Sexually transmitted infections (STIs) are the most pervasive and harmful infectious disorders among adolescents. According Centers for Disease Control and Prevention, (2018) found that youths aged between 15 and 24years old account for 50% of all reported STI cases. This prevalence is due to youths being more prone to participate in risky activities, specifically in developed nations that elevate their chance of acquiring STIs [16].
The average age of the patients in the current research was in their twenties. On the same line, the same age range was taken into account in North East Scotland and Egyptian studies looking at STIs in young people [17, 18].
Our study showed that 98.94% of participants had a low level of knowledge before the intervention; this may be due to talking about STIs being frowned upon in Egyptian culture due to ethical and social issues that create numerous barriers. This is consistent with a study conducted in Saudi Arabia, Egypt and India [12, 19,20,21]. But our result disagreed with an Iranian and an Ethiopian studies that found a total of 49% and 39.1% of the participants had low sexually transmitted infections knowledge scores respectively [22,23,24].
Current study showed no significant difference in the pre-intervention level of knowledge about STIs between health science and non- health science students. These findings contrast with studies conducted in Malaysian, Turkey, Saudi Arabia, and Italy that showed students from health science possessed a higher level of good knowledge of STIs than non-health sciences at pre-intervention [25,26,27,28].
In the present study, the knowledge of the students at pre-intervention was not influenced by the gender and residence of the students. This was consistent with studies conducted in Ethiopia and Iran [29, 30]. But in opposition to studies conducted in Malaysia and Iraq that detected a higher level of knowledge was observed among females and participants from the urban areas [25, 31]. This could be explained by that STIs are stigmatized and have major societal and personal consequences since they are associated with shame, embarrassment, and discrimination especially in Middle East countries.
Parents’ educational backgrounds and socioeconomic status had no effect on the research group’s pre-intervention knowledge level, but were connected with their level of knowledge immediately after the intervention. This matched with studies in Malaysia, Egypt and Iraq that found a high educational level and socioeconomic status mediated an increase in adolescents’ awareness of STIs [31,32,33].
The current study found no statistically significant relationship between gender, residence, and socioeconomic status qualification concerning students’level of knowledge immediately after the intervention. This coincides with research conducted in Egypt-Banha city [18]. In contrast to another Egyptian study in Zagazig city that showed females, urban inhabitants, and high socioeconomic status had a higher post-intervention knowledge about STIs [33].
According to current research, knowledge and attitudes concerning STIs increased significantly, after the health education intervention was completed. This is consistent with several STI health education interventional research studies [2, 18, 34, 35]. Health education sessions were crucial in educating students about the definition, causes, modes of transmission, and prevention of STIs, which helped them develop a more positive attitude on the disease.
The results of the current study showed that students’knowledge about sexually transmitted infections was markedly significant increases immediately after the intervention then it slightly declined when tested four months later but still higher than the pre-intervention state. This is corresponding to an Egyptian conducted in Zagazig City [33] but disagreed with research in Iran and Netherlands which demonstrated that smart phone applications efficiently maintained the educational program’s effects on STI-related preventative behavior [36, 37].
In terms of attitude level prior to intervention, health science students have a greater attitude level than non- health science students; this finding contradicted an Iranian research [38]. The health science students’attitude is extremely important because it has the potential to cause social stigma, lack of proper care and attention, and distance from those who have STIs. This could then result in discrimination in the provision of services for those who have these diseases.
In the present study, their gender and residents did not influence the attitude of the students at pre-intervention time. This matched with a study on health science students of Menoufia University [29]. This may be explained by the stigma associated with the diseases, which affects everyone without regard to sex or place of residence and keeps people feeling anxious and ashamed.
The educational and socioeconomic status of students’parents affected their pre-intervention attitude level in the current study. This conclusion was consistent with Ethiopian and Brazilian studies [39, 40], but not with an Egyptian study [33].
This study found a considerably marked improvement in attitudes toward STIs immediately following the intervention also slightly increased when tested four months later which is similar to Egyptian studies [2, 33].
The improvement in research students’attitudes immediately after the intervention compared to before the intervention seems to be brought about by their increased knowledge. In other words, having more information is linked to having a better attitude. This matched with Nigerian and Romanian studies [41, 42].
According to Becker’s health belief model, people’s knowledge and attitudes about health-related issues may influence how they behave in the future. This means that studing the psychoeducational implications of studies that evaluate these indices can be helpful in developing and implementing education and public health campaigns that are appropriate for the local environment [43].
The majority of present study students are willing to seek medical care if they experience any STI symptoms, believed that STIs should be taught in schools, and getting checked for STIs before getting married is critical, these findings were in agreement with other researches in Malaysia, Saudi Arabia, and Egypt [25, 27, 32, 33, 44]. Only 63.5% accept sharing a meal with an HIV-positive person, contrary to an Indian research that found around (84%) [45]. Indian study illustrated that 8% of study group talk to parents about sexual matters, and receive information from them. The positive relationship between parents and children was connected with reduced levels of unprotected sex, unwanted pregnancies, and STIs in teens [23]. These results support the beneficial impact of interventional orientation sessions in educating students and fostering a positive attitude on STI diseases.
Limitation
The research topic was socially sensitive, which led to the students’ shyness. The study conducted on a certain number of university students and not all students were covered. The STI stigma prevented more students from participating. It was challenging to plan and organize four health education sessions for each study faculty. Guidance lectures were at the end of the school day, which affected the students’ ability to comprehend well due to their fatigue. Assessment challenges four months later and communication breakdowns with students to evaluate the final research evaluation. Financial support was not available and therefore a guidance booklet for students was not provided.
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