Sexually Transmitted Infections: Does knowledge impact perceived susceptibility?

Introduction: Young adults (18-24) have high rates of sexually transmitted infections (STIs), including bacterial infections such as chlamydia and gonorrhea. STI research commonly focuses on disease prevention through reducing the associated risk behaviors, such as condomless sexual activity, but limited research exists on risk perceptions related to STIs. Perceived susceptibility, a Health Belief Model construct, describes perceived risk of acquiring a disease. This study assessed perceived susceptibility to chlamydia and gonorrhea and the relationship with STI knowledge.

Methods: An online survey panel was used to recruit sexually active young adults aged 18-24 (n=375). STI knowledge was assessed using the Sexually Transmitted Disease Knowledge Questionnaire, a 27-item validated scale. The participants responded to each statement with either true, false, or don’t know. Correct responses were given one point and the scores were averaged to calculate a knowledge score, with a perfect score being 27. Perceived susceptibility to chlamydia and gonorrhea infection was measured using three categories (strongly disagree/disagree, neutral, agree/strongly agree). Demographics including gender, race, sexual orientation, and education status were collected. Participants also reported on prior gonorrhea and/or chlamydia diagnoses as well as current sex practices and risk behaviors. Descriptive and bivariate analyses were conducted in SPSS. This study was approved by the university’s Institutional Review Board.

Results: The average knowledge score among participants was 8.3 (standard deviation=5.4, range 0-22). Most respondents perceived that they were not at risk (strongly disagreed/disagreed) for acquiring chlamydia (54%) or gonorrhea (50%). The average knowledge score did not significantly differ by participants perceived susceptibility to chlamydia (p=.087). However, those who agreed/strongly agreed that they were at risk of contracting gonorrhea had a significantly higher knowledge score (mean of 9.9) than those who were neutral (mean knowledge score of 7.7; p=.016) or strongly disagreed/disagreed (mean knowledge score of 8.0; p=.021).

Conclusion: The results from this study indicate a significant relationship between STI knowledge and perceived susceptibility to contracting gonorrhea, leading to the conclusion that individuals with more knowledge about STIs can more accurately assess their potential risk of infection. However, this relationship was not noted with perceived susceptibility of contracting chlamydia. Further exploring the difference in overall STI knowledge scores based on susceptibility of disease may provide insight into specific areas of STI knowledge to improve. Future aims should be broadly directed towards STI education among sexually active young adults to increase perceived susceptibility to these infections and improve preventative behaviors, such as increasing condom use.