NEWPORT BEACH, CALIF. — Only one in five female adolescents correctly identified nine common sexually transmitted infections or correctly answered seven true-false questions about their sequelae in a study of 259 subjects.
Questionnaires completed by patients aged 12–20 years at an outpatient clinic showed that most of them did not recognize hepatitis B or C as sexually transmitted infections (see bar chart), and 46% did not know that symptoms of sexually transmitted infections are less likely to appear in males than in females.
Almost half (45%) thought that birth control methods besides condoms could prevent sexually transmitted infection, and a majority of the cohort reported inconsistent condom use, Dr. Seema Menon reported in a poster presentation at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.
The age of respondents and their primary source of information did not seem to affect their level of knowledge about sexually transmitted infection. The only factor that predicted greater knowledge was having had one of the infections, which was reported by 47% of the cohort, said Dr. Menon of the University of South Carolina, Columbia, and her associates.
“A prior history of sexually transmitted infection should not be the sole driving force for teens to acquire knowledge,” she said. “Health care providers should aim to increase education about sexually transmitted infections during routine visits, as well as actively create new educational tools to improve accurate knowledge in the adolescent population that is so vulnerable to these infections.”
Given a list of nine common sexually transmitted infections, only 19% of participants correctly identified them all as sexually transmitted.
Although 93% correctly identified HIV/AIDS as a sexually transmitted infection, 91% incorrectly said that it is the only serious sexually transmitted infection by marking it true on a list of seven true-or-false statements about sequelae.
The fact that cervical cancer is linked with a sexually transmitted infection was not known by 27%. Asked about gonorrhea and chlamydia infections, 19% of respondents did not know that these infections can affect fertility, 25% did not know that they can lead to surgery, and 13% did not know that they can lead to a serious illness.
Responses to a list of four true-or-false statements about strategies to prevent sexually transmitted infection showed that 11% thought Depo-Provera use prevents infection and 13% thought oral contraceptive pills prevent infection, while 48% did not know that condoms can prevent transmission of herpes simplex virus and human papillomavirus.
Among 253 participants who provided information about their current birth control methods (including condoms), 59% reported inconsistent use of condoms, 24% used condoms consistently, 25% were on Depo-Provera, 18% used contraceptive pills, 2% used a contraceptive ring, 1% used a contraceptive patch, and 30% used no contraception. (More than one response was allowed.)
Reasons for not using condoms were identified as monogamy by 73%, dislike of condoms by 29%, use of another contraceptive method by 17%, refusal by a sexual partner in 11%, embarrassment by 5%, and cost by 2%.
Among 199 participants who identified a source of their information about sexually transmitted infections, 30% said a doctor or nurse, 30% said classes at school, 28% said family, 5% said friends, 2% said boyfriends, and 5% said TV, radio, or the Internet.
The 199 in this subgroup did not reach a preset goal of 200 participants needed to reach a power of 80% in detecting a difference, so it is possible that information from doctors still made a difference in the adolescents' knowledge of sexually transmitted infections.
“The impact a health care provider may have on sexually transmitted infection education or condom use should not be undervalued,” Dr. Manon said.
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