A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities
Abstract
:1. Background
Aim
2. Methods
2.1. Study Design and Questionnaire
2.2. Knowledge on STI
- Sexually transmittable;
- Non sexually transmittable; or
- Whether (s)he did not know.
2.3. Knowledge on Prevention of STI
- Correct answers, where, “sexual abstinence” and “condom” (simultaneously) were indicated, even if additional options were ticked.
- Wrong answer: any other combination.
2.4. STI History
- I asked a friend for advice;
- I referred to a consultant gynecologist;
- I tried to solve it on my own;
- I went to my general practitioner (GP);
- I went to accident and emergency (A&E);
- I discussed the issue with a family member;
- I discussed the issue with my partner.
2.5. Statistical Analysis
2.6. Ethical Considerations
3. Results
3.1. Descriptive Analysis
3.2. Outcome Analysis
4. Discussion
4.1. Key Findings
- The overall knowledge of STIs among sample students was low (Table 2);
- Students with histories of STIs referred mostly to their GPs (38.1%), followed by a consultant gynecologist (13.1%), a family member (15.1%), or an experienced friend (12.5%), whereas discussing the problem with their partner was reported only by 13.1% freshmen (Table 4);
- Only 28% of the students knew the most effective prophylactic device to prevent a STI (i.e., sexual abstinence and condom); the percentage being slightly higher for females (31.3%) than males (25.8%) (Table 5);
- Significantly lower levels of STI knowledge were found among males, students at the University of Palermo, those who completed a vocational secondary school education, and non-Italian nationals (Table 6);
- Categories of individuals significantly less knowledgeable on the most effective options in preventing STI included males, students at the university of Palermo, students in educational sciences, students in economics/political sciences, those of foreign nationality, those with two siblings, and those whose fathers had lower educational levels (Table 6);
- The risk of contracting a STI was found to be lower in males, in students with fathers aged < 50 years and in students not in a stable relationship; by contrast it increased with higher knowledge of STIs (Table 7).
4.2. Comparison of Findings with the Relevant Literature
4.2.1. STIs Knowledge
4.2.2. STI Prevention Knowledge
4.2.3. STI History
4.3. Sexual Health Education
4.4. Sexual Health Clinics
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
A&E | Accident and Emergency Service |
EU | European Union |
GP | general practitioner |
HIV | human immunodeficiency virus |
HAV | hepatitis A virus |
HBV | hepatitis B virus |
HCV | hepatitis C virus |
HPV | human papilloma virus |
IUD | intra-uterine device |
SHE | sexual health education |
SHK | sexual health knowledge |
STI | sexually transmitted infection |
WHO | World Health Organization |
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Variables | Classes | Number (%) |
---|---|---|
Sex (Missing: 8) | Female | 3194 (70.3) |
Male | 1350 (29.7) | |
Age (years) (Missing: 24) | Mean | 21.4 ± 2.2 |
<21 | 2125 (46.9) | |
21–24 | 1956 (43.2) | |
25+ | 447 (9.9) | |
Nationality | Italian | 4405 (96.8) |
Non-Italian | 147 (3.2) | |
Undergraduate course of study | Educational sciences | 1591 (35.0) |
Literature/foreign language | 516 (11.3) | |
Biology/medicine/chemistry/natural sciences | 817 (18.0) | |
Engineering/architecture | 971 (21.3) | |
Political sciences/economics | 657 (14.4) | |
Previous education (Missing: 84) | Scientific/classic/university degree | 2659 (59.5) |
Language/socio-pedagogical/artistic | 612 (13.7) | |
Vocational (technical) | 1197 (26.8) | |
Residence (Missing: 29) | City center | 951 (21.0) |
City Outskirt | 838 (18.5) | |
Town > 15,000 inhabitants | 768 (17.0) | |
Town < 15,000 inhabitants | 1966 (43.5) | |
Father’s age (years) (Missing: 587) | <50 | 795 (20.1) |
