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Sexual Practices and Health Seeking Behaviour among STD Patients in Seychelles

Sexual Practices and Health Seeking Behaviour among STD Patients in Seychelles. Ministry of Health, Seychelles N. E. Udonwa R. Brewer J. Nwosu G. Furneau M. Francoise M. Pragassen University of Brescia, Italy A. Matteelli S. Calgaris A. Tebaldi N. Gulletta.

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Sexual Practices and Health Seeking Behaviour among STD Patients in Seychelles

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  1. Sexual Practices and Health Seeking Behaviour among STD Patients in Seychelles • Ministry of Health, Seychelles • N. E. Udonwa • R. Brewer • J. Nwosu • G. Furneau • M. Francoise • M. Pragassen • University of Brescia, Italy • A. Matteelli • S. Calgaris • A. Tebaldi • N. Gulletta Xth International Conference on AIDS and STD in Africa, December 1997

  2. ABSTRACT • Objectives: To determine the pattern of sexual practices and health seeking behavior among STD patients consulting public services in the Seychelles. • Methods: We enrolled all consecutive, symptomatic, first attendant patients, at the national reference STD clinic (Communicable Diseases Control Unit-CDCU) in Victoria, Seychelles during the period February 1996 –March 1997. Anagraphic and behavioral data were collected by trained interviewers and data recorded on a case report form. Data were computed in a Dbase file and analysed with the epiinfo6. program. • Results: 254 STD patients were enrolled, 84 males (33%) and 170 females. Males had a mean age of 30, compare to 27 in females. A stable occupation was reported by 90% and 78%, and secondary education by 54% and 58% of males and females respectively. 41% of the females and 46% of the males were single; among the remainder consensual union was largely prevalent on regular marriage. The mean age of first coitus was 17 and 18 years for males and females respectively. All reported heterosexual habits, except for 1 male. Oral sex was practiced by 20% of both sexes, while less than 1% of the women reported anal sex. 33% of the males but only 4% of the females reported more than one partner in the last month, and 27% and 5% of males and females respectively had changed the stable partner in the previous three months. Condom had never been used. By 69% of the females and 67% of the males. The number of days between onset of symptoms of the current STD episode was lower than 7 in 67% of males and 60% of females. 32% of males and 22% of females had already consulted other health services, including private services in 11% of the males and 6% of females. 21% of the males and 9% of the females had already taken drugs for the current episode : only males (40%) reported use of medical herbs. • Comments: The study sample population have a moderate/low prevalence of indicators of sexual promiscuity, especially as far as females are concerned. Condom use is very infrequent. The CDCU seems to be consulted first and early in the STD episode, providing a good opportunity for high quality case management of STD patients. Xth International Conference on AIDS and STD in Africa, December 1997

  3. Questions What is the pattern of sexual practices and health seeking behaviour among STD patients consulting public services in the Seychelles ? Xth International Conference on AIDS and STD in Africa, December 1997

  4. Site Comunicable Diseases Control Unit (CDCU), Victoria which acts as the national reference STD clinic in Victoria in the Seychelles Period February 1996 to March 1997 Study population All consecutive, symptomatic, first attendant patients attendancies related to genital problems during the study period Method Anagraphic and behavioural data were collected by trained interviewers and recoreded on case report form. Data were analysed with Epiinfo pgrogram Materials and Methods Xth International Conference on AIDS and STD in Africa, December 1997

  5. DNA probes (Gen probe - Medical Systems) RPR TPHA reactive WBC > 5/field with negative gonococcal and chlamydia tests Culture onto Sabouraud destrose agar EIA Antigen detection (Sanofi Pasteur) wet mout preparation of vaginal specimens abnormal discharge AND vaginal PH >5 AND clue cells and vaginal Gram CHLAMYDIA GONORRHEA Trichomonas Syphilis Non Specific Infections (NGI) Bacterial vaginosis Candida Xth International Conference on AIDS and STD in Africa, December 1997

  6. 170 Females 84 males Xth International Conference on AIDS and STD in Africa, December 1997

  7. Results Study sample: n=254 Males 84 Females 170 Males Females Age mean 30 27 range 18-62 14-48 % with stable job 90 78 % with secondary education 54 58 % single 46 41 %consenual union on regular marriage 62 73 Anagraphic characteristics Xth International Conference on AIDS and STD in Africa, December 1997

  8. Results Sexuals habits Males Females % heterosexual habit 98 100 Mean age at first coitus 16.3 17.6 % reporting oral sex 20 20 % reporting anal sex 5 1 % with > 1 partners (last month) 33 4 % changed partner (last 3 months) 27 5 % never used condom 67 69 Xth International Conference on AIDS and STD in Africa, December 1997

  9. Results Health seeking habits Males Females % Days b/w symptoms onset and STD episode <1wk (7 days) 67 60 % Consulted other Health Services 32 22 % Consulted Private Health Services 11 6 % Taken drugs for current STD episode 21 9 % Used Herbs 40 0 Xth International Conference on AIDS and STD in Africa, December 1997

  10. Reason for consultation Xth International Conference on AIDS and STD in Africa, December 1997

  11. Etiologic diagnosis (n=84) 29.6% 28.4% 3.7% 1.2% GonorrheaChlamydialTrichomoniasis Syphilis infection Xth International Conference on AIDS and STD in Africa, December 1997

  12. Etiologic diagnosis in 65 males with urethral discarge Xth International Conference on AIDS and STD in Africa, December 1997

  13. Reason for consultation Xth International Conference on AIDS and STD in Africa, December 1997

  14. Etiologic diagnosis among (n=170) Xth International Conference on AIDS and STD in Africa, December 1997

  15. Comments Female attendants have a moderate/low prevalence of indicators of sexual promiscuity. Males, as expected, have a higher one. Regular condom use is very rarely reported. STD patients seems to attend CDCU first and early for STD episodes. This provides a good opportunity for high quality case management and education of STD patients.

  16. Comments Neisseria gonorrhoea and Chlamydia trachomatis are responsible for 27% and 25% of cases presenting with urethral discharge in the Seychelles and are present as coinfection in another 11% of such cases: syndromic treatment needs to be effective on both pathogens. GUD account for 11% of consultations, and only a minority of cases are clinically attributable to Herpes. Low syphilis and HIV seroprevalence rates are found, in agreement with reports of surveillance system

  17. Poster prepared and printed with the contribution of the European Commission - Project 7 ACP RPR 28 for STD/HIV action in the Indian Ocean

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