Determinants of sexually transmitted infection-related care-seeking behavior among reproductive-age women in sub-Saharan Africa: A multilevel analysis

Abstract

Background Sexually transmitted infections (STIs) remain a major public health threats in sub-Saharan Africa (SSA). Delay in seeking care is a significant barrier for the prevention and control of STIs. This study aimed to assess the proportion of women seeking STI-related care and its determinants in SSA. Method This study was conducted using Demographic and Health Survey (DHS) data from eleven SSA countries between 2017/18 and 2022/23. It included 47,924 reproductive-age women who reported having STIs or STI symptoms. A multilevel logistic regression model was fitted to identify factors associated with STI-related care-seeking behavior. The strength of association was estimated using adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Finally, variables with a p-value of <0.05 were considered statistically significant predictors. Result In this study, the overall proportion of women seeking STI-related care was 62.2%. Younger age (AOR = 0.76; 95% CI: 0.70, 0.82), higher education level (AOR = 1.20; 95% CI: 1.13, 1.28), higher wealth index (AOR = 1.58; 95% CI: 1.48, 1.69), having >1 sexual partner (AOR = 1.55; 95% CI: 1.37, 1.75), ever heard of STIs (AOR = 2.16; 95% CI: 1.89, 2.47), asking a husband to use a condom (AOR = 2.10; 95% CI: 1.99, 2.22), being pregnant (AOR = 1.29; 95% CI: 1.21, 1.38), media exposure (AOR = 1.20; 95% CI: 1.14, 1.27), residing in West Africa (AOR = 1.51; 95% CI: 1.41, 1.61), being interviewed in 2019 (AOR = 2.27; 95% CI: 2.13, 2.42), and living in a community with low poverty levels (AOR = 1.23; 95% CI: 1.08, 1.40) were identified as significant predictors of STI-related care-seeking behavior. Conclusion This study revealed that a significant proportion of women did not seek STI-related care. Therefore, national strategies and policies should be implemented to address barriers to seeking care.