Self-reported sexually transmitted infections and associated risk factors among female university students

Keywords: Sexually transmitted diseases, sexual behavior, unsafe sex, sexual health, young adult

Abstract

Background: The spread of sexually transmitted infections (STIs) is an ongoing public health challenge, and awareness of risk factors is essential for designing effective preventive interventions. This study aimed to assess self-reported STI occurrences and identify risk factors and sexual behaviors associated with STIs among female university students.

Methods: This is a cross-sectional, online questionnaire study, including 384 female university students seeking contraceptive counseling at a gynecology clinic in Uppsala, Sweden, and reporting having had sex. Associated risk factors and behaviors were assessed by comparing those who reported STIs and those who did not.

Results: The mean age of participants was 22.8 years. Seventy-eight (20%) had contracted at least one STI, with seven (9%) experiencing multiple infections. Seventy-three (94%) reported first-date sexual activity without a condom among STI experienced. Chlamydia trachomatis was the most common STI pathogen (68% of all infections), followed by Herpes simplex virus (18%) and Mycoplasma genitalium (13%). Behavioral factors associated with self-reported STIs were first-date sexual activity without a condom, not using condom at first intercourse, younger age at first intercourse, a higher number of sexual partners overall and in the last 12 months, experience of anal sex, dating app usage, and regretting sexual activity after substance use (P < 0.003 for all).

Conclusions: Condom use was low among the respondents, and STIs were common regardless of the high level of education in this group. Contraceptive counseling needs to highlight the importance of condom use in addition to contraceptive efficacy. It is also essential to consider the specific risk factors and behaviors prevalent among young adults to reduce the spread of STIs.

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References

1. Unemo M, Bradshaw CS, Hocking JS, de Vries HJC, Francis SC, Mabey D, et al. Sexually transmitted infections: challenges ahead. Lancet Infect Dis. 2017;17(8):e235–79. doi: 10.1016/S1473-3099(17)30310-9

2. Van Gerwen OT, Muzny CA, Marrazzo JM. Sexually transmitted infections and female reproductive health. Nat Microbiol. 2022;7(8):1116–26. doi: 10.1038/s41564-022-01177-x

3. Durbeej N, Elgán T, Roa JP. Berusningsdrickande i studentlivet. Report No.: 2. Stockholm: IQ; 2017, pp. 1–16. Available from: http://www.stad.org/sites/default/files/media/IQ%20rapport%202017-2%20Berusningsdrickande%20i%20studentlivet_1.pdf [cited 17 April 2024].

4. Davoren MP, Demant J, Shiely F, Perry IJ. Alcohol consumption among university students in Ireland and the United Kingdom from 2002 to 2014: a systematic review. BMC Public Health. 2016;16:173. doi: 10.1186/s12889-016-2843-1

5. Carey KB, Guthrie KM, Rich CM, Krieger NH, Norris AL, Kaplan C, et al. Alcohol use and sexual risk behavior in young women: a qualitative study. AIDS Behav. 2019;23(6):1647–55. doi: 10.1007/s10461-018-2310-3

6. Scott-Sheldon LAJ, Carey KB, Cunningham K, Johnson BT, Carey MP, MASH Research Team. Alcohol use predicts sexual decision-making: a systematic review and meta-analysis of the experimental literature. AIDS Behav. 2016;20(Suppl 1):S19–39. doi: 10.1007/s10461-015-1108-9

7. Hansen BT, Kjaer SK, Munk C, Tryggvadottir L, Sparén P, Hagerup-Jenssen M, et al. Early smoking initiation, sexual behavior and reproductive health – a large population-based study of Nordic women. Prev Med. 2010;51(1):68–72. doi: 10.1016/j.ypmed.2010.03.014

8. Bao YP, Liu ZM, Li JH, Zhang RM, Hao W, Zhao M, et al. Club drug use and associated high-risk sexual behaviour in six provinces in China. Addict Abingdon Engl. 2015;110(Suppl. 1):11–19. doi: 10.1111/add.12770

9. Khadr SN, Jones KG, Mann S, Hale DR, Johnson AM, Viner RM, et al. Investigating the relationship between substance use and sexual behaviour in young people in Britain: findings from a national probability survey. BMJ Open. 2016;6(6):e011961. doi: 10.1136/bmjopen-2016-011961

10. Guo C, Wen X, Li N, Wang Z, Chen G, Zheng X. Is cigarette and alcohol use associated with high-risk sexual behaviors among youth in China? J Sex Med. 2017;14(5):659–65. doi: 10.1016/j.jsxm.2017.03.249

11. Ren Z, Zhou Y, Liu Y. Factors associated with unsafe sexual behavior among sexually active Chinese university students, Hebei Province, 2019. BMC Public Health. 2021;21(1):1904. doi: 10.1186/s12889-021-11992-2

12. Anderson LE, Dingle GA, Moran C, Gullo MJ. Testing a psychosocial model of sexual communication and sexual risk-taking: a cross-sectional, online survey study of Australian university students. Sex Reprod Healthc Off J Swed Assoc Midwives. 2022;34:100788. doi: 10.1016/j.srhc.2022.100788

13. Cabecinha M, Mercer CH, Gravningen K, Aicken C, Jones KG, Tanton C, et al. Finding sexual partners online: prevalence and associations with sexual behaviour, STI diagnoses and other sexual health outcomes in the British population. Sex Transm Infect. 2017;93(8):572–82. doi: 10.1136/sextrans-2016-052994

