STI Knowledge in Berlin Adolescents

Young People Awareness of Sexually Transmitted Diseases and Contraception: A Portuguese Population-Based Cross-Sectional Study

Adolescents and young adults are an important target concerning reducing health-risk behavior adoption, including sexual health. Studying their knowledge concerning sexuality and their main counsellors, can be an important step in targeting an updated health promotion approach. This study characterized adolescents and young adults' knowledge and attitudes about sexually transmitted diseases (STDs), and contraception, prospecting for their main trusted counseling sources. We conducted a cross-sectional, population-based, self-report survey of 746 individuals aged between 14 and 24 years from Paredes, Portugal. The questionnaire included many dimensions, as demographic characteristics, youth behavior, currently sexually active status, main counselors concerning health topics, awareness, and knowledge about STDs and contraception. Mean age of the participants was 18.3 years, 50.5% of them had started their sexual activity. Males present themselves as more sexually active, starting earlier, and have more sexual partners than females. Participants reported an adequate knowledge perception about STDs and contraception methods, however we found different patterns on specific STDs and contraceptive methods, according to gender, age, and sexually active status. Our results help design specific interventions to reach youth, community, and healthcare providers, pointing out the value of bringing people to the center of health policies.

Knowledge attitudes and readiness of nursing students in assessing peoples' sexual health problems

BACKGROUND

Sexual health is an important part of human physical health. Sexual wellbeing is a condition of physical, emotional, mental, and social ease concerning sexuality. Therefore, all health care professionals should respect, protect, and fulfil the sexual-health needs of a person.

PURPOSE

This research aims to assess the knowledge, attitudes, and readiness of nursing students in assessing people's sexuality.

METHODOLOGY

Cross-sectional descriptive research design was used to conduct this research. A stratified random sampling technique was used to recruit 195 nursing students from BSN (semester VI & VIII), Post RN (semester II & IV). Three self-administered tools Sexually Transmitted Diseases Knowledge Questionnaire (STD-KQ), Self-Addressing Sexual-Health (SA-SH), and Self-Addressing Sexual-Health History Taking was used to collect data from the participants. Data analysis was conducted on SPSS V-23.

RESULT

Majority (111, 56.9%) of participants belong to the public sector as compared to the private. The majority of the students were female (n = 117, 60%). Most (153, 78.5%) of the participants were interested in people's sexual-health history taking; they had positive attitudes toward people's sexuality. Most (139, 71.3%) of the study participants were comfortable and ready to some extent to deal with sexual health issues. Religion, culture, and people's opposite-gender were identified barriers in assessing people's sexuality.

CONCLUSION

This study identified that nursing students had insufficient knowledge regarding STDs, but they had positive attitudes toward addressing peoples' sexual-health concerns. Students are comfortable and ready to some extent to deal with sexual problems.

Sexual and reproductive health-related knowledge, attitudes and support network of Italian adolescents

Objectives

What is the state of sexual and reproductive health (SRH) knowledge among teens? What about adolescents' attitudes toward SRH and the available supporting network?

Study design

A cross-sectional study conducted between April and May 2018.

Methods

An anonymous 36-item questionnaire on SRH knowledge, behaviors, and networks was developed, revised and validated by a multidisciplinary health professional team, then distributed to high school students in Udine (Italy).

Results

747 questionnaires were collected in five high schools; respondents were predominantly male, mean age 14.8 years; 48% of students have sufficient SRH knowledge (considered as above the mean value). Factors associated with higher knowledge levels were female sex, age, SES according to father's profession, first SRH information at age 11-13, Italy as country of origin, and attendance at a technical school.

Conclusions

Students' knowledge on SHR resulted relatively poor. Sex, school type and previous experience of sexuality education were the most important factor associated with SRH knowledge.

