Sexually Transmitted Infection
AWARENESS ON RISK FACTORS OF SEXUALLY TRANSMITTED INFECTION AND SEXUAL RISK BEHAVIORS AMONG STUDENTS OF CAVITE STATE UNIVERSITY
An undergraduate thesis presented to the faculty of the College of Nursing, Cavite State University, Indang Cavite, in partial fulfillment of the requirements in research. Prepared with the supervision of Mrs. Nenita B. Panaligan, RN, MAN.
Introduction
As time goes on, countries around the world become more industrialized and modernized. As part of it, life of people became easier when modern technologies introduced to them. However, as these continue to multiply problems unbalancing the society exists too. Nowadays, issues regarding reproductive health are being published in newspapers to television and radios around the world. People around the world are aware about the existence of this pandemic sexual infections, but do they really know how this diseases being acquired? How aware they are? This became a public health problem to both industrialized and developing countries around the globe. Mostly in many developing countries like Philippines and other neighboring countries had their rampant cases of Sexually Transmitted Infections (STI’s) due to exploitation and human trafficking and considering the poor management of National Health Department in implementing different programs to control the spread of these infections. Sexually transmitted disease also known as Sexually Transmitted Infection (STI) or Venereal Disease (VD) is an illness that has significant of transmission between humans or animals by means of human sexual behavior, including vaginal intercourse oral sex and anal sex. While in the past, these illnesses has mostly been referred to us STD or VD, in recent years the term sexually transmitted infection has been preferred, as it has a broader range of meaning; a person may be infected and may potentially infect others, without showing signs of disease. Some STI’s can also be transmitted via the use of needles after its use by an infected person. WHO stated that sexually transmitted infections (STIs) are infections that are spread primarily through person-to-person sexual contact. There are more than 30 different sexually transmissible bacteria, viruses and parasites. The most common conditions they cause are gonorrhea, chlamydia infection, syphilis, trichomoniasis, chancroid, genital herpes, genital warts, human immunodeficiency virus (HIV) infection and hepatitis B infection. Several, in particular HIV and syphilis, can also be transmitted from mother to child during pregnancy and childbirth, and through blood products and tissue transfer. Sexually transmitted infections have impact in all dimensions of person’s life. STI can negatively influence a person’s self concept and may profoundly affect a person’s entire life and his family. Society, often associate STI’s with discrimination and socially unacceptable behaviors. This makes most persons afflicted with STI hesitate immediate treatment and often the disease is on its progress stage before the infected individual finally decides to consult health care practitioners. Therefore, health organizations need to educate high risk individuals on prevention of STI’s. Furthermore, health practitioners need to be alert to indicators of STI’s since prognosis can be influenced by early diagnosis and treatment, hence this study will exhibit the awareness on risk factors of sexually transmitted diseases and sexual risk behavior among some college students of Cavite State University.
Statement of the problem
This study aims to determine the awareness of Cavite State University (CvSU) students on risk factors about Sexual Transmitted Infections (STI) and their sexual risk behaviors. Specifically, it seeks to answer the following questions:
1. What is the demographic profile of the respondents in terms of 1. Gender 2. Age 3. Civil status
2. What are the sexual risk behaviors among CvSU students?
3. Are CvSU college students aware on the risk factors of sexually transmitted infection?
4. Is there a relationship between demographic profile and level of awareness on risk factors of STI’s among CvSU college students?
5. Is there a relationship between demographic profile and sexual risk behavior of CvSU college students?
6. Is there a relationship between level of awareness and sexual risk behavior among CvSU college students?
Objectives of the study
Generally, the study aims to determine the awareness and risk factors about STI’s and sexual risk behaviors among students of Cavite State University (CvSU). Specifically, it aims to;
1. Determine the demographic profile of the respondents in terms of 1. Gender 2. Age 3. Civil status
2. Identify the sexual risk behavior among CvSU college students
3. Identify how aware CvSU college students are on risk factors of sexually transmitted infection
4. Determine the relationship between demographic profile and level of awareness on risk factors among CvSU college students
5. Identify the relationship between demographic profile and sexual risk behavior among CvSU college students
6. Determine the relationship between level of awareness and sexual risk behavior among CvSU college students
Hypothesis
Null Hypothesis
Ho - There is no relationship between demographic profile and awareness on risk factors of STI’s among CvSU college students. Ho - There is no relationship between demographic profile and sexual risk behavior of CvSU college students. Ho -There is no relationship between level of awareness and sexual risk behavior among CvSU college students.
Alternative Hypothesis Ha - There is a relationship between demographic profile and awareness on risk factors of STI’s among CvSU college students. Ha - There is a relationship between demographic profile and sexual risk behavior of CvSU college students. Ha - There is a relationship between level of awareness and sexual risk behavior among CvSU college students.
THEORETICAL FRAMEWORK DOROTHEA OREM SELF-CARE THEORY
NURSING “The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness” • Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well being. • Has a strong health promotion and maintenance focus • Identified 3 related focus: 1. Self-care- activities of an individual performs independently throughout life to promote and maintain personal well-being. 2. Self-care deficit- results when self-care agency (individual’s ability) is not adequate to meet known self-care needs. 3. Nursing system- nursing interventions needed when individual is unable to perform the necessary self-care activities: 1. Wholly compensatory- nurse provides entire self-care for the individuals. 2. Partial compensatory- nurse and individual perform care, individual can perform selected self-care activities, but also accepts care done by the nurse for needs of the individual that cannot meet independently. 3. Supportive educative- nurse’s actions are to help the client develop/learn their own self-care abilities through knowledge, support and encouragement.
Conceptual Framework
Input Outcome
Figure 1.1
The input consists of demographic profile of the respondents including their awareness on risk factors of Sexually Transmitted Infections (STI’s) and on its outcome is to determine their sexual risk behavior that contribute to the risk of acquiring Sexually Transmitted Infection (STI’s).
Significant of the study
The result of the study will benefit the following:
CvSU college students- This study can help CvSU college students to use as a secondary data and as a comparative baseline data for future researches regarding level of awareness on risk factors of Sexually Transmitted Infections (STI’s) and sexual risk behavior among college students of CvSU. They can utilize this study to formulate their health teaching plans and such development of programs and to participate in the promotion of health.
Parents- This study can help not only their sons/ daughters but themselves as well to comprehend the importance of awareness on risk factors of STI’s for them to identify the proper intervention and management regarding to their health especially to those who has risky sexual behavior.
Faculty Members- This study can help faculty members recognize/ distinguish the level of awareness of their students about risk factors of sexually transmitted infection and sexual risk behavior. This could be their guide on to what extent should they add on their discussions regarding the said topic.
CvSU Administrator- This study can help the CvSU Administrators like Office of the Students Affairs (OSA) to facilitate programs regarding health promotion and counseling to the student who are in need for proper guidance.
Future Researchers- This study will serve as reference for the future researchers and use as a secondary data.
Scope and limitation
The scope of the study mainly focuses on the awareness on risk factors about sexually transmitted infection and sexual risk behaviors among college students of Cavite State University. This study is limited only to selected students of five Colleges in Cavite State University specifically College of Nursing (CON), College of Engineering and Information Technology (CEIT), College of Education (CED), College of Arts and Sciences (CAS) and College of Economics, Management and Development Studies (CEMDS) and situations that may include client-imposed restrictions upon the interview, restrictions beyond the client's control, or the existence of other conditions precluding necessary interview procedures.
Definition of terms
Abstinence- The act or practice of abstaining; voluntary forbearance of any action Circumcision- Surgical procedure in which the prepuce of the penis or the prepuce of the clitoris is excise. Chlamydia- Bacterial disease can cause pelvic pain, painful intercourse, and burning and painful urination and a foul vaginal discharge. Contraception- the deliberate prevention of conception or impregnation by any of various drugs, techniques, or devices; birth control. Genital Herpes- Acute painful genital sores Genital Warts- Soft, moist warts in genital and anal area Gonorrhea- Chronic pelvic and abdominal pain from adhesions and scaring and infertility Infertility- The condition of being unable to produce offspring compares sterility Menarche- First menstrual period Placenta- formed in the lining of the uterus by the union of the uterine mucous membrane with the membranes of the fetus Protozoan- Any of a large group of single-celled, usually microscopic, eukaryotic organisms, such as amoebas, ciliates, flagellates, and sporozoans. Syphilis- a chronic infectious disease, caused by a spirochete, Treponema pallidum, usually venereal in origin but often congenital, and affecting almost any organ or tissue in the body, esp. the genitals, skin, mucous membranes, aorta, brain, liver, bones, and nerves.
