Correlates of sexually transmitted infections among Syrian refugee women and girls in Lebanon: knowledge, symptoms, and health-seeking behaviors

Background: Syrian refugee girls and young women in Lebanon face a disproportionate risk of poor Sexual Reproductive Health (SRH) outcomes, especially Sexually Transmitted Infections (STIs). However, limited research has explored the factors associated with SRH vulnerabilities. This study aimed to quantify the associations between sociodemographic and clinical characteristics, and experiences of self-reported STI symptoms, health-seeking behaviors, and knowledge of HIV/AIDS. 

Methods: This study is part of the Self-Efficacy and Knowledge (SEEK) Trial, which aims to improve SRH and Family Planning (FP) among Syrian refugee women and girls in humanitarian settings. Baseline data (n = 485) were collected from two primary healthcare centers in the Bekaa in Lebanon, using the PAPFAM tool during November and December 2023. 

Results: Findings highlight some factors that align and others that contradict previous literature, as discussed in the manuscript. Logistic regression models showed that reporting STI symptoms was significantly associated with younger age of participants (aOR = 0.58, 95% CI=[0.25, 0.84], p-value = 0.025), financial barriers to seeking healthcare (aOR = 1.99, 95% CI = [1.07, 3.69], p-value = 0.028), and use of FP methods (aOR = 1.88, 95%CI= [1.01,3.51], p-value = 0.045). Better knowledge of HIV/AIDS was significantly associated with higher education of participants (aOR = 2.12, 95% CI = [1.08, 4.11], p-value = 0.028), higher age of spouse (aOR = 3.08, 95% CI= [1.97, 4.83], p-value < 0.001), and use of FP methods (aOR = 1.604, 95% CI=[1.01, 2.52], p-value = 0.042). Knowledge of HIV/AIDS transmission was also significantly associated with higher spouse age (aOR = 2.62, 95% CI=[1.46, 4.70], p-value = 0.001), higher education of participants (aOR = 3.99, 95% CI = [2.33, 5.64], p-value < 0.001), and use of FP methods (aOR = 3.21, 95% CI [1.63, 6.33], p-value = 0.001). 

Conclusion: This study highlights the role of key factors associated with the experience of self-reported STI symptoms, knowledge of HIV/AIDS, and health-seeking behaviors. Findings suggest that age, education, economic barriers, and use ofFP methods should be considered in targeted interventions aiming to improve SRH outcomes among this population. 

Trial registration: Clinical Trial Number NCT07008950 initial release on February 28th 2025 and last release on June 5th 2025 with the clinical trial registry at National Institute of Health (NIH) protocol registration system.