School-Based Interventions for Promoting Sexual and Reproductive Health of Adolescents in India: A Review

In India, the prevalent stigma and taboos regarding sexuality prevent adolescents from acquiring information about sexual and reproductive health. This review assessed the school-based interventions for adolescents designed to enhance their sexual health knowledge, attitudes, and behaviors. Studies were gathered from 4 online databases: PubMed, DOAJ, Google Scholar, and ScienceDirect. Relevant studies conducted in India among adolescents, published in peer-reviewed journals between 2000 and 2020, available in the public domain and written in English, were considered for the review. 14 studies were selected through database searches that fulfilled the eligibility criteria. Findings highlighted that school-based sexuality education positively influences adolescents to develop their knowledge, attitude, and behavior related to sexual and reproductive health outcomes. Sexual and reproductive health (SRH) programs and interventions are limited to small-scale experiments conducted in a few schools. The researchers recommend educating adolescents about pregnancy prevention, sexually transmitted infections (STIs), sexual hygiene, and reproductive health. Comprehensive reproductive health education programs should be implemented in every school setting to ensure that all school-going adolescents are convinced of the importance of sexual and reproductive health.

Kenntnisse bayerischer Schüler zu sexuell übertragbaren Infektionen: eine Querschnittsstudie

HINTERGRUND UND ZIELE

Trotz zahlreicher Informationsquellen und Kampagnen zu sexuell übertragbaren Infektionen (STI) haben diese Krankheiten in Deutschland in den letzten Jahren zugenommen. Ziel war es, das Bewusstsein und den Wissensstand junger Schüler in Bayern zu sexuell übertragbaren Krankheiten (STI) mit Schwerpunkt auf humane Papillomaviren (HPV) zu bewerten.

METHODEN

In einer vollständig irreversibel anonymisierten Querschnittsstudie wurden insgesamt 4100 bayerische Schüler im Alter zwischen 12 und 17 Jahren anhand eines Multiple-Choice-Fragebogens hierzu befragt.

ERGEBNISSE

Insgesamt wurden 3834 Fragebögen in die Datenanalyse einbezogen. Interessanterweise ist der Bekanntheitsgrad von HPV im Vergleich zu anderen STI bemerkenswert geringer. Mädchen und Jugendliche, die bereits vorbeugende Jugendgesundheitsuntersuchungen absolviert hatten, zeigten im Durchschnitt ein größeres Wissen über STI. Darüber hinaus konnten wir zeigen, dass Jugendliche mit geringerem Bildungsniveau, wie Realschüler, über die geringsten Kenntnisse verfügten.

SCHLUSSFOLGERUNGEN

Die Querschnittsstudie zeigt, dass viele junge Menschen noch unzureichend über STI informiert sind. Die Informationslücken unterstreichen die Notwendigkeit einer intensiven und langfristigen Aufklärungsarbeit.

Evaluation of the knowledge of students concerning sexually transmitted infections in Bavaria/Germany (a cross-sectional study)

BACKGROUND AND OBJECTIVES

Despite numerous information sources and campaigns on sexually transmitted infections (STIs), there has been an increase in STIs in Germany in recent years. The aim was to evaluate the awareness and knowledge level among young students in Bavaria/Germany for STIs with a focus on human papilloma viruses (HPV).

METHODS

In a cross-sectional survey rendered completely and irreversibly anonymous, a total of 4,100 students from Bavaria between the ages of 12 and 17 were interviewed using a multiple choice questionnaire about their knowledge and awareness of STI, on the basis of gender, school education and preventive youth health examinations that had taken place.

RESULTS

A total of 3,834 questionnaires were included in the data analysis. Interestingly, the awareness level for HPV is remarkably lower compared to other STIs. Girls and adolescents who had already taken preventive youth health examinations showed a higher knowledge of STIs on average. Additionally, we could show that adolescents of lower educational levels, such as secondary school students, had the least knowledge.

CONCLUSIONS

The cross-sectional study shows that many young people are still insufficiently informed about STIs. The gaps in information and lack of knowledge underline the necessity of intensive and long-term educational work.

HIV epidemic in a province of the Brazilian Amazon region: Temporal trend analysis

Background

Although considerable progress has been made over the last decades, human immunodeficiency virus (HIV) incidence and acquired immunodeficiency syndrome (AIDS) mortality rates have remarkably increased in the Brazilian Amazon region. Here, we employed temporal analysis to determine the impact of public policies on the HIV epidemic in the state of Pará, Brazil, which has the second highest HIV incidence rate in the Amazon region.

