","family":"Mitchell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,25]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0263531","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,25]]}}}