Sexually Transmitted Disease Education Research Articles

Knowledge, Attitude and Practice towards Sexually Transmitted Diseases among Medical and Non-medical Female Students of Academy of Professional Studies Šabac, Serbia

Purpose: The incidence of sexually transmitted disease (STDs) is being increased in the Mačva district. The aim of this study is to investigate differences in sexual behaviors, knowledge and attitudes related to STDs among female students of health and non-medical studies.Materials and Methods: In the cross-sectional study, an anonymous questionnaire was used specifically designed for the purpose of this investigation, among female students of health and non-medical studies.Results: A total of 394 students of health and non-medical studies (120 and 274, respectively). The majority (94.3%) had heard of STDs, and 76.6% knew STDs could be present without symptoms (90% students of health and 62% non-medical studies; p=0.000). Among the sexually-active students (81.5%), 36.3% reported having used a condom. Most of students (71.9%) were aware that using condoms for STDs prevention was important. One fifth of students of health study were tested for STDs, while the percentage of tested non-medical students was three times lower (p=0.000). Previous education and faculty type were strongly associated with knowledge level and attitudes among students. The primary and secondary school teachers were the main source of information for one-third of students (51.7% medical and 25.2% non-medical).Conclusion: There is a need to revise the existing STD education curriculum in both schools and universities and implement targeted educational measures.Key words: sexually transmitted diseases, attitudes, female students, health education, condom

Sexually Transmitted Diseases Among Residents in Nursing Homes: The Nurses' Perspective

Background: Examining registered nurses' perceptions of sexually transmitted disease (STD) education among residents in nursing homes allows for broader insight into why STDs continue to increase among older adults. Methods: A 4-page pilot survey was mailed to nursing home directors of nursing in Northwest Ohio (n=99) with a response rate of 32%. Directors of nursing were the target population as they are the most likely employee to hold registered nurse licensure. The health belief model formed the basis for the survey. Results: Most nurses did not see STDs or human immunodeficiency virus (HIV) as problems among their residents (100% and 96%, respectively) yet support for sex among residents was high. All (100%) agreed sex among married residents should be supported, while 77% agreed sex among nonmarried residents should be supported. Most nurses stated they were comfortable discussing HIV risk (84%), STD risk (84%), erectile dysfunction (75%), sexual desire and intimacy (72%), and correct condom use (66%). The most commonly reported perceived barriers to STD education were family opposition (63%), resident embarrassment (56%), and lack of education regarding the prevalence of STDs in older adults (53%). The most commonly reported perceived benefits to STD education were being seen as a leading facility for healthy initiatives (66%) and promotion of healthy sexual relationships among residents (56%). Conclusion: There was strong support for STD education among nurses though implementation remains rare. Addressing the most commonly perceived barriers and benefits may prove beneficial in increasing the number of LTCFs that provide STD education to residents.

Public health opportunities and challenges in the provision of partner notification services: the New England experience

BackgroundPartner notification services (PNS) are recommended by the Centers for Disease Control and Prevention as a public health intervention for addressing the spread of HIV and other sexually transmitted diseases (STDs). Barriers and facilitators to the partner notification process from a public health perspective have not been well described.MethodsIn 2015, a coalition of New England public health STD directors and investigators formed to address the increasing STD prevalence across the region (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) and to promote communication between state STD programs. To evaluate barriers and facilitators of PNS programs, a survey was administered to representatives from each state to describe PNS processes and approaches.ResultsOf the six PNS programs, Connecticut, Maine, Massachusetts, Vermont, and New Hampshire had combined HIV and STD PNS programs; Rhode Island’s programs were integrated but employed separate disease intervention specialists (DIS). All states performed PNS for HIV and syphilis. Maine, New Hampshire and Vermont performed services for all gonorrhea cases. Rhode Island, Connecticut, and Massachusetts performed limited partner notification for gonorrhea due to lack of resources. None of the six states routinely provided services for chlamydia, though Maine and Vermont did so for high-priority populations such as HIV co-infected or pregnant individuals. Across all programs, clients received risk reduction counseling and general STD education as a component of PNS, in addition to referrals for HIV/STD care at locations ranging from Planned Parenthood to community- or hospital-based clinics. Notable barriers to successful partner notification across all states included anonymous partners and index cases who did not feel comfortable sharing partners’ names with DIS. Other common barriers included insufficient staff, inability of DIS to identify and contact partners, and index cases declining to speak with DIS staff.ConclusionsIn New England, state health departments use different strategies to implement PNS programs and referral to STD care. Despite this, similar challenges exist across settings, including difficulty with anonymous partners and limited state resources.

Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study.

This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present without symptoms. HIV remains the best known STD (83.6%) by the students, while chlamydia (26%) and trichomoniasis (21.0%) were rarely known. Gender, age group, educational level and faculty type were strongly associated with knowledge level (p-values < 0.05). Most of them (88.8%) were aware that STD screening was important while use of condoms was protective (63.8%). The majority of them strongly felt that treatment should be sought immediately if they (85.5%) and their partners (87.4%) have symptoms. Among the sexually-active students, 66.7% and 18% had sexual intercourse with multiple partners and commercial sex workers, while 17.4% and 9.4% took alcohol and drugs before having sex, respectively. By logistic regression analysis, students aged 24–30 years old (an odds ratio (AOR) = 0.57, 95% confidence interval (CI) = 0.377–0.859) and faculty type (AOR = 5.69, 95% CI = 4.019–8.057) were the significant predictors for the knowledge level. Knowledge on the non-HIV causes of STDs is still lacking, and the risky behavior practiced by the sexually-active students in this study is alarming. There is a need to revisit the existing STD education curriculum in both schools and universities so that appropriate intervention on STDs can be implemented.

Influence of professional preparation and class structure on HIV, STD, and pregnancy prevention education

Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted. Setting: Data were obtained from the health education classroom level questionnaire of the 2006 SHPPS. Methods: A series of multivariable logistic regression models ( N = 34) were computed to determine if instruction of HIV/STD and/or pregnancy prevention content was dependent on professional preparation and/or class structure. Results: Professionally prepared health educators were found to be significantly more likely than their counterparts to teach about teenage age pregnancy risks, teenage pregnancy impacts, finding information/services related to pregnancy, finding information/services related to HIV, and HIV diagnosis/treatment. These topics and three others (methods of contraception, signs/symptoms of HIV and compassion for persons with HIV/AIDS) were significantly more likely to be taught in health-only classes versus combination classes. Conclusion: Findings from the current study support the need for professionally prepared educators and stand-alone class structure in terms of providing the most effective sexual health education.

Apprentices’ Knowledges and Attitudes about Sexually Transmitted Disease

The aim of this study is to determine the knowledge and attitudes of apprentices about sexually transmitted diseases (STDs). Apprentices are the students who are not able to continue their formal education after primary education in Turkey. This descriptive and cross sectional study was conducted at the “Apprenticeship Training School” in Antalya during February 2007. 1,186 of the 1,500 apprentice students, who were registered at the Apprenticeship Training School, agreed to participate in the study. Participants completed a questionnaire in the classroom which was aimed at determining the level of their knowledge and attitudes about STDs. Percentages and chi square analysis were used in data analysis. 60.9% of the participants recognized at least one of the STDs’ names. The most familiar STD was AIDS (67.4%). 83.6% of the participants did not know about the symptoms of STDs. Only 23.4% of participants reported at least one of the possible contraction of STDs of the STDs and 28.1% indicated that they had knowledge about the protection methods against STDs. 51.4% of the apprentices’ believed that healthy looking persons could also be infectious and most of the STDs were curable (47.6%). Age, gender, the field of apprenticeship and being educated about STDs emerged as the important demographic characteristics on being acquainted with the symptoms, as well as transmission of and protection from the STDs. Results show that STDs’ names and the contraction of and protection from the STDs were known better by the male participants, participants from the field of the personal hygiene education and apprentices whom had prior education about STDs. Results emphasize the need to strengthen the apprentices’ STD education on all aspects, including their attitudes and safe sexual practices.

