Knowledge, attitude and preventive practices of sexually transmitted infections among unmarried youths in an urban community in Lagos State, Nigeria

Development of a scale for attitude toward sexually transmitted infections based on the Health Belief Model

OBJECTIVES

Determination of the attitudes of individuals toward sexually transmitted infections (STIs) can also help identify barriers to health service-seeking behavior. Hence, this study aimed to develop a scale for determining the attitudes of individuals toward sexually transmitted diseases.

STUDY DESIGN

This was a methodological study. The Health Belief Model (HBM) framework was used to elucidate the perceptions and interpretations of illnesses among individuals. After reviewing the relevant literature, an item pool was created to include 4 dimensions (perceived susceptibility (A), perceived severity (B), perceived benefit (C), and perceived barriers and self-efficacy (D)) about sexually transmitted diseases from the perspective of HBM. Exploratory factor analysis was conducted to evaluate the construct validity of the scale. Moreover, confirmatory factor analysis was used to examine the suitability of the items in terms of factor structures.

RESULTS

The final version of the scale comprised 19 items and 4 subdimensions. The first subdimension of the scale accounted for 20.11% of the total variance, whereas the second, third, and fourth subdimensions accounted for 17.83%, 12.50%, and 8.75% of the total variance, respectively. Collectively, these four subdimensions accounted for 59.19% of the total variance. The Cronbach's alpha reliability coefficient of the scale was found to be 0.74.

CONCLUSIONS

Briefly, the present study led to the development of a novel assessment tool, Attitude Toward Sexually Transmitted Infections Scale. Higher scores on the scale indicated higher likelihood of taking action for a possible STI treatment according to the HBM approach.

Sexually transmitted diseases knowledge assessment and associated factors among university students in the United Arab Emirates: a cross-sectional study

Background

Sexually transmitted diseases and infections (STDIs) remain a serious public health menace with over 350 million cases each year. Poor knowledge of STDIs has been identified as one of the bottlenecks in their control and prevention. Hence, assessment of knowledge, both general and domain-specific, is key to the prevention and control of these diseases. This study assessed the knowledge of STDIs and identified factors associated with STDI knowledge among university students in the United Arab Emirates (UAE).

Methods

This is a cross-sectional study among 778 UAE University students across all colleges. An online data collection tool was used to collect data regarding the participants' demographics and their level of knowledge of STDIs across different domains including general STDI pathogens knowledge (8 items), signs and symptoms (9 items), mode of transmission (5 items), and prevention (5 items). Knowledge was presented both as absolute and percentage scores. Differences in STDI knowledge were statistically assessed using Mann-Whitney U and Chi-squared tests. Logistic regression models were further used to identify factors associated with STDI knowledge.

Results

A total of 778 students participated in the study with a median age of 21 years (IQR = 19, 23). The overall median STDI knowledge score of the participants was 7 (out of 27), with some differences within STDI domains-signs & symptoms (1 out of 9), modes of transmission (2 out of 5), general STDI pathogens (2 out of 8), and prevention (1 out of 5). Higher STDI knowledge was significantly associated with being non-Emirati (OR = 1.85, 95% CI = 1.24-2.75), being married (OR = 2.89, 95% CI = 1.50-5.56), residing in emirates other than Abu Dhabi (OR = 1.61, 95% CI = 1.16-2.25), and being a student of health sciences (OR = 4.45, 95% CI = 3.07-6.45).

Conclusion

In general, STDI knowledge was low among the students. Having good knowledge of STDIs is essential for their prevention and control. Therefore, there is a need for informed interventions to address the knowledge gap among students, youths, and the general population at large.

Adolescents' Perceptions of Sexuality: A Qualitative Study

Adolescents have a greater risk of acquiring sexually transmitted infections (STIs), which is a serious public health problem. Education is an effective strategy to improve adolescent sexual health outcomes. However, Spanish adolescents have a lack of sex education. The aim of this study was to explore the perceptions and opinions of a sample of adolescents regarding sexually transmitted infections (STIs). Photovoice is a research method that uses the search for images of everyday events with the intention of bringing about social change. An exploratory, descriptive design was used with a qualitative approach based on the Photovoice methodology. The sample consisted of 26 high school and baccalaureate students of Almería (Spain) selected through a convenience sample. The age of the participants ranged from 14 to 17 years, with a mean age of 15.31 years. Two main categories were extracted from the data analysis: 'Towards a culture of preventing STIs and promoting healthy sexual practices' and 'Adolescents' needs from their perspective'. In conclusion, numerous changes take place at the biopsychosocial level during adolescence that imply a need to explore their sexuality in depth. A lack of knowledge and a carefree attitude during sexual initiation can increase the risk of developing STIs. The study's adolescents stated that they do not have adequate sex education to acquire sufficient knowledge about sexuality and sexual health, and therefore, request that the traditional format be modified in order to achieve better results.

