Abstract
BackgroundAdolescents are a risk group for acquiring sexually transmitted infections (STIs). In the Netherlands, senior vocational school students are particular at risk. However, STI test rates among adolescents are low and interventions that promote testing are scarce. To enhance voluntary STI testing, an intervention was designed and evaluated in senior vocational schools. The intervention combined classroom health education with sexual health services at the school site. The purpose of this study was to assess the combined and single effects on STI testing of health education and school-based sexual health services.MethodsIn a cluster-randomized study the intervention was evaluated in 24 schools, using three experimental conditions: 1) health education, 2) sexual health services; 3) both components; and a control group. STI testing was assessed by self reported behavior and registrations at regional sexual health services. Follow-up measurements were performed at 1, 3, and 6-9 months. Of 1302 students present at baseline, 739 (57%) completed at least 1 follow-up measurement, of these students 472 (64%) were sexually experienced, and considered to be susceptible for the intervention. Multi-level analyses were conducted. To perform analyses according to the principle of intention-to-treat, missing observations at follow-up on the outcome measure were imputed with multiple imputation techniques. Results were compared with the complete cases analysis.ResultsSexually experienced students that received the combined intervention of health education and sexual health services reported more STI testing (29%) than students in the control group (4%) (OR = 4.3, p < 0.05). Test rates in the group that received education or sexual health services only were 5.7% and 19.9%, not reaching statistical significance in multilevel analyses. Female students were more often tested then male students: 21.5% versus 5.4%. The STI-prevalence in the study group was low with 1.4%.ConclusionsDespite a low dose of intervention that was received by the students and a high attrition, we were able to show an intervention effect among sexually experienced students on STI testing. This study confirmed our hypothesis that offering health education to vocational students in combination with sexual health services at school sites is more effective in enhancing STI testing than offering services or education only.
Highlights
Adolescents are a risk group for acquiring sexually transmitted infections (STIs)
Additional first line service is offered by specialized STI-centers, who provide free and anonymous STI care to high risk groups who do not want to visit their general practitioner for sexual health services, for example young people until 25 years [6]
A Chlamydia positivity level of 24.5% was reported in a selective sample of vocational schools in our Municipal Public Health Service (MPHS) “Rotterdam-Rijnmond” in 2005 [8], with a similar rate in a repeated study at the same school in the subsequent year
Summary
Adolescents are a risk group for acquiring sexually transmitted infections (STIs). In the Netherlands, senior vocational school students are particular at risk. The purpose of this study was to assess the combined and single effects on STI testing of health education and school-based sexual health services. Effective prevention of STIs relies on condom use and on early case detection and treatment [3]; test rates among young heterosexual people are low. Additional first line service is offered by specialized STI-centers, who provide free and anonymous STI care to high risk groups who do not want to visit their general practitioner for sexual health services, for example young people until 25 years [6]. A Chlamydia positivity level of 24.5% was reported in a selective sample of vocational schools in our Municipal Public Health Service (MPHS) “Rotterdam-Rijnmond” in 2005 [8], with a similar rate in a repeated study at the same school in the subsequent year (unpublished data)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