Sexually Transmitted Diseases among American Indians in Arizona: An Important Public Health Disparity

We conducted an analysis of rates, geographic distribution, and time to treatment of chlamydia, gonorrhea, and early syphilis (ES) among Arizona American Indians (AIs) to address racial disparities affecting this group. We used the Arizona Department of Health Services' sexually transmitted disease (STD) surveillance database to identify STD cases and calculate rates among AIs in Arizona from 2003 to 2007. We mapped AI ES cases reported during that time frame by reported resident ZIP code, calculated days elapsed from specimen collection to initial treatment, and compared rates and time to treatment for AIs with those of non-Hispanic white (NHW) individuals. Annual Arizona AI STD rates for chlamydia, gonorrhea, and ES from 2003 to 2007 ranged from 2.7 to 7.8 times those of NHW people. During the same time period, the annual rates for all three STDs among adolescents aged 15 to 19 years were also higher among AIs and ranged from 2.0 to 14.8 times those of NHW individuals. The majority of cases for ES reported ZIP codes located in the northeastern and southern central portions of the state. The median time to treatment in AI populations was significantly longer than in NHW populations for chlamydia and gonorrhea, but not for ES. High rates of STDs have been identified among AIs in certain regions of Arizona. Additionally, there are significant delays in treatment for gonorrhea and chlamydia. STD prevention and education programs that prioritize this health disparity and promote expeditious screening, diagnosis, and treatment are needed.

Providing Sexually Transmitted Disease Education and Risk Assessment to Disengaged Young Men Through Community Outreach

This study describes a community outreach project designed to increase access to reproductive health services to young African American men living in low-income urban neighborhoods. The project examined the effectiveness of providing community-based outreach and health education on increasing sexually transmitted disease (STD) screening. Outreach workers provided STD education and risk assessment in community settings, including street corners, parks, schools, and community centers. Data were recorded on outreach contacts, including client demographics, health education topics covered, and risk assessment results. Outreach workers conducted 9,701 contacts in a 176-week period. Most contacts (89%) were with African Americans, and most (84%) were with young men between 15 and 20 years old. Outreach workers discussed each health education item in their protocol at least 85% of the time and each risk assessment item at least 90% of the time. The majority of contacts (94%) reported being sexually active. Compared with the year prior to the project, actual STD testing of the target population doubled at the project clinics. This study suggests that going beyond traditional clinic-based testing to reach young, disenfranchised males constitutes a promising approach to reducing racial disparities in STD infections.

Knowledge of sexually transmitted diseases among secondary school students in Dar es Salaam, Tanzania.

In Tanzania, it is considered a taboo for teachers and parents to talk with children about sexual matters including sexually transmitted diseases (STDs) in schools and at home because of cultural and religious barriers. Political pressure also keeps sexual education and thus education on STDs out of classrooms. Generally, there is disagreement over STDs education on what to teach, by whom, and to what extent. To assess the knowledge of STDs, and attitude towards sexual behavior and STDs among secondary school students. This was a cross-sectional study using a semi-structured questionnaire. A sample size of 635 students was determined by simple random sampling. Majority of the students (98%) said have heard about STDs; however their knowledge of the symptoms associated with STDs was poor. Similarly 147 (23%) students did not know other means of STDs transmission rather than sexual intercourse. A number of students who were capable of identifying all tracer STDs was comparable between the ordinary (10.5%) and advanced (10.6%) level students (p < 0.001). Thirty-two students (8%) were completely unable to identify even a single tracer STD. About 96% respondents said were capable of preventing themselves from contracting STDs, however 38% of them admitted that they were at risk of contracting STDs. Majority (99%) described more than one source of information on STDs, television and radio were the most commonly mentioned sources, whilst none of them cited parents as source of information (p < 0.001). Regarding vulnerability to STDs, 503 (79%) students said female students were more vulnerable to STDs compared to males. The level of knowledge about STDs (ability to identify tracer STDs, to describe symptoms associated with STDs and their mode of transmission) is poor with regard to the students' levels of education. Female students are more vulnerable to STDs compared to male counterparts. Mass media is still the more effective means of educating the students on STDs.

Using biology to teach adolescents about STD transmission and self-protective behaviors

The effects of a prevention program designed to teach 7th grade students about the different risk behaviors associated with human immunodeficiency virus (HIV), chlamydia, and gonorrhea transmission were examined. Over 3 days, the students were taught how to reason about self-protective behaviors using information about the biological causal mechanisms of these sexually transmitted diseases (STDs). Results revealed that these students displayed more biology knowledge and greater certainty in their responses to open-ended risk behavior questions than did a control group of students who learned the same information from a standard rote approach in the same amount of time. Importantly, increased biological reasoning was linked to better performance at identifying risk behaviors for less well-known STDs. The findings support the premise that a biological approach to STD education minimizes the cognitive burden related to memorizing a list of seemingly unconnected facts. Biologically based health instruction can be an effective tool for teaching adolescents about various STDs beyond HIV infection.