Trichomoniasis- a sexually transmitted disease typically asymptomatic in men and resulting in vaginitis with a copious, frothy discharge and itching in women, caused by a trichomonad Trichomonas vaginalis.
REVIEW OF RELATED LITERATURE
LOCAL LITERATURE
According to the Department of Health (DOH), the number of Filipinos who had STI’s as of 2002, contracted the Human immunodeficiency virus (HIV) stood at a mere 1,503. Now compare that to the numbers which, according to figures from the joint United Nations Program on HIV/AIDS (UNAIDS), showed 7.1 million people in the Asia-Pacific region with HIV at the end of 2001 out of a total 40 million people world wide. An estimated 1.07 million people in Asia Pacific region got infected in 2001 alone, with close to half a million death due to AIDS, the disease HIV causes, in the same year. Yet the Philippines only reported a grand total of 1, 503 cases of HIV which is one of the lowest infection rates in the world. This, in a country that has one of the lowest rates of condom usage in Asia. This in a country that has anywhere from half a million to 2 million, a good majority of whom don’t require their customers to wear condom. This in a nation that has more than seven million overseas workers, separated from spouses and often engaging in risky sexual behaviors. This in a country that, as of the moment has practically no awareness program to teach the exploding population of young people about the danger of HIV/ AIDS. -DOH
FOREIGN LITERATURE
Vaginal, anal, and oral intercourse place young people at risk for HIV infection and other sexually transmitted diseases (STDs). Vaginal intercourse carries the additional risk of pregnancy. In the United States In 2007, 48% of high school students had ever had sexual intercourse, and 15% of high school students had had four or more sex partners during their life. In 2007, 39% of currently sexually active high school students did not use a condom during last sexual intercourse. In 2002, 11% of males and females aged 15-19 had engaged in anal sex with someone of the opposite sex; 3% of males aged 15-19 had had anal sex with a male. In 2002, 55% of males and 54% of females aged 15-19 had engaged in oral sex with someone of the opposite sex. In 2006, an estimated 5,259 young people aged 13-24 in the 33 states reporting to CDC were diagnosed with HIV/AIDS, representing about 14% of the persons diagnosed that year. Each year, there are approximately 19 million new STD infections, and almost half of them are among youth aged 15 to 24. In 2002, 12% of all pregnancies, or 757,000, occurred among adolescents aged 15-19.
In addition, young people in the United States use alcohol and other drugs at high rates. Adolescents are more likely to engage in high-risk behaviors, such as unprotected sex, when they are under the influence of drugs or alcohol.7 In 2007, 23% of high school students who had sexual intercourse during the past three months drank alcohol or used drugs before last sexual intercourse.
Abstinence from vaginal, anal, and oral intercourse is the only 100% effective way to prevent HIV, other STDs, and pregnancy. The correct and consistent use of a male latex condom can reduce the risk of STD transmission, including HIV infection. However, no protective method is 100% effective, and condom use cannot guarantee absolute protection against any STD or pregnancy. HIV/STD prevention education should be developed with the active involvement of parents, be locally determined, and be consistent with community values. It should address the needs of youth who are not engaging in sexual intercourse as well as youth who are currently sexually active, while ensuring that all youth are provided with effective education to protect themselves and others from HIV infection and STDs now and lifelong. (http://www.cdc.gov/HealthyYouth/sexualbehaviors/index.htm)
Facts on Sexually Transmitted Infections in the United States (2009)
More than two dozen bacterial, viral or parasitic infections are known to be transmitted largely or exclusively through sexual contact. U.S. public health authorities’ focus on a limited set of these STIs, taking into account how common and contagious each STI is, how easy it is to detect and treat, and how much impact it may have on public health. In most cases, infection does not have a major, lasting impact on an individual’s health if she or he seeks proper treatment. Although they can lead to serious health complications if left untreated, human papillomavirus (HPV) and the bacterial infections chlamydia, gonorrhea and syphilis can be successfully treated or cured. At the other end of the STI spectrum is HIV/AIDS, which is still considered to be ultimately fatal. However, early treatment with antiretroviral drugs and other medical and lifestyle interventions can greatly delay the onset of the disease, and with high-quality care, HIV-positive people can live many years with minimal symptoms. Because the most common STIs are “silent” in that they are often asymptomatic, estimates of the incidence (new cases) and prevalence (total existing cases) of most STIs are difficult to make. Many asymptomatic STIs can be diagnosed only through testing, yet routine screening is not widespread. In addition, it is difficult to measure trends in the incidence and prevalence of STIs because of changes in reporting systems and testing methods. As a result, increases in reported cases may be due to improved testing and reporting, rather than true upsurges in incidence or prevalence. The most recent national estimates, now a decade old, suggest that there are approximately 19 million new cases of STIs each year, half of them among 15–24-year-olds, and that 65 million Americans have at least one viral STI, most commonly genital herpes.
Direct medical costs associated with STIs in the United States are estimated at $14.7 billion annually in 2006 dollars. More than $8 billion is spent each year to diagnose and treat STIs and their complications, not including HIV. For some population subgroups, primarily blacks and men who have sex with men, high prevalence of STIs within the community can be a risk factor in itself, since individuals are more likely to encounter an infected partner. High community prevalence of STIs can be a symptom of other problems in the community, such as a lack of access to health care, poverty, unemployment and other persistent social and economic discrimination. Whereas white Americans acquire STIs predominantly through high-risk sexual behaviors, black Americans acquire them through both high- and low-risk behaviors because levels of infection within the black population are high. (http://www.guttmacher.org/pubs/FIB_STI_US.html)
Understanding the determinants of sexually transmitted disease (STD) acquisition among adolescents and young adults is critical to assess interventions designed to limit the spread of STDs. One set of interventions — adopted by numerous organization sand directly supported by federal policy — are programs that encourage abstinence by encouraging adolescents to make pledge store main virgins until marriage. This article considers the relationship between adolescent virginity pledges and the sexual behavior of young adults, focusing on STD acquisition. In 1993, “True Love Waits” initiated a movement to encourage adolescents to pledge to abstain from sex until marriage. By 1995, an estimated 2.2 million adolescents (12%ofalladolescents) in the United States had taken such pledges. Earlier research demonstrated that adolescent virginity pledges were associated with a significant delay on the baseline rate for the transition to first sex. Although pledging was associated with delayed sexual initiation, the pledge effect was deeply shaped by social context, most importantly, the number of other students in the community that pledged and the social structure of the community with respect to the patterning of friendships. The pledge appears to work where public commitment to abstain from sex is encoded into shared group activities, thus enhancing identification with the movement and encoding promise to remain a virgin into the larger social fabric. -HannahBrückner,Ph.D. ,andPeterBearman,Ph.D.
