Birth control knowledge among freshmen of four Italian universities

Abstract

Since sexual health education (SHE) is not mandatory in Italian schools, we conducted a survey on freshmen of four Italian university campuses in 2012 to investigate the respective level of sexual health knowledge (SHK) in relation to birth control, with the aim to inform public health policy makers. A convenience strategy was employed to sample 4,552 freshmen registered with various undergraduate courses at four Italian universities: Padua university (Veneto Region); university of Milan (Lombardy Region); university of Bergamo (Lombardy Region); university of Palermo (Sicily Region). We investigated the level of SHK on birth control using 6 proxy indicators: (1) the average length of a woman’s period [outcome with 3 levels: wrong (base) vs. acceptable vs. correct]; (2) the most fertile interval within a woman’s period (binary outcome: correct vs. wrong answer); (3) the event between the end of a period and the beginning of the next cycle (binary outcome: correct vs. wrong answer); (4) the average survival of spermatozoa in the womb (binary outcome: correct vs. wrong answer); (5) the concept of contraception (binary outcome: correct vs. wrong answer); (6) the efficacy of various contraceptives to prevent unintended pregnancies (linear score: 0–17). We fitted 6 separate models of multiple regression: multinomial for outcome 1; logistic for outcomes 2, 3, 4, 6; linear for outcome 6. Statistical estimates were adjusted for a number of socio-demographic factors. Results were expressed as odds ratios (OR) for the 4 multiple logistic regression models, linear coefficients (RC) for the linear regression model and relative risk ratio (RRR) for the multinomial logistic regression model. The level of significance of each risk estimate was set at 0.05. The level of SHK of freshmen sampled was rather low, as 60% interviewees did not know the average length of a woman’s period, the average survival of spermatozoa in the womb and the concept of contraception, whilst the most fertile interval within a woman’s period was known only to 55% of interviewees. The mean score of SHK on the efficacy of various contraceptive methods was only 5 (scale 0–17). Some categories of students were consistently and significantly less knowledgeable on birth control at multivariable analysis: males; students from the university of Palermo; those with vocational secondary school education and those not in a romantic relationship at the time the survey was conducted. The results of this survey clearly call for the introduction of SHE programs in Italian schools, as already done in several European countries. School SHE should start as early as possible, ideally even before secondary school. SHE should be holistic and delivered with a multiple agency coordinated approach involving the Ministry of Health, the Ministry of Education, University and Scientific Research (MIUR), families, schools, public health departments, primary health care providers, pharmacists, media, other.

A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities

“…The survey was conducted in 2012 via an anonymous self-reported paper questionnaire. Since there was no validated tool, a new questionnaire (already published elsewhere [ 20 ]) was designed by experts of health education (CX and MB). The same two experts and another academic educator (AC) reviewed the survey instrument, reducing the initial number of questions to 78 and contributing to improve its quality.…”

“…Although SHE programs are no mandatory in Italian schools, students can receive SHE in many other ways. This can include, for example, direct experience, peer group, friends and sexual partners, external courses or activities, university courses, or online resources [ 19 , 20 ].…”

Knowledge difference of sexually transmitted infections between Hong Kong undergraduates from local and international secondary schools: A cross-sectional study

“…In fact, this phenomenon is not unique to the Chinese culture. Sexuality is also considered taboo in some European countries such as Italy, and discussing it in the family is difficult, especially in southern Italy ( 19 , 20 ). However, family can have substantial influences on young people's sexual attitudes and expression of sexual behaviors ( 18 ).…”

“…A study among young people in London, United Kingdom, reported that religious students, unlike those reporting no religious affiliation, generally reported lower sexual health knowledge and were more conservative in their attitudes toward sex ( 30 ). Socio-cultural values such as religious obstructionism might limit the efficacy of sexual health education, which in turn affects the sexual knowledge and attitude of individuals ( 19 , 20 ). More studies are needed to further explore the impacts of religion on sexual health outcomes.…”

“…Individual schools enjoy flexibility in adopting the approach, contents, and delivery mode of sex education according to their background, mission, ethos, and resources (17,18). It is similar to the situation in some European countries, such as Italy, where sex education is not mandatory (19,20). An evaluation of the implementation of sex education in Hong Kong secondary schools revealed a decrease in the percentage of schools having an overall policy on the implementation of sex education owing to a lack of resources and time (17).…”