Design and methods

This is an ecological study conducted in the state of Pará, employing secondary data of HIV/AIDS cases notified to the Information System for Notifiable Diseases, 2007– 2018. The following epidemiological variables were collected: year of notification, municipality of residence, age, sex, education, exposure category, and HIV/AIDS diagnostic criteria. The study population was composed of 21,504 HIV/AIDS cases. The HIV/AIDS incidence rates were analyzed employing the temporal trend analysis (TTA) followed by the chi-square test and residue analysis to determine the association between the epidemiological variables and time series periods.

Results

A total of 50% of the notifications were composed of AIDS cases. TTA identified two periods in HIV/AIDS incidence, with stabilization of cases in the first period (G1, 2007–2012) and an upward trend in the second period (G2, 2012–2018). The most prevalent epidemiological characteristics in G2 (versus G1) were as follows: young people, brown skin color, higher schooling, and homosexuals.

Conclusions

Public policy to control HIV infection in the Brazilian Amazon region has been partially effective. HIV screening tests and treatment should be made widely available to eradicate HIV infection in the Amazon region by 2030.

Factors associated with low knowledge about sexually transmitted infections in subnormal agglomerate, in the Brazilian Amazon

BACKGROUND

Populations living in subnormal agglomerates in urban areas are more vulnerable to infections, including sexually transmitted infections (STIs). In these groups, inadequate knowledge about sexually transmitted infections can further increase the risk of contracting STIs.

AIM

We investigated the factors associated with low knowledge about STIs in a peripheral population in the Brazilian Amazon.

METHODS

This cross-sectional study was conducted in Belém, in the Amazon region that has a high percentage of subnormal agglomerates in an urban area and a high incidence of STIs. Random sampling was adopted which resulted in a sample of 320 participants. To assess knowledge about STIs, the self-administered Sexually Transmitted Disease Knowledge Questionnaire was used. To assess aspects of vulnerability, a questionnaire was constructed which is linked to individual, social, and programmatic factors. The chi-square test, G test, and ordinal regression analyses were all performed.

FINDINGS

The sample of this study was composed of 320 participants. The mean age of the participants was 46.09 years. 37.5% (120), 50.6% (162), and 11.9% (38) showed low, medium, and high knowledge, respectively. Multiple analysis revealed that the factors associated with higher chance of having smaller knowledge about sexually transmitted infections were single/separated/divorced/widow(er) marital status (AOR: 1.80, CI: 1.15-2.84, P = 0.01); income equal to or less than one minimum wage (1.98, CI: 1.21-3.17, P = 0.00); equal to or over than 52 years old (AOR: 1.99, CI: 1.25-3.17, P = 0.00); lack of guidance by a health professional (AOR: 1.59, CI: 1.01-2.51, P = 0.04). Our results show that this community suffer from suboptimal levels of knowledge on STIs, which are linked to individual, social, and programmatic factors. Characterising the risk and vulnerabilities factors allows for carrying out appropriate interventions for populations living in subnormal agglomerates in urban area.

Evidence map on serious games in preventing sexually transmitted infections among adolescents: Systematic review about outcome categories investigated in primary studies (Preprint)

Background

Sexually transmitted infections (STIs) represent a global health risk. Adolescents are at increased risk of infection for several reasons such as lack of knowledge, risky sexual behaviors, and lack of behavioral sills (eg, to negotiate safer sex). Given the fact that adolescents often use digital media and that serious games are considered to have the potential to change knowledge, attitudes and behavior, serious games represent an opportunity for the prevention of STIs.

Objective

The aim of this systematic review was to identify and systematically summarize the dimensions that have been investigated in primary studies on serious games targeting STI prevention among adolescents.

Methods

A systematic review was conducted in PubMed and Web of Science. Studies published from 2009 to 2021 were included that assessed the effectiveness of serious games on adolescent sexual health. A total of 18 studies met the inclusion criteria and were categorized according to dimensions of effectiveness and user experience.

Results

Various dimensions of effectiveness and aspects of user experience were investigated in the primary studies. In total, 9 dimensions of effectiveness were observed: sexual behavior, behavioral intentions, knowledge, attitudes and beliefs, self-efficacy and personal limitations, character traits and future orientation, environmental and individual risk factors, risk perception and risk assessment, as well as normative beliefs and (social) norms. Furthermore, several dimensions related to user experience were investigated in primary studies, that is, motivation, acceptability, trustworthiness, comprehensibility, handling and control, perceived effectiveness, as well as satisfaction.

