Sexually Transmitted Infection Prevalence and Associated Sexual Risk Behaviors Among Adult Haitian Men and Women

Background: Haiti has high rates of sexually transmitted infections (STIs)/HIV. Few studies have evaluated gender differences in factors driving STI.

Methods: We used data from an ongoing study of STI prevalence conducted among men and women recruited from health clinics in Gressier/Léogâne, Haiti (n=1,352). Participants completed a questionnaire assessing sociodemograpics and risk behaviors, and provided urine and blood specimen. We tested urine for chlamydia and gonorrhea using nucleic acid amplification testing and blood for syphilis using rapid point-of-care antibody testing. 

Results: Approximately 58% of participants were women. The mean age was 31.5 years; women were younger than men (30.4 versus 33.1; pvalue<0.0001). Approximately 4% tested positive for syphilis, 2% for gonorrhea, and 6% for chlamydia. Overall, 10% tested positive for at least one STI. Women reported later sexual debut compared to men (18.1 years versus 14.5 years; pvalue<0.0001). Among women, for each year increase in sexual debut, the odds of testing positive for at least one STI decreased 12% (odds ratio (OR)=0.88, 95% confidence interval (CI): 0.81-0.94); sexual debut was not associated among men. Compared to women, a larger proportion of men reported ≥2 sexual partners (10% versus 45%; pvalue<0.0001) and sex trade in the past year (1% versus 5%; pvalue<0.0001). Among women, multiple partners (OR=2.54, 95%CI: 1.40-4.58) and sex trade (OR=4.37, 95%CI: 1.07-17.81) were associated with STI but were not associated among men. A larger proportion of women reported a non-monogamous main sexual partner compared to men (27% versus 5%; pvalue<0.0001). Partner non-monogamy was associated with STI among women (OR=2.20, 95%CI: 1.33-3.66) but not among men. Condom use at last sex was not associated with STI.

Conclusions: Delaying sexual debut, reducing multiple partnerships and sex trade, and addressing factors influencing partnerships with non-monogamous partners may reduce women’s STI risk in Haiti. Additional research is needed to determine factors driving STI among Haitian men.