|Changes in self-reported sexually transmitted infections and symptoms among married couples in India from 2006 to 2016: a repeated cross-sectional multivariate analysis from nationally representative data|
||Jasmin Choi, Deepika Bahl, Monika Arora,and Ziming Xuan
||BMJ Open, DOI: 10.1136/bmjopen-2021-049049
Sexually transmitted infections (STIs)
||Objective: To assess the changes in prevalence of past-year self-reported sexually transmitted infections (STIs) and its symptoms among married couples between 2006 and 2016 in India, overall and by socioeconomic status.
Design: This cross-sectional study uses the two most recent waves (2005-2006 vs 2015-2016) of nationally representative health surveys in India. We examined the changes of self-reported STI and symptoms among married couples aged 15-54 by overall and by socioeconomic status. Adjusted logistic regression was used to assess the changes, accounting for covariates and the complex survey design.
Setting: Cross-sectional, nationally representative population-based survey in 2005-2006 and 2015-2016 from National Family Health Survey data from Demographic and Health Survey.
Participants: 39 257 married couples aged 15-49 years for the 2005-2006 survey wave and 63 696 married couples aged 15-49 years for the 2015-2016 wave.
Outcome measure: Self-reported STI was used as a primary outcome measure.
Results: In 2016, 2.5% of married women reported having had an STI in the past year, a significant increase from 1.6% in 2006 (p<0.001). The past-year self-reported STI prevalence among married men significantly increased from 0.5% in 2006 to 1.1% in 2016 (p<0.001). Adjusted results showed that the uptrend of couples' self-reported STI was more significant among those whose husbands are currently employed and those families in middle or higher wealth quintiles. Alarmingly, among couples who reported STI or symptoms, they were less likely to seek advice or treatment in 2016 as compared with 2006 (adjusted OR=0.50, p<0.001, 95% CI=0.40 to 0.61).
Conclusion: The study identifies a substantial increase in self-reported STI prevalence with a notable treatment seeking gap among married couples in India over the past decade.
Keywords: epidemiology; infectious diseases; public health; sexual medicine