Conclusions

This review provides an overview of serious games interventions that are vastly different in approach, content, and even platform. In previous studies, knowledge has already been comprehensively assessed, and a positive influence of serious games on knowledge about sexual topics is evident. The results clearly show that adolescents’ sexual knowledge has been increased by the serious games interventions. However, methodological and content differences in the surveys make it difficult to draw conclusions about the effectiveness related to changes in attitudes and behavior.

[How good is the knowledge about sexually transmitted infections in Germany? : Results of the first nationwide representative German health and sexuality survey (GeSiD)]

Hintergrund

Sexuell übertragbare Infektionen (STI) sind ein relevanter Risikofaktor für die sexuelle Gesundheit des Einzelnen und der Bevölkerung. Für eine zielgruppenspezifische Präventionsarbeit ist der Wissensstand zu STI in verschiedenen Bevölkerungsgruppen daher von besonderem Interesse.

Ziel

Ziel der vorliegenden Arbeit ist es, den Wissensstand zu neun STI in der deutschen Bevölkerung zu analysieren. Dafür werden Zusammenhänge mit soziodemografischen Variablen, sexualitätsbezogenen Merkmalen sowie der subjektiven Zufriedenheit mit dem Informationsstand untersucht.

Methode

Die GeSiD-Studie „Gesundheit und Sexualität in Deutschland“ erhob von 4955 Personen per Face-to-Face-Interview repräsentative quantitative Daten zum Wissensstand zu STI. Als Auswahlverfahren wurde eine zweifache Zufallsstichprobe gezogen. Dafür wurden zunächst 200 Sample Points (Gemeinden) in ganz Deutschland regional proportional ausgewählt. Anschließend wurde eine Zufallsstichprobe von Adressen über die jeweiligen Einwohnermeldeämter gezogen. Die Teilnahmequote betrug 30,2 %; das Durchschnittsalter lag bei 46,3 Jahren.

Ergebnisse

Wissen über HIV/Aids war in allen Altersgruppen weit verbreitet. Andere STI waren deutlich weniger bekannt. Besonders wenig informiert zeigten sich Ältere und Befragte mit niedrigem Bildungsstand, regionaler sozialer Benachteiligung sowie mit Migrationshintergrund. Eine höhere Anzahl von SexualpartnerInnen hing mit einem besseren Wissensstand zusammen. Gut informiert zeigten sich Personen, die sich nicht als heterosexuell beschreiben, sowie Personen, die schon einmal an einer STI erkrankt waren.

Fazit

Heterosexuelle Erwachsene in Deutschland sind unzureichend über STI informiert. Zielgruppenspezifische Anstrengungen zur Verbesserung des Wissens über STI sind nötig, um sexuelles Risikoverhalten zu vermindern und die Inanspruchnahme von Präventionsangeboten zu verbessern.

Sexually transmitted infections knowledge in different populations attending a French University Hospital - A prospective observational study

We conducted a prospective study about sexually transmitted infections (STIs) knowledge in different populations attending Lyon's University Hospitals in order to estimate awareness on STIs. Pre-exposure prophylaxis (PrEP)-users (PrEP group), persons living with HIV (PLWH group) and persons undergoing free STI screening (screening group) filled an anonymous questionnaire evaluating STI knowledge. A composite STI knowledge score was calculated and was correlated with patients’ characteristics. A total of 756 patients were enrolled in three groups: screening (n = 509), PrEP (n = 103) and PLWH (n = 144). STI transmission knowledge was better for HIV than for other STIs. The median STI knowledge score was significantly higher in PrEP-users than in the screening and PLWH groups. PrEP use and a previous STI diagnosis were independently associated with a higher score. PrEP-users have better STI knowledge than PLWH and persons undergoing free STI screening. Sexual health promotion interventions routinely reserved to PrEP-users in France seem to be effective in raising the awareness of this group for STIs. Continuous efforts are justified for PLWH and the younger layers of the population.

