Protocol for a Cross-Sectional Comparative Analysis of Condom Use and STI Prevalence Among PrEP Users and Non-Users at a Specialised STI Wellness Clinic in Eswatini

1.IntroductionSexually transmitted infections (STIs) represent a significant public health challenge globally, with the Southern Africa region experiencing particularly high rates. In Eswatini, the burden of STIs, including HIV, is alarming, necessitating effective prevention strategies. Pre-exposure prophylaxis (PrEP) has been introduced as a key intervention, yet its impact on condom use and STI prevalence remains underexplored. ObjectiveThis study aims to evaluate and compare condom use patterns and the prevalence of STIs among clients using PrEP and those who do not, among clients attending an STI Wellness Clinic in Eswatini. MethodsA prospective cross-sectional quantitative study will be conducted from February to June 2026 at the LaMvelase STI Wellness Centre. Participants will include HIV-negative individuals aged 15 and above, recruited through purposive sampling. Data will be collected via structured questionnaires and medical records, assessing condom use frequency, sexual behaviour, and STI rates. Laboratory testing will be conducted to confirm STI diagnoses. Statistical analyses will include descriptive statistics and logistic regression to identify associations between PrEP use and STI prevalence. ResultsThis protocol describes a study designed to assess the relationship between PrEP use, condom use behaviour, and STI prevalence among clients attending a specialised STI clinic in Eswatini. Findings will inform public health strategies and educational programs aimed at reducing STI rates and improving sexual health outcomes in Eswatini. ConclusionUnderstanding the dynamics between PrEP use and sexual health practices is crucial for optimising STI prevention strategies. This research will contribute valuable data to guide interventions and health policies and to design more effective intervention strategies in high STI prevalence settings, ultimately supporting efforts to mitigate the impact of STIs and HIV in Eswatini.