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BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature

Authors: Florence N Samkange-Zeeb, Lena Spallek, Hajo Zeeb

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people, not only in developing, but also in developed countries.
We conducted this systematic review to determine awareness and knowledge of school-going male and female adolescents in Europe of STDs and if possible, how they perceive their own risk of contracting an STD. Results of this review can help point out areas where STD risk communication for adolescents needs to be improved.

Methods

Using various combinations of the terms "STD", "HIV", "HPV", "Chlamydia", "Syphilis", "Gonorrhoea", "herpes", "hepatitis B", "knowledge", "awareness", and "adolescents", we searched for literature published in the PubMed database from 01.01.1990 up to 31.12.2010. Studies were selected if they reported on the awareness and/or knowledge of one or more STD among school-attending adolescents in a European country and were published in English or German. Reference lists of selected publications were screened for further publications of interest. Information from included studies was systematically extracted and evaluated.

Results

A total of 15 studies were included in the review. All were cross-sectional surveys conducted among school-attending adolescents aged 13 to 20 years. Generally, awareness and knowledge varied among the adolescents depending on gender.
Six STDs were focussed on in the studies included in the review, with awareness and knowledge being assessed in depth mainly for HIV/AIDS and HPV, and to some extent for chlamydia. For syphilis, gonorrhoea and herpes only awareness was assessed. Awareness was generally high for HIV/AIDS (above 90%) and low for HPV (range 5.4%-66%). Despite knowing that use of condoms helps protect against contracting an STD, some adolescents still regard condoms primarily as an interim method of contraception before using the pill.