Interest in Sexually Transmitted Infections: Analysis of Web Search Data Terms in Eleven Large German Cities from 2015 to 2019

Incidence of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis has increased in recent years in the US and in European countries. In order to implement effective educational programs, the interests of target populations have to be identified. Since the internet is an important source of information-gathering on health issues, this study investigates web search data in large German cities related to STIs. Google Ads Keyword Planner was used to identify STI-related terms and their search volume in eleven German cities from June 2015 to May 2019. The data obtained were analyzed descriptively with regard to total search volumes, search volumes of specific thematic areas, and search volumes per 100,000 inhabitants. Overall, 741 terms with a total search volume of 5,142,560 queries were identified, with more than 70% of all search queries including a specific disease and “chlamydia” being the overall most often searched term (n = 1,196,160). Time courses of search behavior displayed a continuous interest in STIs with synchronal and national rather than regional peaks. Volumes of search queries lacked periodic patterns. Based on the findings of this study, a more open public discussion about STIs with linkage to increased media coverage and clarification of responsibilities among all STI-treating disciplines concerning management of STIs seem advisable.

Knowledge, Information Needs and Risk Perception about HIV and Sexually Transmitted Diseases after an Education Intervention on Italian High School and University Students

Sexually transmitted diseases (STDs) among adolescents and young people represent a significant public health problem that generates a pressing requirement of effective evidence-based education to promote primary and secondary prevention. The objective of the study is to evaluate how knowledge, information needs, and risk perception about HIV and STDs can change after targeted education interventions for students. A total of 436 subjects aged 15-24 attending high school (134 biomedical and 96 non-biomedical fields) and university courses (104 scientific and 102 non-scientific disciplines) were enrolled to respond to a questionnaire before and after the intervention. An improvement in knowledge was found in all groups, with statistically significant knowledge score differences between the four groups in 60% of the items. More than 94% of the students consider it useful to promote information on these issues. Receiving this information generated awareness and safety in more than 85% of high-school students and 93% of University students. Students widely perceived a great risk being infected with HIV/STDs, although pregnancy was seen as a more hazardous consequence of unprotected sex. This study shows that educational interventions are effective in improving knowledge, apart from findings about key knowledge topics, information needs, and risk perception, which provide significant insights to design future targeted education programs.

Adolescents' Perspective on Their Sexual Knowledge and the Role of School in Addressing Emotions in Sex Education: An Exploratory Analysis of Two School Types in Austria

Sex education for adolescents should include building knowledge on the emotional, social and physical aspects of sexuality. This study aimed to find out how adolescents from two different school types perceived their own knowledge on sexual matters, the importance they placed on sex education in school, and how well they felt that emotional, social and physical issues were raised within the frame of sex education. A cross-sectional 74-item questionnaire survey was conducted among adolescents (n = 198, age 13-16 years) from two secondary schools and one polytechnic school in Austria. From the linear regression analyses, secondary school students felt more knowledgeable on sexual matters than polytechnic students (beta = -0.288, p = .005). Secondary school students had more knowledge on the biology of sexuality but were less informed of the emotional aspects and other topics masturbation [mean score (SD)] [2.42(1.24) vs 3.42(1.44); p < .001], forms of sexual contact [2.81(1.08) vs 3.54(1.22), p = .006] and dealing with love and sexual feelings in relationships [2.68(1.19) vs 3.33(2.60); p = .030] than polytechnic students. While teachers were considered important providers of sex education, a more varied and practical means of learning was desired. Sex education should allow for the interplay between fact and emotion using varied teaching and learning strategies.

Sexual behaviour, STI knowledge and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence in an asymptomatic cohort in Ruhr-area, Germany: PreYoungGo study

BACKGROUND AND OBJECTIVES

STIs present a significant threat to individual and public health, disproportionately affecting youth. The study aimed to evaluate (a) the prevalence of asymptomatic Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among youth using a rapid assay platform, (b) the participants' sexual behaviour and STI knowledge, (c) the utility of the rapid assay in reducing diagnosis-to-treatment time.

METHODS

In this study, 272 subjects (14-31 years) were included between 12/2016 and 7/2018. A questionnaire was used to collect sociodemographic data, sexual behaviour and STI knowledge. Prevalence of CT and NG infections were tested from oral, vaginal and anal swabs for women and oral, anal swabs and urine for men, using the Cepheid Xpert^® CT/NG assay. Time intervals between (i) test to the time the patient were informed of the result (turn around time - TAT) and (ii) test to therapy initiation was documented.

