Occupational Medicine Unit, Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy.
Public Health Department, University Health Agency Giuliano-Isontina (ASUGI), 34128 Trieste, Italy.
Int J Environ Res Public Health. 2022 Jan 14;19(2):897. doi: 10.3390/ijerph19020897.
. The peak of sexually transmitted infections (STI) among adolescents/young adults suggests a low level of prevention. In order to assess whether the level of sexual health education (SHE), received by several channels, was effective at improving sexual behaviors, we conducted a survey among freshmen from four Italian universities. . This observational cross-sectional study was carried out with an anonymous self-reported paper questionnaire, administered during teaching lectures to university freshmen of the northern (Padua, Bergamo, and Milan campuses) and southern (Palermo campus) parts of the country. Knowledge of STI (a linear numerical score), knowledge of STI prevention (dichotomous variable: yes vs. no) and previous STI occurrence (polytomous variable: "no"; "don't know"; "yes") were the outcomes in the statistical analysis. . The final number of freshmen surveyed was 4552 (97.9% response rate). The mean age of respondents was 21.4 ± 2.2 years and most of them (70.3%) were females. A total of 60% of students were in a stable romantic relationship. Only 28% respondents knew the most effective methods to prevent STI (i.e., condom and sexual abstinence), with a slightly higher prevalence of correct answers among females (31.3%) than males (25.8%). Students with history of STIs were 5.1%; they reported referring mostly to their general practitioner (GP) (38.1%) rather than discussing the problem with their partner (13.1%). At multivariable analysis, a significantly higher level of STI knowledge was observed in older students (25+ years of age), biomedical students, and those from a non-nuclear family; lower levels were found among students of the University of Palermo, and those who completed a vocational secondary school education. Those who had less knowledge about the most effective tools to prevent STIs included males, students from the University of Palermo, students registered with educational sciences, economics/political sciences, those of foreign nationality, and those whose fathers had lower educational levels. The risk of contracting a STI was significantly lower only in students not in a stable relationship (relative risk ratio, RRR = 0.67; 95% confidence interval, 95%CI = 0.48; 0.94), whereas such risk was significantly higher in students with higher STI knowledge (RRR = 1.15; 95%CI = 1.08; 1.22). . University freshmen investigated in this study had poor knowledge of STIs and their prevention. Unexpectedly, those with higher levels of knowledge had an increased risk of STIs. There have been no educational interventions-with good quality and long-term follow-ups-that increased the confidence that such SHE programs could have population level effects. A new high-quality study is therefore recommended to assess the effectiveness of an intervention generating behavioral changes; increasing only STI knowledge may not be sufficient.
. 性传播感染（STI）在青少年/年轻人中的高峰期表明预防水平较低。为了评估通过多种渠道获得的性健康教育（SHE）是否能有效改善性行为，我们对意大利四所大学的新生进行了一项调查。. 这项观察性横断面研究采用匿名自我报告的纸质问卷进行，在国家北部（帕多瓦、贝加莫和米兰校区）和南部（巴勒莫校区）的大学新生教学讲座期间进行。性传播感染知识（线性数值评分）、性传播感染预防知识（二分变量：是/否）和以前性传播感染的发生（多项变量：“否”；“不知道”；“是”）是统计分析中的结果。. 最终调查的新生人数为 4552 人（应答率为 97.9%）。受访者的平均年龄为 21.4 ± 2.2 岁，其中大多数（70.3%）为女性。共有 60%的学生处于稳定的恋爱关系中。只有 28%的受访者知道预防 STI 最有效的方法（即避孕套和性行为禁欲），女性（31.3%）的正确答案比例略高于男性（25.8%）。有性传播感染史的学生占 5.1%；他们报告主要向他们的全科医生（GP）（38.1%）咨询，而不是向他们的伴侣（13.1%）讨论问题。多变量分析显示，年龄较大（25 岁以上）、生物医学专业学生和来自非核心家庭的学生 STI 知识水平显著较高；巴勒莫大学的学生和完成职业中学教育的学生水平较低。那些对预防 STI 最有效工具的知识较少的人包括男性、巴勒莫大学的学生、注册教育科学、经济学/政治学的学生、外国国籍的学生和父亲教育水平较低的学生。只有不稳定关系的学生（相对风险比，RRR = 0.67；95%置信区间，95%CI = 0.48；0.94）的性传播感染风险显著降低，而 STI 知识水平较高的学生的风险显著增加（RRR = 1.15；95%CI = 1.08；1.22）。. 在这项研究中，调查的大学新生对性传播感染及其预防的知识很差。出乎意料的是，那些知识水平较高的人感染性传播感染的风险更高。还没有高质量的长期随访的教育干预措施，增加了这种 SHE 项目可能对人群水平产生影响的信心。因此，建议进行一项新的高质量研究，以评估产生行为改变的干预措施的有效性；仅增加 STI 知识可能还不够。
