Table 1 presents the unweighted pooled demographic characteristics of the survey participant. There were 1432 MSM, 1240 FSW and 492 PWID enrolled in the surveys distributed across the three cities as follows: Maputo (MSM: 34.6%, FSW: 32.2%, PWID: 71.8%), Beira (MSM: 40.7%, FSW: 33.2%), Nampula/Nacala (MSM: 24.7%, FSW: 34.6%, PWID: 28.3%). Male PWID made up the overwhelming majority of the sample population (94.9%). The majority of MSM and FSW were less than 24 years of age, at 79.2% and 71.6%, respectively, while only 18.7% of PWID were young. Most survey participants were single or never married (MSM: 83.9%, FSW: 64.7%, PWID: 58.7%); of note, 7.1% of MSM were married or cohabitating with women, while 3.4% of MSM were married or cohabitating with men. Across all three populations, the majority of participants had secondary education or higher (MSM: 83.3%, FSW: 63.0%, PWID: 57.2%). Among MSM participants, 59.9% were employed while among FSW participants, 23.8% reported additional employment aside from sex work; employment status was not assessed for PWID. Close to two-thirds of MSM participants and male PWID participants were circumcised, 64.3% and 65.7% respectively. Most FSW participants reported ever being pregnant (69.2%).
RDS-weighted aggregate estimates of self-reported symptoms and STIs among MSM, FSW and PWID survey participants are presented in Table 2. Among MSM participants, 5.8% (95% CI: 3.4-8.2) reported penile discharge, 6.6% (95% CI: 4.0-9.2) reported a sore or ulcer near the anus or penis, and 5.0% (95% CI: 3.5-6.5) reported a previous STI diagnosis; as such 11.9% (95% CI: 7.8-16.0) of MSM participants had a self-reported STI. For FSW participants pooled across the three survey cities, vaginal discharge was reported by 26.7% (95% CI: 19.0-34.5), while 9.1% (95% CI: 1.6-16.7) reported a sore or ulcer near the vagina and 11.2% (95% CI: 7.1-15.2) reported having been previously diagnosed with an STI; there were 33.6% of FSW participants with self-reported STIs (95% CI: 26.0-41.3). Among PWID participants – the majority of whom were men (94.9%) – 13.0% (95% CI: 9.6-16.3) reported an abnormal discharge from the vagina, anus or penis, 9.7% (95% CI: 6.7-12.6) reported a sore or ulcer near the vagina, penis or anus, and 14.2% (95% CI: 11.0-17.4) reported being diagnosed with an STI; self-reported STI was reported by 22.0% (95% CI: 17.0-27.0) of participants.
Correlates of STI self-report among MSM
When controlling for potential confounders in the multiple regression analysis, MSM participants who had been circumcised (aOR=1.9, 95% CI: 1.3-2.6 ; p<0.001), HIV positive (aOR= 2.0, 95% CI: 1.2-3.4; p=0.009), reported illicit drug use (aOR= 2.2, 95% CI: 1.4-3.6; p=0.001), engaged in receptive anal sex (aOR= 1.4, 95% CI: 1.0-2.0; p=0.043), and reported non-condom use with their last male partner (aOR= 1.8, 95% CI: 1.2-2.5; p=0.001) had greater odds of STI self-report, as presented in Table 3.
Correlates of STI self-report among FSW
Table 4 presents the unweighted pooled estimates of risk factors associated with self-reported STIs among FSW. In the multivariable analysis, when controlling for potential confounders, FSW participants living in Beira (aOR=2.0, 95% CI: 1.5-2.8, p<0.001), currently married (aOR= 2.0, 95% CI: 1.2-3.3, p=0.005), having employment aside from sex work (aOR= 1.5, 95% CI: 1.1-2.0, p=0.007), having experienced physical violence (aOR= 1.5, 95% CI: 1.1-2.2, p=0.023), having experienced sexual violence (aOR= 2.0, 95% CI: 1.3-2.9, p=0.001), reporting drug use (aOR= 4.0, 95% CI: 1.5-10.5, p=0.005), having access to comprehensive HIV prevention services (aOR= 1.4, 95% CI: 1.0-2.0, p=0.031), reporting non-condom use with last client (aOR= 1.4, 95% CI: 1.0-1.9; p=0.030), and having had concurrent sexual relationship with a non-client steady partner while engaging in sex work (aOR= 1.4, 95% CI: 1.1-1.9, p=0.007) had greater odds of STI self-report.
Correlates of STI self-report among PWID
There were greater odds of self-reported STI among PWID who were living in Nampula/Nacala (aOR= 4.8, 95% CI: 2.3-10.3; p<0.001), had access to HIV prevention services (aOR= 2.3, 95% CI: 1.2-4.5; p<0.011) and reported receiving drugs in exchange for money (aOR= 2.2, 95% CI: 1.0-4.7; p=0.40), as presented in Table 5.