A spike in sexually transmitted infections among gay students in Nairobi has been described as “disturbingly high”, with health experts pleading with the Ministry of Health not to ignore them.
Nearly 60 per cent of the students tested positive for at least one STI, in a study led by researchers from the University of Nairobi (UoN) and the Kenya Medical Research Institute.
Most prevalent are chlamydia and gonorrhoea, two bacteria that increase the chances of contracting HIV and, in rare cases, cause infertility.
The researchers tested 248 male students who have sex with men, from different colleges and universities around Nairobi.
They found that the prevalence of each of the five STIs tested was at least twice that in the general population.
Globally, STIs are also rebounding, especially in key populations such as men who have sex with men.
The tests showed 51 per cent of students had Chlamydia, 11.3 per cent had gonorrhoea and six per cent had Mycoplasma genitalium infection, a little-known STI that causes watery discharge and burning sensation while peeing.
At least 1.5 per cent had trichomoniasis, which causes burning after peeing or ejaculating, and 0.7 per cent had syphilis.
“While not neglecting the general population, there is need to focus more attention on the prevention and control of STIs among key populations such as MSM, including tertiary students MSM,” lead author Samuel Mwaniki of the UoN’s Health Services, and his colleagues, said.
The authors added; “This approach may further foster benefits for the prevention and control of STIs in the general population, given that MSM who also have sex with women (36.8 per cent in our study) form a bridge population that may transmit STIs to women, and these women in turn transmit to men in the general population, thus amplifying the STI epidemics.”
The researchers selected the 248 students, aged 18 to 24, from different colleges and universities around Nairobi in February and March 2021.
They all self-reported engaging in anal and oral sex with another man in the past year.
Samples collected included urine, anorectal and oropharyngeal swabs for the four infections and blood for syphilis.
Factors independently associated with STI prevalence were inconsistent condom use and the last sex partner being a regular partner.
This is because condomless internal ejaculation is considered a demonstration of intimacy and commitment, and therefore those with regular partners stopped using condoms with time.
“STI prevalence among tertiary student MSM in Nairobi, Kenya, is disturbingly high, demonstrating urgent need for tailored testing, treatment and prevention interventions for this population,” the researchers said.
They noted the MSM students engaged in both receptive and insertive anal and oral sex, making them susceptible to anorectal and oropharyngeal STIs besides the usual genital STIs.
Unlike the genital STIs, extra-genital STIs are often asymptomatic and thus remain largely undiagnosed and untreated.
The concern with students who move to Nairobi is that most find themselves with unprecedented freedom, limited direct supervision and many opportunities to engage in behavioural risks such as casual sex.
“For tertiary student MSM, exposure to peers with similar sexual orientation and behaviour provides an environment with more socialising opportunities compared to their secondary school days,” the researchers said.
Half of those who participated in the study met many of their partners through dating apps such as Grindr.
The other researcher are UoN's Peter Mwenda, Peter Mugo of Kemri and Thesla Palanee-Phillips of the University of the Witwatersrand in South Africa.
The study was published in January in the Sexual Health journal under the title, "Prevalence of five curable sexually transmitted infections and associated risk factors among tertiary student men who have sex with men in Nairobi."
-Edited by SKanyara
