Determinants of care seeking behavior for sexually transmitted infections in a context of social vulnerability: Evidence from Essaouira, Morocco

Nezha Nacer, Samia Rkha, Abdelmounaim Manoussi, Imane Kajjoune, Jaouad Chouikh, Nadia Ouzennou

Abstract

This study was designed to examine the care practices adopted in the presence of signs of sexually transmitted infection among women of childbearing age in the province of Essaouira, Morocco. A cross-sectional study was carried out on a sample of 1100 sexually active women of childbearing age. Data were collected via questionnaires. The results showed that more than half of the women (63%) consulted a health professional if they showed signs of an STI. However, 37% chose other non-medical remedies. Place of residence [OR: 1.52 (CI: 1.56-1.94)], education level [OR: 1.48 (CI: 1.23-1.85)], and healthcare decision-making [OR: 1.32 (CI: 1.30-1.65)] were the main determinants of healthcare use. Integrated strategies aimed at improving literacy, geographical accessibility to health services, and gender equity are therefore crucial for enhancing healthcare utilization in this population.

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References

World Health Organization (WHO). Sexually transmitted infections (STI) 2023. Available at:https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis). Accessed July 31, 2023.

Kassie BA, Yenus H, Berhe R , Kassahun EA. Prevalence of sexually transmitted infections and associated factors among the University of Gondar students, Northwest Ethiopia: a cross-sectional study. Reprod Health 2019; 16: 1-8. doi: 10.1186/s12978-019-0815.

World Health Organization (WHO). Half the world's population lacks access to essential health services 2017. Available at: https://www.who.int/fr/news/item/13-12-2017-world-bank-and-who-half-the-world-lacks-access-to-essential-health-services-100-million-still-pushed-into-extreme-poverty-because-of-health-expenses. Accessed November 18, 2024.

Shannon CL, Klausner JD. The growing epidemic of sexually transmitted infections in adolescents: a neglected population. Curr Opin Pediatr 2018; 30(1): 137. doi: 10.1097/MOP.0000000000000578.

Shakya S, Thingulstad S, Syversen U, Nordbø SA, Madhup S, Vaidya K, Karmacharya BM, Åsvold BO ,Afset JE. Prevalence of Sexually Transmitted Infections among Married Women in Rural Nepal. Infectious diseases in obstetrics and gynecology 2018 (1): 4980396. https://doi.org/10.1155/2018/4980396.

Cristaudo A , Giuliani M. Sexually Transmitted Infections: Advances in Understanding and Management. Cham: Springer International Publishing 2020. Available at: http://link.springer.com/10.1007/978-3-030-02200-6. Accessed Feb 28, 2023.

Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, Stevens G, Gottlieb S, Kiarie J , Temmerman M. Global estimates of the prevalence

and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PloS one 2015; 10(12): e0143304. doi.org/10.1371/journal.pone.0143304.

Whitford K, Whybrow B, Haire B, Nikitas A, Williams S, Monaghan R , Lafferty L. Sexual and Reproductive Health Service Access among Aboriginal and Torres

Strait Islander Young People in Regional NSW, Australia. Health & Social Care in the Community 2024; (1): 1845971. doi.org/10.1155/2024/1845971.

Come Yélian Adohinzin C, Méda N, Anicet Ouédraogo G, Gaston Belem AM, Ouédraogo GA, Sombié I, Berthé A , Fond-Harmant L. Knowledge and attitudes of young people in Bobo-Dioulasso regarding the prevention of HIV and unwanted pregnancy. Public Health 2016; 28(4): 525. doi.org/10.11604/pamj.2016.25.132.9767.

Zegeye B, Anyiam FE, Ahinkorah BO, Ameyaw EK, Budu E, Seidu AA , Yaya S. Women’s decision-making capacity and its association with comprehensive knowledge of HIV/AIDS in 23 sub-Saharan African countries. Arch Public Health 2022; (80): 111.