Conclusion

In general, the studies reported low levels of awareness and knowledge of sexually transmitted diseases, with the exception of HIV/AIDS. Although, as shown by some of the findings on condom use, knowledge does not always translate into behaviour change, adolescents' sex education is important for STD prevention, and the school setting plays an important role. Beyond HIV/AIDS, attention should be paid to infections such as chlamydia, gonorrhoea and syphilis.
Appendix
Available only for authorised users
Literature
1.
World Health Organisation: Global prevalence and incidence of selected curable sexually transmitted infections. 2001, WHO, Geneva
2.
Panchaud C, Singh S, Feivelson D, Darroch JE: Sexually transmitted diseases among adolescents in developed countries. Fam Plan Persp. 2000, 32: 24-32 &45. 10.2307/2648145.CrossRef
3.
Berglund T, Fredlund H, Giesecke J: Epidemiology of the re-emergence of gonorrhoea in Sweden. Sex Transm Dis. 2001, 111-114.
4.
Health protection Surveillance Centre.: Surveillance of STI. A report by the Sexually Transmitted Infections subcommittee for the Scientific Advisory committee of the health Protection Surveillance Centre. December 2005,
5.
6.
7.
Adler MW: Sexually transmitted infections in Europe. Eurohealth. 2006, 12: 3-6.
8.
PHLS, DHSS & PS and the Scottish ISD(D)5 Collaborative Group: Trends in Sexually Transmitted Infections in the United Kingdom 1990-1999. 2000, Public Health Laboratory Service London
9.
Stamm W, Guinan M, Johnson C: Effect of treatment regiments for Neisserie gonorrhoea on simultaneous infections with Chlamydia trachomatis. New Eng J Med. 1984, 310: 545-559. 10.1056/NEJM198403013100901.CrossRefPubMed
10.
MacDonald NE, Brunham R: The Effects of Undetected and Untreated Sexually Transmitted Diseases: Pelvic Inflammatory Disease and Ectopic Pregnancy in Canada. The Canadian Journal of Human Sexuality. 1997, 6 (2): Special Issue: STDs and Sexual/Reproductive Health-
11.
Simms I, Stephenson JM: Pelvic inflammatory disease epidemiology; What do we know and what do we need to know?. Sex Trans Inf. 2000, 76: 80-87. 10.1136/sti.76.2.80.CrossRef
12.
Bozon M, Kontula O: Sexual initiation and gender in Europe. Sexual behavior and HIV/AIDS in Europe. Edited by: M Hubert, N Bajos, and T Sandfort. 1998, London: UCL Press, 37-67.
13.
14.
Ross J, Godeau E, Dias S: Sexual health. Young people's health in context. Health Behaviour in School-aged Children (HSBC) study: International report from the 2001/2002 survey. Edited by: Currie C, Roberts C, Morgan A, et al. 2004, Copenhagen: WHO
15.
Bundeszentrale für gesundheitliche Aufklärung: Jugendsexualität. Repräsentative Wiederholungsbefragung von 14- bis 17-Jährigen Jugendlichen und ihren Eltern. 2006, BZgA
16.
Tucker JS, Fitzmaurice AE, Imamura M, Penfold S, Penney GC, van Teijlingen E, Schucksmith J, Philip KL: The effect of the national demonstration project Healthy Respect on teenage sexual health behaviour. Eur J Public Health. 2006, 17 (1): 33-41. 10.1093/eurpub/ckl044.CrossRefPubMed
17.
Godeau E, Gabhainn SN, Vignes C, Ross J, Boyce W, Todd J: Contraceptive use by 15-year-old students at their last sexual intercourse: Results from 24 countries. Arch Paediatr Adolesc Med. 2008, 162: 66-73. 10.1001/archpediatrics.2007.8.CrossRef
18.
Bundeszentrale für gesundheitliche Aufklärung: Sexualität und Migration: Milieuspezifische Zugangswege für die Sexualaufklärung Jugendlicher. Ergebnisse einer repräsentativen Untersuchung der Lebenswelten von 14- bis 17-Jährigen Jugendlichen mit Migrationshintergrund. 2010, BZgA,
19.
20.
Berrington de González A, Sweetland S, Green J: Comparisons of risk factors for squamous cell and adenocarcinomas of the cervix: a meta-analysis. Br J Cancer. 2004, 90: 1787-1791.PubMedPubMedCentral
21.
Reich O: Is early first intercourse a risk factor for cervical cancer?. Gynäkol Geburtshilfliche Rundsch. 2005, 45: 251-256. 10.1159/000087143.CrossRefPubMed
22.
Gille G, Klapp C: Chlamydia trachomatis infections in teenagers. Der Hautarzt. 2007, 58: 31-37. 10.1007/s00105-006-1265-x.CrossRefPubMed
23.
Hwang LY, Ma Y, Miller Benningfield S, Clayton L, Hanson EN, Jay J, Jonte J, Godwin de Medina C, Moscicki AB: Factors that influence the rate of epithelial maturation in the cervix of healthy young women. J Adolesc Health. 2009, 44 (2): 103-110. 10.1016/j.jadohealth.2008.10.006.CrossRefPubMedPubMedCentral
24.
25.
Ford N: The AIDS awareness and sexual behaviour of young people in the South-west of England. J Adolesc. 1992, 15: 393-413. 10.1016/0140-1971(92)90071-C.CrossRefPubMed
26.
Persson E, Sandströäm B, Jarlbro G: Sources of information, experiences and opinions on sexuality, contraception and STD protection among young Swedish students. Advances in Contraception. 1992, 8: 41-49. 10.1007/BF01849347.CrossRefPubMed
27.
Editorial team: Young people's knowledge of sexually transmitted infections and condom use surveyed in England. Euro Surveill. 2005, 10 (31): pii = 2766- Last accessed 30.11.2010
28.
Lister-Sharpe D, Chapman S, Stewart-Brown S, Sowden A: Health promoting schools amd health promotion in schools: two systematic reviews. Health Technol Assess. 1999, 3 (22): 1-207.
29.