Sexually transmitted infection knowledge among men who have sex with men in Nairobi, Kenya

BACKGROUND

High rates of sexually transmitted infections (STIs) among men who have sex with men (MSM) have been reported, but there is little research on their STI knowledge. Our study sought to determine participants' characteristics that contribute to either high or low STI knowledge among MSM in Nairobi, Kenya.

METHODS

We mobilized MSM aged ≥18 years from Nairobi into a cross-sectional study. To determine their understanding of STIs, a pre-tested structured questionnaire was administered. Knowledge score was generated by summing up the number of responses answered correctly by a participant. We dichotomized scores as "low" and "high", by splitting the group at <12 and ≥12 which was the mean.

RESULTS

A total of 404 participants were interviewed between March and August 2020. The mean age was 25.2 (SD = 6.4) years. Majority were single (80.4%) and Christians (84.2%). All participants had some formal education ranging from primary to tertiary; the majority (92.3%) had secondary education or more. Most (64.0%) were employed and their monthly income ranged from <50->150 USD. Almost all (98.5%) were Kenyans. Of the 404 (90.6%) self-identified as male and (47.5%) reported to be exclusively top partners. Many (39.9%) reported being versatile, while those reporting to be bottom partners were, (12.6%). The last 12 months, (55.4%) of the participants reported having sex with men only and (88.6%) reported to have had multiple sexual partners. Participants scored an average of 12.2, SD 4.5. Multivariable backward elimination logistic regression revealed that participants who had tertiary education (aOR = 0.50, 95% CI 0.32-0.77), a higher income (aOR = 0.40, 95% CI 0.22-0.75) and were engaging in vaginal sex (aOR = 1.86, 95% CI 1.25-2.78) predicted significantly higher odds of high knowledge in the final multivariable model.

CONCLUSION

Participant's knowledge level regarding STIs was low. We recommend health care workers to continue educating patients about STIs.

Knowledge, attitudes, and practices of Lebanese university students related to sexually transmitted diseases: a cross-sectional study

AIM

To appraise Lebanese university students' knowledge, attitudes, and practices related to sexually transmitted diseases (STDs).

METHODS

This cross-sectional study was conducted in March and April 2020. A total of 402 students (67.9% women) from ten universities located in different Lebanese regions were recruited through convenient sampling.

RESULTS

Pursuing a major in non-health sciences compared with a major in health sciences (adjusted odds ratio [aOR]=0.08) was significantly associated with lower odds of having better knowledge of STDs. Older age (aOR=1.09) was significantly associated with higher odds of having better knowledge of STDs. Having good vs poor knowledge (aOR=3.88) was significantly associated with higher odds of having favorable attitudes toward STDs, whereas pursuing a major in non-health sciences compared with a major in health sciences (aOR=0.28) was significantly associated with lower odds of having favorable attitudes toward STDs. Women compared with men (aOR=2.21) had higher odds of having healthier practices related to STDs. Attitude did not mediate the association between knowledge and practice.

CONCLUSION

Attitude did not significantly mediate the association between knowledge and practice. Therefore, educational programs and awareness campaigns should be implemented in secondary schools and among vulnerable non-medical students. Such efforts can help students identify the symptoms of STDs, seek medical attention, and make informed decisions to protect themselves.

Enhancing HIV Self-Testing Among Nigerian Youth: Feasibility and Preliminary Efficacy of the 4 Youth by Youth Study Using Crowdsourced Youth-Led Strategies

Although HIV self-testing (HIVST) has expanded in many regions, a few HIVST services have been tailored for and organized by youth. Innovative HIVST models are needed to differentiate testing services and generate local demand for HIVST among youth. The current pilot study aimed at examining the feasibility and efficacy of crowdsourced youth-led strategies to enhance HIVST as well as sexually transmitted infection (STI) testing. Teams of youth iteratively developed HIVST interventions using crowdsourcing approaches and apprenticeship training. Five interventions were selected and then evaluated among youth (ages 14-24) from September 2019 to March 2020. Given the similar outcomes and approaches, we present cumulative data from the completed interventions. We assessed HIVST uptake (self-report), STI uptake (facility reports for gonorrhea, syphilis, hepatitis B, and chlamydia testing), and quality of youth participation. Mixed-effect logistic regression models estimated intervention effects at baseline and 6 months. Of the 388 youths enrolled, 25.3% were aged 14-19, 58.0% were male, and 54.1% had completed secondary education. We observed a significant increase in HIVST from 3 months compared with 6 months (20% vs. 90%; p < 0.001). Among those who received an HIVST at 3 months, 324 out of 388 were re-tested at 6 months. We also observed significant increases in testing for all four STIs: syphilis (5-48%), gonorrhea (5-43%), chlamydia (1-45%), and hepatitis B testing (14-55%) from baseline to the 6-month follow-up. Youth participation in the intervention was robust. Youth-led HIVST intervention approaches were feasible and resulted in increased HIV/STI test uptake. Further research on the effectiveness of these HIVST services is needed.