Investigation of the Sociodemographic Characteristics and Sexual Health Behaviours of University Students
Condition: Sexually Transmitted Diseases
MeSH terms: Sexually Transmitted Diseases
Study type: Observational

Summary: 
      The 10-19 age group is defined as the "Adolescent" and the 15-24 age group is defined as the
      "Youth" by the WHO. Adolescent period is the most vulnerable time to risks in terms of sexual
      health. Among the sexual health problems experienced by adolescents are sexually transmitted
      infections(STI), unwanted pregnancies, induced abortions and related complications, not using
      contraception, STI-induced cancer and infertility, sexual dysfunction.University students are
      at risk for sexual health because they are in the adolescent age group, they are
      inexperienced in gaining life experiences, and they are mostly away from the family
      environment for the first time. Insufficient knowledge in terms of sexual health and
      insufficient education on sexuality can affect students' attitudes and behaviors related to
      sexuality. In addition, in developing countries such as Turkey, sexuality is seen as a taboo,
      and the meanings attributed to sexuality vary according to men and women. In limited studies,
      it was determined that 24.1% of university student had sexual intercourse at least once, and
      40.7% of them had sexual intercourse with more than one person in the last six months. It was
      determined that 15.5% of the adolescents 60.7% of the youth had sexual experience. In another
      study with men, it was determined that the students had their first sexual experience at the
      age of 17-18 on average and 31.0% of them still had active sexual lives. According to the
      results of a research conducted on first year students of eight universities; It was
      determined that 19% of the students had sexual experience. These results reveal that one out
      of every three young people in our country has sexual experience, and that the majority of
      them are not protected and there is a lack of information about sexuality. It is noteworthy
      that the rate of becoming sexually active in adolescents and young people is increasing. For
      this reason, studies are needed to examine the relationship between the status of having a
      sexual partner and sexual health in university students who have sexual experience. It is
      important to investigate this relationship and to provide at-risk students with trainings
      that increase their awareness of sexual health and sexual education. It is planned to examine
      the relationship between the status of having a sexual partner and sexual health of students
      studying at Kastamonu University.
    

Detailed description: 
      Adolescence is the period of life between childhood and adulthood, between the ages of 10 and
      19. This period is a unique stage of human development in which the foundations of physical,
      sexual, and psychosocial development are laid. Adolescents make up one sixth of the world's
      population. Approximately 85-90% of adolescents, who make up 18% of the entire world
      population, live in developing countries, including Turkey. The transition from adolescence
      to adulthood is a complex and exciting period for young adults as they begin to explore their
      sexual identity and sexual relationships. When starting college, students gain more autonomy
      over their behaviour and responsibilities related to their health. As a result of this newly
      acquired autonomy, students frequently engage in various risky behaviours and endanger their
      health.

      Early sexual activity, which is one of the risky health behaviours among adolescents, is
      increasing worldwide. Various studies conducted in sub-Saharan Africa show that the
      initiation of premarital sexual intercourse is high among adolescents and this rate is
      increasing gradually. In a study conducted in North Carolina, it was determined that the
      first sexual intercourse age of adolescents was 16.5 and 66% of adolescents who had sexual
      intercourse were between the ages of 15-20. Mohammadi et al. (2006) reported that in their
      study in Iran 28% of youth aged 15-18 years had at least one sexual intercourse (including
      hugging, kissing, and any sexual experience from touching to sexual intercourse. In our
      country, it has been determined that 36.7% of university students have sexual experience and
      sexual experience is more common in men .

      University students are among the population with the highest risk of sexually transmitted
      infections, unwanted pregnancy and other adverse health outcomes. Young people who are
      sexually active are exposed to risks such as sexually transmitted diseases and unwanted
      pregnancies, as their developmental status is insufficient in the assessment and management
      of these risks. Evidence suggests that young adults aged 20 to 24 are more susceptible to
      STIs than other age groups. In addition, adolescents are vulnerable to sexually transmitted
      diseases and infections, including HIV/AIDS, unplanned premature birth, and unsafe abortions
      as a result of early sexual intercourse due to their limited knowledge of their bodies and
      sexuality. Halcón, et al. (2001) found benign cellular changes in 15.6%, reactive changes in
      9.2%, and epithelial cell abnormalities in 9.9% of adolescent girls who started sexual
      intercourse at an early age.

