Chlamydia knowledge and screening attitudes among university students

Background – Chlamydia (CT) is the most reported infectious disease in the US, with adolescents/young adults at greatest risk. Educational interventions frequently target university students, but associations between CT knowledge and screening likelihood are complex.

Objective – To determine student knowledge of CT extent and etiology, and attitudes towards screening.

Methods – University students were surveyed in 2011 concerning their CT knowledge and personal screening influences.

Results – Of 289 valid surveys, 45.3% were female, 51.2% were white, mean age was 19.4 years. From 9 CT knowledge questions, mean correct score was 4 (no gender or race differences); 89.2% indicated CT may be acquired from an asymptomatic person, but only 8.3% knew the chance of infection from unprotected sex (INFECT) is ~33% (37.8% indicated 95% chance). Reasons for avoiding screening included not being sexually active (28.7%), practicing safe sex (52.6%), and having no infected friends (44.8%; no gender differences). Females were more likely to report avoiding screening because they didn't have sex with strangers (78.5% vs. 61.5%; p=0.002). Among sexually active students, condom use frequency (CONDOM) was related to stating safe sex practice (p<0.011 each gender), but <39% report ‘always' using condoms. No associations existed between CONDOM and previous CT infection or INFECT (no gender differences). Among females, CONDOM significantly decreased with previous CT testing (p=0.020).

Conclusions – Erroneous safety beliefs and the lack of association between heightened perceived risk (chance of infection, past infection) and increased condom use suggest that effective educational interventions may require a behavioral modification component.