{
  "abstract": "Introduction Little is known about the burden of sexually transmitted infections (STIs) among adolescent girls and young women (AGYW) employed as domestic workers in Ugandan households.Methods We conducted a community-based cross-sectional study from November 2023 to March 2024 to determine the prevalence and correlates of STIs among Ugandan AGYW aged 14–24 in the Kampala Metropolitan Area. Self-collected vaginal swabs were tested for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) using GeneXpert. HIV and syphilis testing were performed using the Bioline HIV/syphilis Duo test. Correlates of STI prevalence were determined using modified Poisson regression.Results Among 262 AGYW, median age was 20 years (IQR 18–23) and 87 (33%) had an STI: CT (27.5%), syphilis (5.7%), HIV (4.6%) and NG (1.5%). Overall, 14.9% had >1 STI. Of 12 AGYW with HIV, 3 (25%) were newly diagnosed and 6/9 had detectable viral loads (≥1000 copies/mL). In the prior 12 months, 126 (48%) had received syndromic STI treatment, but only 35 (28%) notified their partners. Additionally, 102 (39%) had used emergency contraception and 54% believed it was protective against STIs, including HIV. Factors associated with STI prevalence included non-cash compensation for domestic work (adjusted prevalence ratio (aPR) 2.26; 95% CI 1.04 to 4.92; p=0.040), lower educational attainment (aPR 1.73; 95% CI 1.16 to 2.57; p=0.007), alcohol consumption in the past 6 months (aPR 1.72; 95% CI 1.12 to 2.64; p=0.013) and transactional sex during the past 6 months (aPR 1.43; 95% CI 1.01 to 2.04; p=0.045). Conversely, self-reported sexual abuse was negatively associated with STIs (aPR 0.48; 95% CI 0.28 to 0.83; p=0.008).Conclusion The high prevalence of undiagnosed STIs and unsuppressed HIV among AGYW domestic workers in Central Uganda highlights the urgent need to increase STI/HIV prevention, testing and treatment coverage for these underserved and vulnerable young women. Targeted interventions are needed to mitigate STI/HIV acquisition in this population.",
  "authors": [
    {
      "affiliations": [
        "Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"
      ],
      "name": "Annet Onzia"
    },
    {
      "affiliations": [
        "Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"
      ],
      "name": "Andrew Mujugira"
    },
    {
      "affiliations": [
        "Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"
      ],
      "name": "Vivian Nakate"
    },
    {
      "affiliations": [
        "Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"
      ],
      "name": "Joseph Musaazi"
    },
    {
      "affiliations": [
        "Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda"
      ],
      "name": "Eric Ssegujja"
    },
    {
      "affiliations": [
        "Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda"
      ],
      "name": "Justine Bukenya"
    },
    {
      "affiliations": [
        "Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda",
        "Public Health, Queen’s University Belfast Faculty of Medicine Health and Life Sciences, Belfast, UK"
      ],
      "name": "Rosalind Parkes Ratanshi"
    },
    {
      "affiliations": [
        "Medicine, Kampala International University - Western Campus, Bushenyi, Uganda"
      ],
      "name": "Patricia A Ajeru"
    },
    {
      "affiliations": [
        "Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Johan H Melendez"
    },
    {
      "affiliations": [
        "Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Matthew M Hamill"
    },
    {
      "affiliations": [
        "Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Yukari Carol Manabe"
    },
    {
      "affiliations": [
        "Infectious Disease Institute, Makerere University College of Health Sciences, Kampala, Uganda"
      ],
      "name": "Barbara Castelnuovo"
    }
  ],
  "title": "Prevalence and correlates of prevalent sexually transmitted infections among young women employed as domestic workers in Central Uganda: a community-based cross-sectional study",
  "uid": "f8a6330d-c090-55d9-b054-984efb98ff2a"
}