Prevalence And Risk Factors Of Sexually Transmitted Infection Symptoms Among Women In Far-Western, Nepal

Background: The aim of this study was to measure the prevalence of potential STI symptoms and syndromes among women in Bajura, Nepal and explore the association with having a migrant worker husband (MWH). Methods: This was a cross-sectional survey of married women aged 16-35, selected via multi-stage random sampling from 10 Village Development Committees in Bajura district. STI symptoms were assessed using a standardized survey that employed definitions from the Nepali STI syndromic management algorithm. Modified Poisson regression with robust standard errors was used to estimate the prevalence ratio (PR) and 95% confidence interval (95% CI) of factors associated with STI syndromes. Results: During July 2014, 426 women were enrolled, with median age 26, 45% with no education, and 31% with MWH. Self-reported STI symptoms were common: 17.2% vaginal discharge syndrome (VDS), 14.4% lower abdominal pain syndrome (LAPS), and 8.9% genital ulcer disease (GUD). Multivariable adjusted prevalence of VDS and GUD were 74% (95% CI: 1.14, 2.67) and 53% (95% CI: 0.80, 2.91) higher among women with MWH. The association between MWH and prevalence of VDS was modified by reported unwilling sexual intercourse with husband and women’s education level. Age, caste, and specific family planning methods were also associated with higher prevalence of potential STI syndromes while education was associated with lower prevalence. Conclusion: This study indicates that the burden of STI symptoms and syndromes is high among women in Bajura district, especially among women with MWH. STI/HIV prevention and control programs should continue to target migrant workers and their wives.