Comparing the awareness of and beliefs in sexually transmitted infections among university students in Madagascar and the United States of America

Abstract

Young adults have a higher risk of contracting sexually transmitted infections (STIs) than other age groups. This risk may be mediated by their social and cultural setting which can impact young adults' awareness of, beliefs in, and risk of contracting STIs (including HIV/AIDS). In order to understand how these factors vary among young adults of different cultures, it is important to study these issues on a cross-cultural scale. This study aimed to increase understanding of the relationship between the culture of a place of study and: (1) STI awareness; (2) belief in STIs; and (3) self-reported STI prevalence in the study population. Survey data were collected from university students in Madagascar (n = 242 surveys in 2013) and the United States of America (n = 199 surveys in 2015). Compared to students at the American university, students at the Malagasy university: (1) did not appear to have a conclusively lower awareness of STIs; (2) did not differ in rates of belief in the existence of gonorrhea and syphilis, but had higher rates of disbelief in HIV/AIDS; and (3) were more likely to report having been infected with syphilis and gonorrhea, but not with HIV/AIDS. Students at the Malagasy university also listed different reasons than the students at the American university for why they believed in the existence of STIs. These findings highlight the need for further cross-cultural research to better adapt intervention strategies to different cultural settings.

Keywords: HIV/AIDS; Madagascar; Sexual health; Sexually transmitted infections; United States of America; University students.

Figure 1. The percent of respondents, by place of study, who expressed disbelief in the existence of common sexually transmitted infections (STIs) (out of the students that provided information for each individual STI).

Only STIs with more than 20 respondents for each gender, in each country, are included in the graph.

Figure 2. Reasons provided respondents as to why they believed that gonorrhea, HIV/AIDS, and syphilis were real. Sample sizes are the number of people who listed the STI and indicated that they felt it was real.

^∗ I have seen it/seen people with this illness/know someone with this disease. ^∗∗ I learned about it/due to outreach/because of the existence of outreach/education. ^∗∗∗ Science/medicine exists for it/research/statistics/reports/facts/evidence/proof/because it does.

Figure 3. Reasons provided by respondents as to why they felt that HIV/AIDS was not a real disease.

Sample sizes were too small to present information for gonorrhea and syphilis.

Figure 4. Rates of sexually transmitted infections (STIs) as self-reported by respondents (out of the students who provided information about these STIs in response to question 6; Table 1).

It is possible that students who had contracted the STI may not have listed it on the survey and would therefore not have self-reported it to researchers.