Sexual Transmitted Disease and Youth Awareness

An estimate of 22% of the new cases of HIV documented in 2014 in the United States alone was from the sector of society between ages 13 to 24 years old (Sexual risk behaviors: HIV, STD, & teen pregnancy prevention, 2016). The majority of political analysts blame the problem on the youths’ risky behavior coupled with the youths’ shallow understanding of the risks involved in unprotected sex (Ezeokoli, Ayodele, & Olaleye, 2014).

In a correlational study conducted by Ezeokoli et al. in 2014, several contributing factors were to be considered to the growing number of adolescents being diagnosed with HIV and STDs on a yearly basis. Quite considerably, it is true that knowledge, along with the proper attitude towards healthcare (r =.167*, N= 220, P <.05), can help reduce the risks of the infection being transmitted (Ezeokoli et al., 2014, p. 47).

This study is consistent with the current research and outlines problems that are rather similar to those that are reviewed by the researcher. Considering the fact that the researcher expects to prove the hypothesis that proper clinical intervention is projected to minimize the number of young people affected by STDs, this study fits perfectly into the context of the current research. Nevertheless, this study proved that knowledge of regular healthcare does not aid much in rendering significant result to motivate adolescents to seek testing and treatment (Crit-t = 1.96, Cal.t = 3.065, DF = 218, P <.05), neither did factors like gender, in terms of knowledge (t-cal =.528, t-crit = 1.960, P =.05), type of school system (Crit-t = 1.96, Cal.t = 1.096, df = 218, P <.05), or family structure (Crit-t = 1.96, Cal.t = 0.323, DF = 218, P >.05 level) and (Crit-t = 1.96, Cal.t = 0.259, DF = 218, P >.05) on both knowledge and attitude respectively (Ezeokoli et al., 2014).

Significant correlation, however, was noted in gender as far as their attitude towards regular treatment is concerned (t-cal = 2.310, t-crit = 1.960, P =.05), which significantly improves the result for testing and treatment as a proposed intervention to reduce the risk of acquiring STDs and HIV among adolescents. Overall, the study provides a multifactorial understanding of how the youth’s knowledge and attitude impact the success of testing and treatment as an initiative to reduce the growing incidence of HIV and STD among this sector of society.

In a similar study conducted in 2012, Trejos-Castillo, Treviño-Schafer, Brice, and McPherson explored how the conventional approach is a failure as far as the objective of educating and deterring the youths from investigating sexual acts is concerned. Instead, the authors proposed an intervention called “Teen Straight Talk,” which was first introduced in 2007 as a community prevention evidence-based program (Trejos-Castillo et al., 2011).

While the primary goal was simply to help significantly reduce teenage pregnancy, the health education program also aimed at informing the youth, along with their parents, on the growing issue of acquiring STDs and HIV (Trejos-Castillo et al., 2011). This research is relevant for the investigator because it presents an extensive description of the study design and methodology. The proposed intervention of allowing students to talk about their experiences and their thoughts about the sexual activity was being perceived as an active medium to understand the youth’s psyche. The researcher uses a similar approach and expects that the findings of their own study will be rather close to Trejos-Castillo et al.’s findings.

The researcher also believes that psychological factors play one of the key roles in the implementation and consequent assessment of the outcomes of the study. The information generated from the proposed intervention would then be utilized to develop a broader approach that would combat the problem of teenage pregnancy and the spread of STDs among youth. However, the study failed to satisfy the study’s general objective quantitatively. There were no correlational or any statistical pieces of evidence that would suggest the efficiency of “Teen Straight Talk” in contrast to the earlier proposed intervention known as the “Abstinence-Only Education” mentioned by the authors at the beginning of the study (Trejos-Castillo et al., 2011).

A 2013 cross-sectional survey initiated in Northern Germany focuses on the relevance of educating the youth about the different types of sexually transmitted diseases along with the risks involved in acquiring the infection. According to authors Samkange-Zeeb, Pöttgen, and Zeeb (2013), the reason why the risk of acquiring sexually transmitted diseases like HIV, chlamydia, and genital human papillomavirus (HPV) is very high in the cities of Bremen and Bremerhaven, in particular among the youth.

This research is consistent with the current study in terms of data collection and analysis. Samkange-Zeeb et al.’s (2013) study feature a survey intended to explicitly present the current state of affairs in the area of STDs in young people. This analysis was made primarily due to the lack of knowledge on how it is acquired and how it can be prevented. The researcher put together a table that features the main characteristics of the three studies and briefly dwells on the outcomes of those studies (Table 1).

Studies	Design	Sample	Outcome
Ezeokoli, R. N., Ayodele, K. O., & Olaleye, Y. L. (2014)	Descriptive Research Design	N = 220; Four secondary schools	A significant correlation between student knowledge and attitude toward regular health care in testing and treatment for STD and HIV
Trejos-Castillo, E., Treviño-Schafer, N., Brice, L., & McPherson, K. (2011)	Empirical Data Analysis	Studies from 2008	Active discussion and social support group discussion aid in the wide understanding of youths’ thoughts and ideas regarding STD and HIV
Samkange-Zeeb, F., Pöttgen, S., & Zeeb, H. (2013)	Cross-sectional Survey	N = 1,148; 55% female students	68% of student respondents were at medium/high risk of acquiring HIV, while there was 19% risk for HPV and 25% risk for acquiring chlamydia

Table 1. Overall outcomes of the studies.

