Abstract
This study was done to assess knowledge, attitude and preventive practices towards sexually transmitted infections among secondary school students in Mlimba Division, Ifakara, Tanzania.
A descriptive cross-sectional study was conducted in March 2021. A total of 365 secondary school students (193 male; 172 female) aged between 12 and 23 years were surveyed by using a pretested self-administered questionnaire.
The study found the majority 95.9% had heard of STDs, 77.8% knew symptoms of STDs, 86.8% knew mode of transmission, 94.0% knew the importance of use of condom during sexual intercourse. Among the sexually-active students, 70.7% had practiced sexual intercourse and 42.2% used condom during sexual intercourse.
The risky behavior practiced by the sexually-active students in this study is alarming. There is a need to introduce STD education curriculum in secondary schools so that appropriate intervention on STDs can be implemented.
Author Contributions
Copyright© 2021
J. Kavana Nicholas.
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Competing interests The authors have declared that no competing interests exist.
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Introduction
Sexually transmitted infections (STIs) also referred to as sexually transmitted diseases(STDs) and venereal disease (VD) are illnesses that have a significant probability of transmission between humans by means of human sexual behavior including vaginal intercourse, oral and anal sex It is estimated that more than 500 million people still are at high risk of infection; over 140 million persons are infected and about 6 million are in Africa, Middle East, central and south-east Asia and countries in Latin America No previous research has been conducted in Mlimba division on assessment of knowledge, attitude and practices towards STIs among secondary schools students. Therefore, this study was a descriptive cross-sectional study to assess the knowledge, attitude and practice towards sexually transmitted infections among secondary school students in Mlimba Division, Ifakara, Tanzania.
Results
Socio demographic characteristics of the respondents A total of 365 students took part in the study. Of these, 193(52.9%) were male and 172(47.1%) were female. The age of the respondents ranged from 12 to 23 years, 114(31.2%) aged between 12 to 15 years, 241(66%) aged between 16 to 19 years and 10(2.7%) aged between 20 to 23 years ( A total of 350 (95.9%) students had heard about STDs, 79 (21.6%) male and 60(16.4%) female students mentioned AIDS, gonorrhea and syphilis are sexually transmitted infections, The majority of sexual intercourse as main mode of transmission of STDs. The main source was from teachers and mass media. Main symptom mentioned was discharge from genital organs, penis was 138(37.8%) male and vagina was 128(35.1%) female students ( The majority of students responded that condom protect people from STDs, 190(52.1%) male and 165(45.2%) female students, 180(49.3%) male and 163(44.7%) female responded it was necessary to use condom during sexual intercourse. Both 186(51.0%) male and 186(51.0%) female students responded it was necessary to do screening while 193(52.9%) male and 153(41.9%) female students. All participants agreed to seek treatment after noticing symptoms were 193(52.9%) male and 172(47.1%) females ( Participants who had sex before were 43(11.8%) males and 91(24.9%) females, those who used condom first time to have sex were 62(17.0%) male and 47(12.9%) females, who used condom last time to have sex were 37(10.1%) male and 97(26.6%) females, participants who do sex with a single partner were 61(16.7%) male and 73(20.0%) females (
Sex
Male
193(52.9%)
Female
172(47.1%)
Age
12-15
114(31.2%)
16-19
241(66.0%)
20-23
10(2.7%)
Characteristic
Sex
Male
Female
Have you ever heard of STIs?
Yes
187(51.2%)
163(44.7%)
No
6(1.6%)
9(2.5%)
Which of the following is an STD?
AIDS
18(4.9%)
12(3.3%)
Gonorrhea
3(0.8%)
2(0.6%)
Syphilis
1(0.3%)
1(0.3%)
AIDS and gonorrhea
11(3.0%)
30(8.2%)
AIDS and syphilis
5(1.4%)
9(2.5%)
Gonorrhea and syphilis
38(10.4%)
20(5.5%)
AIDS, syphilis and gonorrhea
79(21.6%)
60(16.4%)
others(genital warts, chancroid and herpes)
0(0%)
2(0.6%)
Does not know
38(10.4%)
36(9.9%)
How is STDs transmitted?
Sexual intercourse
165(45.2%)
145(39.7%)
Blood transfusion
9(2.5%)
17(4.7%)
Sharing food/drinks
19(5.2%)
10(2.7%)
Where did you get information on STDs
Mass media
59(16.2%)
47(12.9%)
Health workers
47(12.9%)
27(7.4%)
Family, Friend, Collegues and neighbors
16(4.4%)
27(7.4%)
Religious leader
1(0.3%)
3(0.8%)
Teachers
70(19.2%)
68(18.6%)
What are the symptoms of STDs
Discharge from vagina
25(6.8%)
128(35.1%)
Discharge from penis
138(37.8%)
9(2.5%)
Ulcers in the genital organ
12(3.3%)
18(4.9%)
Pain while passing urine
18(4.9%)
17(4.7%)
Characteristics
Sex
Male
Female
Do you think condom protect people from STDs?
Yes
190(52.1%)
165(45.2%)
No
3(0.8%)
7(1.9%)
Do you think screening for STDs is important?
Yes
186(51.0%)
153(41.9%)
No
7(1.9%)
19(5.2%)
If you notice symptoms of STD will you seek treatment?
Yes
193(52.9%)
172(47.1%)
No
0(0%)
0(0%)
Characteristics
Sex
Male
Female
Have you had sex before?
Yes
43(11.8%)
91(24.9%)
No
150(41.1%)
81(22.2%)
Was a condom used the first time you had sex?
Yes
62(17.0%)
47(12.9%)
No
131(35.9%)
125(34.2%)
Was a condom used the last time you had sex?
Yes
37(10.1%)
97(26.6%)
No
156(42.7%)
75(20.5%)
Do you have sex with only one partner?
Yes
61(16.7%)
73(20.0%)
No
157(43.0%)
99(27.1%)
Discussion
This study was conducted among secondary school students in Mlimba Division, Tanzania. The purpose of using secondary school students in Mlimba Division was to assess whether these students have good knowledge, attitudes and preventive practices towards STDs. The age category from 16-19 years in this study is in agreement with the characteristics of current student population in secondary schools in Ethiopia The three STDs; AIDS, syphilis and gonorrhea were the most known by the participating students 21.6% males and 16.4% females. However, genital warts, chancroid and herpes were poorly known by the participating students 0% males and 0.6% females. The findings in our study could be these are uncommon types of STDs which are neglected by policy makers. The present study indicates that teachers and mass media were the sources of information on STDs to secondary school students in Mlimba Division. Students who reported teachers were source of information; 19.2% males and 18.6% females while mass media; 16.2% males and 12.9% females. The results in this study are low compared to studies conducted in Ethiopia where teachers and mass media contributed 48.1% and 39.7% respectively The findings of this study showed that the prevalence of sexual initiation among secondary school students is 11.8% males and 24.9% females. This finding is lower for males and higher for females comparing to the study conducted in Ethiopia which was 21.5% The majority of participating students had knowledge that condom protects people from STDs; 52.1% were males and 45.2% were females. This result is higher than a study done in Ethiopia where 39.7% had knowledge that condom protects people from STDs
Conclusion
The study revealed that almost all students had heard about STDs. Knowledge regarding modes of transmission, prevention methods was low but the attitude on condom use during sexual intercourse as a preventive measure for STDs was high. Among those who practiced sexual intercourse, some of them did not use condom. The study showed that, signs and symptoms associated with STDs in both males and females were not well known by the students. The mass media and teachers are still major effective means of educating students, on STDs.