14. Deogan C, Jacobsson E, Mannheimer L, Björkenstam C. Meeting sexual partners online and associations with sexual risk behaviors in the Swedish population. J Sex Med. 2020;17(11):2141–7. doi: 10.1016/j.jsxm.2020.08.001

15. Chanakira E, O’Cathain A, Goyder EC, Freeman JV. Factors perceived to influence risky sexual behaviours among university students in the United Kingdom: a qualitative telephone interview study. BMC Public Health. 2014;14:1055. doi: 10.1186/1471-2458-14-1055

16. Guleria S, Faber MT, Hansen BT, Arnheim-Dahlström L, Liaw KL, Munk C, et al. Self-perceived risk of STIs in a population-based study of Scandinavian women. Sex Transm Infect. 2018;94(7):522–7. doi: 10.1136/sextrans-2017-053397

17. Liuccio M, Borgia C, Chiappetta M, Martino B, Giordano F. The condom use among young adults and its determinants: an Italian study. Clin Ter. 2019;170(4):e278–84.

18. Tiblom Ehrsson Y, Stenhammar C, Rosenblad A, Åkerud H, Larsson M, Tydén T. Self-reported sexually transmitted infections among female university students. Ups J Med Sci. 2016;121(1):45–9. doi: 10.3109/03009734.2015.1093568

19. Tydén T, Olsson S, Björkelund-Ylander C. Female university students in Sweden: sex, contraception and STDs. Adv Contracept Off J Soc Adv Contracept. 1991;7(2–3):165–71. doi: 10.1007/BF01849406

20. Tydén T, Björkelund C, Odlind V, Olsson SE. Increased use of condoms among female university students: a 5-year follow-up of sexual behavior. Acta Obstet Gynecol Scand. 1996;75(6):579–84. doi: 10.3109/00016349609054675

21. Larsson M, Tydén T. Increased sexual risk taking behavior among Swedish female university students: repeated cross-sectional surveys. Acta Obstet Gynecol Scand. 2006;85(8):966–70. doi: 10.1080/00016340600626941

22. Tydén T, Palmqvist M, Larsson M. A repeated survey of sexual behavior among female university students in Sweden. Acta Obstet Gynecol Scand. 2012;91(2):215–19. doi: 10.1111/j.1600-0412.2011.01297.x

23. Stenhammar C, Ehrsson YT, Åkerud H, Larsson M, Tydén T. Sexual and contraceptive behavior among female university students in Sweden – repeated surveys over a 25-year period. Acta Obstet Gynecol Scand. 2015;94(3):253–9. doi: 10.1111/aogs.12565

24. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. doi: 10.1016/j.jbi.2008.08.010

25. Folkhälsomyndigheten. Klamydiainfektion – sjukdomsstatistik. Available from: https://www.folkhalsomyndigheten.se/folkhalsorapportering-statistik/statistik-a-o/sjukdomsstatistik/klamydiainfektion/?tab=tab-report&rid%5B%5D=123532 [cited 9 May 2024].

26. Folkhälsomyndigheten. Gonorré – sjukdomsstatistik. Available from: https://www.folkhalsomyndigheten.se/folkhalsorapportering-statistik/statistik-a-o/sjukdomsstatistik/gonorre/?tab=tab-report [cited 9 May 2024].

27. Björnelius E. Mycoplasma genitalium – en ny utmaning för våra mottagningar. Läkartidningen. 2021;118(44–45):21062.

28. Folkhälsomyndigheten. 2023. När hände vad under pandemin? Available from: https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utbrott/aktuella-utbrott/covid-19/nar-hande-vad-under-pandemin/ [cited 15 April 2024].

29. Borneskog C, Häggström-Nordin E, Stenhammar C, Tydén T, Iliadis SI. Changes in sexual behavior among high-school students over a 40-year period. Sci Rep. 2021;11(1):13963. doi: 10.1038/s41598-021-93410-6

30. Regushevskaya E, Dubikaytis T, Laanpere M, Nikula M, Kuznetsova O, Karro H, et al. The determinants of sexually transmitted infections among reproductive age women in St. Petersburg, Estonia and Finland. Int J Public Health. 2010;55(6):581–9. doi: 10.1007/s00038-010-0161-4

31. Faber MT, Nielsen A, Nygård M, Sparén P, Tryggvadottir L, Hansen BT, et al. Genital chlamydia, genital herpes, Trichomonas vaginalis and gonorrhea prevalence, and risk factors among nearly 70,000 randomly selected women in 4 Nordic countries. Sex Transm Dis. 2011;38(8):727–34. doi: 10.1097/OLQ.0b013e318214bb9b

32. Svenskarna och internet 2021. Internetstiftelsen; 2021, pp. 262–79. Available from: https://svenskarnaochinternet.se/app/uploads/2021/09/internetstiftelsen-svenskarna-och-internet-2021.pdf [cited 3 July 2024].
Published
2024-10-01
How to Cite
Smeds S., Obern C., Sundström Poromaa I., Westerbergh J., Tydén T., & Gyllenberg F. (2024). Self-reported sexually transmitted infections and associated risk factors among female university students. Upsala Journal of Medical Sciences, 129, e10943. https://doi.org/10.48101/ujms.v129.10943