Prevalence of five curable sexually transmitted infections and associated risk factors among tertiary student men who have sex with men in Nairobi, Kenya: a respondent-driven sampling survey

Abstract Background Young men who have sex with men (MSM), are a key population at high risk of sexually transmitted infections (STIs) yet are often underrepresented in research in settings where same sex sexual behavior is criminalized. We conducted a respondent-driven sampling (RDS) bio-behavioral survey to estimate the prevalence of five curable STIs: Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhea (NG), Trichomonas vaginalis (TV) and syphilis, and associated risk factors among tertiary student MSM (TSMSM) in Nairobi, Kenya. Methods Between February and March 2021, we recruited 248 TSMSM aged ≥ 18 years who self-reported engaging in anal and/or oral sex with another man in the past year. Samples collected included urine, provider-collected anorectal and oropharyngeal swabs for pooled CT/MG/NG/TV testing using multiplex nucleic acid amplification tests (NAATs), and venous blood for serological syphilis screening using Rapid plasma reagin (RPR) followed by Treponema pallidum haemagglutination assay (TPHA) for confirmation of current infection. Participants self-completed a behavioral survey on REDCap digital platform. Data analysis was done using RDS-Analyst (v0.72) and Stata (v15). Differences in proportions were examined using the chi-square (X2) test, and unweighted multivariate logistic regression was used to assess factors associated with STI prevalence. Results RDS-adjusted prevalence of STIs was: at least one of five STI: 58.8%, 95% confidence interval (CI): 50.4–67.3%, CT: 51.0%, 95% CI: 42.3–59.8%, NG: 11.3%, 95% CI: 6.1–16.5%, MG: 6.0%, 95% CI: 2.6–9.4%, TV: 1.5%, 95% CI: − .3-3.3% and latent syphilis: 0.7%, 95 CI: -0.1-1.5%. Frequency of co-infection with more than one STI was: CT/NG: 5.7%, 95% CI: 2.7–8.7%, CT/MG: 4.5%, 95% CI: 2.3–6.7% and MG/NG = CT/MG/NG: 1.7%, 95% CI: 0.1–3.3%. Factors independently associated with STI prevalence were inconsistent condom use during anal sex with a man in the 12 months preceding the survey (adjusted odds ratio [AOR] = 1.89, 95% CI: 1.03–3.47, p = 0.038) and the last sex partner being a regular partner (AOR = 2.35, 95% CI: 1.12–4.92, p = 0.023). Conclusion STI prevalence among TSMSM in Nairobi is disturbingly high and is associated with inconsistent condom use and having a regular sex partner. Tailored STI testing, treatment and prevention interventions are urgently needed for this population.