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Abstract
Adolescence is the most dynamic period in human development. It is marked by profound biological and psychological changes. In spite of this, adolescent health, especially reproductive health, is a neglected area, as evidenced by the absence of reliable sexual health related information. Adolescents are subjected to many influences, including those of parents, teachers, colleagues, health care providers, and particularly religious and culture norms. Moreover, adolescence is a time of confusion and vulnerability to certain risk-taking behavior, which may lead to serious complications as STDs. Accordingly, there is an urgent need to focus more attention on adolescence sexual and reproductive health to reduce vulnerability of adolescent girls to STDs.
The present study aim was to recognize the perception of adolescent girls regarding the sexually transmitted diseases. The work was directed to answer the questions: ”Do adolescent girls have any information about the signs and symptoms of sexually transmitted infections? Do adolescent girls have any information about personal hygiene? Is there a relation between knowledge about sexually transmitted diseases and socio-demographic characteristic of adolescent girls?”.
This descriptive cross-sectional study was done in three different governmental secondary schools for girls in Benha city. Subjects included 420 secondary school girl selected by random sampling technique. The data were collected using a self-administered questionnaire. It consisted of five parts: socio-demographic characteristics, medical history, menstrual history, knowledge about STDs and reproductive health, and an attitude rating scale intended to assess the attitude of adolescent girls toward STDs and reproductive health. Data were collected over six months throughout the period form 1/11/2006 to 1/5/2007.
The study results revealed the following:
Students’ mean age was 15.6±1.0, most fathers (62.6%) and mothers (50.2%) had university education (50.2%).
Family size ranged between 3 to 11, 63.8% had insufficient family income, 68.1% had a crowding index less than two, and 77.4% were from urban areas.
Anemia affected 22.6% of the students, and 7.6% had bronchial asthma; 21.0% were taking regular medications
Slightly more than half of students (52.9%) were circumcised, the majority (87.8%) done by doctors, and 4.1% had related complication.
The majority (97.9%) had menarche, mostly at the age 12 to 13 years, with 94.1% having associated pain.
Less than two thirds (62.1%) of the students knew the correct meaning of STDs; the most commonly known STD was AIDS (89.3%), followed by gonorrhea (62.6%) and syphilis (62.1%); only 23.8% had the knowledge about the risk of unclean toilet in transmission
Concerning symptoms of STDs, 60.2% had a correct knowledge about ulcers/nodules on genitalia (60.2%), while only 21.0% mentioned greenish-yellow vaginal secretion; infertility was the most known complication (76.2%), followed by abortion (57.1%).
Knowledge about treatment was low, especially for herpes and chlamydia, 6.0% and 3.8%, respectively.
The most commonly reported menstrual symptom was abdominal pain (89.0%) and low back pain (54.8%); 80.5% of students had correct knowledge about washing hands after changing pads; only 42.4% mentioned changing pads regularly.
The highest levels of satisfactory knowledge were related to anatomy of reproductive system (73.8%), and female genital mutilation (73.6%); only 29.0% had satisfactory knowledge about sexually transmitted diseases.
The sources of information about STDs and reproductive health were mainly the school in the sciences subject (44.7%), and mass media (29.0%).
The highest percentage of positive attitude towards was related to nutrition (70.0%), followed by menstruation and menstrual hygiene (50.2%); only 45.0% had positive attitudes regarding STDs; 52.1% of the students had total positive attitude.
More students residing in urban areas had satisfactory knowledge (49.2%), compared to those in rural areas (30.5%), p<0.001, and more students having municipal system for sewage disposal had satisfactory knowledge, compared to those having trench latrines, 47.2% and 25.6%, respectively, p=0.007.
Students having had information through mass media (p=0.006), school science subject (p<0.001), school curricula (p<0.001), and seminars in schools (p<0.001) had higher percentage of satisfactory knowledge, compared to those not depending on these sources.
The highest percentage of positive attitude was in the third year (59.3%), while the lowest percentage was in the second years (44.3%).
Students with working mothers had a higher percentage of positive attitude (57.7%) compared to those whose mothers were housewives (47.3%), p=0.03.
Students with a history of FGM and who had related complications had statistically significantly lower percentages of positive attitudes (47.3% and 0.0%, respectively), compared to those with negative history.
A statistically significant moderate positive correlation was revealed between students’ scores of knowledge and attitude towards sexually transmitted diseases and reproductive health (r= 0.402, p<0.001).
In conclusion, most of the studied female students had unsatisfactory knowledge about reproductive health and STDs. Urban residence was associated with better knowledge. Still negative attitudes prevail regarding STDs and related health-seeking behaviors. Knowledge and attitude were positively correlated.
Based on the study findings, it is recommended to conduct sessions discussing sexual health and STDs for mothers, with the cooperation of Non-Governmental Organizations (NGOs), and worship places (mosques and churches), as well as the National Women Council, and media. Further research is proposed to explore the various socio-cultural and behavioral determinants of sexual risk behaviors, which may lead to STDs.