Sexually transmitted diseases and condoms: high school students' knowledge, attitudes and behaviours

Researchers conducted a survey of 199 students enrolled 2 public high schools in Alberta in Canada to learn of their knowledge about sexually transmitted diseases (STDs) and knowledge, attitude, and behaviors about condoms and their use. 41% were sexually active. 41% of these students did not or rarely used condoms. 44% had =or+ 3 partners. 61% of those with =or+ 3 partners used condoms and 56% with 1 partner used them. Knowledge of STDs and condom use stood high regardless of sex or sexual activity. 93% of the boys, 80% of the girls, 88% of sexually active and 87% of nonsexually active students stated it was their responsibility to carry condoms if they are sexually active. Moreover 96% of the boys, 78% of the girls, 81% of sexually active and 91% of nonsexually active students said they would use a condom during sexual intercourse. Nevertheless males and sexually active students did express some negative attitudes towards condoms, such as reduce sensation and interference with sexual spontaneity. Nonsexually active students tended to view condom use as a negative stigma (p.05). Most students claimed to be more likely to buy condoms from condom vending machines in the rest rooms than from stores (p.05). Sexual partners had the largest influence on students, especially sexually active students, to have or not have sexual intercourse followed by concerns about STDs, friends, and family. Further, the large majority of all students, especially females and sexually active students, said they would choose their sexual partner carefully because of the concern for AIDS and other STDs. They also tended to be monogamous and avoided high risk groups. In conclusion, no reliable differences occurred between attitudes towards condoms and use or nonuse of condoms to explain behavior. Future studies should be designed to center on factors that influence sexual behavior.     

Knowledge, behavior, and attitudes toward sex among adolescent students at a junior/high school in Cote d'Ivoire

OBJECTIVES: To be able to provide appropriate information about sex to adolescent students in the Cote D'Ivoire, we conducted a study to determine knowledge, behavior, and attitudes toward sex. METHODS: We conducted a cross-sectional study at a junior/high school using a self-administered questionnaire which contained students' characteristics (age, sex, grade, tribe, region), their knowledge about sex, sexual behavior (including experience of sex and contraception), and attitudes toward sex. Knowledge about sex and proportions employing contraception were compared between males and females and between the lower and the upper grades. We also examined associations between attitudes toward sex and contraception. RESULTS: A total of 695 (males: 278, females: 417) students filled in our questionnaire (response rate: 33.1%). The proportion of the students who had experienced sex was 84.2% for males, 46.5% for females, and the average age of the first sex was 14.3 and 15.6 years in males and females, respectively the proportions using contraception was 49.6% and 46.9%. In students of the lower grades, males had greater knowledge than females, but this difference was reduced with progression through the upper grades. The proportion using contraception in the upper grades was also higher and an association between attitude toward sex and contraception was clear. CONCLUSION: Adolescent students' knowledge, behavior, and attitudes toward sex could be relatively easily investigated at a junior/high school of Cote D'Ivoire. The majority of males and half of the females in this setting already had experience of sexual intercourse. The study showed that difference in sexual knowledge between males and females shrunk with increase in school grade. We also showed an association between attitude toward sex and contraception.     

Adolescents' discussions about contraception or STDs with partners before first sex

CONTEXT: Limited research has examined the individual, family and relationship factors that determine whether teenagers discuss contraception or STDs with their sexual partners before having sex for the first time. METHODS: Logistic regression analyses of data from 1,426 teenagers who participated in Waves 1 (1995) and 2 (1996) of the National Longitudinal Study of Adolescent Health and who had first sex between waves examined factors influencing whether respondents discussed contraception or STDs with their partner before first sex, and whether these factors differ by gender. RESULTS: Fifty-three percent of females and 45% of males discussed contraception or STDs before having first sex. The greater respondents' perceived condom knowledge and the greater their communication with their parents about everyday life, the higher their odds of discussing contraception or STDs before first sex (odds ratio, 1.2 for each). Being black was positively associated with sexual communication before first sex (1.9); as the number of dating activities and score on a test of verbal ability increased, so did the odds of such communication (1.6 and 1.02, respectively). The predictors of discussions about contraception or STDs did not differ by gender. CONCLUSIONS: By increasing teenagers' knowledge about condoms and other methods of contraception, pregnancy and STD prevention programs can help to encourage communication among teenage partners before the initiation of sexual intercourse. Programs should also encourage conversations between parents and teenagers, even when not about sex.     