A recent spate of articles by journalists describing patterns of oral sex among middle school students in particular communities has heightened interest in understanding the prevalence of this and other nonvaginal sexual activities among young teenagers.* Much of the in-formation about these activities has been collected in non representative surveys of teen-agers, however. Although the prevalence of vaginal sexual experience is closely monitored at the national level because of its attendant risks of unintended pregnancy and sexually transmitted disease (STD) trans-mission, little attention has been paid to other, nonvaginal sexual activity, even though oral and anal intercourse also expose youth to STDs. To address this gap in in-formation, we provide estimates of the incidence of various sexual practices from the 1995 National Survey of Adolescent Males. We also examine how reports of these practices have changed from 1988 to 1995. -Gary J. Gates and Freya L. Sonenstein 2001
Ninth graders surveyed in two California public schools had more experience with oral than with vaginal intercourse, and their intended behavior in the next six months favored oral sex. The teenagers estimated that they have less chance of becoming pregnant or contracting chlamydia or HN if they engage in oral sex than if they have vaginal intercourse, as well as less chance of jeopardizing their relation-ship or their reputation, getting into trouble or feeling guilty about their behavior. Respondents expressed greater acceptance of oral sex than of vaginal intercourse for youth their age, and said that oral sex is the more prevalent behavior among their peers. The survey was conducted in 2003 as part of a longitudinal study of the relationship between risk and benefit perceptions and sexual activity. In all, 580 ninth graders, with an aver-age age of 14.5 years, completed the self-administered questionnaire; 58% were female and 42% male. Forty percent of respondents were white, 24% Hispanic, 17% Asian and the rest members of other ethnic groups. Roughly equal proportions said that their mothers were college graduates, had some college education and had a high school education or less. Finally, when asked to estimate the prevalence of behaviors and intentions among youth their age, respondents said they believed that 47% of their peers of had had oral sex, but that only 41 % had had vaginal sex. Similarly, they anticipated that in the next six months, a larger proportion will have oral sex than will have vaginal sex (39% vs. 34%), and a smaller pro-portion will choose not to have oral sex than not to have vaginal intercourse (42% vs. 45%). They thought that 27% will wait until they are married to have oral sex, compared with 31 % for vaginal sex. The researchers acknowledge a number of limitations to their study, notably that the survey defined vaginal but not oral sex for participants, and that the data do not permit an assessment of causal relationships between perceptions and behavior. Nevertheless, they contend that the findings have critical public health implications. They conclude that "to help adolescents make informed sexual decisions, parents, health care providers, and other educators must broaden their clinical and educational efforts"; in particular, these efforts should cover the possible health, emotional and social consequences of all sexual behaviors, coital and non coital, as well as methods for preventing unhealthy outcomes.-D. Hollander 2004
Adolescents and young adults are examined because of growing incidence of STI. The average age of menarche among young girls has declined and the majorities for male and female teenagers are sexuality active at age of 19.-Hockenberry and others, 2005
According to an Australian study of foreign sex workers, most prostitutes are not aware they can contract STI through oral sex. The study, which will be presented to the international association for dental research meeting June 28- July 1 in Brisbane, found that sex workers knew the dangers of vaginal sex but not oral sex. Nair said there had been few studies on awareness levels among Australian workers but international trends indicated a general ignorance in the region. -According to Maria McMahon 2006
STI can be caused by bacteria, viruses, protozoa and fungi. Anyone who engage in intimate physical contact can contract and transmit STI. Many health workers providers do not always acknowledge that fact, specially in regard to middle class, upper class or older clients. Although younger people have the highest rates for STI (86%), all age groups are at risk. The fetus or neonate can be infected across the placenta or during the vaginal birth. -Hawks, 2002 The incidence of STI in the United States has the highest rates of STI in the industrialize world Center for Diseases Control and Prevention CDC, 1999 the prevalence of STI is a major health concern because treatment is costly and the incidence is high in minority populations of low socio economic status. Prevalent STI include syphilis, gonorrhea, Chlamydia, trichomoniasis and infection with HPV and herpes simplex virus respectively. It is transmitted from an infected individuals to partners during intimate sexual contact. The site of transmission is usually genitals but it may also be oral genital or anal genital. Hose person most likely to be infected share one key characteristics unprotected sex with multiple partners. - Potter, 2004.
AIDS
AIDS is a mysterious and tragic illness in which the body’s protective immune system becomes unable to ward off infections. It was first recognized in the U.S as a separate entity in 1981. Those at greater risk of this disease are homosexual and bisexual males and their sexual partners and drug abusers of both sexes who inject drugs into their veins. A scientific evidence now indicates that a retrovirus is a causative agent and that this virus occurs in the blood, saliva or the semen of person afflicted. The virus easily transmitted from person to person by intimate contact. A person without symptoms may harbor the virus and transmit it to his sexual partners. The number of reported cases continues to increase alarmingly. The illness consist of various kinds of infection, often involving the lungs plus the development in about one third of the cases of a malignancy of the skin (Kaposi’s sarcoma). The incubation period may be as long as two years. As yet there is no specific treatment and the mortality rate is 70-90 percent within two years. Now that the causative virus has been identified, some progress is being made in developing a vaccine but absolutely prevention is yet in the future. - Modern Medical Guide (revised edition 2001) Harold Shryock, M
Chlamydia and Gonorrhea Chlamydia and gonorrhea are bacterial infections that can be cured with antibiotics. Untreated chlamydia and gonorrhea infections in women may lead to pelvic inflammatory disease (PID), a serious infection that itself may lead to ectopic pregnancy, infertility and chronic pain. Evidence suggests that roughly 10–40% of untreated chlamydia cases will lead to PID and that as many as 20% of women with PID will develop infertility. Forty-two percent of young women were tested for chlamydia in 2007, compared with only 25% in 2000. Chlamydia and gonorrhea must be reported to state health departments and the Centers for Disease Control and Prevention (CDC). In 2007, the CDC reported 1.1 million chlamydia diagnoses and 356,000 gonorrhea diagnoses. However, since most chlamydia and gonorrhea cases go undiagnosed or unreported, the true number of new infections is probably much greater. In 2007, the overall reported rate of chlamydia infection among women (544 cases per 100,000 females) was almost three times the rate among men (190 per 100,000 males). Blacks are the group most heavily affected by chlamydia and gonorrhea. The reported rates of both infections are 9–19 times higher among blacks than whites. Although the magnitude of these disparities may be distorted due to discrepancies in reporting, the disparities are real. Rates of gonorrhea and chlamydia are heavily concentrated among young people. Young women aged 15–24 are hit hardest by chlamydia, with rates more than five times as high as women overall. Routine screening for chlamydia among women younger than 26 is widely recommended by the CDC and major medical associations, and it is considered to be a cost-effective and underutilized form of preventive health care by the U.S. Preventive Services Task Force because of its potential for helping to reduce rates of pelvic inflammatory disease. The U.S. Preventive Services Task Force recommends that clinicians screen all sexually active women, including those who are pregnant, for gonorrhea infection if they are at increased risk for infection (that is, if they are young or have other individual or population risk factors).
Human Papillomavirus (HPV)
HPV is an extraordinarily common viral infection in the United States, so much so that it has been described as a virtual “marker” for having had sex. The CDC estimates that 20 million people are currently infected with HPV, 6.2 million Americans become infected each year and at least 50% of sexually active individuals will acquire an HPV infection at some point in their lives. Most HPV infections cause no clinical problems and resolve on their own without treatment. (As many as 91% of new infections clear up within two years. Certain HPV strains lead to genital warts. These warts can be removed, but if the immune system fails to clear the virus entirely, symptoms may reappear. Other HPV strains are deemed “high-risk” because they occasionally develop into a persistent infection that can progress to cervical cancer if left untreated, usually over the course of decades. The incidence of cervical cancer in the United States has been on the decline for some time, and today cervical cancer is rare, relative to the incidence of HPV infection. The American Cancer Society estimates that 11,000 cases will occur among American women this year, resulting in 4,000 deaths. The major reason cervical cancer rates in this country are low today—despite high rates of HPV infection—is the widespread availability and use of Pap tests. Pap tests can detect not only early-stage cervical cancer, which is highly treatable, but also cervical dysplasia—precancerous changes of cervical cells which can linger for years—allowing for the removal of affected tissue long before invasive cancer sets in. Pap tests are fairly common in the United States, but 17% of American women aged 18–64 in 2005 had not been tested in the past three years. These women account for the majority of cervical cancer diagnoses. In 2006, the U.S. Food and Drug Administration approved an HPV vaccine that protects against the four key strains of HPV that account for 70% of cervical cancers and 90% of genital warts. The three-dose vaccine can be given to girls as young as age nine, but is recommended for girls aged 11–12, with catch-up vaccinations recommended for those aged 13–26.
Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. HIV can be transmitted through the blood, sexual fluids or breast milk of an HIV-infected person. Since 1981, when the first AIDS cases were identified, more than 1.6 million Americans have been infected with HIV, and more than 540,000 have already died. Roughly 56,000 new HIV infections occur each year—a number that has remained stable since 2000. An estimated 1–1.2 million individuals in the United States are living with HIV. Of new HIV infections in 2006, 53% were among men who had sex with men; 31% resulted from heterosexual contact; 12% resulted from injection drug use; and 4% were among men who had sex with men and also used injection drugs. In 2006, women accounted for 25% of HIV/AIDS diagnoses among adolescents and adults, and men for 75%. However, among infections that resulted from heterosexual contact, women account for a growing majority. Eighty percent of women diagnosed with HIV/AIDS in 2006 contracted the virus through heterosexual contact. Among both males and females, blacks have the highest rates of new infections. Although blacks make up approximately 13% of the U.S. population, they accounted for almost half of the estimated new HIV/AIDS diagnoses in 2006. In 2002, half of men and women aged 15–44 reported that they had been tested at least once for HIV (other than through blood donation);20 15% had been tested in the past 12 months.
Close to 40% of people who test positive for HIV are diagnosed with full-blown AIDS within one year, and the majority of those who get an HIV test late in the course of their infection do so because they are already ill. Current federal guidelines recommend that HIV testing be a standard part of medical care for every American aged 13–64, that more people be tested and that people be tested sooner. In 2006, as many as one in five individuals with HIV may have been unaware of their status, down from one in four in 2003.
