Knowledge of sexually transmitted infection among adults living in Saudi Arabia: a national cross-sectional study

Sexually transmitted infections (STIs) are a major global health, occurring in different worldwide nations. Discussing STIs in Saudi society is considered taboo, due to social and ethical constraints. Sexual health is a serious issue in Saudi Arabia due to conservative religious values make sexual health among youth a significant concern, as young people face heightened vulnerability to STIs due to increased sexual experimentation, limited awareness, and difficulty accessing treatment. The study purpose is to evaluate the knowledge of STIs among adults in Saudi Arabia. This cross-sectional study involves adult men and women from various regions of Saudi Arabia. Sexually transmitted diseases (STD) knowledge scores were calculated using a validated 27-item Arabic questionnaire adapted from existing tools. Survey data were analyzed using IBM SPSS version 20.0. Results are presented as frequencies and percentages. Chi-squared or Fisher’s exact tests were used for comparisons, with statistical significance set at p < 0.05. In a study with 1706 participants (94.7% response rate), the gender distribution was 825 males (48%) and 881 females (52%). Most respondents were aged 18–23 (43%), followed by 24–31 (27%) and 32–39 (14%) years. Geographically, 71% were from the central region, with significant gender differences in regional distribution (p < 0.0001). The estimated overall mean of knowledge scores (STDs-KS) was 6.65 ± 3.1. The STD-KS showed no significant association with age. However, gender had a significant association (p < 0.0001), with males having slightly lower scores (6.5 ± 3.0) than females (6.8 ± 3.2). Marital status showed marginal significance (p = 0.042), and educational status had a significant association (p < 0.0001) with STD-KS. In conclusion, this study highlights the significance of demographic factors in STD knowledge. It emphasizes the need for targeted interventions considering age, gender, marital status, education and geography to enhance STI awareness and prevention.

Sexually transmitted diseases; Sexually transmitted infection; Saudi Arabia; Knowledge

[1] Henderson ER, Subramaniam DS, Chen J. Rural-urban differences in human immunodeficiency virus testing among US adults: findings from the behavioral risk factor surveillance system. Sexually Transmitted Diseases. 2018; 45: 808–812.

[2] Madani TA. Sexually transmitted infections in Saudi Arabia. BMC Infectious Diseases. 2006; 6: 3.

[3] Samkange-Zeeb FN, Spallek L, Zeeb H. Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature. BMC Public Health. 2011; 11: 727.

[4] von Rosen FT, von Rosen AJ, Müller-Riemenschneider F, Damberg I, Tinnemann P. STI knowledge in Berlin adolescents. International Journal of Environmental Research and Public Health. 2018; 15: 110.

[5] Folasayo AT, Oluwasegun AJ, Samsudin S, Saudi SN, Osman M, Hamat RA. Assessing the knowledge level, attitudes, risky behaviors and preventive practices on sexually transmitted diseases among university students as future healthcare providers in the central zone of malaysia: a cross-sectional study. International Journal of Environmental Research and Public Health. 2017; 14: 159.

[6] Drago F, Ciccarese G, Zangrillo F, Gasparini G, Cogorno L, Riva S, et al. A survey of current knowledge on sexually transmitted diseases and sexual behaviour in Italian adolescents. International Journal of Environmental Research and Public Health. 2016; 13: 422.

[7] Nigussie T, Yosef T. Knowledge of sexually transmitted infections and its associated factors among polytechnic college students in Southwest Ethiopia. Pan African Medical Journal. 2020; 37: 68.

[8] Fageeh W. Awareness of sexually transmitted diseases among adolescents in Saudi Arabia. Journal of King Abdulaziz University: Medical Sciences. 2008; 15: 77–90.

[9] Albanghali MA, Othman BA. A cross-sectional study on the knowledge of sexually transmitted diseases among young adults living in Albaha, Saudi Arabia. International Journal of Environmental Research and Public Health. 2020; 17: 1872.

