title: Prevalence of sexually transmitted infections, genital symptoms and health-care seeking behaviour among HIV-negative female sex workers in Kigali, Rwanda.
abstract: Timely diagnosis and treatment of sexually transmitted infections (STIs) is often hampered by the lack of symptoms, inadequate diagnostics and/or poor availability, accessibility and quality of treatment in resource-limited settings. Female sex workers (FSW) are highly vulnerable for HIV and key transmitters of STIs. Among FSW (n = 400) participating in a prospective HIV incidence study in Kigali, Rwanda, only 15% (17/116) of women with laboratory-diagnosed non-ulcerative STIs at baseline reported symptoms. Only 27% (20/74) of women self-reporting genital symptoms sought care at enrolment, and 39% (46/117) of women with self-reported genital symptoms during follow-up. During focus group discussions, FSW considered treatment-seeking and partner notification important. Shame and feeling disrespected by doctors or other health-care workers were identified as barriers to seeking health care. A comprehensive STI control programme targeting both symptomatic and asymptomatic FSW should be considered in this setting.
authors.affiliation: Academic Medical Center of the University of Amsterdam, Department of Global Health, and Amsterdam Institute for Global Health and Development (AIGHD), PO Box 22700, 1100 DE Amsterdam, The Netherlands.
authors.forename: N J
authors.initials: NJ
authors.lastname: Veldhuijzen
authors.forename: M
authors.initials: M
authors.lastname: van Steijn
authors.forename: J
authors.initials: J
authors.lastname: Nyinawabega
authors.forename: E
authors.initials: E
authors.lastname: Kestelyn
authors.forename: M
authors.initials: M
authors.lastname: Uwineza
authors.forename: J
authors.initials: J
authors.lastname: Vyankandondera
authors.forename: J H H M
authors.initials: JH
authors.lastname: van de Wijgert
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D018023:HIV Seronegativity; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D012432:Rwanda / Q000453:epidemiology; D057566:Self Report; D060386:Sex Workers / Q000523:psychology* / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control
keywords: Rwanda; female sex workers; genital symptoms; health-care seeking behaviour; prevalence; sexually transmitted infections