Determinants of care-seeking behavior for sexually transmitted infections among sexually active men in East Africa: A multilevel mixed effect analysis.

ABSTRACT

BACKGROUND: Addressing the global challenge of sexually transmitted infections (STIs) is crucial and demands immediate attention. Raising awareness, improving healthcare facilities, and implementing preventive measures are necessary to reduce the spread and mitigate their adverse effects. The treatment seeking behavior of individuals in relation to STIs is an important factor in STI prevention and control. Thus, this study aimed to identify factors associated with STI-related care-seeking behavior among sexually active men in East Africa. METHODS: A weighted sample of 3,302 sexually active men from recent Demographic and Health Surveys (DHSs) in East African countries were included for analysis. To accommodate the inherent clustering in DHS data and the binary nature of the dependent variable, we applied a multi-level mixed-effect logistic regression model. The deviance value was used to select the best-fitted model. The strength of the association was estimated using an adjusted odds ratio, along with a 95% confidence interval, and statistical significance was determined at a p-value < 0.05. RESULT: The pooled prevalence of STI-related care-seeking behavior among sexually active men in East Africa was 71% (95%CI 69.76, 72.75). In the multivariable multilevel model, individuals in the age groups of 25-34 (AOR = 1.58, 95%CI 1.22, 2.04) and 44 years and above (AOR = 1.44, 95%CI 1.01, 2.02), those who were married (AOR = 1.62, 95%CI 1.25, 2.11), had 1 (AOR = 1.88, 95%CI 1.50, 2.35) and ≥2 (AOR = 2.53, 95%CI 1.89, 3.39) sexual partners excluding their spouse, had ever been tested for HIV (AOR = 1.86, 95%CI 1.52, 2.28), and had media exposure (AOR = 1.30, 95%CI 1.04, 1.62) had a positive association with care-seeking behavior for STIs. CONCLUSION: Based on our findings, seven out of ten sexually active men in East Africa exhibit care-seeking behavior for STIs. It is crucial to implement policies and strategies aimed at improving the health-seeking habits of young, unmarried men. Utilizing diverse media platforms to disseminate accurate information and success stories about STI symptoms is pivotal in achieving this goal.