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THE LEVEL OF KNOWLEDGE AND SOURCES OF INFORMATION ON SEXUALLY TRANSMITTED INFECTIONS (STIS) AMONG SCHOOL CHILDREN IN NIGERIA
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Abstract
Background
Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students’ awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes.
Methods
Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form.
Results
Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 ± 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022).
It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.
Sexually transmitted Infections (STIs) rank among the five most important causes of healthy productive life loss in developing countries The World Health Organization (WHO) estimates that the global incidence of new cases of selected curable STIs – Gonorrhea, Syphilis, Chlamydia and Trichomoniasis was 340 million in 1999. The largest number of new infections occurred in South and Southeast Asia
According to a report published by UNAIDS/WHO working group on global HIV/AIDS and STI surveillance in December 2006 there were 70,559 reported cases of STIs in Malaysia by the end of 2005 out of which 10,663 cases were of AIDS and the rest were of other STIs Evidence strongly suggested that presence of one STI facilitated transmission of HIV by a factor of 2-5 times.Sexually Transmitted Infections
Historically knowledge about STIs has been very low even in communities where there is high prevalence of STIs. Sometimes STIs may be viewed as unavoidable or may even be viewed as an “initiation into adulthood”. There may be lack of concern about STIs because they may be viewed as easily curable. Knowledge is an important prevention factor for STIs . It has been suggested that knowledge about STI transmission might influence sexual behavior . There is some data available on youth’s knowledge on STIs in some of the states of Malaysia with Pulau Pinang as one of the exception. This research will serve as baseline information that could be linked with future follow-up studies or interventions. The main objectives of the study were to describe the level of knowledge and sexual behavior of school students and their attitudes towards STIs and to determine the association between socio-demographic factors and sexual practice with the knowledge towards STIs.Sexually Transmitted Infections
The stages of education system in Malaysia consist of pre-school, priAprily education, secondary education, tertiary education, and postgraduate studies. The education system is attained either through government schools or private schools mandated by Malaysian law and handled by the Ministry of Education. Secondary education comprises of 5 years of schooling known as form 1 to form 5 catering the education needs of children aged between 13 to 18 years. At the end of form 5 students are required to take the Sijil Pelajaran Malaysia (SPM) or the Malaysian Certificate of Education examination, before graduating secondary school. After form 5, students (aged between 18 to 20 years) can take up either matriculation (British ‘A’ levels, the Canadian matriculation etc) or form 6, comprising of two years of education before students could sit for Sijil Tinggi Persekolahan Malaysia (STPM) or Malaysian Higher School Certificate examination.Sexually Transmitted Infections
Convenience sampling technique was employed for the selection of schools in Penang Island. A total of eleven schools were approached to participate in this survey and the heads from six of the schools gave permission to conduct this study in their schools. All the students belonging to form 4, form 5 and form 6 (representing adolescents and young adults) of the six government schools were included in the study. Private schools in Malaysia mostly represent one out of the three main ethnic groups (Malays, Chinese and Indians). Majority of private schools are either representatives of Chinese population or Indian population. Therefore, in order to avoid bias only government schools were approached with the understanding that they represent all the three main ethnic groups according to their real distribution in the country.Sexually Transmitted Infections
For data collection an 18-item questionnaire was developed in English. The questionnaire was then translated into Bahasa Melayu (national language of Malaysia). Seven questions addressed socio-demographic information, one on the knowledge about different types of STIs, one on symptoms, one on preventive measures, one on the risk groups, one on complications, one on transmission route, one on causative organisms, six on sexual attitudes and history and one on knowledge source. Each knowledge question included multiple options or statements, for example the options for the question on different STIs that the respondents could be aware of included AIDS, syphilis, gonorrhoea, rheumatoid arthritis, herpes, leukemia, chlamydia, trichomoniasis and don’t know. The respondents could select more than one option.Sexually Transmitted Infections