Other STIs
Other common STIs include viral infections, such as herpes and hepatitis A and B, which are incurable but treatable; and bacterial and parasitic infections, such as syphilis and trichomoniasis, which can be cured with antibiotics.
Syphilis, hepatitis A and hepatitis B are required to be reported to state health departments and the CDC. In 2007, the most infectious stages of syphilis—primary and secondary—were diagnosed in about 11,500 Americans. The estimated number of new hepatitis B virus infections was 46,000, while only 4,800 acute clinical cases were reported in 2006. An estimated 1.5 million people in the United States have chronic hepatitis B. Although other STIs are not required to be reported to the CDC, estimates are available for some. The CDC estimates that one out of five adolescents and adults have had a genital herpes infection. Although genital herpes is incurable and can cause painful sores and psychological distress, it has become increasingly manageable in the United States. About 7.4 million new cases of trichomoniasis occur each year. Left untreated, trichomoniasis can be an irritant, causing vaginal discharge, discomfort during intercourse and painful urination.
Late-stage syphilis can, years later, cause irreversible damage to the nervous system and heart, possibly leading to blindness, insanity, paralysis and death. Hepatitis B can cause inflammation of the liver, and chronic cases can cause liver cell damage, which can lead to cirrhosis of the liver and cancer. It is estimated that 5,000 people die each year in the United States due to the complications of cirrhosis and liver cancer as a result of hepatitis B. Herpes, trichomoniasis and many other STIs have two other very real health consequences. First, they can increase an individual’s susceptibility of HIV infection. Second, they can have serious negative health outcomes during pregnancy and childbirth. Therefore, public health authorities have put an emphasis on testing and treating women during pregnancy. http://www.guttmacher.org/pubs/FIB_STI_US.html Methodology
Research Design This study will use the descriptive research method. This method involves collecting data in order to take hypothesis or answer question regarding the subject of the study. In this method, the awareness on risk factors of sexually transmitted infection and sexual risk behavior among students of Cavite State University will be described and evaluated.
Target Population/ Study subjects This study will focus among officially enrolled college students SY 2010- 2011 of Cavite State University. Fifty percent (50%) of the total population of Cavite State University specifically five colleges such College of Nursing (CON), College of Engineering and Information Technology (CEIT), College of Education (CED), College of Arts and Sciences (CAS) and College of Economics, Management and Development Studies (CEMDS). This will determine their awareness on risk factors of Sexually Transmitted Infections (STI’s) and their sexual risk behavior. In addition, their college buildings and faculties are easily accessible for the researchers.
Sampling type and technique In choosing the respondents, the researchers will be utilizing simple random sampling technique and convenient sampling. With the help of the faculty members of the five colleges, the researchers will be provided with total number of officially enrolled college students SY 2010- 2011. Using Slovin’s formula, the researchers will compute for twenty- five percent (25%) of the total population of all five colleges. The researchers would also compute for the ideal sampling size of the population for every college in order that every department of each college will have their respondents equally. From there, the researchers will be standing in every entrance of the five buildings. The student who enters the building and will be given questionnaires should be officially enrolled and should be with the appropriate course for the building. However, students who will be exiting from the building are not included.
Slovin’s Formula: n = N 1 + Ne²
Research Instrument A questionnaire is developed and will be utilized in conducting and collecting data regarding the study; it will enable to determine the awareness on risk factors of sexually transmitted infection and their sexual risk behavior among students of Cavite State University by answering the prepared questions. The questionnaire is subdivided into two (2) parts. Part I- Demographic data of the respondents. This includes the name (optional), the age, gender, civil status and the college of the said respondent. Part II- Awareness on Risk factors of Sexually Transmitted Infection asks the awareness of the college students of Cavite State University. Part III- Sexual Risk Behavior that asks the sexual risk behaviors of the college students of Cavite State University. The respondents will be ask to evaluate or rate their individual perception on the statements based on the scale of 5- always, 4- often, 3- sometimes, 2- seldom and 1- never. After they finished answering the said questionnaires, it will be evaluated by the researchers. Respondents who have a total of thirty five means (part II- ten points and part III- twenty five points) that they are really aware about sexually transmitted infections. Respondents who have fifteen and below means that they are not aware about sexually transmitted infection and that they have the need to be well informed about the said infection.
Validation of Research
The validation of the research instrument will be done by means of consulting the thesis adviser Mrs. Nenita B. Panaligan, RN, MAN and the technical critic Ms. Divinia Joy Tuzon, RN. Pre-testing will be performed to validate the reliability of the research instrument and if it responds with the objective of the study. It will as well verify if the research instrument will be beneficial to the respondents. Pre-testing will be done by targeting twenty- five percent (25%) of the officially enrolled college students in each five colleges.
Materials
The entire process of assessing the awareness on risk factors of sexually transmitted infection and sexual risk behaviors among students of Cavite State University required the following material: questionnaires.
Statistical Treatment
The slovin's formula is used which is to determine the ideal sample size for a population.
n = N 1 + Ne²
Where: n = number of samples N = total population e = margin of error
Sample Calculation:
A group of students want to know the age of students in a high school but do not have the resources to survey an entire population of 2,500. If they want to use a sample with a 5% margin of error, what should their sample size be?
Given: N = 2,500 e = 5% = 0.05
Required: n = ?
Solution: n = N / ( 1 + (N*e^2)) n = 2500 / ( 1 + (2500*.05^2)) n = 2500 / 7.25 n = 344.83 ~ 355
CAVITE STATE UNIVERSITY
(CvSU)
DON SEVERINO DE LAS ALAS CAMPUS
Indang, Cavite
( (046) 415-0021 ( (046) 415-0012
E-mail: cvsu@asia.com
COLLEGE OF NURSING
This questionnaire is going to utilize to evaluate the awareness on risk factors of sexually transmitted infections (STI’s) and sexual risk behavior among college students of Cavite State University.
Part I. DEMOGRAPHIC PROFILE
Name: (Optional)______________________________________________ Age: _______
Gender: ________ Civil Status: __________________ College: _______________
|QUESTIONS |YES |NO |
|Do you use condom when having sex? | | |
|Do you have multiple sexual partners? | | |
|Do you have warts in genital area? | | |
|Are you having frequent sexual contact? | | |
|Do you have partner with same sex? | | |
|Is there a nearest health center in your community where you can seek for health? | | |
|Is there a high prevalence of STI within your community? | | |
|Do you have proper guidance from your guardian/parents? | | |
| Is your institution (school) having programs regarding health education? | | |
|Do you have known programs of Department of Health that has been implemented regarding STI? | | |
Part II. RISK FACTORS OF SEXUALLY TRANSMITTED INFECTION
INSTRUCTION:
Check the box that corresponds to your answer. Select only one answer for each question.
PART III. SEXUAL RISK BEHAVIOR
INSTRUCTION:
Check the box that corresponds to your answer. Select only one box for each sentence.
5- Always 4- Often 3- Sometimes 2- Seldom 1- Never
|QUESTIONS |5 |4 |3 |2 |1 |
| | | | | | |
|I read pornographic materials. | | | | | |
|I’m watching x-rated/scandal movies. | | | | | |
|I visit night clubs/sex den etc. | | | | | |
|I practice exhibitionism exposure of private body parts/cyber sex. | | | | | |
|I enjoy expressing oneself by SOP/SOT. | | | | | |
|I use sex toys. | | | | | |
|I share syringe with others when using injectables. | | | | | |
|I engage with multiple sexual acts. | | | | | |
|I’m having oral sex with same sex. | | | | | |
|I’m having oral sex with opposite sex. | | | | | |
|I’m having anal sex with same sex. | | | | | |
|I’m having anal sex with opposite sex. | | | | | |
|I’m having sexual intercourse vaginally. | | | | | |
|I’m having sexual contact with the influence of alcohol. | | | | | |
|I’m having sexual contact with the influence of drugs. | | | | | |
|I’m having sexual intercourse with the same sex/ gender. | | | | | |
|I’m having sexual intercourse with guest relation officer. | | | | | |
|I’m having sexual intercourse with callboys. | | | | | |
|I have multiple sexual partners. | | | | | |
|I engage with multiple sexual acts. | | | | | |
|I’m having sexual intercourse with my bf/ gf as a sign of my love for him/ her. | | | | | |
|I’m influenced by my peers to do sexual acts. | | | | | |
|I’m willing to try other sexual activities with animals. | | | | | |
|I trade sex for money. | | | | | |
|I spend money for sex. | | | | | |
|TOTAL |
THANK YOU FOR YOUR TIME!!!
GOD BLESS…..