RESULTS

Of the 272 subjects (48.9% female, 48.9% male, undisclosed 2.2%), 56.6 % reported university education. 46.6% were men who have sex with men (MSM), and 47.4% of women and 63.1% of men had anal intercourse. 59.9% had previously been tested for HIV, while only 39.7% had for CT, 20.6% for NG. Among these asymptomatic youth 7.7% were positive for CT and 5.5% for NG. The localization of CT were 3.7% genital, 5.5% anal and 2.2% oral, while the corresponding localization of NG were 0.4%, 2.9%, 4.4% respectively. 91.8% of the participants were informed of a positive result within 24 h with a median TAT of 03:09 h. 73.3% initiated therapy within 24 h, with a median time from testing to therapy initiation being 06:50 h.

CONCLUSION

Asypmtomatic CT and NG infections are common and often not tested in persons at risk. The Cepheid Xpert^® CT/NG assay is an effective strategy as it reduces STI diagnosis-to-treatment time to less than a day.

Awareness of Chlamydia trachomatis infection by people attending a sexual transmitted infection (STI) clinic and missed opportunities for screening in a primary health care setting

OBJECTIVES

To characterize awareness of Chlamydia trachomatis infection among persons consulting in a screening center in Ille-et-Vilaine, France, as well as the missed opportunities for screening in a primary health care setting during the 6 months preceding a diagnosis.

PATIENTS AND METHOD

Cross-sectional study including persons over 15 years of age consulting in the centers of Rennes and Saint-Malo between 4 April 2019 and 1 July 2019 with data collection by self-administered questionnaire and telephone interview.

RESULTS

We included 723 persons with a median age of 22 years. A third of them (34%) had never heard of Chlamydia, while 36% thought that testing sexually active youth was recommended. Among the 37 infected persons we were able to contact and interview, 9 (24.3%) had missed at least one opportunity for screening.

CONCLUSION

People's lack of awareness and failure to appropriate recent recommendations by professionals could constitute an obstacle to large-scale screening.

A Joinpoint Regression Analysis of Syphilis and Gonorrhea Incidence in 15-19-Year Old Adolescents between 2005 and 2017: A Regional Study

Background and Objectives: Surveillance of syphilis and gonorrhea in Romania is case-based and makes use of European case definitions. Adolescence is a period characterized by vulnerabilities and opportunities, a period when health decisions, including those related to sexually transmitted infections, may have a lifetime impact. The present study investigates the trends recorded in the incidence of syphilis and gonorrhea in 15-19 year-old adolescents in the central and northwestern regions of Romania. Materials and Methods: An observational study was conducted and this included surveillance data for syphilis and gonorrhea in the period 2005-2017 (n = 939). The distribution of demographic and epidemiological variables in adolescents with syphilis and gonorrhea was evaluated, as well as the tendency of the incidence of syphilis and gonorrhea in the studied population. Joinpoint regression analysis was used to characterize the incidence trend for syphilis and gonorrhea. Results: Between 2005 and 2017, 773 cases of syphilis and 166 cases of gonorrhea were reported. The incidence of syphilis and gonorrhea decreased. Most cases of syphilis have been found out by active detection. Most cases of gonorrhea have been found out by passive detection. The age distribution in the group diagnosed with syphilis was similar to that in the group diagnosed with gonorrhea. There was a higher frequency of syphilis in females and gonorrhea was more common in males. Syphilis was more common in rural areas. Gonorrhea was more common in urban areas. Conclusions: There was a decreasing tendency in the incidence of syphilis and gonorrhea in adolescents aged 15-19 during the studied period.

Predictors for Sexual Intercourse Experience among Runaway Female At-Risk Adolescents

This study attempted to provide basic data for creating a program to help promote safe sexual behavior among runaway female at-risk adolescents by identifying factors related to the sexual experiences. This study conducted a logistic regression analysis using data regarding 182 female at-risk adolescents, which were sourced from the 2016 survey of Korean adolescents’ contact with media usage and harmful environment. This study showed that adolescents’ age, smoking, and harmful environments are associated with the occurrence of sexual activity among at-risk female adolescents. One significant outcome of this study was the identification of harmful environmental factors and their impact on sexual behavior. Since smoking and sex-related problems among adolescents can act as risk factors for adult sexual health in the future, schools should institute direct and indirect channels for assessing sex-related problems among runaway female at-risk adolescents and establishing proactive and preventive measures for promoting their sexual health. In addition, a social cooperation system should be established in order to assess, and mediate within, the environments around schools in order to minimize adolescents’ exposure to harmful environments.

