Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Sexual health literacy of the student population of the University of Tasmania: results of the RUSSL Study

Steve Simpson Jr A F , Christine Clifford B , Kaz Ross C , Neil Sefton D , Louise Owen E , Leigh Blizzard A and Richard Turner A D
+ Author Affiliations
- Author Affiliations

A Menzies Institute for Medical Research, University of Tasmania, Private bag 23, Hobart, Tas. 7000, Australia.

B School of Psychology, University of Tasmania, Hobart, Tas. 7000, Australia.

C School of Humanities, University of Tasmania, Hobart, Tas. 7005, Australia.

D School of Medicine, University of Tasmania, Hobart, Tas. 7000, Australia.

E Sexual Health Service Tasmania, Tasmanian Department of Health and Human Services, Hobart, Tas. 7000, Australia.

F Corresponding author. Email: steve.simpson@utas.edu.au

Sexual Health 12(3) 207-216 https://doi.org/10.1071/SH14223
Submitted: 7 November 2014  Accepted: 23 February 2015   Published: 27 April 2015

Abstract

Background: Evidence suggests a varied level of sexual health literacy (SHL) among university student populations, so we evaluated the SHL among students at the University of Tasmania. Methods: Students were invited to complete an anonymous online questionnaire during August/September 2013. SHL was assessed using the ARCSHS National Survey of Australian Secondary Students & Sexual Health (ARC) and the Sexual Health Questionnaire (SHS). Predictors of literacy scores were evaluated by linear regression. Results: The study recruited 1786 participants (8.2% of 2013 student population), of similar composition to the general university population. Female sex, older age, sexual education, and sexual experience were significant predictors of SHL. As hypothesised, students in medical/nursing disciplines had the highest SHL. Less expected were the significant differences by birthplace and religious affiliation, many of which persisted on adjustment for confounders. Compared with Australian/New Zealander students, overseas-born students had significantly lower ARC (–3.6%, P < 0.001) & SHS (–4.2%, P < 0.001); this was driven by Malaysian, Indian, and Chinese students. Compared with agnostic/atheist-identifying students, those of Buddhist (ARC: –5.4%, P = 0.014; SHS: –6.7%, P = 0.002), Hindu (ARC: –8.8%, P = 0.098; SHS: –12.2%, P = 0.027), Muslim (ARC: –16.5%, P < 0.001; SHS: –13.4%, P = 0.001) and Protestant (ARC: –2.3%, P = 0.023; SHS: –4.4%, P < 0.001) identifications had markedly lower SHL. Conclusions: This study, one of the first among university students in Australia, found a varied SHL by sex, age, sexual education and sexual experience, as well as by birthplace and religious affiliation. These findings have applications in orientation and education programs at Australian universities.


References

[1]  McKelvey RS, Webb JA, Baldassar LV, Robinson SM, Riley G. Sex knowledge and sexual attitudes among medical and nursing students. Aust N Z J Psychiatry 1999; 33 260–6.
Sex knowledge and sexual attitudes among medical and nursing students.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3mslaltQ%3D%3D&md5=b74a3da97507520f0e88a7c10dfb3abfCAS | 10336225PubMed |

[2]  Tagoe M, Aggor RA. Knowledge, behaviour, perceptions and attitudes of University of Ghana students towards HIV/AIDS: what does behavioural surveillance survey tell us? J Health Hum Serv Adm 2009; 32 51–84.
| 19558033PubMed |

[3]  Badenhorst G, van Staden A, Coetsee E. HIV/AIDS risk factors among residence students at the University of the Free State. Curationis 2008; 31 27–35.
HIV/AIDS risk factors among residence students at the University of the Free State.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1M7gsV2mug%3D%3D&md5=c35c76c10710d18e52f8ff35139c627aCAS | 19177968PubMed |

[4]  Randolph ME, Torres H, Gore-Felton C, Lloyd B, McGarvey EL. Alcohol use and sexual risk behavior among college students: understanding gender and ethnic differences. Am J Drug Alcohol Abuse 2009; 35 80–4.
Alcohol use and sexual risk behavior among college students: understanding gender and ethnic differences.Crossref | GoogleScholarGoogle Scholar | 19253158PubMed |

[5]  Munoz-Silva A, Sanchez-Garcia M, Martins A, Cristina N. Gender differences in HIV-related sexual behavior among college students from Spain and Portugal. Span J Psychol 2009; 12 485–95.
Gender differences in HIV-related sexual behavior among college students from Spain and Portugal.Crossref | GoogleScholarGoogle Scholar | 19899650PubMed |