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Demographic
Profile:
Age:
Gender:
Civil Status:
Sexual Risk behavior
Awareness on risk factors of sexually transmitted infections (STI’s)
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An undergraduate thesis presented to the faculty of the College of Nursing, Cavite State University, Indang Cavite, in partial fulfillment of the requirements in research. Prepared with the supervision of Mrs. Nenita B. Panaligan, RN, MAN.
Introduction
As time goes on, countries around the world become more industrialized and modernized. As part of it, life of people became easier when modern technologies introduced to them. However, as these continue to multiply problems unbalancing the society exists too. Nowadays, issues regarding reproductive health are being published in newspapers to television and radios around the world. People around the world are aware about the existence of this pandemic sexual infections, but do they really know how this diseases being acquired? How aware they are? This became a public health problem to both industrialized and developing countries around the globe. Mostly in many developing countries like Philippines and other neighboring countries had their rampant cases of Sexually Transmitted Infections (STI’s) due to exploitation and human trafficking and considering the poor management of National Health Department in implementing different programs to control the spread of these infections. Sexually transmitted disease also known as Sexually Transmitted Infection (STI) or Venereal Disease (VD) is an illness that has significant of transmission between humans or animals by means of human sexual behavior, including vaginal intercourse oral sex and anal sex. While in the past, these illnesses has mostly been referred to us STD or VD, in recent years the term sexually transmitted infection has been preferred, as it has a broader range of meaning; a person may be infected and may potentially infect others, without showing signs of disease. Some STI’s can also be transmitted via the use of needles after its use by an infected person. WHO stated that sexually transmitted infections (STIs) are infections that are spread primarily through person-to-person sexual contact. There are more than 30 different sexually transmissible bacteria, viruses and parasites. The most common conditions they cause are gonorrhea, chlamydia infection, syphilis, trichomoniasis, chancroid, genital herpes, genital warts, human immunodeficiency virus (HIV) infection and hepatitis B infection. Several, in particular HIV and syphilis, can also be transmitted from mother to child during pregnancy and childbirth, and through blood products and tissue transfer. Sexually transmitted infections have impact in all dimensions of person’s life. STI can negatively influence a person’s self concept and may profoundly affect a person’s entire life and his family. Society, often associate STI’s with discrimination and socially unacceptable behaviors. This makes most persons afflicted with STI hesitate immediate treatment and often the disease is on its progress stage before the infected individual finally decides to consult health care practitioners. Therefore, health organizations need to educate high risk individuals on prevention of STI’s. Furthermore, health practitioners need to be alert to indicators of STI’s since prognosis can be influenced by early diagnosis and treatment, hence this study will exhibit the awareness on risk factors of sexually transmitted diseases and sexual risk behavior among some college students of Cavite State University.
Statement of the problem
This study aims to determine the awareness of Cavite State University (CvSU) students on risk factors about Sexual Transmitted Infections (STI) and their sexual risk behaviors. Specifically, it seeks to answer the following questions:
1. What is the demographic profile of the respondents in terms of 1. Gender 2. Age 3. Civil status
2. What are the sexual risk behaviors among CvSU students?
3. Are CvSU college students aware on the risk factors of sexually transmitted infection?
4. Is there a relationship between demographic profile and level of awareness on risk factors of STI’s among CvSU college students?
5. Is there a relationship between demographic profile and sexual risk behavior of CvSU college students?
6. Is there a relationship between level of awareness and sexual risk behavior among CvSU college students?
Objectives of the study
Generally, the study aims to determine the awareness and risk factors about STI’s and sexual risk behaviors among students of Cavite State University (CvSU). Specifically, it aims to;
1. Determine the demographic profile of the respondents in terms of 1. Gender 2. Age 3. Civil status
2. Identify the sexual risk behavior among CvSU college students
3. Identify how aware CvSU college students are on risk factors of sexually transmitted infection
4. Determine the relationship between demographic profile and level of awareness on risk factors among CvSU college students
5. Identify the relationship between demographic profile and sexual risk behavior among CvSU college students
6. Determine the relationship between level of awareness and sexual risk behavior among CvSU college students
Hypothesis
Null Hypothesis
Ho - There is no relationship between demographic profile and awareness on risk factors of STI’s among CvSU college students. Ho - There is no relationship between demographic profile and sexual risk behavior of CvSU college students. Ho -There is no relationship between level of awareness and sexual risk behavior among CvSU college students.
Alternative Hypothesis Ha - There is a relationship between demographic profile and awareness on risk factors of STI’s among CvSU college students. Ha - There is a relationship between demographic profile and sexual risk behavior of CvSU college students. Ha - There is a relationship between level of awareness and sexual risk behavior among CvSU college students.
THEORETICAL FRAMEWORK DOROTHEA OREM SELF-CARE THEORY
NURSING “The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness” • Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well being. • Has a strong health promotion and maintenance focus • Identified 3 related focus: 1. Self-care- activities of an individual performs independently throughout life to promote and maintain personal well-being. 2. Self-care deficit- results when self-care agency (individual’s ability) is not adequate to meet known self-care needs. 3. Nursing system- nursing interventions needed when individual is unable to perform the necessary self-care activities: 1. Wholly compensatory- nurse provides entire self-care for the individuals. 2. Partial compensatory- nurse and individual perform care, individual can perform selected self-care activities, but also accepts care done by the nurse for needs of the individual that cannot meet independently. 3. Supportive educative- nurse’s actions are to help the client develop/learn their own self-care abilities through knowledge, support and encouragement.
Conceptual Framework
Input Outcome
Figure 1.1
The input consists of demographic profile of the respondents including their awareness on risk factors of Sexually Transmitted Infections (STI’s) and on its outcome is to determine their sexual risk behavior that contribute to the risk of acquiring Sexually Transmitted Infection (STI’s).
Significant of the study
The result of the study will benefit the following:
CvSU college students- This study can help CvSU college students to use as a secondary data and as a comparative baseline data for future researches regarding level of awareness on risk factors of Sexually Transmitted Infections (STI’s) and sexual risk behavior among college students of CvSU. They can utilize this study to formulate their health teaching plans and such development of programs and to participate in the promotion of health.
Parents- This study can help not only their sons/ daughters but themselves as well to comprehend the importance of awareness on risk factors of STI’s for them to identify the proper intervention and management regarding to their health especially to those who has risky sexual behavior.
Faculty Members- This study can help faculty members recognize/ distinguish the level of awareness of their students about risk factors of sexually transmitted infection and sexual risk behavior. This could be their guide on to what extent should they add on their discussions regarding the said topic.
CvSU Administrator- This study can help the CvSU Administrators like Office of the Students Affairs (OSA) to facilitate programs regarding health promotion and counseling to the student who are in need for proper guidance.
Future Researchers- This study will serve as reference for the future researchers and use as a secondary data.
Scope and limitation
The scope of the study mainly focuses on the awareness on risk factors about sexually transmitted infection and sexual risk behaviors among college students of Cavite State University. This study is limited only to selected students of five Colleges in Cavite State University specifically College of Nursing (CON), College of Engineering and Information Technology (CEIT), College of Education (CED), College of Arts and Sciences (CAS) and College of Economics, Management and Development Studies (CEMDS) and situations that may include client-imposed restrictions upon the interview, restrictions beyond the client's control, or the existence of other conditions precluding necessary interview procedures.
Definition of terms
Abstinence- The act or practice of abstaining; voluntary forbearance of any action Circumcision- Surgical procedure in which the prepuce of the penis or the prepuce of the clitoris is excise. Chlamydia- Bacterial disease can cause pelvic pain, painful intercourse, and burning and painful urination and a foul vaginal discharge. Contraception- the deliberate prevention of conception or impregnation by any of various drugs, techniques, or devices; birth control. Genital Herpes- Acute painful genital sores Genital Warts- Soft, moist warts in genital and anal area Gonorrhea- Chronic pelvic and abdominal pain from adhesions and scaring and infertility Infertility- The condition of being unable to produce offspring compares sterility Menarche- First menstrual period Placenta- formed in the lining of the uterus by the union of the uterine mucous membrane with the membranes of the fetus Protozoan- Any of a large group of single-celled, usually microscopic, eukaryotic organisms, such as amoebas, ciliates, flagellates, and sporozoans. Syphilis- a chronic infectious disease, caused by a spirochete, Treponema pallidum, usually venereal in origin but often congenital, and affecting almost any organ or tissue in the body, esp. the genitals, skin, mucous membranes, aorta, brain, liver, bones, and nerves.
Trichomoniasis- a sexually transmitted disease typically asymptomatic in men and resulting in vaginitis with a copious, frothy discharge and itching in women, caused by a trichomonad Trichomonas vaginalis.