Sexual attitudes and risk-taking behaviors of high school students in Turkey

BACKGROUND: The risk of sexually transmitted diseases is high but opportunities of sexual education for adolescents are limited in Turkey. The aim of this study was to evaluate sexual attitudes and behaviors and to determine the predictors of sexual initiation among adolescents. METHODS: A questionnaire designed by the researchers was administered to 861 senior year high school students in their classrooms. RESULTS: The rates of masturbation and sexual intercourse and the median partner numbers among males were higher than females. The rates of having negative feelings after the first sex among females were higher than males. The rates of having sexual intercourse and the mean age at first sexual intercourse among males were similar to developed countries. However, the use of a condom at first intercourse was low. Lower academic performance and grade repetition experience among males and cigarette smoking among both gender groups were related to having sexual intercourse. CONCLUSIONS: This is one of the first studies about sexual risk-taking behaviors among high school students in Turkey. Differences found between gender groups regarding attitudes and behaviors reflect the social structure in Turkey. These findings may be helpful in producing effective solutions for improving education and preventive health care.     

Peer education by medical students in a public health course

Sex education by peers is becoming popular in Japan. To improve youth's reproductive health by continuous peer education and to encourage medical students to obtain the methodology necessary for health promotion, we started peer sex education by medical students in the annual public health course. One junior high school and one senior high school in Kitakyushu City in Japan asked medical students to conduct peer sex education classes at their schools. Medical students planned and carried out these classes based on the results of a questionnaire that they gave to the junior high school and senior high school students before the peer education. After the class, the students' responses to the class were investigated by another questionnaire. In this questionnaire, over 90% of the students answered that they were interested in talking about sexual issues with medical students. As for the medical students, they said that they could understand better the methodology of health promotion and also gained confidence by this experience. We will continue to carry out peer education in the medical school's public health course, and we intend to research further how junior high school and senior high school students' sexual behavior may change in the future.     

Positive and negative perceived consequences of first intercourse among middle and high school students in Puebla,Mexico

Relatively little is known about young people’s interpretations of sexual behaviour in Latin America. In this study, we examine the most commonly perceived consequences of first sexual intercourse among Mexican middle and high school students, how perceived consequences differ by gender, and factors that may predict experiencing more positive or negative consequences. Sexually active Mexican students aged 12–19 years (n = 268) reported whether they had experienced each of 19 consequences following first intercourse. Both positive consequences, such as physical satisfaction and closeness to partner, and negative consequences, such as worry about STDs and pregnancy, were common. Sex with a non-relationship partner was associated with fewer positive and more negative consequences, with the effect for positive consequences being stronger for young women. Pressure to have sex was associated with fewer positive consequences of first intercourse, and pressure to remain a virgin was associated with more positive and negative consequences. These findings suggest that young people often report mixed feelings about their first sexual intercourse and that relationship context and sexual socialisation influence their perceptions of the event.     

Rural high school students' knowledge, attitudes and behaviours related to sexually transmitted diseases.

High school students are at high risk for contracting sexually transmitted diseases (STDs). A sample of 69 rural high school students from the province of Alberta, Canada were surveyed regarding their knowledge, attitudes and behaviours related to STDs to ascertain whether they differ from urban students. Results indicate that rural and urban high school students are similar in terms of knowledge about STDs, attitudes towards their prevention and also in terms of sexual behaviours. As with other studies, behaviours lagged behind knowledge and attitudes with reported condom use low. Sexual decision making was influenced mainly by the peer group. Males and females were mainly influenced by the same factors which include the willingness of their partner, the behaviours of their friends and family, concern about contracting a STD. These data emphasize the need to implement primary prevention programs for high school aged youth in rural as well as urban settings.     

广州某重点大学医学生性态度、性行为状况调查分析

目的了解医学生的性态度、性行为状况和相关认知,为医学院校开展青春期性健康教育提供背景资料和依据。方法采用自编问卷,对广州某医科大学200名本科三年级医学生的性态度、性行为及避孕知识情况进行调查。结果84．0％的大学生对婚前性行为持可接受态度;53．0％的学生有恋爱经历;5．0％的学生承认发生过性行为,男生明显多于女生,无保护性行为使20．0％的学生或其性伴侣意外妊娠;41．0％的学生知道安全套的用法。结论大部分医学生对婚前性行为持宽容态度,但对其后果考虑不足,对避孕知识了解差,医学院校有必要及早对医学生进行系统、全面、规范的性健康教育。     

An exhibition on sexually transmissible diseases and AIDS for Vaudois apprentices

An exhibition on STDs and AIDS, animated constantly by specially trained professionals, was organized in a school for apprentices (6500 pupils). Its purposes: to help youngsters make more personal and responsible decisions about their sexual lives; to reinforce their knowledges on STDs and AIDS transmission and prevention; modify their attitudes and behavior in the field of contraception (discussions with partner, use of condoms). The impact of this exhibition will be measured scientifically.     