[6]  Othero DM, Aduma P, Opil CO. Knowledge, attitudes and sexual practices of university students for advancing peer HIV education. East Afr Med J 2009; 86 11–5.
Knowledge, attitudes and sexual practices of university students for advancing peer HIV education.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MvisVSgsQ%3D%3D&md5=dc33405ba80c1197eb79c01a0f2f769bCAS | 19530543PubMed |

[7]  Makhubele JC. Students’ attitudes towards reproductive health and rights in the University of Limpopo (Turfloop Campus) - South Africa: a social work perspective. East Afr J Public Health 2010; 7 126–30.
| 1:STN:280:DC%2BC3M3nsl2ltw%3D%3D&md5=b1fc5b51cd3df1608af13265ebc29236CAS | 21413589PubMed |

[8]  Zekan S, Novotny TE, Begovac J. Unsafe sexual behavior among HIV-infected patients in Croatia, 2006: prevalence and associated factors. AIDS Behav 2008; 12 86–92.
Unsafe sexual behavior among HIV-infected patients in Croatia, 2006: prevalence and associated factors.Crossref | GoogleScholarGoogle Scholar |

[9]  Yilmaz HB, Kavlak O, Atan SU. Sexual activity, knowledge and contraceptive usage by gender among university students in Turkey. Eur J Contracept Reprod Health Care 2010; 15 433–40.
Sexual activity, knowledge and contraceptive usage by gender among university students in Turkey.Crossref | GoogleScholarGoogle Scholar | 20874085PubMed |

[10]  Song A, Richters J, Crawford J, Kippax S. HIV and sexual health knowledge and sexual experience among Australian-born and overseas-born students in Sydney. J Adolesc Health 2005; 37 243.e9–243.e14.
HIV and sexual health knowledge and sexual experience among Australian-born and overseas-born students in Sydney.Crossref | GoogleScholarGoogle Scholar |

[11]  Crosby RA, Danner F. Adolescents’ sexually transmitted disease protective attitudes predict sexually transmitted disease acquisition in early adulthood. J Sch Health 2008; 78 310–3.
Adolescents’ sexually transmitted disease protective attitudes predict sexually transmitted disease acquisition in early adulthood.Crossref | GoogleScholarGoogle Scholar | 18489463PubMed |

[12]  Fisher WA, Grenier G, Watters WW, Lamont J, Cohen M, Askwith J. Students’ sexual knowledge, attitudes toward sex, and willingness to treat sexual concerns. J Med Educ 1988; 63 379–85.
| 1:STN:280:DyaL1c3gtVagtg%3D%3D&md5=b15f1ca803262b9427b88cd2b21a17ddCAS | 3361589PubMed |

[13]  Sanchez NF, Rabatin J, Sanchez JP, Hubbard S, Kalet A. Medical students’ ability to care for lesbian, gay, bisexual, and transgendered patients. Fam Med 2006; 38 21–7.
| 16378255PubMed |

[14]  Robb N. Medical schools seek to overcome “invisibility” of gay patients, gay issues in curriculum. CMAJ 1996; 155 765–70.
| 1:STN:280:DyaK28vitVGhsQ%3D%3D&md5=71b6787746e0f9b2d9745c2f68977d8cCAS | 8823221PubMed |

[15]  Dinas K, Zepiridis L, Arvanitidou O, Mavromatidis G, Nasioutziki M, Loufopoulos P, Danilidis A, Mamopoulos A, Pantazis K, Dovas D, Theodoridis T, Loufopoulos A. Level of knowledge about genital chlamydial infection among Greek midwives and midwifery students. Scand J Infect Dis 2010; 42 249–53.
Level of knowledge about genital chlamydial infection among Greek midwives and midwifery students.Crossref | GoogleScholarGoogle Scholar | 20085427PubMed |

[16]  Orisatoki RO, Oguntibeju OO. Knowledge and attitudes of students at a Caribbean offshore medical school towards sexually transmitted infections and use of condoms. West Indian Med J 2010; 59 171–6.
| 1:STN:280:DC%2BC3M7ltVOgug%3D%3D&md5=807959a5657e4f228f54deed78c38fe9CAS | 21275121PubMed |

[17]  Gott M, Galena E, Hinchliff S, Elford H. “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract 2004; 21 528–36.
“Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care.Crossref | GoogleScholarGoogle Scholar | 15367475PubMed |