REVIEW OF RELATED LITERATURE
LOCAL LITERATURE
According to the Department of Health (DOH), the number of Filipinos who had STI’s as of 2002, contracted the Human immunodeficiency virus (HIV) stood at a mere 1,503. Now compare that to the numbers which, according to figures from the joint United Nations Program on HIV/AIDS (UNAIDS), showed 7.1 million people in the Asia-Pacific region with HIV at the end of 2001 out of a total 40 million people world wide. An estimated 1.07 million people in Asia Pacific region got infected in 2001 alone, with close to half a million death due to AIDS, the disease HIV causes, in the same year. Yet the Philippines only reported a grand total of 1, 503 cases of HIV which is one of the lowest infection rates in the world. This, in a country that has one of the lowest rates of condom usage in Asia. This in a country that has anywhere from half a million to 2 million, a good majority of whom don’t require their customers to wear condom. This in a nation that has more than seven million overseas workers, separated from spouses and often engaging in risky sexual behaviors. This in a country that, as of the moment has practically no awareness program to teach the exploding population of young people about the danger of HIV/ AIDS. -DOH
FOREIGN LITERATURE
Vaginal, anal, and oral intercourse place young people at risk for HIV infection and other sexually transmitted diseases (STDs). Vaginal intercourse carries the additional risk of pregnancy. In the United States In 2007, 48% of high school students had ever had sexual intercourse, and 15% of high school students had had four or more sex partners during their life. In 2007, 39% of currently sexually active high school students did not use a condom during last sexual intercourse. In 2002, 11% of males and females aged 15-19 had engaged in anal sex with someone of the opposite sex; 3% of males aged 15-19 had had anal sex with a male. In 2002, 55% of males and 54% of females aged 15-19 had engaged in oral sex with someone of the opposite sex. In 2006, an estimated 5,259 young people aged 13-24 in the 33 states reporting to CDC were diagnosed with HIV/AIDS, representing about 14% of the persons diagnosed that year. Each year, there are approximately 19 million new STD infections, and almost half of them are among youth aged 15 to 24. In 2002, 12% of all pregnancies, or 757,000, occurred among adolescents aged 15-19.
In addition, young people in the United States use alcohol and other drugs at high rates. Adolescents are more likely to engage in high-risk behaviors, such as unprotected sex, when they are under the influence of drugs or alcohol.7 In 2007, 23% of high school students who had sexual intercourse during the past three months drank alcohol or used drugs before last sexual intercourse.
Abstinence from vaginal, anal, and oral intercourse is the only 100% effective way to prevent HIV, other STDs, and pregnancy. The correct and consistent use of a male latex condom can reduce the risk of STD transmission, including HIV infection. However, no protective method is 100% effective, and condom use cannot guarantee absolute protection against any STD or pregnancy. HIV/STD prevention education should be developed with the active involvement of parents, be locally determined, and be consistent with community values. It should address the needs of youth who are not engaging in sexual intercourse as well as youth who are currently sexually active, while ensuring that all youth are provided with effective education to protect themselves and others from HIV infection and STDs now and lifelong. (http://www.cdc.gov/HealthyYouth/sexualbehaviors/index.htm)
Facts on Sexually Transmitted Infections in the United States (2009)
More than two dozen bacterial, viral or parasitic infections are known to be transmitted largely or exclusively through sexual contact. U.S. public health authorities’ focus on a limited set of these STIs, taking into account how common and contagious each STI is, how easy it is to detect and treat, and how much impact it may have on public health. In most cases, infection does not have a major, lasting impact on an individual’s health if she or he seeks proper treatment. Although they can lead to serious health complications if left untreated, human papillomavirus (HPV) and the bacterial infections chlamydia, gonorrhea and syphilis can be successfully treated or cured. At the other end of the STI spectrum is HIV/AIDS, which is still considered to be ultimately fatal. However, early treatment with antiretroviral drugs and other medical and lifestyle interventions can greatly delay the onset of the disease, and with high-quality care, HIV-positive people can live many years with minimal symptoms. Because the most common STIs are “silent” in that they are often asymptomatic, estimates of the incidence (new cases) and prevalence (total existing cases) of most STIs are difficult to make. Many asymptomatic STIs can be diagnosed only through testing, yet routine screening is not widespread. In addition, it is difficult to measure trends in the incidence and prevalence of STIs because of changes in reporting systems and testing methods. As a result, increases in reported cases may be due to improved testing and reporting, rather than true upsurges in incidence or prevalence. The most recent national estimates, now a decade old, suggest that there are approximately 19 million new cases of STIs each year, half of them among 15–24-year-olds, and that 65 million Americans have at least one viral STI, most commonly genital herpes.
Direct medical costs associated with STIs in the United States are estimated at $14.7 billion annually in 2006 dollars. More than $8 billion is spent each year to diagnose and treat STIs and their complications, not including HIV. For some population subgroups, primarily blacks and men who have sex with men, high prevalence of STIs within the community can be a risk factor in itself, since individuals are more likely to encounter an infected partner. High community prevalence of STIs can be a symptom of other problems in the community, such as a lack of access to health care, poverty, unemployment and other persistent social and economic discrimination. Whereas white Americans acquire STIs predominantly through high-risk sexual behaviors, black Americans acquire them through both high- and low-risk behaviors because levels of infection within the black population are high. (http://www.guttmacher.org/pubs/FIB_STI_US.html)
Understanding the determinants of sexually transmitted disease (STD) acquisition among adolescents and young adults is critical to assess interventions designed to limit the spread of STDs. One set of interventions — adopted by numerous organization sand directly supported by federal policy — are programs that encourage abstinence by encouraging adolescents to make pledge store main virgins until marriage. This article considers the relationship between adolescent virginity pledges and the sexual behavior of young adults, focusing on STD acquisition. In 1993, “True Love Waits” initiated a movement to encourage adolescents to pledge to abstain from sex until marriage. By 1995, an estimated 2.2 million adolescents (12%ofalladolescents) in the United States had taken such pledges. Earlier research demonstrated that adolescent virginity pledges were associated with a significant delay on the baseline rate for the transition to first sex. Although pledging was associated with delayed sexual initiation, the pledge effect was deeply shaped by social context, most importantly, the number of other students in the community that pledged and the social structure of the community with respect to the patterning of friendships. The pledge appears to work where public commitment to abstain from sex is encoded into shared group activities, thus enhancing identification with the movement and encoding promise to remain a virgin into the larger social fabric. -HannahBrückner,Ph.D. ,andPeterBearman,Ph.D.