Age specific evaluation of sexual behavior, STI knowledge and infection among asymptomatic adolescents and young adults

OBJECTIVES

Adolescents and young adults account for 50% of new infections with sexually transmitted infection (STI), while representing only 25% of the sexually active population. An evaluation of sexual behavior, STI knowledge and infection among youth of different age groups is relevant to formulate effective sexual health strategies.

METHODS

In this monocentric, open, prospective cross-sectional study, 268 asymptomatic subjects (14-30 years) were partitioned into three cohorts I: 14-19 (n=42), II: 20-25 (n=147) and III: 25-30 (n=79) years. A comparative analysis of their sexual behavior and STI knowledge was performed using a 21-item questionnaire at the WIR-Center for Sexual Health and Medicine. Prevalence of chlamydia and gonococcal infections were tested, using the Cepheid Xpert® CT/NG assay.

RESULTS

The three age-specific cohorts showed statistically significant differences in their relationship status, their sexual contacts and the number of life-time sexual partners. Independent of age, men who have sex with men had greater number of sexual partners across all age groups. Although >95% of participants were aware of HIV in all age groups, the corresponding awareness of non-HIV STI was consistently lower in cohort I. The awareness of trichomonas, mycoplasma and candida in particular was <50% across all agedemographies. Chlamydia screening remains poor despite current chlamydia infection among cohort I, II & III being 7.1%, 5.4%, & 11.4% respectively.

CONCLUSION

Our study demonstrates a demographic divide in the knowledge on most frequent STI apart from HIV. Current education, screening and vaccination programs for STI among the younger demographic should be improved.

A Cross-Sectional Study on the Knowledge of Sexually Transmitted Diseases among Young Adults Living in Albaha, Saudi Arabia

Background: Sexually transmitted diseases (STDs) remain one of the most important health challenges in not only developing countries but also developed countries. Discussing STDs in the Saudi society is considered taboo, as social factors and ethics give rise to many obstacles. This study evaluates the knowledge of STDs among young adult students enrolled in Albaha University. Methods: This research is a cross-sectional study involving 1902 young adult students registered at Albaha University. STDs knowledge scores (STDs-KSs) were calculated using a predesigned and validated STDs knowledge questionnaire with 27 items adapted from previously developed questionnaires. Results: The estimated overall mean of STDs-KS was 7.95 ± 4.29. Female participants showed a significantly higher mean of STDs-KS, compared to males (8.51 ± 4.14 vs. 7.32 ± 4.38, p < 0.0001). Participants registered in health sciences programs showed higher STDs-KS, compared to participants from arts and sciences programs (p < 0.0001). Conclusions: Evidence from this study suggests a lack of STDs knowledge among young adults. To promote STDs awareness among this population, more health educational programs should be included in school curricula at the late stages of secondary education.

Sexual knowledge and practice of adolescent learners in a rural South African school

BACKGROUND

Premature sexual activity has become a norm in South African society, often resulting in teenage pregnancy and sexually transmitted diseases (STD). Occurrence of premature sexual activity is related to insufficient education, gender inequalities, household poverty and place of residence. The Stepping Stones project uses a 10-session programme to educate learners about relationships, HIV-prevention and teenage pregnancy. The purpose was to measure and describe learners' sexual knowledge and activities in a rural technical secondary school in North-west Province, South Africa.

METHODS

A cross-sectional survey. Questionnaires were distributed to learners in grade 8 to 12. Descriptive statistics was used in analysis.

RESULTS

Seventy-nine questionnaires were analysed. Despite a young sample, 26.6% were sexually active and 24.1% engaged in sexual activity. The mean age for first-time sexual intercourse was 15.2±2.3 years. The use of contraceptives was low (41.2%) and participants reported difficulty in talking to partners about condom use (54.8%). Almost half (45.5%) of the participants had never heard of STDs. Participants expressed a need to use social media as a sex education tool (12.3%). The primary source of information was from school-based programmes (58.0%).

CONCLUSION

Findings point to unsafe sexual practice of learners at a school in rural South Africa, even from an early age. This concern is accompanied by the occurrence of low levels of sexually-related knowledge. The learners would benefit from continued implementation of the Stepping Stones programme. Implementation could be improved by incorporating social media and emphasising gender equality and negotiation skills in sexually vulnerable situations.

