A survey to estimate the prevalence of STIs among youth in Zambia

Project Details


Annually, there are an estimated 376 million new cases of curable sexually transmitted infections (STIs), including chlamydia (CT), gonorrhea (NG), trichomoniasis (TV), and syphilis, world-wide.1 Despite accounting for only one-quarter of the global population, adolescents and young people (AYP) aged 10-24 years have the highest burden of STIs globally.2 Despite a high burden, AYP have limited access to STI services. In a recent behavioral survey among AYP in Lusaka, Zambia, we found that only 12% of sexually active AYP reported testing for an STI, other than HIV, in the last 12 months.3 Young men aged 20-24 in particular had inequitable access, with only 24% reporting ever testing for an STI compared to 32% of women.3 Since 2011, there have been declines in the incidence of curable STIs;4 however, these declines have been limited relative to declines in incident HIV infection and, in the absence of high-quality data on the burden of STIs, the true burden of curable STIs among AYP remains unknown in many low-resourced countries.

Eastern and southern Africa bears 40% of the global burden of STIs.5 In the region, young women aged 15-24 years have the highest HIV incidence rates globally.6,7 There is strong synergy between STIs and HIV,8 especially for AYP, in whom high rates of STIs may help explain the high HIV incidence in this group, especially among young women.9 Effective STI control is a key priority for resource-limited settings, including Zambia, where HIV is prevalent.10 Despite growing concern regarding the control of STIs, population-level data on the prevalence and incidence of STIs remain sparse in many countries with limited resources and laboratory capacity.

Collecting information on the prevalence of STIs across representative populations is essential to advocate, fund, plan, and implement interventions for STI prevention and control. This study will contribute data to describe the national STI epidemic in Zambia and regional STI epidemics in southern Africa. A cross-sectional population-based survey will be carried out in Chawama, a high-density urban setting in Zambia, to measure the prevalence of curable STIs (CT, NG, TV, and syphilis) among 15-24 year-olds. Data generated through this survey will fill a critical gap in information on the burden of STIs among 15-24 year-olds in Zambia, a population group with increased vulnerability to STIs yet inequitable access to available STI testing and treatment services, and are the first step towards informing STI control strategies.


The overall aim of this project is to design and implement a population-based survey to measure the prevalence of curable STIs among 15-24 year-olds in Zambia.


Secondary Objectives are to:

·        Estimate the prevalence of HIV and syphilis, and co-infection with other STIs, among 15-24 year-olds.

·        Determine risk factors for curable STIs, including self-reported STI symptoms and sexual behaviors, such as selling and paying for sex.

·        Quantitatively understand care seeking behaviors for STI symptoms.

·        Conduct qualitative research to understand the barriers to care seeking for STI symptoms, preferences for STI results delivery and perceptions regarding the burden of STIs among AYP.

Short titleCHoNGeTSa
Effective start/end date7/12/2331/07/24


  • Bill & Melinda Gates Foundation: €72,719.98


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