A recent spate of articles by journalists describing patterns of oral sex among middle school students in particular communities has heightened interest in understanding the prevalence of this and other nonvaginal sexual activities among young teenagers.* Much of the in-formation about these activities has been collected in non representative surveys of teen-agers, however. Although the prevalence of vaginal sexual experience is closely monitored at the national level because of its attendant risks of unintended pregnancy and sexually transmitted disease (STD) trans-mission, little attention has been paid to other, nonvaginal sexual activity, even though oral and anal intercourse also expose youth to STDs. To address this gap in in-formation, we provide estimates of the incidence of various sexual practices from the 1995 National Survey of Adolescent Males. We also examine how reports of these practices have changed from 1988 to 1995. -Gary J. Gates and Freya L. Sonenstein 2001
Ninth graders surveyed in two California public schools had more experience with oral than with vaginal intercourse, and their intended behavior in the next six months favored oral sex. The teenagers estimated that they have less chance of becoming pregnant or contracting chlamydia or HN if they engage in oral sex than if they have vaginal intercourse, as well as less chance of jeopardizing their relation-ship or their reputation, getting into trouble or feeling guilty about their behavior. Respondents expressed greater acceptance of oral sex than of vaginal intercourse for youth their age, and said that oral sex is the more prevalent behavior among their peers. The survey was conducted in 2003 as part of a longitudinal study of the relationship between risk and benefit perceptions and sexual activity. In all, 580 ninth graders, with an aver-age age of 14.5 years, completed the self-administered questionnaire; 58% were female and 42% male. Forty percent of respondents were white, 24% Hispanic, 17% Asian and the rest members of other ethnic groups. Roughly equal proportions said that their mothers were college graduates, had some college education and had a high school education or less. Finally, when asked to estimate the prevalence of behaviors and intentions among youth their age, respondents said they believed that 47% of their peers of had had oral sex, but that only 41 % had had vaginal sex. Similarly, they anticipated that in the next six months, a larger proportion will have oral sex than will have vaginal sex (39% vs. 34%), and a smaller pro-portion will choose not to have oral sex than not to have vaginal intercourse (42% vs. 45%). They thought that 27% will wait until they are married to have oral sex, compared with 31 % for vaginal sex. The researchers acknowledge a number of limitations to their study, notably that the survey defined vaginal but not oral sex for participants, and that the data do not permit an assessment of causal relationships between perceptions and behavior. Nevertheless, they contend that the findings have critical public health implications. They conclude that "to help adolescents make informed sexual decisions, parents, health care providers, and other educators must broaden their clinical and educational efforts"; in particular, these efforts should cover the possible health, emotional and social consequences of all sexual behaviors, coital and non coital, as well as methods for preventing unhealthy outcomes.-D. Hollander 2004
Adolescents and young adults are examined because of growing incidence of STI. The average age of menarche among young girls has declined and the majorities for male and female teenagers are sexuality active at age of 19.-Hockenberry and others, 2005
According to an Australian study of foreign sex workers, most prostitutes are not aware they can contract STI through oral sex. The study, which will be presented to the international association for dental research meeting June 28- July 1 in Brisbane, found that sex workers knew the dangers of vaginal sex but not oral sex. Nair said there had been few studies on awareness levels among Australian workers but international trends indicated a general ignorance in the region. -According to Maria McMahon 2006
STI can be caused by bacteria, viruses, protozoa and fungi. Anyone who engage in intimate physical contact can contract and transmit STI. Many health workers providers do not always acknowledge that fact, specially in regard to middle class, upper class or older clients. Although younger people have the highest rates for STI (86%), all age groups are at risk. The fetus or neonate can be infected across the placenta or during the vaginal birth. -Hawks, 2002 The incidence of STI in the United States has the highest rates of STI in the industrialize world Center for Diseases Control and Prevention CDC, 1999 the prevalence of STI is a major health concern because treatment is costly and the incidence is high in minority populations of low socio economic status. Prevalent STI include syphilis, gonorrhea, Chlamydia, trichomoniasis and infection with HPV and herpes simplex virus respectively. It is transmitted from an infected individuals to partners during intimate sexual contact. The site of transmission is usually genitals but it may also be oral genital or anal genital. Hose person most likely to be infected share one key characteristics unprotected sex with multiple partners. - Potter, 2004.
AIDS
AIDS is a mysterious and tragic illness in which the body’s protective immune system becomes unable to ward off infections. It was first recognized in the U.S as a separate entity in 1981. Those at greater risk of this disease are homosexual and bisexual males and their sexual partners and drug abusers of both sexes who inject drugs into their veins. A scientific evidence now indicates that a retrovirus is a causative agent and that this virus occurs in the blood, saliva or the semen of person afflicted. The virus easily transmitted from person to person by intimate contact. A person without symptoms may harbor the virus and transmit it to his sexual partners. The number of reported cases continues to increase alarmingly. The illness consist of various kinds of infection, often involving the lungs plus the development in about one third of the cases of a malignancy of the skin (Kaposi’s sarcoma). The incubation period may be as long as two years. As yet there is no specific treatment and the mortality rate is 70-90 percent within two years. Now that the causative virus has been identified, some progress is being made in developing a vaccine but absolutely prevention is yet in the future. - Modern Medical Guide (revised edition 2001) Harold Shryock, M
Chlamydia and Gonorrhea Chlamydia and gonorrhea are bacterial infections that can be cured with antibiotics. Untreated chlamydia and gonorrhea infections in women may lead to pelvic inflammatory disease (PID), a serious infection that itself may lead to ectopic pregnancy, infertility and chronic pain. Evidence suggests that roughly 10–40% of untreated chlamydia cases will lead to PID and that as many as 20% of women with PID will develop infertility. Forty-two percent of young women were tested for chlamydia in 2007, compared with only 25% in 2000. Chlamydia and gonorrhea must be reported to state health departments and the Centers for Disease Control and Prevention (CDC). In 2007, the CDC reported 1.1 million chlamydia diagnoses and 356,000 gonorrhea diagnoses. However, since most chlamydia and gonorrhea cases go undiagnosed or unreported, the true number of new infections is probably much greater. In 2007, the overall reported rate of chlamydia infection among women (544 cases per 100,000 females) was almost three times the rate among men (190 per 100,000 males). Blacks are the group most heavily affected by chlamydia and gonorrhea. The reported rates of both infections are 9–19 times higher among blacks than whites. Although the magnitude of these disparities may be distorted due to discrepancies in reporting, the disparities are real. Rates of gonorrhea and chlamydia are heavily concentrated among young people. Young women aged 15–24 are hit hardest by chlamydia, with rates more than five times as high as women overall. Routine screening for chlamydia among women younger than 26 is widely recommended by the CDC and major medical associations, and it is considered to be a cost-effective and underutilized form of preventive health care by the U.S. Preventive Services Task Force because of its potential for helping to reduce rates of pelvic inflammatory disease. The U.S. Preventive Services Task Force recommends that clinicians screen all sexually active women, including those who are pregnant, for gonorrhea infection if they are at increased risk for infection (that is, if they are young or have other individual or population risk factors).
Human Papillomavirus (HPV)
HPV is an extraordinarily common viral infection in the United States, so much so that it has been described as a virtual “marker” for having had sex. The CDC estimates that 20 million people are currently infected with HPV, 6.2 million Americans become infected each year and at least 50% of sexually active individuals will acquire an HPV infection at some point in their lives. Most HPV infections cause no clinical problems and resolve on their own without treatment. (As many as 91% of new infections clear up within two years. Certain HPV strains lead to genital warts. These warts can be removed, but if the immune system fails to clear the virus entirely, symptoms may reappear. Other HPV strains are deemed “high-risk” because they occasionally develop into a persistent infection that can progress to cervical cancer if left untreated, usually over the course of decades. The incidence of cervical cancer in the United States has been on the decline for some time, and today cervical cancer is rare, relative to the incidence of HPV infection. The American Cancer Society estimates that 11,000 cases will occur among American women this year, resulting in 4,000 deaths. The major reason cervical cancer rates in this country are low today—despite high rates of HPV infection—is the widespread availability and use of Pap tests. Pap tests can detect not only early-stage cervical cancer, which is highly treatable, but also cervical dysplasia—precancerous changes of cervical cells which can linger for years—allowing for the removal of affected tissue long before invasive cancer sets in. Pap tests are fairly common in the United States, but 17% of American women aged 18–64 in 2005 had not been tested in the past three years. These women account for the majority of cervical cancer diagnoses. In 2006, the U.S. Food and Drug Administration approved an HPV vaccine that protects against the four key strains of HPV that account for 70% of cervical cancers and 90% of genital warts. The three-dose vaccine can be given to girls as young as age nine, but is recommended for girls aged 11–12, with catch-up vaccinations recommended for those aged 13–26.
Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. HIV can be transmitted through the blood, sexual fluids or breast milk of an HIV-infected person. Since 1981, when the first AIDS cases were identified, more than 1.6 million Americans have been infected with HIV, and more than 540,000 have already died. Roughly 56,000 new HIV infections occur each year—a number that has remained stable since 2000. An estimated 1–1.2 million individuals in the United States are living with HIV. Of new HIV infections in 2006, 53% were among men who had sex with men; 31% resulted from heterosexual contact; 12% resulted from injection drug use; and 4% were among men who had sex with men and also used injection drugs. In 2006, women accounted for 25% of HIV/AIDS diagnoses among adolescents and adults, and men for 75%. However, among infections that resulted from heterosexual contact, women account for a growing majority. Eighty percent of women diagnosed with HIV/AIDS in 2006 contracted the virus through heterosexual contact. Among both males and females, blacks have the highest rates of new infections. Although blacks make up approximately 13% of the U.S. population, they accounted for almost half of the estimated new HIV/AIDS diagnoses in 2006. In 2002, half of men and women aged 15–44 reported that they had been tested at least once for HIV (other than through blood donation);20 15% had been tested in the past 12 months.
Close to 40% of people who test positive for HIV are diagnosed with full-blown AIDS within one year, and the majority of those who get an HIV test late in the course of their infection do so because they are already ill. Current federal guidelines recommend that HIV testing be a standard part of medical care for every American aged 13–64, that more people be tested and that people be tested sooner. In 2006, as many as one in five individuals with HIV may have been unaware of their status, down from one in four in 2003.
Other STIs
Other common STIs include viral infections, such as herpes and hepatitis A and B, which are incurable but treatable; and bacterial and parasitic infections, such as syphilis and trichomoniasis, which can be cured with antibiotics.