Charron J, Troude P, De La Rochebrochard E, Segouin C , Piron P. Notification of sexually transmitted infection (STI) screening results by SMS: better understanding the refusal barrier of people consulting a Parisian CeGIDD. International Journal of STD and AIDS 2022; 33(3): 257-264. doi.org/10.1177/09564624211048555.

El Hamdani FZ, Zouini M, Baali A, Aboussad A, Baudot P, Vimard P , Cherkaoui M. Morbidity and use of maternal health care among women in the city of Marrakech. Correlations with the rural exodus and with socioeconomic and biodemographic factors. Bulletins and memoirs of the Society of Anthropology of Paris 2012; (24): 179-189.

Hassambay R, Bennis FZ, Rwegera B , Loû ADD The community approach to health: a lever for protecting vulnerable people in times of health crisis? Trib Sante 2022; 72(2): 83-92. doi.org/10.3917/seve1.072.0083.

Chollier M, Tomkinson C , Philibert P. Stigma and impact on care: the example of STI/HIV. Sexologies 2016; 25(4): 179-83. doi.org/10.1016/j.sexol.2016.03.006.

Fageeh W, Bana F, Addas M, Baghdadi R, Almokri R Sait S, Fagih S , Alahmadi S. Knowledge and attitudes towards sexually transmitted illnesses (STIs) among the general population of Saudi Arabia. Clin. Exp. Obstet. Gynecol 2022; 49(1): 026. doi.org/10.31083/j.ceog4901026.

Laraqui CH, Tripodi D, Rahhali A, Bichara M, Laraqui S, Curtes JP, Verger C , Zahraoui M. Analysis of the practices, knowledge and attitudes of hospital staff to the risk of occupational HIV transmission in Morocco. Med Mal Infect 2002; 6(32): 307-14.

Tuddenham S, Hamill MM , Ghanem KG. Diagnosis and treatment of sexually transmitted infections: a review. Jama 2022; 327(2): 161-172. doi.org/10.1001/jama.2021.23487

Marrakech Safi Chamber of Commerce, Industry and Services. Monographie de la province d'Essaouira 2016. Available at: https://www.ccisrms.ma/wp-content/uploads/pdf/Essaouira.pdf. Accessed May 13, 2024.

High Commissariat for Planning (HCP). Morocco's Social Indications 2018. Available at: https://www.hcp.ma/region-drda/Les-indicateus-sociaux-du-Maroc-Edition-2018_a239.html. Accessed October 11, 2023.

Machrafi K. Guaranteed Minimum Interprofessional Wage (GMIW) in Morocco 2022. Available at: https://blog.ojraweb.com/gestion-de-la-paie-maroc-valeur-du-smig-au-01-janvier-2021. Accessed January 11, 2022.

Gruénais MÉ , Guillermet É. Deciding to access health care in Morocco. About the “first deadline. Insaniyat إنسانيات Rev Algér Anthropol Sci Soc 2018; (80-81): 71-89.

Mulka L , Cassell J. Public health aspects of STIs including vaccination strategies and partner notification. Medicine (Baltimore) 2022; 50(4): 197-201. doi.org/10.1016/j.mpmed.2022.01.001

World Health Organization (WHO). Sexually Transmitted Infections and Other Reproductive Tract Infections Integrated Management of Reproductive Health Essential Practice Guide 2005. Available at: http://apps.who.int/iris/bitstream/handle/10665/43327/924259265X.pdf?sequence=1. Accessed October 21, 2023.

Sihavong A, Lundborg CS, Syhakhang L, Akkhavong K, Tomson G , Wahlström R. Antimicrobial self medication for reproductive tract infections in two provinces in Lao People's Democratic Republic. Sex Transm Infect 2006 ; 82(2): 182-6. doi.org/10.1136/sti.2005.016352.

Entz A, Prachuabmoh V, van Griensven F , Soskolne V. STD history, self treatment, and healthcare behaviours among fishermen in the Gulf of Thailand and the Andaman Sea. Sex Transm Infect 2001; 77(6): 436-40. doi.org/10.1136/sti.77.6.436.

