Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey data

Abstract Introduction Sexually transmitted infections (STIs) represent a significant global public health concern, contributing substantially to illness and mortality, particularly in Sub-Saharan Africa (SSA). Women of reproductive age who initiated sexual intercourse at an early age are at high ris...

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Main Authors: Getachew Teshale, Melak Jejaw, Kaleb Assegid Demissie, Nebebe Demis Baykemagn, Tirualem Zeleke Yehuala, Jenberu Mekurianew Kelkay
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11138-4
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author Getachew Teshale
Melak Jejaw
Kaleb Assegid Demissie
Nebebe Demis Baykemagn
Tirualem Zeleke Yehuala
Jenberu Mekurianew Kelkay
author_facet Getachew Teshale
Melak Jejaw
Kaleb Assegid Demissie
Nebebe Demis Baykemagn
Tirualem Zeleke Yehuala
Jenberu Mekurianew Kelkay
author_sort Getachew Teshale
collection DOAJ
description Abstract Introduction Sexually transmitted infections (STIs) represent a significant global public health concern, contributing substantially to illness and mortality, particularly in Sub-Saharan Africa (SSA). Women of reproductive age who initiated sexual intercourse at an early age are at high risk of acquiring STIs. However, comprehensive data on their care-seeking behaviors in SSA are lacking. This study determines the prevalence of STI-related care-seeking behavior and identifies associated factors among these women. Method This study utilized data from the most recent Demographic and Health Surveys (DHS) conducted in 22 SSA countries between 2018 and 2024. A weighted sample of 54,425 reproductive-age women who initiated sexual intercourse at an early age and reported STIs or related symptoms in the past year was analyzed. A multilevel mixed-effects logistic regression model identified individual and community-level factors, with statistical significance set at *p* < 0.05. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated. Results The pooled prevalence of STI-related care-seeking behavior among women initiated sexual intercourse at early age in SSA countries was 39.18% (95% CI: 33.25%, 45.03%). Multilevel analysis revealed significant associations with age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, community education, media exposure, and poverty. Conclusion STI-related care-seeking behavior remains lower in this population compared to other studies. Associated factors include age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, and community-level factors such as education, media exposure, and poverty. Public health efforts should prioritize socioeconomically disadvantaged women by strengthening counseling and awareness during cervical cancer screenings and antenatal visits. Policies to improve healthcare access and financial support for these women are essential.
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spelling doaj-art-4d7ca078bcf14bf79046421daf4eee6d2025-08-20T01:52:24ZengBMCBMC Infectious Diseases1471-23342025-05-0125111110.1186/s12879-025-11138-4Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey dataGetachew Teshale0Melak Jejaw1Kaleb Assegid Demissie2Nebebe Demis Baykemagn3Tirualem Zeleke Yehuala4Jenberu Mekurianew Kelkay5Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Public Health, College of Health Sciences, Debark UniversityAbstract Introduction Sexually transmitted infections (STIs) represent a significant global public health concern, contributing substantially to illness and mortality, particularly in Sub-Saharan Africa (SSA). Women of reproductive age who initiated sexual intercourse at an early age are at high risk of acquiring STIs. However, comprehensive data on their care-seeking behaviors in SSA are lacking. This study determines the prevalence of STI-related care-seeking behavior and identifies associated factors among these women. Method This study utilized data from the most recent Demographic and Health Surveys (DHS) conducted in 22 SSA countries between 2018 and 2024. A weighted sample of 54,425 reproductive-age women who initiated sexual intercourse at an early age and reported STIs or related symptoms in the past year was analyzed. A multilevel mixed-effects logistic regression model identified individual and community-level factors, with statistical significance set at *p* < 0.05. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated. Results The pooled prevalence of STI-related care-seeking behavior among women initiated sexual intercourse at early age in SSA countries was 39.18% (95% CI: 33.25%, 45.03%). Multilevel analysis revealed significant associations with age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, community education, media exposure, and poverty. Conclusion STI-related care-seeking behavior remains lower in this population compared to other studies. Associated factors include age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, and community-level factors such as education, media exposure, and poverty. Public health efforts should prioritize socioeconomically disadvantaged women by strengthening counseling and awareness during cervical cancer screenings and antenatal visits. Policies to improve healthcare access and financial support for these women are essential.https://doi.org/10.1186/s12879-025-11138-4Healthcare seekingEarly age sexual intercourseSTISub-SaharanDHS
spellingShingle Getachew Teshale
Melak Jejaw
Kaleb Assegid Demissie
Nebebe Demis Baykemagn
Tirualem Zeleke Yehuala
Jenberu Mekurianew Kelkay
Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey data
BMC Infectious Diseases
Healthcare seeking
Early age sexual intercourse
STI
Sub-Saharan
DHS
title Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey data
title_full Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey data
title_fullStr Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey data
title_full_unstemmed Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey data
title_short Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018–2024 demographic and health survey data
title_sort healthcare seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 sub saharan african countries a multilevel analysis of 2018 2024 demographic and health survey data
topic Healthcare seeking
Early age sexual intercourse
STI
Sub-Saharan
DHS
url https://doi.org/10.1186/s12879-025-11138-4
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