Chlamydia screening of youth and young adults in non-clinical settings throughout California.

Urine-based chlamydia tests enable screening in non-clinical settings. The goal of this study was to determine the prevalence of chlamydia infection among high-risk youth and young adults in non-clinical settings. County sexually transmitted disease (STD) programs implemented chlamydia screening projects in non-clinical settings using nucleic acid amplification tests. Demographic and access to care data were collected. Overall, 16,279 female and male youth were screened for chlamydia in 24 counties throughout California. The 158 screening venues included 32 educational, 32 correctional, and 94 community-based settings. Chlamydia infection rates varied significantly by gender, age, and venue type. Among females, the highest prevalence was found in jail settings (14.6%), juvenile detention (13.0%), and alternative schools (10.0%). Among males, the highest prevalence was found in jail (7.9%) and juvenile detention (5.8%). Venue types that serve populations with poor access to care and high rates of infection were identified. Screening projects in non-clinical settings identify high-risk youth in need of STD care, improve access to STD screening and education, and foster local collaborations.

Who knows more about sexually transmitted diseases (STDs)? parents or adolescents?

Previous research at our institution on adolescent STD knowledge found that adolescents lacked basic knowledge about STDs. They were unable to name the 8 major STDs and provide information on STD curability. The teens in our study received much of their STD education from their parents. There is little documented, however, on the level of parental STD knowledge. Using the same STD knowledge assessment used in the adolescent study, we sought to evaluate basic STD knowledge in a convenience sample of parents and compare their knowledge to that of our adolescents previously studied.

Syphilis in Atlanta during an era of declining incidence.

Syphilis transmission in Atlanta is ongoing despite declining incidence. To identify risk factors and missed opportunities for prevention. A case-control study design was used. Twenty-five sexually transmitted disease (STD) clinic patients with primary or secondary syphilis by polymerase chain reaction and serology and 49 matched controls were interviewed. Persons with syphilis more frequently had HIV infection (24% versus 2%; P = 0.005), crack-using sex partners (52% versus 18%; odds ratio [OR] = 5.1; 95% CI = 1.7-15.5), and a history of incarceration (80% versus 57%; OR = 3.0; CI = 1.0-9.3). Many cases (48%) and controls (31%) had received drug-abuse treatment. Only 40% of previously incarcerated patients and 74% of those with a history of drug treatment reported receiving STD/HIV education in those settings. Among all patients reporting recent HIV education, 41% were told about STD recognition and treatment. Unprotected sex and delay in seeking care were common. To prevent syphilis and associated HIV, more extensive STD education is needed in jails and drug-treatment centers.

Attitudinal and behavioral correlates of condom use in urban adolescent males

To determine correlates of condom use in adolescent males, we administered a sexual behavior questionnaire to 105 urban males attending a general adolescent clinic. The mean age was 16.5 ± 1.6 years, and all reported heterosexual activity during the prior 3 months. Condom use was significantly ( p < 0.05) associated with perceived hassle of use (Spearman's ϱ = − 0.40), perception of girlfriend's attitude toward condoms (ϱ = − 0.36), self-confidence in correct use (ϱ = 0.26), younger age (ϱ = 0.25), reported degree of exposure to sexually transmitted disease (STD) education (ϱ = 0.23), perceived condom safety (ϱ = 0.23), and perceived risk of STD if not wearing a condom (ϱ = 0.21). Using stepwise multiple regression, four variables explained a significant amount of variation in condom use: perceived hassle of use, perceived girlfriend's attitude toward condom use, age, and self-confidence in correct use (adjusted R 2 = 0.28, p < 0.001). Intention to use free condoms was significantly ( p < 0.05) associated with past use (ϱ = 0.63), girlfriend's attitude toward use (ϱ = − 0.46), self-confidence in correct use (ϱ = 0.36), perceived hassle (ϱ = − 0.31), and degree of exposure to STD education (ϱ = 0.25). Three variables in a regression model explained a significant amount of variation in intent to use free condoms: selfreported past use, girlfriend's attitude, and self-confidence in correct use (adjusted R 2 = 0.51, p < 0.001).