Van BT, Minh KP , Strobel M. Management of sexually transmitted infections in private pharmacies in Hanoi. Public Health (Bucur) 2014; 26(4) :491-8.

García PJ, Holmes KK, Cárcamo CP, Garnett GP, Hughes JP, Campos PE, Whittinggton WLH , Peru PREVEN Study Team. Prevention of sexually transmitted infections in urban communities (Peru PREVEN) : a multicomponent community-randomised controlled trial. The Lancet 2012; 379(9821): 1120-8.

Irwin DE, Thomas JC, Spitters CE, Leone PA, Stratton JD, Martin DH, Zenilman J, Schebke JR , Hook EW. Self-Treatment Patterns Among Clients Attending Sexually Transmitted Disease Clinics and the Effect of Self-Treatment on STD Symptom Duration. Sex Transm Dis 1997; 24(6): 372.

Gomez GB, Campos PE, Buendia C, Carcamo CP, Garcia PJ, Segura P, Whittington WL, Hughes JP, Ward H, Garnett GP , Holmes RK. Studying complex interactions among determinants of healthcare-seeking behaviours : self-medication for sexually transmitted infection symptoms in female sex workers. Sex Transm Infect 2010; 86(4): 285-91.

Andrianavalonirina AM , Ramanandraibe VV. Ethnobotanical study on the use of medicinal plants in the treatment of sexually transmitted infections (STI) in the rural commune of Antanifotsy, Vakinankaratra region (Madagascar). Pharmacopée Médecine Tradit Afr 2023; 22(1): 127-37.

Hossan S, Hanif A, Agarwala B, Sarwar S, Karim M, Taufiq-Ur-Rahman M, Janah R , Rahmatullah M. Traditional Use of Medicinal Plants in Bangladesh to Treat Urinary Tract Infections and Sexually Transmitted Diseases 2010. Accessed July 11, 2024. Available at: http://hdl.handle.net/10125/21000.

Naidoo D, Vuuren SFV, Zyl RLV , Wet HD. Plants traditionally used individually and in combination to

treat sexually transmitted infections in northern Maputaland, South Africa: Antimicrobial activity and cytotoxicity - ScienceDirect 2013; 149(3): 656-67. doi.org/10.1016/j.jep.2013.07.018.

Aboussad A, Cherkaoui M , Vimard P. Health and vulnerabilities in Morocco 2010. Accessed July 12, 2024. Available at: https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers20-02/010051210.pdf.

Kambizi L , Afolayan AJ. An ethnobotanical study of plants used for the treatment of sexually transmitted diseases ( njovhera ) in Guruve district, Zimbabwe. J Ethnopharmacol 2001; 77(1): 5-9.

Kwasikumah F, Osisiogu EU, Asumang P, Collins A, Close A , Ringway O. Assessment of public opinion on the use of herbal medicine for the treatment of sexually transmitted infections (STI) in accra. Traditional Medicine and Modern Medicine 2024 ; (7): 1-12.

Mathibela MK, Potgieter MJ , Tshikalange TE. Medicinal plants used to manage sexually transmitted infections by Bapedi traditional health practitioners in the Blouberg area, South Africa. South Afr J Bot 2019;122:385‑90.

Ghourri M, Zidane L , Douira A. Herbal medicine and urinary tract infections (Pyelonephritis and cystitis) in the Moroccan Sahara (Tan-Tan). Journal of Animal & Plant Sciences 2014; 20(3) : 3171-3193. http://www.m.elewa.org/JAPS/2014/20.3/4.pdf.

Tsega NT, Abebe B, Ebabu T, Asmare T, Kassa M, Haile TT, Seyoum AT, Endalew M , Wondie KY (2022). Sexually Transmitted Infections and Associated Factors During Pregnancy in Gondar City, Northwest Ethiopia : A Multicenter Study. Clinical Epidemiology and Global Health 2021; 16: 101096. doi.org/10.1016/j.cegh.2022.101096.

Zaouaq K. Women and access to reproductive health care in Morocco. The Maghreb Year 2017; (17): 169-83. doi.org/10.4000/anneemaghreb.3236.

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