Syphilis, hepatitis A and hepatitis B are required to be reported to state health departments and the CDC. In 2007, the most infectious stages of syphilis—primary and secondary—were diagnosed in about 11,500 Americans. The estimated number of new hepatitis B virus infections was 46,000, while only 4,800 acute clinical cases were reported in 2006. An estimated 1.5 million people in the United States have chronic hepatitis B. Although other STIs are not required to be reported to the CDC, estimates are available for some. The CDC estimates that one out of five adolescents and adults have had a genital herpes infection. Although genital herpes is incurable and can cause painful sores and psychological distress, it has become increasingly manageable in the United States. About 7.4 million new cases of trichomoniasis occur each year. Left untreated, trichomoniasis can be an irritant, causing vaginal discharge, discomfort during intercourse and painful urination.
Late-stage syphilis can, years later, cause irreversible damage to the nervous system and heart, possibly leading to blindness, insanity, paralysis and death. Hepatitis B can cause inflammation of the liver, and chronic cases can cause liver cell damage, which can lead to cirrhosis of the liver and cancer. It is estimated that 5,000 people die each year in the United States due to the complications of cirrhosis and liver cancer as a result of hepatitis B. Herpes, trichomoniasis and many other STIs have two other very real health consequences. First, they can increase an individual’s susceptibility of HIV infection. Second, they can have serious negative health outcomes during pregnancy and childbirth. Therefore, public health authorities have put an emphasis on testing and treating women during pregnancy. http://www.guttmacher.org/pubs/FIB_STI_US.html Methodology
Research Design This study will use the descriptive research method. This method involves collecting data in order to take hypothesis or answer question regarding the subject of the study. In this method, the awareness on risk factors of sexually transmitted infection and sexual risk behavior among students of Cavite State University will be described and evaluated.
Target Population/ Study subjects This study will focus among officially enrolled college students SY 2010- 2011 of Cavite State University. Fifty percent (50%) of the total population of Cavite State University specifically five colleges such College of Nursing (CON), College of Engineering and Information Technology (CEIT), College of Education (CED), College of Arts and Sciences (CAS) and College of Economics, Management and Development Studies (CEMDS). This will determine their awareness on risk factors of Sexually Transmitted Infections (STI’s) and their sexual risk behavior. In addition, their college buildings and faculties are easily accessible for the researchers.
Sampling type and technique In choosing the respondents, the researchers will be utilizing simple random sampling technique and convenient sampling. With the help of the faculty members of the five colleges, the researchers will be provided with total number of officially enrolled college students SY 2010- 2011. Using Slovin’s formula, the researchers will compute for twenty- five percent (25%) of the total population of all five colleges. The researchers would also compute for the ideal sampling size of the population for every college in order that every department of each college will have their respondents equally. From there, the researchers will be standing in every entrance of the five buildings. The student who enters the building and will be given questionnaires should be officially enrolled and should be with the appropriate course for the building. However, students who will be exiting from the building are not included.
Slovin’s Formula: n = N 1 + Ne²
Research Instrument A questionnaire is developed and will be utilized in conducting and collecting data regarding the study; it will enable to determine the awareness on risk factors of sexually transmitted infection and their sexual risk behavior among students of Cavite State University by answering the prepared questions. The questionnaire is subdivided into two (2) parts. Part I- Demographic data of the respondents. This includes the name (optional), the age, gender, civil status and the college of the said respondent. Part II- Awareness on Risk factors of Sexually Transmitted Infection asks the awareness of the college students of Cavite State University. Part III- Sexual Risk Behavior that asks the sexual risk behaviors of the college students of Cavite State University. The respondents will be ask to evaluate or rate their individual perception on the statements based on the scale of 5- always, 4- often, 3- sometimes, 2- seldom and 1- never. After they finished answering the said questionnaires, it will be evaluated by the researchers. Respondents who have a total of thirty five means (part II- ten points and part III- twenty five points) that they are really aware about sexually transmitted infections. Respondents who have fifteen and below means that they are not aware about sexually transmitted infection and that they have the need to be well informed about the said infection.
Validation of Research
The validation of the research instrument will be done by means of consulting the thesis adviser Mrs. Nenita B. Panaligan, RN, MAN and the technical critic Ms. Divinia Joy Tuzon, RN. Pre-testing will be performed to validate the reliability of the research instrument and if it responds with the objective of the study. It will as well verify if the research instrument will be beneficial to the respondents. Pre-testing will be done by targeting twenty- five percent (25%) of the officially enrolled college students in each five colleges.
Materials
The entire process of assessing the awareness on risk factors of sexually transmitted infection and sexual risk behaviors among students of Cavite State University required the following material: questionnaires.
Statistical Treatment
The slovin's formula is used which is to determine the ideal sample size for a population.
n = N 1 + Ne²
Where: n = number of samples N = total population e = margin of error
Sample Calculation:
A group of students want to know the age of students in a high school but do not have the resources to survey an entire population of 2,500. If they want to use a sample with a 5% margin of error, what should their sample size be?
Given: N = 2,500 e = 5% = 0.05
Required: n = ?
Solution: n = N / ( 1 + (N*e^2)) n = 2500 / ( 1 + (2500*.05^2)) n = 2500 / 7.25 n = 344.83 ~ 355
CAVITE STATE UNIVERSITY
(CvSU)
DON SEVERINO DE LAS ALAS CAMPUS
Indang, Cavite
( (046) 415-0021 ( (046) 415-0012
E-mail: cvsu@asia.com
COLLEGE OF NURSING
This questionnaire is going to utilize to evaluate the awareness on risk factors of sexually transmitted infections (STI’s) and sexual risk behavior among college students of Cavite State University.
Part I. DEMOGRAPHIC PROFILE
Name: (Optional)______________________________________________ Age: _______
Gender: ________ Civil Status: __________________ College: _______________
|QUESTIONS |YES |NO |
|Do you use condom when having sex? | | |
|Do you have multiple sexual partners? | | |
|Do you have warts in genital area? | | |
|Are you having frequent sexual contact? | | |
|Do you have partner with same sex? | | |
|Is there a nearest health center in your community where you can seek for health? | | |
|Is there a high prevalence of STI within your community? | | |
|Do you have proper guidance from your guardian/parents? | | |
| Is your institution (school) having programs regarding health education? | | |
|Do you have known programs of Department of Health that has been implemented regarding STI? | | |
Part II. RISK FACTORS OF SEXUALLY TRANSMITTED INFECTION
INSTRUCTION:
Check the box that corresponds to your answer. Select only one answer for each question.
PART III. SEXUAL RISK BEHAVIOR
INSTRUCTION:
Check the box that corresponds to your answer. Select only one box for each sentence.
5- Always 4- Often 3- Sometimes 2- Seldom 1- Never
|QUESTIONS |5 |4 |3 |2 |1 |
| | | | | | |
|I read pornographic materials. | | | | | |
|I’m watching x-rated/scandal movies. | | | | | |
|I visit night clubs/sex den etc. | | | | | |
|I practice exhibitionism exposure of private body parts/cyber sex. | | | | | |
|I enjoy expressing oneself by SOP/SOT. | | | | | |
|I use sex toys. | | | | | |
|I share syringe with others when using injectables. | | | | | |
|I engage with multiple sexual acts. | | | | | |
|I’m having oral sex with same sex. | | | | | |
|I’m having oral sex with opposite sex. | | | | | |
|I’m having anal sex with same sex. | | | | | |
|I’m having anal sex with opposite sex. | | | | | |
|I’m having sexual intercourse vaginally. | | | | | |
|I’m having sexual contact with the influence of alcohol. | | | | | |
|I’m having sexual contact with the influence of drugs. | | | | | |
|I’m having sexual intercourse with the same sex/ gender. | | | | | |
|I’m having sexual intercourse with guest relation officer. | | | | | |
|I’m having sexual intercourse with callboys. | | | | | |
|I have multiple sexual partners. | | | | | |
|I engage with multiple sexual acts. | | | | | |
|I’m having sexual intercourse with my bf/ gf as a sign of my love for him/ her. | | | | | |
|I’m influenced by my peers to do sexual acts. | | | | | |
|I’m willing to try other sexual activities with animals. | | | | | |
|I trade sex for money. | | | | | |
|I spend money for sex. | | | | | |
|TOTAL |
THANK YOU FOR YOUR TIME!!!
GOD BLESS…..
-----------------------
Demographic
Profile:
Age:
Gender:
Civil Status:
Sexual Risk behavior
Awareness on risk factors of sexually transmitted infections (STI’s)
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