title: STI prevalence and associated factors among urban men in Pakistan.
abstract: OBJECTIVE
  To measure the prevalence of selected sexually transmitted infections (STIs) among urban men in Pakistan and identify associated factors.
  
  
  METHODS
  A cross-sectional survey of 2400 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 behavioural 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 gonorrhoea (PCR).
  
  
  RESULTS
  Of the 2383 respondents whose results were received, 4.4% (n = 106) tested positive for at least one of the five STIs. The prevalence of the individual organisms was as follows: syphilis, 1.3%; HIV, 0.1%; HSV-2, 3.4%; gonorrhoea, 0.8% and chlamydia, no cases. City-wise, the highest prevalence was in Karachi (8.5%) followed by Lahore (5.3%), Faisalabad (4.0%) Quetta (4.3%), Rawalpindi (2.5%) and Peshawar (2.0%). 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. 92% of men who tested positive for any STI were asymptomatic.
  
  
  CONCLUSIONS
  HIV prevalence in Pakistan remains low, however, the 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.
authors.affiliation: Population Council, House 7, Street 62, F-6/3, Islamabad, Pakistan. amir@popcouncil.org
authors.forename: A M
authors.initials: AM
authors.lastname: Mir
authors.forename: A
authors.initials: A
authors.lastname: Wajid
authors.forename: L
authors.initials: L
authors.lastname: Reichenbach
authors.forename: M
authors.initials: M
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006558:Herpes Genitalis / Q000453:epidemiology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology; D014504:Urban Health; D055815:Young Adult