The survey proved that there is a 68% higher risk involved among those who openly admitted to being sexually active as far as HIV is concerned. Nevertheless, chlamydia and HPV risks were reported lower at 195 and 25%, respectively (Samkange-Zeeb et al., 2013, p. 4). This result was because the student’s knowledge of these two infections is comparatively lower than the other types of sexually transmitted disease. In retrospect, Samkange-Zeeb et al. (2013) offered an interesting revelation that the risk of acquiring sexually transmitted disease becomes significantly higher due to the lack of awareness of the pathophysiology of the disease.

Overall, these three studies strongly favor the need to launch an aggressive campaign towards information campaign focusing on school-aged adolescents regarding the pathophysiology and the treatment plan for HIV and STDs. The current research offers an overview of the articles (Table 2). Nevertheless, knowledge without the appropriate behavior would do the program no good. Thus, the active campaign towards health education should be coupled with behavioral modification to ensure efficiency and effectiveness.

The investigator expects to utilize major features of the three reviewed studies and believes that the outcomes of the conducted research will be consistent with the reviewed studies and used interventions (Table 3). The investigator is choosing the method that involves a survey and a sample consisting of adolescents who agreed to take part in the experiment.

	1	2	3
Level I: Systematic review or meta-analysis		X
Level II: Randomized controlled trial	X
Level III: Controlled trial without randomization
Level IV: Case-control or cohort study			X
Level V: Systematic review of qualitative or descriptive studies	X
Level VI: Qualitative or descriptive study (includes evidence implementation projects)	X	X	X
Level VII: Expert opinion or consensus

Table 2. Review of the articles.

The strategy for dissemination involves the presentation of the research and its findings to a commission consisting of teachers, students, and medical professionals.

	Studies
	1	2	3
Interventions
Education and reproductive health service	X	X	X
Counseling	X	X
Social intervention		X
Self-reporting			X

Table 3. Research interventions.

This approach is intended to help investigators develop a universal method for intervention that would be beneficial in terms of encouraging safe sex in teenagers. The researcher believes that social intervention, combined with education and reproductive health service, would elicit the best outcomes in young people.

