Assessment of Transmission Dynamics and Healthcare Response to Sexually Transmitted Infections (STIs) Among Sexually Active People in Monze District, Zambia
Authors:   Faculty of Nursing and Midwifery Sciences, Lusaka Apex Medical University, Lusaka, Zambia, Saul Simbeye Tinkler , Chisanga Arthur , Chimwala Mary , M'samalia Chimwala-Selico Charity ,   College of Nursing, Charles R. Drew University of Medicine & Science, Los Angeles California, USA. North America, Mweene Damian ,   Department of Public Health, Texila American University, Georgetown, Guyana, South America
Published: October 2024

Introduction: A sexually transmitted infection (STI) is an infection caused by viruses, bacteria, fungi, or parasites that people can acquire through unprotected sexual contact. Sexually transmitted infections (STIs) continue to pose a significant public health challenge, particularly impacting young individuals and men who have sex with men. Sexually transmitted infections (STIs) present a danger to all demographic groups, with those aged 20–24 being particularly vulnerable. While abstinence is the only method that offers complete protection against STIs and unplanned pregnancies, consistently using condoms is the most effective alternative. Globally, it is estimated that 374 million sexually transmitted infections occur annually. Over 30 different bacteria, viruses, and parasites are known to be transmitted through sexual contact, including vaginal, anal, and oral sex. Additionally, some STIs can be passed from mother to child during pregnancy, labour, childbirth, and breastfeeding. Sexually Transmitted Infections (STIs) remain a significant public health challenge, particularly in developing regions such as Monze District, Zambia. Objectives: This study aims to investigate the behavioral risk factors associated with the transmission of sexually transmitted infections (STIs) among sexually active people in Monze District, Zambia. It also seeks to assess the availability and accessibility of sexual health services, including testing and treatment, within the Monze District of Zambia. Methods: This study utilized a cross-sectional study design to assess transmission dynamics and healthcare responses to sexually transmitted infections among sexually active people in Monze district, Zambia. Ethical approval for this study was sought from CHRESO University Research and Ethics Committee, Texila American University, and Monze District Health Office respectively. Apart from that, a simple random sampling technique was utilized to select 271 respondents in randomly selected health facilities to participate in the study. Participants who voluntarily gave their consent were given a questionnaire to fill out. A structured questionnaire was used for data collection, which was then analyzed using Statistical Package for Social Sciences (SPSS) version 28.0 and presented in tables. Multivariate logistic regression analysis was applied to examine the relationships between socio-demographic characteristics and the parameters for the transmission dynamics and healthcare response to sexually transmitted infections among sexually active people in Monze district. Results: The study disclosed that, most of the respondents (82.3%) believed that having sex while drunk or having multiple sexual partners (86%) increases the risk of acquiring STIs. The study also disclosed that, only 43.2% of respondents are in monogamous relationships, and 25.5% reported having three or more sexual partners in the past year, suggesting potential for increased risk behaviors. The findings from this study also exposed that, only 19.2% of respondents reported always using condoms during sexual intercourse. The study also demonstrated that, 81.9% of study participants were aware of common modes of STIs transmission, while 18.1% were unaware of common modes of STI transmission in Monze district of Zambia. The study further revealed that, most of the respondents (67.9%) have sought sexual health services while a good proportion of study participants (32.1%) did not seek health services in the health facilities in Monze district. This is an indication of a significant engagement with the healthcare system. The findings from this study also demonstrate that, the perceptions of the availability of sexual health services vary, with a notable portion of study participants rating it as good (41%) while 9.6% of study participants rated them as poor. In addition, despite the majority (65.3%) finding sexual health services affordable, a non-negligible proportion (15.9%) of respondents perceive them as expensive. Not only that, a good proportion of study participants (18.8%) were not sure whether the sexual health services were affordable or not. A good proportion (75.3%) of study participants were aware of the locations of STI testing and treatment centers. Not only that, more than half of the respondents (55.7%) report facing barriers when seeking sexual health services. The most common barriers to sexual health services faced by the people in Monze district include lack of information (49.5%), negative attitudes of healthcare providers towards patients and clients (27.8%), cost of health services (10.3%), and stigma and discrimination (9.2%). Conclusion: All in all, the study disclosed that, a substantial majority of respondents (82.3%) believe that engaging in sexual activities while intoxicated and having multiple sexual partners (86%) increases the risk of acquiring sexually transmitted infections (STIs), yet only 43.2% are in monogamous relationships, with 25.5% having had three or more sexual partners in the past year. Only 19.2% consistently use condoms during sexual intercourse, indicating a need for public health intervention. While 81.9% of participants are aware of common STI transmission modes, 18.1% still lack this crucial knowledge. More so, the majority (67.9%) of study participants have sought sexual health services, though 32.1% have not, highlighting varied engagement levels with the healthcare system. Perceptions of sexual health services are mixed, with 41% rating them as good and 9.6% as poor. The study further disclosed that 65.3% find services affordable while 15.9% perceive them as expensive, and 18.8% are unsure about the costs. A significant proportion (75.3%) of respondents are aware of STI testing and treatment centers' locations; however, more than half (55.7%) face barriers in accessing these services, primarily due to lack of information (49.5%), negative attitudes of healthcare providers (27.8%), cost (10.3%), and stigma and discrimination (9.2%). The author recommends that, there is need to enhance public health awareness campaigns via radio, television, and social media platforms to disseminate messages that challenge myths and misconceptions about STIs and promote positive attitudes among healthcare providers towards the respondents. This can also be done through health fairs, workshops, and community theater performances to increase awareness about STI transmission and prevention, and to promote consistent condom use. Additionally, developing community-based initiatives such as peer education and support groups formation is vital to combat stigma and discrimination and create a supportive environment for all the people in the community.