[18]  Maheux B, Haley N, Rivard M, Gervais A. Do physicians assess lifestyle health risks during general medical examinations? A survey of general practitioners and obstetrician-gynecologists in Quebec. CMAJ 1999; 160 1830–4.
| 1:STN:280:DyaK1MzjsVWguw%3D%3D&md5=cd73eef093998512782b51aac00a2acfCAS | 10405667PubMed |

[19]  Haley N, Maheux B, Rivard M, Gervais A. Sexual health risk assessment and counseling in primary care: how involved are general practitioners and obstetrician-gynecologists? Am J Public Health 1999; 89 899–902.
Sexual health risk assessment and counseling in primary care: how involved are general practitioners and obstetrician-gynecologists?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3os1Ogtg%3D%3D&md5=06fe2a5f93117ab2d9f3247daf9ad138CAS | 10358682PubMed |

[20]  Hinchliff S, Gott M, Galena E. GPs’ perceptions of the gender-related barriers to discussing sexual health in consultations–a qualitative study. Eur J Gen Pract 2004; 10 56–60.
GPs’ perceptions of the gender-related barriers to discussing sexual health in consultations–a qualitative study.Crossref | GoogleScholarGoogle Scholar | 15232525PubMed |

[21]  Boekeloo BO, Marx ES, Kral AH, Coughlin SC, Bowman M, Rabin DL. Frequency and thoroughness of STD/HIV risk assessment by physicians in a high-risk metropolitan area. Am J Public Health 1991; 81 1645–8.
Frequency and thoroughness of STD/HIV risk assessment by physicians in a high-risk metropolitan area.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK38%2FotFyqug%3D%3D&md5=6e37d847f4addf495a073d63a09d6288CAS | 1746664PubMed |

[22]  Dolcini MM, Catania JA, Coates TJ, Stall R, Hudes ES, Gagnon JH, Pollack LM. Demographic characteristics of heterosexuals with multiple partners: the National AIDS Behavioral Surveys. Fam Plann Perspect 1993; 25 208–14.
Demographic characteristics of heterosexuals with multiple partners: the National AIDS Behavioral Surveys.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c%2FosFGgtg%3D%3D&md5=f30a28b2205257533cffb8216c876943CAS | 8262169PubMed |

[23]  Davis K, Glass N. Safe sex and student nurses in rural Australia: nurses’ knowledge and practices (Part 1). Contemp Nurse 2002; 12 78–82.
Safe sex and student nurses in rural Australia: nurses’ knowledge and practices (Part 1).Crossref | GoogleScholarGoogle Scholar | 12013522PubMed |

[24]  The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013. Sydney: The Kirby Institute, The University of New South Wales; 2013.

[25]  Smith A, Agius PA, Mitchell A, Barrett C, Pitts M. Secondary students and sexual health 2008, Monograph Series No. 70. Melbourne: Australian Research Centre in Sex, Health & Society, La Trobe University; 2009.

[26]  Eastman-Mueller H, Carr D, Osterlind S. Sexual health survey. In Fisher TD, Davis CM, Yarber W, Davis SL, editors. Handbook of sexuality-related measures, 3rd edn. Danvers, MA: Taylor and Francis Publishing; 2010. pp. 340–44.

[27]  Zulkifli SN, Low WY. Sexual health education for youths–a Malaysian experience. Asia Pac J Public Health 2000; 12 S58–66.
| 11338741PubMed |

[28]  Shaw SA, El-Bassel N. The influence of religion on sexual HIV risk. AIDS Behav 2014; 18 1569–94.
The influence of religion on sexual HIV risk.Crossref | GoogleScholarGoogle Scholar | 24510402PubMed |

[29]  Fakoya I, Johnson A, Fenton K, Anderson J, Nwokolo N, Sullivan A, Munday P, Burns FM. Religion and HIV diagnosis among Africans living in London. HIV Med 2012; 13 617–22.
Religion and HIV diagnosis among Africans living in London.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38jktF2htw%3D%3D&md5=a55a52ac64abb6a9d305146cae9f46f7CAS | 22726318PubMed |

[30]  Caetano ME, Linhares IM, Pinotti JA, Maggio da Fonseca A, Wojitani MD, Giraldo PC. Sexual behavior and knowledge of sexually transmitted infections among university students in Sao Paulo, Brazil. Int J Gynaecol Obstet 2010; 110 43–6.
Sexual behavior and knowledge of sexually transmitted infections among university students in Sao Paulo, Brazil.Crossref | GoogleScholarGoogle Scholar | 20394925PubMed |