Baseline STD prevalence in a community intervention trial of the female condom in Kenya

Objective: We present baseline sexually transmitted disease (STD) prevalenc e rates from an ongoing intervention trial at Kenyan agricultural sites. Methods: After gaining the cooperation of management, we identified six mat ched pairs of tea, coffee, and flower plantations and enrolled approximatel y 160 women at each site. Six intervention sites received an information pr ogramme and distributed female and male condoms, while six control sites re ceived male condoms only and similar information about them. At clinic visi ts, we tested participants for cervical gonorrhoea (GC) and Chlamydia trach omatis (CT) by ligase chain reaction on urine specimens, and Trichomonas va ginalis (TV) by culture. The study has 80% power to detect a 10% prevalence difference during follow up, assuming a combined STD prevalence of 20%, 25 % loss to follow up and intracluster correlation coefficient (ICC) of 0.03. Results: Participants at intervention and control sites (total 1929) were s imilar at baseline. Mean age was 33 years, the majority were married, more than half currently used family planning, 78% had never used male condoms, and 9% reported more than one sexual partner in the 3 months before the stu dy. Prevalences of GC, CT, and TV were 2.6%, 3.2%, and 20.4% respectively ( 23.9% overall), and were similar at intervention and control sites. The ICC for STD prevalence was 0.0011. Baseline STD was associated with unmarried status, non-use of family planning, alcohol use, and more than one recent s exual partner, but the highest odds ratio was 1.5. Conclusions: Baseline results confirm a high prevalence of trichomoniasis a nd bacterial STD at these Kenyan rural sites. Improved STD management is ur gently needed there. Our ongoing female condom intervention trial is feasib le as designed.