Journal Article

STI prevalence and associated factors among urban men in Pakistan

Objectives
To measure the prevalence of selected STIs among urban men in Pakistan and identify associated factors.

Methods
A cross-sectional survey of 2,400 urban men aged 16–45 years was carried out in six cities of Pakistan. Respondents were selected through a multistage systematic sampling design. After obtaining informed consent a structured behavioral questionnaire was administered. Blood and urine samples were also collected and tested for HIV (ELISA), HSV-2 (ELISA), syphilis (RPR and TPHA), chlamydia (PCR), and gonorrhea (PCR).

Results
Of the 2,383 respondents whose results were received, 4.4 percent (n=106) tested positive for at least one of the five STIs. The prevalence of the individual organisms was as follows: syphilis: 1.3 percent; HIV: 0.1 percent; HSV-2: 3.4 percent; gonorrhea: 0.8 percent; and chlamydia: no cases. City-wise, the highest prevalence was in Karachi (8.5 percent) followed by Lahore (5.3 percent), Faisalabad (4.0 percent), Quetta (4.3 percent), Rawalpindi (2.5 percent), and Peshawar (2.0 percent). At the univariate and multivariate level, older age, less schooling, and having more than four sexual partners were significantly associated with the presence of an STI. Ninety-two percent of men who tested positive for any STI were asymptomatic.

Conclusions
HIV prevalence in Pakistan remains low, however, emergence of genital herpes is a matter of concern as it could lead to a future conduit for HIV spread. Health education messages should target less-educated segments of society and specifically advocate safe sex practices and early diagnosis.