Appendix A

Evaluation Table

Aletha Akers (2012)	None	Qualitative	N=37 black adolescents (20 females, 17 male) Setting=two rural North Carolina	The participant’s understanding of how primary prevention strategies reduce STD transmission, the common barriers they encounter in trying to adopt these strategies, and the risk reduction strategies that they employ.	All focus group discussions were recorded and transcribed. To identify and organize participants’ perspectives regarding the study’s major topics of interest, they used the methodological approach to content analysis and the constant comparison method.	Emergent themes	Adolescents understood how primary prevention strategies reduce STD transmission. However, they perceived sex as normal and abstinence as unlikely during adolescence. They also considered the remaining primary prevention strategies difficult to implement because these strategies depend on partner cooperation and incorrectly assume that STD prevention is paramount when adolescents make sexual decisions.	The issues were identified, and the intervention was able to be implemented, but it was not found effective.
Jennifer L Brown (2012)	None	Cohort	N=964 African American adolescent females Setting= four mid-sized cities: Syracuse NY, Providence RI, Macon GA, and Columbia, SC	STI transmission knowledge, sex refusal self-efficacy, condom use self-efficacy, and peer norms for sexual behavior.	African American adolescents were recruited in cohorts of 25–30 youth for random assignment to one of two interventions. Data were collected via audio computer-assisted self-interviews	Descriptive statistics	17% of participants with a laboratory-confirmed STI reported either lifetime abstinence or recent abstinence from vaginal sex (discordant self-report). Lower STI knowledge, the belief that fewer peers were engaging in sex, and the belief that more peers will wait until marriage to have sex were associated with discordant reports. Discordance between self-reported abstinence and incident STIs was marked among African American female adolescents.	The issues were identified and result in highlight discrepancies between adolescents’ self-reported sexual behaviors and STI incidence.
Richard Charnigo, PH.D. (2010)	None	Cross-sectional study	N=266 African American men who: (1) newly diagnosed with an STD; (2) self-identification as African American; (3) 18 to 29 years of age; (4) English speaking; (5) reporting that a male condom had been used at least once in the past 3 months; and (6) indicating he was not knowingly HIV positive Setting= the Southern USA	Condom use at last encounter, attitude towards condom use, self-efficacy to use condoms, communication with sex partner about condoms, and perceived barriers to condom use.	The participants completed a brief self-administered, paper-and-pencil questionnaire lasting about 20 min.	OR, p-value, and 95% confidence interval.	Nearly ½ of the participants had used condoms during their last sexual encounter. Specific attitudes towards condom use and partner-related barriers showed to be of great significance.	Specific attitudes towards condom use and partner-related barriers may be important when deciding to create behavioral interventions for high-risk heterosexual African American males.
Rita Nikruka Ezeokoli (2014)	None	Descriptive survey research of an ex-post-facto type.	N=220 students from four selected secondary schools Setting=Ibadan North Local Government Area of Oyo State, Nigeria	Knowledge, attitude, gender, family type and school type (independent variables) & HIV/STD treatment and testing (dependent variables)	A twenty-eight self-developed questionnaire tagged “Adolescent Knowledge and Attitude Scale (AKAS).”	Descriptive statistics (frequency counts and percentages), inferential statistics (t-test), and significant at.05 alpha level.	There was a significant relationship between students’ knowledge and attitude to regular healthcare on the testing and treatment of HIV/STDs.	Results of the relationship between students’ knowledge and attitude to regular healthcare on the testing and treatment of HIV/STDs indicated a significant relationship between knowledge and attitude. The implication of the finding is that because the students lack the essential and adequate information about healthcare provision to HIV/STDs testing and treatment, their attitude towards these dreaded infections is not favorable.
Elissa Kennedy	None	Qualitative study	N=341 male and female adolescents aged 15-19 years Setting= rural and urban communities on two islands of Vanuatu	access to comprehensive sexual and reproductive health (SRH) information and adolescent knowledge about SRH	Qualitative methods	All discussion was recorded and transcribed	Gaps were identified, including prevention of pregnancy, condom use, puberty, sexuality, and relationships. Peer educators and health workers were adolescents’ preferred sources of information because they were considered knowledgeable and trustworthy.	Providing adolescents with comprehensive SRH information can have life-long protective benefits. However, there are important content gaps in the information currently provided in Vanuatu.
Florence Samkange-Zeeb (2013)	None	Cross-sectional study	N= 1,148 students Setting= n 8 secondary schools in two cities in northern Germany, Bremen and Bremerhaven	Maternal education status, peer and own risk perception for HIV, HPV, and chlamydia	Descriptive statistics	Questions on knowledge and awareness of STIs and risk perception were constructed based on questionnaires used in other studies.	The risk of getting infected with HIV was perceived as being higher than that of getting infected with HPV or chlamydia, most likely due to the fact that the students were more aware of HIV than of the other two infections.	Efforts should be made to improve awareness and knowledge of HPV and chlamydia among school-going adolescents and to make them realize that these are common infections that are preventable.
Li Ping Wong (2012)		Qualitative study	N= 34 FGDs (16 FGDs for secondary school students and 18 FGDs for university undergraduates) Setting= secondary schools from Selangor and the Federal Territory of Kuala Lumpur.	sexual attitudes, behaviors, and contraceptive use	Qualitative measures	The sampling process, data collection, and analysis were continuous and iterative. All group discussions were immediately analyzed and compared with the analysis of the previous discussions,	The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices.	This study underscores the importance of the development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.

For definitions of columns, see Appendix C in the text below from which this template was created.

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Critical appraisal of the evidence: Part III. American Journal of Nursing, 110(11), 43-51.

Appendix B

PICOT question organizer

PICOT
P	Population	Adolescent ages 16 to 17 years old
I	Intervention or Issue of interest	Early Sex Education and Education on STDs
C	Comparison	Sex Education
O	Outcome	Free from any forms of STDs
T	Timeframe	6 months

Appendix C

Search Tracker.

Search #	Initial search terms	Database	And/Or?	Added search terms	Title (Ti) Anywhere, etc.	# of articles found
1	Sexually transmitted diseases	ProQuest, PubMed		Age, sex,	I am predicting behavior. Sexually transmitted infections among African American female adolescents	3
2	Adolescent behavior and attitude toward sex	ProQuest, Psychology & Behavioral Sciences Collection			Sexual Risk Behavior Guidelines & Strategies	2
3	Early intervention STDs	PubMed ProQuest		15 to 17-year	Psychosocial constructs associated with condom use among high-risk African American men newly diagnosed with a sexually transmitted disease.	5
4	Adolescent and Sexual	Ebscohost			A sex Positive Framework for Research on Adolescent Sexually	3
5	Sexual behavior	American Psychological Association Database		Risk sexual behavior	These issues are not talked about at home.	3

References

Ezeokoli, R. N., Ayodele, K. O., & Olaleye, Y. L. (2014). Adolescents’ knowledge and attitude towards regular healthcare as a way of improving HIV/STD testing and treatment. International Journal of Psychological Studies, 4(11), 44-51.

Samkange-Zeeb, F., Pöttgen, S., & Zeeb, H. (2013). Higher risk perception of HIV than of chlamydia and HPV among secondary school students in two German cities. PLOS One, 5(1), 1-8.

Sexual risk behaviors: HIV, STD, & teen pregnancy prevention. (2016). Web.

Trejos-Castillo, E., Treviño-Schafer, N., Brice, L., & McPherson, K. (2011). Teen pregnancy and sexually transmitted infections in youth: A community prevention evidence-based program in Texas, USA. Revista CES Psicología, 47(2), 25-38.