Clinical Epidemiological Assessment of Sexually Transmitted Infections among Reproductive-age Adults in Rivers State, Nigeria

Abstract

Background: Sexually transmitted infections (STIs) cause substantial morbidity and adverse reproductive outcomes, yet population‑representative data from high‑burden settings like Rivers State, Nigeria, remain scarce. This study estimated the prevalence and correlates of curable and viral STIs among reproductive‑age adults using a clinical epidemiological approach. Methods: A cross‑sectional analytic study enrolled 752 adults aged 15‑49 years from 15 health facilities and 10 community outreaches in Rivers State from February to October 2025. Structured interviews collected sociodemographic and behavioural data. Laboratory testing included nucleic acid amplification tests for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV); serological tests for active syphilis, HSV‑2, hepatitis B surface antigen (HBsAg), and HIV. Survey‑weighted logistic regression identified correlates of any curable STI. Results: Weighted prevalence of any curable STI was 16.9% (95% CI 14.2–19.9): CT 8.1%, TV 6.2%, NG 2.9%, active syphilis 1.7%. HSV‑2 seropositivity was 40.2%, HBsAg 6.1%, and HIV 3.5%. Most curable infections (61.2%) were asymptomatic. Independent correlates of any curable STI included age 20‑24 years (AOR 1.51; 95% CI 1.00–2.30), ≥2 sexual partners in the past year (AOR 1.82; 1.30–2.55), inconsistent condom use (AOR 1.46; 1.02–2.10), and prior STI diagnosis (AOR 1.69; 1.10–2.58). Model discrimination was acceptable (AUROC 0.73). Conclusion: Curable STIs affect one in six reproductive‑age adults in Rivers State, with most infections asymptomatic. Behavioural factors align with global risk patterns. Aetiological testing substantially improves case detection over syndromic management. Integration of targeted nucleic acid amplification testing, risk‑stratified screening, and strengthened partner services is urgently needed.