Abstract
The objective of this research was to assess that knowledge, attitudes, and practices regarding sexual heath among rural college students in Nebraska. We administered an electronic survey (n = 125) that was adapted from the YRBSS and National College Health Assessment to compare results to national estimates. Results show condom use was below the national average (38.4% vs. 54.1%) during last time of having sexual intercourse. Only half (51%) of rural college students had received the HPV vaccine, and significantly less among males (18%) compared to females (60%). 37% of participants strongly agreed/agreed they felt their parents would find out if they had an STI screening, and even more felt their social group would find out (42%). Nearly all (92%) of the participants strongly agreed/agreed that they would tell their partner if they noticed that they had symptoms of an STI; although, over half (60%) of the participants strongly agreed/agreed that they thought they could tell if there was a change in their body indicating after contracting a STI, 33% did not know that STIs can have no symptoms, and over half (52%) almost never/never get STI screening when they had new partners. There was a significant positive association between with highest level of sexual health education and composite knowledge scores. The results show that sexual health among rural college students is an important, but understudied, health disparity. Online and college-oriented interventions could be used to help bridge the gap of sexual health education in states that do not mandate sexual health education, like Nebraska.
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References
Centers for Disease Control and Prevention. (2019). Sexually transmitted disease surveillance 2018. Atlanta: Department of Health and Human Services. https://doi.org/10.15620/cdc.79370
Center for Disease Control and Prevention. (2017). Genital HPV infection-fact sheet. Retrieved April 2020 from https://www.cdc.gov/std/hpv/HPV-FS-July-2017.pdf.
Hood, J. E., & Friedman, A. L. (2011). Unveiling the hidden epidemic: a review of stigma associated with sexually transmissible infections. Sexual health, 8(2), 159–170.
Shepherd, L., & Harwood, H. (2017). The role of STI-related attitudes on screening attendance in young adults. Psychology, health & medicine, 22(6), 753–758.
Wong, J. P., Chan, K., Karen, B., Boi-Doku, R., & Mcwatt, S. (2012). Risk discourse and sexual stigma: Barriers to STI testing, treatment and care among young heterosexual women in disadvantaged neighbourhoods in Toronto. Canadian Journal of Human Sexuality, 21(2), 75–89.
Marcantonio, T. L., Jozkowski, K. N., Angelone, D. J., & Joppa, M. (2018). Student’s alcohol use, sexual behaviors, and contraceptive use while studying abroad. Journal of Community Health. Retrived 21 April 2020 from https://springer.longhoe.net/article/10.1007/s10900-018-0554-5.
Rural Health Information Hub (RHIH). (2017) Rural health disparities. Retrieved April 21, 2020 from https://www.ruralhealthinfo.org/topics/rural-health-disparities.
Center for Disease Control and Prevention (CDC). (2017). Nebraska—state health profile. Atlanta: U.S. Department of Health and Human Service. Retrieved April 10, 2020 from https://www.cdc.gov/nchhstp/stateprofiles/pdf/Nebraska_profile.pdf.
Nebraska Legislature. (2020). Chapter 79. Retrieved January 15, 2020 from https://nebraskalegislature.gov/laws/browse-chapters.php?chapter=79.
Center for Disease Control and Prevention (CDC). (2018). Youth risk behavior surveillance system (YRBSS). Atlanta, GA. Department of Health and Human Services; 2018. Retrieved May 8, 2020 from https://www.cdc.gov/healthyyouth/data/yrbs/index.htm.
American College Health Association (ACHA). (2020). American College Health Association-National College Health Assessment II: Undergraduate Student Reference Group Data Report Fall 2019. Silver Spring, MD: American College Health Association.
Folasayo, A. T., Oluwasegun, A. J., Samsudin, S., Saudi, S. N. S., Osman, M., & Hamat, R. A. (2017). Assessing the knowledge level, attitudes, risky behaviors and preventative practices on sexually transmitted diseases among future healthcare providers in the central zone of Malaysia: A Cross-sectional study. International Journal of Environmental Research and Public Health, 14, 159.
Center for Disease Control and Prevention (CDC). (2017). STDs and HIV -CDC fact sheet. Atlanta: U.S. Department of Health and Human Services; 2017. Retrieved May 8, 2020 from https://www.cdc.gov/std/hiv/stdfact-std-hiv.htm.
Kann, L., McManus, T., Harris, W. A., et al. (2018). Youth risk behavior surveillance—United States, 2017. MMWR Surveillance Summaries, 67(No. SS-8), 1–114.
Bersamin, M., Fisher, D. A., Marcell, A. V., & Finan, L. J. (2016). Reproductive health services: Barriers to use among college students. Journal of Community Health. Retrieved April 21, 2020 from https://springer.longhoe.net/article/10.1007/s10900-016-0242-2.
McCool-Meyers, M., Myo, A., & Carter, J. A. (2019). Barriers to purchasing condoms in a High HIV/STI-risk urban area. Journal of Community Health. Retrieved April 21, 2020 from https://springer.longhoe.net/article/10.1007/s10900-019-00670-5.
Chesson, H. W., Dunne, E. F., Hariri, S., & Markowitz, L. E. (2014). The estimated lifetime probability of acquiring human papillomavirus in the United States. Sexually Transmitted Diseases, 41, 660–664.
American Cancer Society. (2020). Cancer facts and figs. 2020. American Cancer Society. Retrieved April 2020, from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf.
Giuliano, A. R., Nyitray, A. G., Kreimer, A. R., Campbell, C. M. P., Goodman, M. T., Sudenga, S. L., et al. (2014). EUROGIN 2014 roadmap: Differences in human papillomavirus infection natural history, transmission and human papillomavirus-related cancer incidence by gender and anatomic site of infection. International Journal of Cancer, 136, 2752–2760.
Walker, T. Y., Elam-Evans, L. D., Yankey, D., et al. (2019). National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2018. Morbidity and Mortality Weekly Report, 68, 718–723. https://doi.org/10.15585/mmwr.mm6833a2
U.S. Department of Health and Human Services (DHHS). (2020). National center for immunization and respiratory diseases. The 2018 national immunization survey - teen. Atlanta (GA): Centers for Disease Control and Prevention. Retrieved May 10, 2020 from https://www.cdc.gov/vaccines/imz-managers/nis/downloads/NIS-TEEN-PUF18-CODEBOOK.pdf.
Walker, T. Y., Elam-Evans, L. D., Yankey, D., et al. (2018). National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2017. Morbidity and Mortality Weekly Report, 67, 909–917.
Kornides, M. L., McRee, A. L., & Gilkey, M. B. (2018). Parents who decline HPV vaccination: Who later accepts and why? Academic Pediatric, 18(2S), S37–S43.
Hoffman, J. L., & Argeros, G. (2019). An online sexual health educational intervention involving young adult female students: A mixed methods study. Journal of Community Health. Retrieved April 21, 2020 from https://springer.longhoe.net/article/10.1007/s10900-019-00756-0.
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McMann, N., Trout, K.E. Assessing the Knowledge, Attitudes, and Practices Regarding Sexually Transmitted Infections Among College Students in a Rural Midwest Setting. J Community Health 46, 117–126 (2021). https://doi.org/10.1007/s10900-020-00855-3
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DOI: https://doi.org/10.1007/s10900-020-00855-3