      The age of first sexual experience decreases in adolescents, contraceptive use also
      decreases. As the result of non contraception, pregnancy rates were 22.3 per 1,000 women aged
      15-19 years and 43% for women aged 18-19 years between 2007 and 2015, birth rates fell 54%
      for females aged 15-17 years. More than one third of all adolescent girls do not use any
      contraceptive method during the first sexual intercourse. In a study conducted in Tanzania,
      it was reported that 29.7% of adolescent boys and 40.3% of adolescent girls did not use
      contraceptive methods during sexual intercourse. Not using contraceptive methods may cause
      adolescent pregnancies.

      In adolescent pregnancies, the risk of experiencing problems such as preterm labour,
      perinatal death, fetal and neonatal death, and low birth weight baby is high. However,
      depression symptoms and deterioration in self-image are more common in young people who start
      sexual intercourse at a young age. It is noteworthy that the rate of becoming sexually active
      in adolescents and young people, who make up approximately 20% of the population of our
      country, is increasing. For this reason, studies are needed to examine the relationship
      between having a sexual partner and sexual health in university students who have sexual
      experience. It is thought that it will be important to investigate this relationship and to
      provide at-risk students with trainings that increase their awareness of sexual health and
      sexual education. With the results obtained, it is aimed to provide individuals with the
      necessary motivation, knowledge, and behavioural skills to determine the sexual health
      problems of the students and to prevent their problems and to improve their sexual health.

      Materials and methods:

      Participants This cross-sectional study was conducted at 5 faculties and three vocational
      schools of a university. The population of the research consisted of 13420 undergraduate
      students studying at faculties and vocational schools. Students who attended the university
      during the study period and were willing to participate in the study were included in the
      sample. The minimum sample size of the study was determined according to the frequency
      formula in cases with a known population. The frequency of the investigated event was
      accepted as 37% according to the related literature. In conclusion, this study aimed to
      include 307 students with a minimum sample size for 0.05 deviation and 95% confidence
      interval (α = 0.05). A total of 825 students participated in the research.

      Setting The research was carried out in a university located in the Western Black Sea region,
      within two weeks (4 weeks in total) when the final exams were held in the 2019 spring and
      2020 fall semesters.

      Data collection tools In the data collection, a semi-structured interview form was used to
      determine the sociodemographic characteristics and sexual health behaviours prepared by the
      researchers in line with the literature.

      Data Collection The questionnaire and semi-structured interview form were applied to the
      students during the 2019-2020 academic year fall semester and spring semester final exams.
      Question papers were distributed to the students by the researchers in a sealed envelope
      before the exam time. After the students who volunteered to participate in the research
      filled out the forms, they submitted them to the researchers in a closed envelope. The
      practice started on the first day of the exams and continued until the last day.

      Ethical dimension of research Before starting the research, permission was obtained from the
      Non-Interventional Clinical Research Ethics Committee of Karabük University (decision no.
      12/1 dated 03.12.2018) and the rectorate of the university where the research would be
      conducted (approval of the rectorate dated 12.12.2018 and numbered 80404136-044-E-50015).
      Written informed consent was obtained from the students who volunteered to participate in the
      study. Throughout the study, the Helsinki Declaration was acted upon.
      Participants/non-participants did not have any gains/losses such as money, grades, absentee
      rights, etc.

      Statistical analysis:

      While evaluating the data, descriptive statistical methods (Number, Percentage, Mean,
      Standard deviation, variance) were used. The conformity of the data to the normal
      distribution was determined by the Kruskall-Wallis test in independent samples. and Kendall's
      Tau-C correlation coefficient was calculated for correlation analyzis.
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Students of a university
      
Keywords: students; sexual activities; sexually transmitted diseases; sexual health; community health education