50–54 | 1384 (34.9) | |
55–59 | 1090 (27.5) | |
60+ | 696 (17.6) | |
Mother’s age (years) (Missing: 552) | <45 | 386 (9.7) |
45–49 | 1294 (32.4) | |
50–54 | 1345 (33.6) | |
55+ | 975 (24.4) | |
Mother’s nationality (Missing: 251) | Italian | 4158 (96.7) |
Non-Italian | 143 (3.3) | |
Father’s nationality (Missing: 273) | Italian | 4163 (97.3) |
Non-Italian | 116 (2.7) | |
Father’s education (Missing: 148) | University/more | 791 (18.0) |
Secondary | 2097 (47.6) | |
Lower | 1516 (34.4) | |
Mother’s education (Missing: 104) | University/more | 711 (16.0) |
Secondary | 2200 (49.5) | |
Lower | 1537 (34.6) | |
Father’s Occupation (Missing: 361) | Manager/professionals | 828 (19.8) |
Technical employees | 2077 (49.6) | |
Generic employees | 657 (15.7) | |
Other | 629 (15.0) | |
Mother’s occupation (Missing: 306) | Manager/professionals | 747 (17.6) |
Technical employees | 1455 (34.3) | |
Generic employees | 1837 (43.3) | |
Other | 207 (4.9) | |
Type of family (Missing: 17) | Nuclear | 3796 (83.7) |
Other | 739 (16.3) | |
Number of siblings | 0 | 846 (18.6) |
1 | 2429 (53.4) | |
2 | 999 (22.0) | |
3+ | 278 (6.1) | |
Older sibling of same sex (Missing: 4) | Singleton | 846 (18.6) |
Female with at least on older sister | 309 (6.8) | |
Male with at least on older brother | 812 (17.8) | |
Other | 2581 (56.8) | |
Current relationship? (Missing: 37) | Yes | 2710 (60.0) |
No | 1805 (40.0) | |
Have you ever contracted a sexually transmitted disease? (Missing: 134) | No | 4055 (91.8) |
Do not Know | 137 (3.1) | |
Yes | 226 (5.1) | |
Are you in love with your partner? (Missing: 42) | Yes | 2378 (89.1) |
No | 64 (2.4) | |
Do not Know | 226 (8.5) | |
Duration of the current relationship (months) (Missing: 29) | <3 | 199 (7.4) |
3–6 | 218 (8.1) | |
7–12 | 312 (11.6) | |
13–24 | 558 (20.8) | |
24+ | 1394 (52.0) | |
Place where you first met your partner (Missing: 1) | School | 557 (10.6) |
Club | 555 (20.5) | |
Gym | 87 (3.2) | |
Friend’s place | 664 (24.5) | |
Internet | 162 (6.0) | |
Charity | 113 (4.2) | |
Other | 571 (21.1) |
Diseases | Answers | ||
---|---|---|---|
Yes | No | DK | |
Warts | 575 (15.0) | 309 (8.1) | 2943 (76.9) |
Streptococcus | 747 (19.6) | 870 (22.8) | 2199 (57.6) |
Lymphogranuloma venereum | 1247 (32.1) | 444 (11.4) | 2194 (56.5) |
Hepatitis A | 733 (19.1) | 1051 (27.4) | 2050 (53.5) |
Gonorrhea | 1737 (44.9) | 339 (8.8) | 1793 (46.3) |
Hepatitis B | 1260 (31.5) | 955 (25.1) | 1650 (43.4) |
HPV | 1954 (50.5) | 337 (8.7) | 1578 (40.8) |
TB | 327 (8.5) | 2018 (52.2) | 1524 (40.0) |
Hepatitis C | 1629 (42.2) | 862 (22.4) | 1366 (35.4) |
Candida | 2258 (58.0) | 277 (7.0) | 1385 (35.0) |
Mononucleosis | 1139 (29.3) | 1791 (46.2) | 948 (24.5) |
Syphilis | 3195 (80.0) | 147 (3.7) | 62 (16.3) |
Genital Herpes | 3369 (84.0) | 157 (3.9) | 491 (12.2) |
HIV | 4056 (97.2) | 48 (1.2) | 68 (1.6) |
Negative control: psoriasis | 305 (7.9) | 1389 (36.1) | 2154 (56.0) |
Preventative Methods | Total | Males | Females |
---|---|---|---|
Condom | 3712 (86.4) | 1084 (85.3) | 2623 (86.9) |
Sexual abstinence | 1467 (32.2) | 392 (29.0) | 1074 (33.6) |
Anti-contraceptive pill | 1152 (25.3) | 362 (26.8) | 787 (24.6) |
Coil | 432 (9.5) | 118 (8.7) | 314 (9.8) |
Morning after pill | 367 (8.1) | 174 (12.9) | 190 (6.0) |
Diaphragm | 254 (5.6) | 80 (5.9) | 172 (5.4) |
Contraceptive plaster | 121 (2.7) | 26 (1.9) | 95 (3.0) |
Transparent membrane | 116 (2.6) | 41 (3.0) | 75 (2.4) |
Interrupted coitus | 112 (2.5) | 74 (2.8) | 38 (2.3) |
Cervical cap | 99 (2.2) | 22 (1.6) | 77 (2.4) |
Vaginal washing | 95 (2.1) | 32 (2.4) | 63 (2.0) |
Spermicide | 90 (2.0) | 36 (2.7) | 52 (1.6) |
Basal temperature thermometer | 73 (1.6) | 24 (1.8) | 49 (1.5) |
Billing method | 61 (1.3) | 24 (1.8) | 37 (1.2) |
Male pill | 12 (0.3) | 7 (0.5) | 5 (0.2) |
Ulipristal acetate | 4 (0.1) | 3 (0.2) | 1 (0.0) |
Contraceptive sponge | 17 (0.4) | 9 (0.7) | 8 (0.3) |
Answers | Total * | Males * | Females * |
