{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:47:19Z","timestamp":1789480039960,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Sexually transmitted infections (STI) symptoms (e.g., abnormal genital discharge and genital sores\/ulcers) are a major public health concern in Bangladesh because the symptoms can indicate an STI and cause sexual and reproductive health complications in women of reproductive age. To our knowledge, no study examined the prevalence and risk factors of STI symptoms using a nationally representative sample. This study investigates the prevalence of STI symptoms among ever-married women in Bangladesh and the associations of STI symptoms with various demographic, socioeconomic, and behavioral risk factors using the most recent available data (2007, 2011, and 2014) of the Bangladesh Demographic and Health Surveys (BDHS). The BDHS employs a two-stage stratified sampling technique. The analytic sample comprised 41,777 women of reproductive age (15\u201349 years). Outcome variables included STI symptoms: abnormal genital discharge and genital sores\/ulcers. Multivariate logistic regression was employed to find the adjusted odds ratio with a 95% confidence interval to assess the associations of outcome measures with explanatory variables. The study found that the prevalence of abnormal genital discharge and genital sores\/ulcers among ever-married women aged 15\u201349 years was 10% and 6%, respectively. Multivariable analysis revealed that for women aged 25\u201334 years, those who used contraceptives and married earlier had an increased likelihood of STI symptoms. Furthermore, women from the wealthiest wealth quintile and couple\u2019s joint decision-making were less likely to have STI symptoms. Findings have implications for interventions efforts aiming to improve women\u2019s sexual and reproductive health in Bangladesh.<\/jats:p>","DOI":"10.3390\/ijerph19031906","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T23:37:48Z","timestamp":1644363468000},"page":"1906","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representative Surveys in Bangladesh"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-1266","authenticated-orcid":false,"given":"Md. Nazmul","family":"Huda","sequence":"first","affiliation":[{"name":"School of Population Health, University of New South Wales, Kensington, NSW 2052, Australia"},{"name":"School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"School of Liberal Arts and Social Sciences, Independent University, Dhaka 1229, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1733-5216","authenticated-orcid":false,"given":"Moin Uddin","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Translation Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"Institute of Health Economics, University of Dhaka, Dhaka 1000, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Bakhtiar","family":"Uddin","sequence":"additional","affiliation":[{"name":"School of Social Sciences, University of New South Wales, Kensington, NSW 2052, Australia"},{"name":"Department of Economics, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh 2220, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Kamrul","family":"Hasan","sequence":"additional","affiliation":[{"name":"Bangladesh Institute of Social Research Trust, Dhaka 1207, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalal","family":"Uddin","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5758-7525","authenticated-orcid":false,"given":"Tinashe Moira","family":"Dune","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"Translation Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia"},{"name":"Diabetes, Metabolism and Obesity Translational Research Unit, Western Sydney University, Campbelltown, NSW 2560, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e25346","DOI":"10.1002\/jia2.25346","article-title":"Mechanisms of sexually transmitted infection-induced inflammation in women: Implications for HIV risk","volume":"22","author":"Mwatelah","year":"2019","journal-title":"J. Int. AIDS Soc."},{"key":"ref_2","unstructured":"World Health Organisation (2021, February 22). Sexually Transmitted Infections (STIs). Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/sexually-transmitted-infections-(stis)."},{"key":"ref_3","first-page":"1","article-title":"STD\/AIDS Asia and world perspective","volume":"3","author":"Faruk","year":"2018","journal-title":"Clin. Med. Investig."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1097\/AOG.0000000000000429","article-title":"Biological and Behavioral Risks for Incident Chlamydia trachomatis Infection in a Prospective Cohort","volume":"124","author":"Hwang","year":"2014","journal-title":"Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1177\/0956462419898982","article-title":"Prevalence and risk factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium among women in Pelotas, Southern Brazil","volume":"31","author":"Silveira","year":"2020","journal-title":"Int. J. STD AIDS"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"258","DOI":"10.5172\/hesr.2012.21.3.258","article-title":"At special risk: Biopolitical vulnerability and HIV\/STI syndemics among women","volume":"21","author":"Ostrach","year":"2012","journal-title":"Health Sociol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/MOP.0000000000000578","article-title":"The growing epidemic of sexually transmitted infections in adolescents: A neglected population","volume":"30","author":"Shannon","year":"2018","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_8","first-page":"8642685","article-title":"The Risk of Sexually Transmitted Infection and Its Influence on Condom Use among Pregnant Women in the Kintampo North Municipality of Ghana","volume":"2017","author":"Abdulai","year":"2017","journal-title":"J. Sex. Transm. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1080\/13691058.2014.901561","article-title":"Can a woman refuse sex if her husband has a sexually transmitted infection? Attitudes toward safer-sex negotiation among married women in Bangladesh","volume":"16","author":"Jesmin","year":"2014","journal-title":"Cult. Health Sex."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Korenromp, E.L., Wi, T., Resch, S., Stover, J., and Broutet, N. (2017). Costing of National STI Program Implementation for the Global STI Control Strategy for the Health Sector, 2016\u20132021. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170773"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1136\/sti.77.5.344","article-title":"Faculty Opinions recommendation of Prevalence of infectious diseases in Bangladeshi women living adjacent to a truck stand: HIV\/STD\/hepatitis\/genital tract infections","volume":"77","author":"Morrow","year":"2001","journal-title":"Sex. Transm. Infect."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3329\/bjmm.v3i1.2968","article-title":"Prevalence of Sexually Transmitted Diseases and Transmission of HIV in Dhaka, Bangladesh","volume":"3","author":"Shirin","year":"2009","journal-title":"Bangladesh J. Med. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1136\/sti.77.2.114","article-title":"Sexually transmitted infections among married women in Dhaka, Bangladesh: Unexpected high prevalence of herpes simplex type 2 infection","volume":"77","author":"Bogaerts","year":"2001","journal-title":"Sex. Transm. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/01.olq.0000225325.23340.a3","article-title":"Sexually Transmitted Infections and Risk Factors Among Truck Stand Workers in Dhaka, Bangladesh","volume":"34","author":"Alam","year":"2007","journal-title":"Sex. Transm. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ijid.2021.06.006","article-title":"Prevalence of high-risk human papillomavirus infection among Kazakhstani women attending gynecological outpatient clinics","volume":"109","author":"Babi","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_16","first-page":"661","article-title":"Factors associated with repeat genital symptoms among sexually transmitted infection service attendees in South Africa, 2015\u20132016","volume":"110","author":"Mathebula","year":"2020","journal-title":"S. Afr. Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Nankinga, O., Misinde, C., and Kwagala, B. (2016). Gender relations, sexual behaviour, and risk of contracting sexually transmitted infections among women in union in Uganda. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3103-0"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1177\/0971521516678530","article-title":"Sexually Transmitted Infections and Spousal Violence: The Experience of Married Women in India","volume":"24","author":"Shabnam","year":"2017","journal-title":"Indian J. Gend. Stud."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.srhc.2017.06.002","article-title":"Marital violence and sexually transmitted infections among women in post-revolution Egypt","volume":"13","author":"Vyas","year":"2017","journal-title":"Sex. Reprod. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e07576","DOI":"10.1016\/j.heliyon.2021.e07576","article-title":"Sexually transmitted infection associated syndromes among pregnant women attending antenatal care clinics in southwest Ethiopia","volume":"7","author":"Yosef","year":"2021","journal-title":"Heliyon"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1177\/0956462418804115","article-title":"Relationship between socioeconomic status and risk of sexually transmitted infections in Uganda: Multilevel analysis of a nationally representative survey","volume":"30","author":"Anguzu","year":"2018","journal-title":"Int. J. STD AIDS"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1007\/s12529-013-9302-5","article-title":"Intimate Partner Violence and Symptoms of Sexually Transmitted Infections: Are the Women from Low Socio-economic Strata in Bangladesh at Increased Risk","volume":"21","author":"Rahman","year":"2014","journal-title":"Int. J. Behav. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"585","DOI":"10.4314\/ahs.v21i2.13","article-title":"Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia","volume":"21","author":"Isara","year":"2021","journal-title":"Afr. Health Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12930-014-0007-y","article-title":"Urban\u2013rural and socioeconomic variations in lifetime prevalence of symptoms of sexually transmitted infections among Bangladeshi adolescents","volume":"13","author":"Gani","year":"2014","journal-title":"Asia Pac. Fam. Med."},{"key":"ref_25","first-page":"1","article-title":"Access to Mass Media and Awareness of Sexually Transmitted Diseases (STDs) Among the Truck Drivers in Dhaka City: Do Mass Media Make Them Aware?","volume":"1","author":"Huda","year":"2016","journal-title":"S. Asian J. Soc. Sci."},{"key":"ref_26","unstructured":"National Institute of Population Research Training\u2014NIPORT (2016). Bangladesh, Mitra Associates, and ICF International, Bangladesh Demographic and Health Survey 2014, Technical Report."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ijgo.2007.06.045","article-title":"Intimate partner violence and sexually transmitted disease symptoms in a national sample of married Bangladeshi women","volume":"100","author":"Decker","year":"2008","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4980396","DOI":"10.1155\/2018\/4980396","article-title":"Prevalence of Sexually Transmitted Infections among Married Women in Rural Nepal","volume":"2018","author":"Shakya","year":"2018","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"26","DOI":"10.5455\/ajpmph.20190904055225","article-title":"Prevalence and correlates of HIV\/AIDS knowledge among ever married women of reproductive age in Bangladesh: An update from the Bangladesh Demographic and Health Survey 2014","volume":"6","author":"Tariqujjaman","year":"2020","journal-title":"Am. J. Prev. Med. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1080\/13625180802601110","article-title":"Multiple sexual partnership mediates the association between early sexual debut and sexually transmitted infection among adolescent and young adult males in Nigeria","volume":"14","author":"Fatusi","year":"2009","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Yaya, S., Bishwajit, G., Danhoundo, G., Shah, V., and Ekholuenetale, M. (2016). Trends and determinants of HIV\/AIDS knowledge among women in Bangladesh. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3512-0"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Khan, M.N., and Islam, M.M. (2018). Women\u2019s attitude towards wife-beating and its relationship with reproductive healthcare seeking behavior: A countrywide population survey in Bangladesh. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0198833"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1093\/oxfordjournals.aje.a116813","article-title":"Simulation Study of Confounder-Selection Strategies","volume":"138","author":"Maldonado","year":"1993","journal-title":"Am. J. Epidemiol."},{"key":"ref_34","unstructured":"ICF International (2020, November 03). Demographic and Health Surveys Sampling and Household Listing Manual. DHS Toolkit. Available online: https:\/\/dhsprogram.com\/publications\/publication-dhsm4-dhs-questionnaires-and-manuals.cfm."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1002\/(SICI)1097-0258(19990330)18:6<681::AID-SIM71>3.0.CO;2-R","article-title":"Multiple imputation of missing blood pressure covariates in survival analysis","volume":"18","author":"Boshuizen","year":"1999","journal-title":"Stat. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1093\/aje\/kwq137","article-title":"Strategies for Multiple Imputation in Longitudinal Studies","volume":"172","author":"Spratt","year":"2010","journal-title":"Am. J. Epidemiol."},{"key":"ref_37","unstructured":"Huda, M.N. (2019). A Mixed-Methods Study of Sex Work and the HIV Prevention Environment for Female Sex Workers in Bangladesh, The University of New South Wales."},{"key":"ref_38","first-page":"1291","article-title":"Early marriage and HIV\/AIDS: Risk factors among young women in India","volume":"42","author":"Santhya","year":"2007","journal-title":"Econ. Political Wkly."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.puhe.2019.03.014","article-title":"Association between child marriage and institutional delivery care services use in Bangladesh: Intersections between education and place of residence","volume":"171","author":"Uddin","year":"2019","journal-title":"Public Health"},{"key":"ref_40","unstructured":"Nguyen, M.C., and Wodon, Q. (2014). Impact of Child Marriage on Literacy and Education Attainment in Africa, UNICEF and UNESCO Statistics."},{"key":"ref_41","unstructured":"Makino, M., Shonchoy, A.S., and Wahhaj, Z. (2021, August 18). Early Effects of the COVID-19 Lockdown on Children in Rural Bangladesh. Available online: https:\/\/knowledgecommons.popcouncil.org\/cgi\/viewcontent.cgi?article=2254&context=departments_sbsr-pgy."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2147\/OAJC.S135439","article-title":"Contraceptive use and the risk of sexually transmitted infection: Systematic review and current perspectives","volume":"9","author":"Deese","year":"2018","journal-title":"Open Access J. Contracept."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1136\/sti.72.5.330","article-title":"Is oral contraceptive associated with genital warts?","volume":"72","author":"Ross","year":"1996","journal-title":"Sex. Transm. Infect."},{"key":"ref_44","unstructured":"Sabet, D.M., and Rahman, T.A.S. (2012). Commercial sex and vulnerability to HIV infection: A study among the children of sex workers (SWs) in Tangail brothel. Sex Workers and Their Children in Bangladesh: Addressing Risks and Vulnerabilities, University of Liberal Arts Bangladesh and ActionAid Bangladesh."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jpag.2007.08.009","article-title":"Young women\u2019s perspective of the pros and cons to seeking screening for chlamydia and gonorrhea: An exploratory study","volume":"21","author":"Chacko","year":"2008","journal-title":"J. Pediatric Adolesc. Gynecol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"21224","DOI":"10.7448\/IAS.19.1.21224","article-title":"Couple interdependence impacts HIV-related health behaviours among pregnant couples in southwestern Kenya: A qualitative analysis","volume":"19","author":"Rogers","year":"2016","journal-title":"J. Int. AIDS Soc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1017\/S0021932010000222","article-title":"Spousal agreement on maternal health practices in Kathmandu, Nepal","volume":"42","author":"Mullany","year":"2010","journal-title":"J. Biosoc. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1080\/07448480009596266","article-title":"Understanding men\u2019s health and illness: A gender-relations approach to policy, research, and practice","volume":"48","author":"Schofield","year":"2000","journal-title":"J. Am. Coll. Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s10995-005-0030-6","article-title":"Spousal abuse against women and its consequences on reproductive health: A study in the urban slums in Bangladesh","volume":"10","author":"Salam","year":"2006","journal-title":"Matern. Child Health J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/OLQ.0b013e3182478fa5","article-title":"Intimate Partner Violence and Sexually Transmitted Infections Among Young Adult Women","volume":"39","author":"Hess","year":"2012","journal-title":"Sex. Transm. Dis."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1906\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:16:20Z","timestamp":1760134580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,8]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["ijerph19031906"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19031906","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,8]]}}}