Determinants of STI knowledge among university students: the role of education and risk

Background

Sexually transmitted infections (STIs) remain a major public health concern among young adults. Among university students, STI-related knowledge varies considerably, yet the factors shaping both objective knowledge and self-perceived competence across different educational and behavioural risk profiles warrant further investigation.

Methods

Cross-sectional survey among students at the University of Verona (Italy, 2020–21). An anonymous online questionnaire assessed awareness of specific STIs, knowledge of preventive methods, self-perceived competence about STI contraction and transmission, and sexual behaviours. Participants were classified into four sexual behavioural risk profiles, which were included alongside sociodemographic and educational factors in multivariable logistic regression models examining each outcome separately.

Results

A total of 2,187 students participated (mean age 21.9 years; 76.2% female; response rate 9.8%). Only 7.6% were aware of all 11 STIs assessed. Medical school enrollment was the strongest predictor of STI awareness (OR 14.52; 95% CI 9.68–21.79; p < 0.001), knowledge of preventive methods (OR 1.97; 95% CI 1.57–2.47; p < 0.001), and self-perceived competence about contraction (OR 2.65; 95% CI 1.75–4.03; p < 0.001) and transmission (OR 2.45; 95% CI 1.66–3.61; p < 0.001). Higher risk profiles were associated with greater STI awareness and self-perceived competence (OR range 1.62–5.04; all p ≤ 0.05), but predicted knowledge of preventive methods only at medium (OR 1.58; p = 0.008) and high risk (OR 1.59; p = 0.029). Older age predicted objective knowledge (OR 1.22; p < 0.001) but not self-perceived competence. Sex and sexual orientation were not significant predictors in any model.

Conclusions

STI-related knowledge is strongly shaped by educational pathway and sexual experience. The dissociation between objective and self-perceived knowledge has direct implications for the design of targeted university prevention programmes.

Key messages

• Medical education is the strongest predictor of STI knowledge; non-medical students represent a critical gap for university prevention programs.

• Objective and self-perceived STI knowledge are shaped by different factors, highlighting the need for interventions that address both dimensions.