Knowledge gaps of STIs in Africa; Systematic review

Sexually Transmitted Infections (STIs) are ambiguous burden of tremendous health, social and economic consequences. The current systematic review was conducted in order to determine awareness and knowledge of Africans toward sexually transmitted infections, not only concerning HIV/AIDS, but also other STIs such as gonorrhea, syphilis, HBV, HCV and HPV. A systematic review of literature was conducted, studies were retrieved and selected after fulfilling the inclusion criteria as well as passing the assessment procedure. Related data was extracted, quantitative analysis was conducted among participants who responded to questions related to HIV, HBV, HCV, HPV or STIs knowledge, sensitivity analysis as well as subgroup analysis were also conducted. Seventy four articles addressing knowledge among 35 African countries were included and 136 questions were analyzed and synthesized. The question "does using condom reduces HIV transmission?" was answered by 1,316,873 Africans in 35 countries, 66.8% [95% Cl; 62.6, 70.9] answered yes. While the question "is sexual contact a possible route of HBV transmission?" was answered by 7,490 participants in 5 countries; 42.5% [95% Cl; 20.4, 64.7] answered yes. The differences observed among populations are highlighting the possibility for improvement by directing light toward specific populations as well as addressing specific awareness knowledge to ensure that the general as well as the related specific preventive knowledge is improved.

Differences in Sexually Transmitted Infections between the Precrisis Period (2000⁻2007) and the Crisis Period (2008⁻2014) in Granada, Spain

Objective: To analyze the difference in the prevalence of sexually transmitted infections (STIs) between two time periods (2000–2007 and 2008–2014, with the latter period characterized by the economic crisis), as well as determine differences in sociodemographic factors, clinical care, and risk indicators. Methods: This was a retrospective, observational, and analytical study, reviewing 1437 medical records of subjects attending a specialized center in the province of Granada (Spain) for consultation associated with the presence or suspicion of an STI between 2000–2014. Data were collected on variables relating to the research objective. A descriptive and bivariate statistical analysis was performed by multiple logistic regression. Results: In the analysis comparing the presence of STIs between the crisis and non-crisis periods, the percentage of positive diagnoses reached 56.6% compared to 43.4% negative diagnoses during the non-crisis period, while the percentages were 75.2% and 24.8%, respectively, during the crisis period. This difference was statistically significant (p < 0.001) with an odds ratio (OR) of 2.21 after adjusting for age, sex, days since last unprotected sexual intercourse, and partners in the last year. Conclusions: There are significant differences in the prevalence of STIs between the study periods, which is consistent with the reports of some authors regarding the effect of the financial crisis on these conditions; however, it is worth considering other aspects that might explain the differences.

STI Health Disparities: A Systematic Review and Meta-Analysis of the Effectiveness of Preventive Interventions in Educational Settings

The purpose of this systematic review and meta-analysis was to address disparities related to sexual health among students by examining the effectiveness of sexually transmitted infection (STI) preventive interventions in educational settings. PubMed, Medline, Cochrane Library, Public Health Database, and EMBASE databases were used to conduct searches. Information relating to studies, programs, participants, and quantitative outcome variables were extracted. Risk of bias was assessed and meta-analysis was conducted. This systematic review included 16 articles. The outcomes were classified into behavioral and psychosocial categories. The behavioral category included sexual partners, sexual activity, condom use, STI/HIV testing, and alcohol/drug use before sex. The psychosocial category consisted of knowledge, motivational factors, and skills. Interventions had a significantly positive impact on both behavioral (OR, 1.28; 95% CI, 1.17–1.39) and psychosocial (OR, 1.92; 95% CI, 1.36–2.72) outcomes. Among the psychosocial outcomes, the interventions were most effective at promoting knowledge (OR, 3.17; 95% CI, 2.13–4.72), followed by enhancing motivational factors (OR, 1.69; 95% CI, 1.04–2.75) and increasing behavioral skills (OR, 1.43; 95% CI, 1.13–1.81). The results of this systematic review provide empirical evidence for public health professionals and policy makers regarding planning, implementation, evaluation, and modification of STI preventive intervention programs in educational settings.