Wight D, Raab G, Henderson M, Abraham C, Buston K, Hart G, Scott S: Limits of teacher delivered sex education: interim behavioural outcomes from randomised trial. BMJ. 2002, 324: 1-6.CrossRef
30.
Stephenson J, Strange V, Forrest S, Oakley A, Copas A, Allen E, Babiker A, Black S, Ali M, Monteiro H, Johnson AM: Pupil-led sex education in England (RIPPLE study): cluster randomised intervention trial. Lancet. 2004, 364 (9431): 338-346. 10.1016/S0140-6736(04)16722-6.CrossRefPubMed
31.
32.
Bundeszentrale für gesundheitliche Aufklärung: Country papers on youth sexuality in Europe - Synopsis. 2006, BZgA,
33.
Bobrova N, Sergeev O, Grechukhina T, Kapiga S: Social-cognitive predictors of consistent condom use among young people in Moscow. Perspect Sex Reprod Health. 2005, 37 (4): 174-178. 10.1363/3717405.CrossRefPubMed
34.
35.
36.
Fogarty J: Knowledge about AIDS among leaving certificate students. Irish Med Journal. 1990, 83: 19-21.
37.
Andersson-Ellström A, Forssman L: Sexually transmitted diseases - knowledge and attitudes among young people. J Adolesc Health. 1991, 12: 72-76. 10.1016/0197-0070(91)90446-S.CrossRefPubMed
38.
Tyden T, Norden L, Ruusuvaara L: Swedish students' knowledge of sexually transmitted diseases and their attitudes to the condom. Midwifery. 1991, 7: 25-30. 10.1016/S0266-6138(05)80131-7.CrossRefPubMed
39.
Lunin I, Hall TL, Mandel JS: Adolescent sexuality in Saint Petersburg, Russia. AIDS. 1995, 9 (suppl 1): S53-S60.PubMed
40.
Andersson-Ellström A, Forssman L, Milsom I: The relationship between knowledge about sexually transmitted diseases and actual sexual behaviour in a group of teenage girls. Genitourin Med. 1996, 72: 32-36.PubMedPubMedCentral
41.
Eriksson T, Sonesson A, Isacsson A: HIV/AIDS - information and knowledge: a comparative stud of Kenyan and Swedish teenagers. Scand J Soc Med. 1997, 25: 111-118.PubMed
42.
Garside R, Ayres R, Owen M, Pearson VAH, Roizen J: 'They never tell you about the consequences': young people's awareness of sexually transmitted infections. Int J STD & AIDS. 2001, 12: 582-588. 10.1258/0956462011923750.CrossRef
43.
Goodwin R, Kozlova A, Nizharadze G, Polyakove G: HIV/AIDS among adolescents in Eastern Euorpe: knowledge of HIV/AIDS, social representations of risk and sexual activity among school children and homeless adolescents in Russia, Georgia and the Ukraine. J Health Psych. 2004, 9: 381-396.CrossRef
44.
Macek M, Matkovic V: Attitudes of school environment towards integration of HIV-positive pupils into regular classes and knowledge about HIV/AIDS: cross-sectional study. Croat Med J. 2005, 26: 320-325.
45.
Woodhall Sc, Lehtinen M, Verho T, Huhtala H, Hokkanen M, Kosunen E: Anticipated acceptance of HPV vaccination at the baseline of implementation: a survey of parental and adolescent knowledge and attitudes in Finland. J Adolesc Health. 2007, 40: 466-469. 10.1016/j.jadohealth.2007.01.005.CrossRefPubMed
46.
Gottvall M, Larsson M, Högkund AT, Tydén T: High HPV vaccine acceptance despite low awareness among Swqedish upper secondary school students. Eur J Contr Repr Health Care. 2009, 14: 399-405. 10.3109/13625180903229605.CrossRef
47.
Höglund AT, Tydén T, Hannerfors AK, Larsson M: Knowledge of human papillomavirus and attitudes to vaccination among Swedish high school students. Int J STD & AIDS. 2009, 20: 102-107. 10.1258/ijsa.2008.008200.CrossRef
48.
Pelucchi C, Esposito S, Galeone C, Semino M, Sabatini C, Picciolli I, Consolo S, Milani G, Principi N: Knowledge of human papillomavirus infection and its prevention among adolescents and parents in the greater Milan area, Northern Italy. BMC Public Health. 2010, 10: 378-10.1186/1471-2458-10-378.CrossRefPubMedPubMedCentral
49.
Sachsenweger M, Kundt G, Hauk G, Lafrenz M, Stoll R: Knowledge of school pupils about the HIV/AIDS topic at selected schools in Mecklenburg-Pomerania: Results of a survey of school pupils. Gesundheitswesen. 2010, online publication 2.3.2010, , [http://​dx.​doi.​org/​10.​1055/​s-0029-1246199]
50.
Vinten G: Open versus closed questions - an open issue?. Manag. 1995, 33: 27-31.
51.
52.
Piccinino LJ, Mosher WD: Trends in contraceptive use in the United States: 1982-1995. Family Planning Perspectives. 1998, 30: 4-10. 10.2307/2991517.CrossRefPubMed
53.
Glei DA: Measuring contraceptive use patterns among teenage and adult women. Family Planning Perspectives. 1999, 31: 73-80. 10.2307/2991642.CrossRefPubMed
54.
Everett SA, Warren CW, Santelli JS, Kann L, Collins JL, Kolbe LJ: Use of birth control pills, condoms and withdrawal among U.S. high school students. Journal of Adolescent Health. 2000, 27: 112-118. 10.1016/S1054-139X(99)00125-1.CrossRefPubMed
55.
Kaaya SF, Flisher AJ, Mbwambo JK, Schaalma H, Aaro LE, Klepp KI: A review of studies of sexual behaviour of school students in sub-Saharan Africa. Scandinavian Journal of Public Health. 2002, 30: 148-160.PubMed
56.
Abraham C, Wight D: Developing HIV-preventive behavioural interventions for young people in Scotland. Int Journal of STD and AIDS. 1996, 7 (suppl 2): 39-42.CrossRef
57.
Helfferich C, Heidtke B: Country papers on youth sex education in Europe. 2006, BZgA
Metadata
Title
Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature
Authors
Florence N Samkange-Zeeb
Lena Spallek
Hajo Zeeb
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-727

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