School sex education, a process for evaluation: methodology and results

This study outlines a method used to evaluate sex education.Results from a questionnaire are presented from 3314 Year 11students in 25 schools from non-metropolitan Britain. Over 70%answered that their sex education had included ‘a lot’or ‘some’ education on sexual intercourse, contraceptionand sexually transmitted diseases (STDs); 51% demonstrationof condoms; 45% personal morality; and 36% assertiveness trainingincluding ‘how to say no’. Teenagers' assessmentof sex education was varied but only the minority (44%) consideredit satisfactory. Over 70% said they thought teaching a widerange of topics should start in Year 8 (aged 11/12 years), most(75%) wanted outside agencies involved in the teaching, (57%)did not want parents to provide ‘most of it’ and(70%) did not want it taught in single-sex groups. School wasthe most frequently specified source of ‘most helpful’information on contraception (38%) and STDs (45%). Teenagerswithin schools perceived to deliver above average input on contraceptionand STDs were more likely to cite school as their most helpfulsource of information. Increasing input was not associated withincreasing awareness of risks from STDs nor improved knowledgeof contraception. The questionnaire and reporting of comparativefindings back to the schools will allow an assessment of currentpractice and future change to sex education programmes.     

北京市大学生性病艾滋病知识,认知及性行为的调查分析

北京市１３１０名大学生性病艾滋病知识、认知及婚前性行为现状的调查结果显示：９０％以上的学生都听说过艾滋病、淋病和梅毒,但大学生对常见性病和艾病传播途径的知识则了解较少。半数以上的学生对性病艾滋病存在不同程度的恐惧心理。１５％的男生和１３％的女生承认有过婚前性交行为。但首次性行为发生时,只有９％的人回答用过避孕套。另外,３．６％的被调查对象报告他们曾有过１种或多种可通过性交传播的疾病。Ｌｏｇｉｓｔｉｃ回归分析结果表明,除了性态度、同伴性行为、色情出版物和父母离异等变量外,大学生对性病艾滋病严重性的认知与婚前性行为发生有关。提示应在北京大学生中开展综合性的性病艾滋病防治教育和培养大学生的自我保护技能。     

Differences and similarities in sexual and contraceptive knowledge, attitudes, and behavior among Latino male adolescent students in California, United States and Lima, Peru

To identify the differences and similarities in sexual and contraceptive knowledge, attitudes, and behavior among Latino male adolescent students living in California and Lima. Self-administered, anonymous surveys were completed by Latino male students aged 12-19 participating in California, and by male adolescent students in four high schools in Lima. Both surveys contained similar questions allowing for comparisons regarding sexual activity and contraceptive behavior. The mean age of male students were 16 and 15 years, respectively. More California males reported having engaged in sexual intercourse (69% vs 43%. The sexual debut was 13 years in both samples. More students in California were aware of their risk of pregnancy at first sexual intercourse than in Lima (82% vs 50%). One-third of the California males reported communicating with their partner about sex and contraception to be "easy" as compared to 53% of males in Lima. More students in California reported knowing a place to obtain contraceptives if they need them (85% vs 63%), having ever gotten someone pregnant (29% vs 7%), and having fathered a child (67% vs 16%).     

Risk factors for HIV and other sexually transmitted diseases among adolescents in St. Petersburg, Russia.

CONTEXT: Over the past several years, there have been sharp increases in the prevalence of HIV and other sexually transmitted diseases (STDs) among young people in Russia. Very little is known about Russian adolescents' behaviors and attitudes that might influence their risk of acquiring these infections. METHODS: A 1995 survey of 533 students aged 15-17 attending eight St Petersburg high schools assessed their sexual risk practices, AIDS-specific attitudes and beliefs, sexual relationship patterns and preferences, and social characteristics. RESULTS: Overall, 39% of students were sexually experienced, and these young people had had, on average, 3.4 sexual partners. Only 29% of sexually experienced students said they consistently used condoms, and 29% said they never did. Unprotected vaginal intercourse was the predominant and preferred sexual practice; it also was the practice that most often occurred with students' last sexual partner. In all, 28% of students defined "safer sex" as condom use. Many young people believed that AIDS is a threat only to members of particular "risk groups"; relatively few believed that they could get AIDS (17%) or said that AIDS information had influenced their sexual behavior (29% of those who were sexually experienced). Females were more likely than males to prefer having an exclusive partner, and males were more likely to prefer having casual partners. CONCLUSIONS: Educational and behavioral interventions are urgently needed to help young people in Russia avoid HIV and other STDs. Risk and social characteristics identified in this study can help to guide the development and tailoring of risk reduction interventions.     

