Is Syndromic Management Approach Of Sti Adequate Among Hiv Positive Key Population? Systematic Data Review In Nairobi Kenya

M. Akolo,J. Kimani, L. Gelmon

SEXUALLY TRANSMITTED INFECTIONS(2021)

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摘要
Background Sex workers Outreach Program (SWOP) is an STI/HIV research center serving 35000 female sex workers (FSW) through outreach services with 18000 seek HIV/STI services from the seven SWOP facilities spread across Nairobi Kenya. Program analysis showed high use of STI syndromic management antibiotics compared to budgetary allocations. This study was done to identify the gap Methodology Systematic data review of HIV positive FSW attending SWOP clinics and having been treated STI through syndromic management was done for the last two years 2020 and 2019. Data was pulled for all female sex workers who had been managed for STI syndromically, HIV status was checked and those who had a HIV diagnosis were retained in the study data base (this is because the HIV positive frequent the sites at least four times in a year compared to HIV negative FSW) Data was then separated into one time STI treatment and revisits with the same signs and symptoms for more than once in one year. Data on consistence condom use was also extracted Results Out of the 17,900 Female sex workers accessing SWOP facilities for key population services, 3038(16.9) were HIV positive. Of this HIV positive at least 4% (122) were treated for STI through syndromic management with highest 66% (81) reporting low abdominal pains with vaginal discharge. 52% (64) come back with same symptom twice of which 79%(51) reported consistent condom use, while 23% (15) come back at least more than twice with the same complains within a year with 89% reporting consistent condom use. Conclusion Given the nature of work, female sex workers have a high possibility of STI misdiagnosis. Hence countries should strive to invest in laboratory screening of STI among female sex workers to improve on correct diagnosis and treatment to reduce unnecessary use of antibiotics
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