Curable sexually transmitted infections (STIs) increase HIV transmission risk and cause morbidity for women. STI testing in community-based venues may address barriers to diagnosis and treatment in South Africa.
Women accessing HIV pre-exposure prophylaxis or hormonal contraception in hair salons in urban South Africa within an ongoing study are offered STI testing by self-collected vaginal swab (gonorrhea, chlamydia, trichomoniasis) and fingerstick blood (syphilis). Treatment is offered at the hair salon or local clinic.
Of 73 eligible women (median age 26y), 71 (97%) accepted STI testing; three (4%) provided blood specimens only. Twenty-three (32%) reported a history of STI and 20 (27%) perceived a ‘moderate’ or ‘great’ chance of acquiring an STI in the next year. Thirty-two of 65 (49%) were in an age-disparate relationship; 33/50 (66%) never used condoms in the preceding month. Among 64 participants with all results available, 19 (30%) had at least one STI. The majority with an STI (15/19, 79%) were asymptomatic. Sixteen (84%) elected treatment in the salon.
STI testing in hair salons in urban South Africa, integrated with HIV prevention and contraceptive services, is acceptable, reaches women with risk factors for STIs and HIV, and reveals high STI prevalence.