(P494) Self-reported uptake of STI testing services among adolescents and young people aged 15-24 in Lusaka, Zambia: findings from the Yathu Yathu trial

Background: There are few population-level data on uptake of STI testing and the burden of STIs in southern African countries. This study describes self-reported uptake of testing for STIs, other than HIV, and ever being diagnosed with an STI, and explores factors associated with ever STI-testing among youth aged 15-24-years in Lusaka, Zambia.

Methods: Secondary analysis of an endline cross-sectional survey conducted as part of a cluster-randomized trial (CRT). The CRT evaluated the impact of community-based, peer-led sexual and reproductive health services for youth aged 15-24 on knowledge of HIV status. In the intervention arm, the community-based services offered syndromic management for curable STIs with referral to the local health facility for testing and treatment. At the start of the CRT, a census was conducted; a random sample of ~2000 youth who were enumerated and consented to study participation were invited to complete the survey. Using analyses appropriate for CRTs with < 15 clusters/arm, we compared self-reported ever and recent (last 12-months) testing for STIs, other than HIV, across the two trial arms. Among AYP ever STI-testing, we described self-reported ever-testing positive for STIs. We used logistic regression to explore sociodemographic factors associated with ever-testing.

Results: Overall, 1989 individuals completed the survey; 75.7% (n=1505) reported ever having sex. Among these youth, 23.3% (n=350) reported ever STI-testing and 11.6% (n=174) recently tested. By trial arm, there was no difference in either outcome. Among youth who ever STI-tested, 6.6% (n=23) reported ever being diagnosed with an STI; five individuals did not know which STI they tested positive for. Among the remaining 18 individuals, 83.3% (n=15) self-reported being diagnosed with syphilis and 16.7% (n=3) gonorrhoea. Among youth ever STI-testing, self-reported prevalence of ever-testing positive for syphilis was 4.3% and for gonorrhoea 0.9%. Age and sex were strongly associated with ever STI-testing.

Conclusion: Only one-quarter of sexually-active youth self-reported ever-testing for an STI, with no difference in ever-testing or recent-testing by trial arm. With incidence and prevalence of curable STIs increasing globally and increased susceptibility among youth, efforts are needed to improve access to STI diagnostic and treatment services among youth in Lusaka.