Sexually Transmitted Disease Knowledge and Infections with Chlamydia and Gonorrhea Among High School Students

Background:
Sexually transmitted diseases (STDs) in the United States (US) are estimated to have reached epidemic proportions and the epidemic is thought to be partly due to the poor knowledge of Americans about STDs.

Objective:
To determine high school students' basic knowledge of STDs and whether poor knowledge is associated with chlamydia and gonorrhea infections.

Method:
During the 2003-2004 and 2004-2005 school years, 3564 students in an urban US school district participated in a chlamydia and gonorrhea screening using nucleic acid amplification tests (NAATs) in urine specimens. They were asked in a self-administered survey to indicate diseases they knew were transmitted sexually from a list composed of gonorrhea, syphilis, hepatitis A, hepatitis B, hepatitis C, herpes, chlamydia and warts; the ones that can be cured; whether a person infected with an STD could have no symptoms; and whether STDs could be prevented. A score was assigned to each knowledge item. For each respondent, the possible total knowledge score ranged between -7 and 30.

Result:
The mean knowledge score for all respondents was 16.24 ± 6.89 (range: -1 to 30, median: 17.00). Mean knowledge scores between students infected with chlamydia and/or gonorrhea were not significantly different from uninfected students. In a multiple regression equation that controlled for gender, age, chlamydia and gonorrhea infections, only gender (p<.001) and age (p<.001) significantly predicted knowledge score. Infections with chlamydia (p=.637) and gonorrhea (p=.440) did not significantly predict knowledge score.

Conclusion:
There was an insufficient knowledge of basic STD facts in this population and a lack of linear association between STD knowledge and infections with chlamydia and gonorrhea. NAATs in self-collected specimens provide opportunities to educate high school students about STDs.

Implications:
STD screening programs targeting adolescents should explore strategies to better educate participants about STDs to increase knowledge and correct misconceptions adolescents might have regarding STDs.