[10] El-Tholoth HS, Alqahtani FD, Aljabri AA, Alfaryan KH, Alharbi F, Alhowaimil AA, et al. Knowledge and attitude about sexually transmitted diseases among youth in Saudi Arabia. Urology Annals. 2018; 10: 198–202.

[11] Balbeesi A, Mohizea S. Knowledge and misconceptions of Saudi women about sexually transmitted infections. Journal of Egyptian Public Health Association. 2017; 92: 235–239.

[12] Hossain M, Mani KK, Sidik SM, Shahar HK, Islam R. Knowledge and awareness about STDs among women in Bangladesh. BMC Public Health. 2014; 14: 775.

[13] Memish ZA, Filemban SM, Al-Hakeem RF, Hassan MH, Al-Tawfiq JA. Sexually transmitted infections case notification rates in the Kingdom of Saudi Arabia, 2005–2012. The Journal of Infection in Developing Countries. 2016; 10: 884–887.

[14] Meyer-Weitz A, Reddy P, Van den Borne HW, Kok G, Pietersen J. Health care seeking behaviour of patients with sexually transmitted diseases: determinants of delay behaviour. Patient Education and Counseling. 2000; 41: 263–274.

[15] Jaworski BC, Carey MP. Development and psychometric evaluation of a self-administered questionnaire to measure knowledge of sexually transmitted diseases. AIDS and Behavior. 2007; 11: 557–574.

[16] ALMalki B. Knowledge and awareness of sexually transmitted disease among male university students in Taif, Saudi Arabia. International Journal of Medical Science and Public Health. 2014; 3: 342.

[17] Alwafi HA, Meer AMT, Shabkah A, Mehdawi FS, El-Haddad H, Bahabri N, et al. Knowledge and attitudes toward HIV/AIDS among the general population of Jeddah, Saudi Arabia. Journal of Infection and Public Health. 2018; 11: 80–84.

[18] Fageeh WM. Sexual behavior and knowledge of human immunodeficiency virus/aids and sexually transmitted infections among women inmates of Briman Prison, Jeddah, Saudi Arabia. BMC Infectious Diseases. 2014; 14: 290.

[19] Filemban SM, Yasein YA, Abdalla MH, Al-Hakeem R, Al-Tawfiq JA, Memish ZA. Prevalence and behavioral risk factors for STIs/HIV among attendees of the Ministry of Health hospitals in Saudi Arabia. The Journal of Infection in Developing Countries. 2015; 9: 402–408.

[20] Petrova D, Garcia-Retamero R. Effective evidence-based programs for preventing sexually-transmitted infections: a meta-analysis. Current HIV Research. 2015; 13: 432–438.

[21] Sani AS, Abraham C, Denford S, Ball S. School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis. BMC Public Health. 2016; 16: 1069.

[22] Morales A, Espada JP, Orgilés M, Escribano S, Johnson BT, Lightfoot M. Interventions to reduce risk for sexually transmitted infections in adolescents: a meta-analysis of trials, 2008–2016. PLOS ONE. 2018; 13: e0199421.

[23] Carey MP, Vanable PA, Senn TE, Coury-Doniger P, Urban MA. Evaluating a two-step approach to sexual risk reduction in a publicly-funded STI clinic: rationale, design, and baseline data from the Health Improvement Project-Rochester (HIP-R). Contemporary Clinical Trials. 2008; 29: 569–586.

[24] Cepeda A, Frankeberger J, Bailey JL, Nowotny KM, Natera-Rey G, Valdez A. HIV and STI knowledge, testing, and risk among adult crack users in Mexico city: baseline findings from a feasibility study. AIDS Care. 2017; 29: 350–354.

[25] Park JJ, Seo YB, Jeong S, Lee J. Prevalence of and risk factors for sexually transmitted infections among Korean adolescents under probation. Journal of Korean Medical Science. 2017; 32: 1771–1778.

[26] Logie CH, Lys CL, Fujioka J, MacNeill N, Mackay K, Yasseen Iii AS. Sexual practices and condom use among a sample of Northern and Indigenous adolescents in Northern Canada: cross-sectional survey results. To be published in BMJ Sex Reprod Health. 2018. [Preprint].