Self-reported sexually transmitted infections and associated factors among sexually active men in East Africa: a multilevel analysis of recent demographic and health surveys

Background Sexually transmitted infections (STIs) are a significant global health challenge, demanding attention and intervention. Despite many STIs being manageable, their asymptomatic nature poses a formidable threat to both mental and physical well-being. This silent impact can lead to substantial morbidity and mortality, which is particularly pronounced in East Africa. Objective To investigate the prevalence and factors associated with self-reported STIs among sexually active men in East Africa. Design Cross-sectional study design. Setting 10 East African countries. Participants 66 833 sexually active men. Primary outcome measure Self-reported STI in the 12 months preceding the survey. A multilevel mixed-effects logistic regression model was fitted to identify factors associated with self-reported STIs. An adjusted OR with the corresponding 95% CI was used to estimate the strength of the association, and statistical significance was set at a p value <0.05. Results The pooled prevalence of self-reported STIs among sexually active men in East Africa was 5.22% (95% CI: 5.34, 5.69). Being married, having multiple sexual partners excluding a spouse and being informed about STIs were significantly associated with higher odds of self-reported STIs. However, being aged 44 years and above, having a higher education level, starting sex after the age of 20, being circumcised and being a rural resident were associated with lower odds of self-reported STIs. Conclusion The prevalence of self-reported STIs was higher than the findings from most previous studies. It is essential to educate men about STIs and increase awareness of the risks associated with having multiple sexual partners. Implementing targeted public health initiatives for men with lower education levels, as well as devising strategies to address factors that elevate the risk of STI contraction, is also crucial.