---|---|---|---|
I asked advice to an expert friend | 39 (12.5) | 7 (11.7) | 32 (12.5) |
I referred to a gynecologist | 41 (13.1) | 1 (1.7) | 40 (15.7) |
I tried to resolve it on my own | 15 (4.8) | 7 (11.7) | 8 (3.1) |
I went to my GP | 119 (38.1) | 25 (41.7) | 93 (36.5) |
I went to A&E | 10 (3.2) | 2 (3.3) | 8 (3.1) |
I spoke with somebody of my family | 47 (15.1) | 8 (13.3) | 39 (15.3) |
I have spoken with my partner | 45 (13.1) | 10 (16.7) | 35 (13.7) |
Total answers provided | 312 | 60 | 255 |
Outcome 1 (Range: 0–15) | Outcome 2 @ | Outcome 3 @ | ||||
---|---|---|---|---|---|---|
Mean ± SD | Wrong Answer | Correct Answer | No | Don’t Know | Yes | |
Total | 5.3 ± 2.9 | 3023 (70.4) | 1273 (29.6) | 4055 (91.8) | 137 (3.1) | 226 (5.1) |
Females | 5.4 ± 2.9 | 2074 (68.7) | 944 (31.3) | 2827 (69.8) | 94 (68.6) | 182 (80.9) |
Males | 5.1 ± 3.1 | 943 (74.2) | 328 (25.8) | 1222 (30.2) | 43 (31.4) | 43 (19.1) |
Padua | 5.8 ± 2.6 | 1158 (64.9) | 626 (35.1) | 1687 (41.6) | 37 (27.0) | 96 (42.5) |
Palermo | 4.8 ± 3.2 | 1248 (78.0) | 352 (22.0) | 1496 (36.9) | 79 (57.7) | 78 (34.5) |
Bergamo | 5.6 ± 2.7 | 412 (65.8) | 214 (34.2) | 599 (14.8) | 17 (12.4) | 34 (15.0) |
Milan | 5.1 ± 2.9 | 205 (71.7) | 81 (28.3) | 273 (6.7) | 4 (2.9) | 18 (8.0) |
Factors | Classes | Outcome 1 | Outcome 2 |
---|---|---|---|
Linear Regression RC (95%CI) | Logistic Regression OR (95%CI) | ||
Sex | Female | Reference | |
Males | 0.66 (0.54; 0.81) | ||
Age (years) | <21 | Reference | |
25+ | 0.61 (0.27; 0.95) | ||
University campus | Padua | Reference | Reference |
Palermo | −0.89 (−1.12; −0.67) | 0.43 (0.35; 0.51) | |
Previous education | Classic/scientific/university degree | Reference | |
Vocational | −0.35 (−0.57; −0.14) | ||
Undergraduate course of study | Educational sciences | −0.79 (−1.07; −0.52) | 0.57 (0.45; 0.71) |
Literature/Foreign language | −0.66 (−1.03; −0.29) | 0.73 (0.53; 0.99) | |
Biology/medicine/chemistry/natural sciences | Reference | Reference | |
Engineering/architecture | −0.68 (−0.96; −0.41) | 0.79 (0.62; 1.00) | |
Political science/economics | −0.35 (−0.66; −0.04) | 0.62 (0.48; 0.80) | |
Nationality | Italian | Reference | |
Non-Italian | 0.19 (0.09; 0.41) | ||
Type of Family | Nuclear | Reference | |
Non-nuclear | 0.55 (0.31; 0.80) | ||
Father’s education | University/more | Reference | |
Secondary | 0.64 (0.50; 0.82) | ||
Lower | 0.69 (0.53; 0.90) | ||
Father’s occupation | Manager/professionals | Reference | |
Technical employees | 0.74 (0.55; 0.99) |
Factors | Classes | RRR and 95%CI for the Answers: | |
---|---|---|---|
Don’t Know | Yes | ||
Sex | Female | Reference | |
Males | 0.62 (0.43; 0.89) | ||
University campus | Padua | Reference | |
Palermo | 1.80 (1.07; 3.03) | ||
Father’s age (years) | 60+ | Reference | |
<50 | 0.45 (0.28; 0.73) | ||
Current relationship | Yes | Reference | Reference |
No | 0.56 (0.34; 0.94) | 0.67 (0.48; 0.94) | |
STI knowledge | Linear numerical score | 1.15 (1.08; 1.22) |
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Cegolon, L.; Bortolotto, M.; Bellizzi, S.; Cegolon, A.; Bubbico, L.; Pichierri, G.; Mastrangelo, G.; Xodo, C. A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities. Int. J. Environ. Res. Public Health 2022, 19, 897. https://doi.org/10.3390/ijerph19020897
Cegolon L, Bortolotto M, Bellizzi S, Cegolon A, Bubbico L, Pichierri G, Mastrangelo G, Xodo C. A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities. International Journal of Environmental Research and Public Health. 2022; 19(2):897. https://doi.org/10.3390/ijerph19020897
Chicago/Turabian StyleCegolon, Luca, Melania Bortolotto, Saverio Bellizzi, Andrea Cegolon, Luciano Bubbico, Giuseppe Pichierri, Giuseppe Mastrangelo, and Carla Xodo. 2022. "A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities" International Journal of Environmental Research and Public Health 19, no. 2: 897. https://doi.org/10.3390/ijerph19020897