Sexual behaviour of young people in Northern Ireland: first sexual experience

Two National Surveys of Sexual Attitudes and Lifestyles in Britain (Natsal) were conducted, one in 1990 and one in 2000. Northern Ireland was excluded from both studies. Now, for the first time, comparable data about sexual attitudes and lifestyles of young people (14- to 25-year-olds) in Northern Ireland are available. Data were collected through self-administered questionnaires, one-to-one interviews and focus-group discussions. As in Natsal 1990 and 2000, young people were asked about their sexual attitudes towards sex, experiences of sex education, knowledge of sexually transmitted infections (STIs) and, if sexually active, about the circumstances in which sexual intercourse occurred. A total of 1013 young people in the target age group completed the self-administered questionnaire. Young people in Northern Ireland do not differ significantly from their counterparts in Britain in terms of sexual lifestyles and attitudes. Some 53.3% of all respondents reported that they had had sexual intercourse. Condom use at first sex was reported by 64% of sexually active respondents; 27.4% said they used no contraception; 26.7% of all respondents said they had sex before age 16. Respondents who first had sex when they were 15 or 16 years were more likely than other respondents to say that ‘being drunk’ was the main reason why intercourse occurred. Peer pressure to engage in sex was more prevalent among males than females. Young people in Northern Ireland regard friends as their most important source of sex education. School is the second most important source but most respondents wanted more sex education in school. It is important that it is needs focused and includes potentially sensitive and contentious information.     

Contraception and STD protection among urban Norwegians

This paper analyses the use of contraception and protection against sexually transmitted diseases (STDs) in an urban Norwegian population. In 1997, a random sample of 5000 persons (18-49 years), drawn from the population register in Oslo, participated in a sexual behaviour survey. Data collection was carried out by means of postal questionnaires. Thirty-seven per cent of respondents reported not using any contraception, 18% used condoms for contraception, 28% used oral contraception (OC) and 19% an intrauterine device (IUD) at most recent intercourse. The use of contraception decreased by a factor of 0.95 for every year increase in age, and also increased with level of education. Twelve per cent reported using some form of STD protection. Older age, being in love with the partner, and having sex in a committed relationship were associated with low use of STD protection. Higher education, having had a same-sex partner, having penetrative sex, longer time since last intercourse, and strong 'love-monogamous' attitudes towards sexuality were associated with the higher use of STD protection.     

Sex behavior among high school students in Sweden: improvement in contraceptive use over time.

PURPOSE: To investigate sexual behavior and attitudes toward sexuality among first-year high school students in Sweden in 1999 and to compare the sexual behavior with that reported from similar studies in 1979 and 1989. METHODS: In Spring 1999, a questionnaire with 47 questions mainly of multiple-choice nature was administered to a random sample of 20 classes in senior high school in two medium-sized cities in Sweden. The median age of the students was 16 years. Differences in sexual behavior and attitudes were evaluated with the Chi-square and Student's t-test. RESULTS: Almost half of the students (46%) had had intercourse, showing that the age of coitarche had not decreased during the past two decades. The median age at intercourse of those who had had intercourse was 15 years in both genders. More students in practical (vocational-technical) programs (60%) than in theoretical (college preparatory) ones (37%) had had sexual intercourse. More teenagers in theoretical (90%) than in practical programs (64%) had used contraceptives at their first intercourse, an increase from 65% in 1979 to 76% in 1999. One-fourth of the teenagers were under the influence of alcohol at the first intercourse, a decrease, compared with 1979. CONCLUSIONS: Contraceptive use at coitarche has increased and alcohol use decreased over the 20-year-period. The tendency noted 10 years ago that students attending practical programs put themselves at more health risk than students in theoretical programs continues. This fact should be considered when planning for counseling and sex education.     

