ArticleTherapeutic advances in reproductive health
Prevalence and associated factors of sexually transmitted infections among adolescent pregnant women at Mbarara Regional Referral Hospital, Uganda.
Article in Therapeutic advances in reproductive health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Adolescents in sub-Saharan Africa shoulder a disproportionate burden of sexually transmitted infections (STIs), yet data for pregnant teenagers in these settings are sparse. Objectives: The study estimated the prevalence of STI seropositivity and its associated factors, among pregnant adolescents at Mbarara Regional Referral Hospital (MRRH), Uganda. Design: Hospital-based cross-sectional study. Methods: Consecutive pregnant adolescents (10-19 years) attending the MRRH antenatal clinic or maternity ward between 1 July and 30 September 2024 were enrolled. A structured questionnaire captured socio-demographic, sexual-behavioural, obstetric, clinical and nutritional variables. Blood samples were tested for HIV (Determine™/STAT-PAK™), syphilis (Treponema pallidum haemagglutination assay) and Hepatitis B (HBsAg rapid test). The composite STI outcome was seropositivity for any infection: HIV, syphilis or HBsAg. Independent associations were examined with Firth-penalised logistic regression; adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported. Results: Among 249 participants (median age 18 years, interquartile range 18-19), the overall prevalence of STI seropositivity was 12.1% (95% CI: 8.3-16.8). Prevalence by each STI was HIV 8.8%, syphilis 4.0% and HBV 0.4%. Multigravidae had higher odds of infection than primigravidae (aOR: 2.81, 95% CI: 1.01-7.84). Having ever used a non-barrier modern contraception tripled the odds of STI (aOR 3.04, 95% CI: 1.10-8.45), whereas marriage or cohabitation reduced risk by 63% (aOR 0.37, 95% CI: 0.14-0.96). Conclusion: Nearly one in eight pregnant adolescents at MRRH were infected with HIV, syphilis or HBV, with these STIs more likely to be among multigravidae and former users of non-barrier contraception and less likely among married/cohabiting pregnant adolescents. These findings support integrating repeat HIV-syphilis testing, dual-method contraceptive counselling and targeted interventions for multigravidae into youth-friendly antenatal services to advance STI-elimination goals.
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