Sexual knowledge, attitudes, and risk behaviors of students in Turkey

This survey produced baseline information about student knowledge of sexually transmitted diseases (STDs), their sexual attitudes, and their behavior to help establish control and education programs. The study was conducted at Ege University, Izmir, Turkey, during the 1999-2000 academic year. A total of 2,217 first- and fourth-year students determined by stratified sampling constituted the study group. All students who volunteered to participate completed a questionnaire assessing sociodemographic and knowledge factors, sexual attitudes, behavior, and history of STDs. The rate of students having had sexual experience was 36.6%. Males were more sexually active than females. Most students (71.4%) began sexual activity at ages 15-19 without any difference by gender. Males reported significantly more sexual partners than females. Similarly, the rate of male students never using condoms was significantly higher than females. Condom was the most frequent contraception method, followed by oral contraceptives and withdrawal. Mean score on the knowledge questions was 16.29 (highest score 30). The most widely known STD was HIV infection and AIDS. Students' knowledge of transmission routes, signs and symptoms, and risk groups of STDs was insufficient. Main sources of knowledge were visual and print media, and friends. Most students (84.7%) viewed prevention from STDs as a person's own responsibility. Young people in Turkey are sexually active and tend to engage in high-risk behavior. However, their knowledge on sexual health and sexually transmitted diseases is insufficient. Study results suggest a need for implementation of STD control programs and provision of school sexuality education for adolescents and young adults.     

育龄男女非婚性行为及避孕套使用情况调查

目的 了解我国育龄男女非婚性行为发生情况，为项目干预措施提供基础资料。方法 2005年11～12月采用分层、三阶段与规模成正比的容量比例抽样方法获得调查对象，采用统一调查问卷由统一培训的调查员入户进行面对面调查。结果 90％以上的育龄男女认为人应该只有1个性伴侣，其中约i／3认为多性伴增加性传播疾病和艾滋病的危险。20．2％的未婚男性有过性行为，其中47．8％在第1次性行为时没有使用任何避孕方法，42．2％使用了避孕套。8．7％的未婚女性有过性行为，30．4％在第1次性行为时没有采取避孕措施，43．5％使用了避孕套。1．6％的已婚男性、0．5％的已婚女性和25．6％有过性行为的未婚男性、4．3％有过性行为的未婚女性有过临时性伴侣，且相当比例在发生性行为时未使用避孕套。结论 虽然大多数认为应该只有1个性伴侣，但仍有一定比例非婚性行为的发生，并且在发生非婚性行为时避孕套的使用较少。在加强道德教育时，还应加大避孕套使用的宣传力度，保证安全性行为。     

Contextual factors associated with sexual behavior among Brazilian adolescents

PurposeThere are few studies about the influence of the context on sexual behavior among adolescents in developing countries, such as Brazil. Adolescent pregnancy and the high incidence of sexually transmitted disease (STDs) among Brazilian youngsters are a public health problem. The object of this study was to investigate whether factors from family and school contexts are associated with sexual behavior among Brazilian adolescents.MethodsThis study used data from 60,973 adolescent participants in the National Survey of School Health. The response variable was sexual behavior, described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into sociodemographic characteristics, number of risk behavior factors (regular use of alcohol, smoking, and experimenting with illicit drugs), and family and school context. Variables associated with having protected and unprotected sexual relations in each context were identified by means of multinomial logistic regression. The reference was "never had sexual intercourse."ResultsApproximately one fourth of adolescents have already had sexual intercourse, most frequently boys. Among the adolescents who declared sexual initiation, the most part had their first sexual relation with age of 13 years or younger. Almost 21% did not use protection the last time they had sex. The greater the number of risk factors involved, the higher the incidence of protected and unprotected sex. In the family context, living with only one or with neither parent and low parental supervision increased the frequency of protected and unprotected sex. Never eating meals with the parents augmented the incidence of unprotected sex (odds ratio [OR], 1.60). In the school context, students from private schools were less likely to have had protected and unprotected sex (OR, 0.58 and 0.68). Not receiving instructions at school about pregnancy prevention increased the frequency of protected and unprotected sex (OR, 1.33 and 1.74, respectively).ConclusionsFamily and school context factors are associated with sexual behavior. These associations are generally stronger for unprotected sex. Information about the prevention of pregnancy and STDs/AIDS has to be disseminated very early owing to the young age of sexual initiation.     

重庆市三峡库区高校大学生性认知调查

目的 了解重庆市三峡库区在校大学生对性知识的认知情况,为高校开展性健康教育提供科学依据.方法 对重庆市万州区4所高校按分层整群抽样原则抽取1126名大学生进行问卷调查,数据用SPSS16.0软件进行统计分析.结果 84.5％的学生认为大学生可以谈恋爱,大学生性交发生率为4.76％,仅有57.1％的大学生知道性传播疾病,有过性交行为的大学生人群中,采取避孕措施的比例仅为19.5％.69.9％的大学生没有接受过正规的性教育.结论 大学生性观念逐渐开放,性知识知晓率低,性法制性道德观念模糊,亟待对大学生进行性健康教育.