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

Factors associated with online sexually transmissible infection information seeking among young people in Malaysia: an observational study

Sharina Mahavera Mohamad Shakir https://orcid.org/0000-0001-8649-3800 A , Li Ping Wong A D , Khatijah Lim Abdullah B and Philippe Adam C
+ Author Affiliations
- Author Affiliations

A Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

B Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.

C Centre for Social Research in Health, UNSW Sydney, NSW 2052, Australia.

D Corresponding author. Email: wonglp@ummc.edu.my

Sexual Health 16(2) 158-171 https://doi.org/10.1071/SH17198
Submitted: 7 November 2017  Accepted: 10 December 2018   Published: 19 March 2019

Abstract

Background: The Internet is an important resource of information about sexually transmissible infections (STIs) among young people. Little is known of the facilitators of online STI information seeking. This study aimed to identify the factors associated with online STI information seeking among youth in Malaysia. Methods: A cross-sectional online survey was conducted among Malaysian youth aged 18–25 years who were recruited through social media. Results: Among 1530 respondents who completed the survey, 57.1% sought online STI information in the past 12 months mostly from general Internet websites, health websites, and Facebook. Respondents’ overall STI knowledge was low. Young people who had higher STI knowledge (OR = 2.47, 95% CI = 1.87–3.25, P = 0.000), had intention-to-seek online STI information (OR = 2.02, 95% CI = 1.23–3.30, P = 0.000), identified as homosexual or bisexual (OR = 1.67, 95% CI = 1.08–2.57, P = 0.020), experienced STI symptoms (OR = 1.51, 95%CI = 1.02–2.22, P = 0.040), were in a relationship (OR = 1.42, 95% CI = 1.08–1.86, P = 0.012) and had high perceived quality of online STI information (OR = 1.41, 95%CI = 1.09–1.83, P = 0.009) were more likely to seek online STI information. Conclusions: Findings suggest the need to increase STI knowledge and perceived quality of online STI information among Malaysian youth. Young people with low STI knowledge, who are heterosexual, sexually active without STI symptoms and single would benefit from reliable sources of online STI information for STI prevention.

Additional keywords: health promotion, Internet, public health, STIs, youth.


References

[1]  Gabarron E, Wynn R. Use of social media for sexual health promotion: a scoping review. Glob Health Action 2016; 9 32193
Use of social media for sexual health promotion: a scoping review.Crossref | GoogleScholarGoogle Scholar | 27649758PubMed |

[2]  Wong LP. An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices. BMC Public Health 2012; 12 865
An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices.Crossref | GoogleScholarGoogle Scholar | 23057505PubMed |

[3]  Buhi ER, Daley EM, Fuhrmann HJ, Smith SA. An observational study of how young people search for online sexual health information. J Am Coll Health 2009; 58 101–11.
An observational study of how young people search for online sexual health information.Crossref | GoogleScholarGoogle Scholar | 19892646PubMed |

[4]  Lim MS, Vella A, Sacks-Davis R, Hellard ME. Young people’s comfort receiving sexual health information via social media and other sources. Int J STD AIDS 2014; 25 1003–8.
Young people’s comfort receiving sexual health information via social media and other sources.Crossref | GoogleScholarGoogle Scholar | 24616114PubMed |

[5]  Freeman G, Smith LW, McNulty A, Donovan B. Sexual health and students: the pathways travelled by those with sexual health concerns. Sex Health 2018; 15 76–8.
Sexual health and students: the pathways travelled by those with sexual health concerns.Crossref | GoogleScholarGoogle Scholar | 29050552PubMed |

[6]  Simon L, Daneback K. Adolescents’ use of the Internet for sex education: a thematic and critical review of the literature. Int J Sex Health 2013; 25 305–19.
Adolescents’ use of the Internet for sex education: a thematic and critical review of the literature.Crossref | GoogleScholarGoogle Scholar |

[7]  UNICEF. Exploring the digital landscape in Malaysia. Kuala Lumpur: UNICEF Malaysia; 2014.

[8]  Consumer Barometer. Consumer barometer with Google. California: Google; 2016. Available online at: https://www.consumerbarometer.com/en/graph-builder/?question=M6&filter=country:malaysia%7CC1:16_24 [verified 2 May 2017].

[9]  Jones K, Eathington P, Baldwin K, Sipsma H. The impact of health education transmitted via social media or text messaging on adolescent and young adult risky sexual behavior: a systematic review of the literature. Sex Transm Dis 2014; 41 413–9.
The impact of health education transmitted via social media or text messaging on adolescent and young adult risky sexual behavior: a systematic review of the literature.Crossref | GoogleScholarGoogle Scholar | 24922099PubMed |

[10]  Bailey J, Mann S, Wayal S, Hunter R, Free C, Abraham C, Murray E. Sexual health promotion for young people delivered via digital media: a scoping review Public Health Research. Southampton: NIHR Journals Library; 2015.

[11]  Guse K, Levine D, Martins S, Lira A, Gaarde J, Westmorland W, Gilliam M. Interventions using new digital media to improve adolescent sexual health: a systematic review. J Adolesc Health 2012; 51 535–43.
Interventions using new digital media to improve adolescent sexual health: a systematic review.Crossref | GoogleScholarGoogle Scholar | 23174462PubMed |

[12]  Bull SS, Levine D, Black SR, Schmiege S, Santelli J. Social media–delivered sexual health intervention: a cluster randomized controlled trial. Am J Prev Med 2012; 43 467–74.
Social media–delivered sexual health intervention: a cluster randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 23079168PubMed |

[13]  Chisolm DJ. Does online health information seeking act like a health behavior?: a test of the behavioral model. Telemed J E Health 2010; 16 154–60.
Does online health information seeking act like a health behavior?: a test of the behavioral model.Crossref | GoogleScholarGoogle Scholar | 20156127PubMed |

[14]  Mitchell KJ, Ybarra ML, Korchmaros JD, Kosciw JG. Accessing sexual health information online: use, motivations and consequences for youth with different sexual orientations. Health Educ Res 2014; 29 147–57.
Accessing sexual health information online: use, motivations and consequences for youth with different sexual orientations.Crossref | GoogleScholarGoogle Scholar | 23861481PubMed |

[15]  Justumus P, Colby D, Mai Doan Anh T, Balestre E, Becquet R, Orne-Gliemann J. Willingness to use the internet to seek information on HIV prevention and care among men who have sex with men in Ho Chi Minh City, Vietnam. PLoS One 2013; 8 e71471
Willingness to use the internet to seek information on HIV prevention and care among men who have sex with men in Ho Chi Minh City, Vietnam.Crossref | GoogleScholarGoogle Scholar | 23977048PubMed |

[16]  Huang FF, Lai Y-H, Lin C-H, Yang H-H. Health knowledge insufficiency motivates health information seeking. IJWA 2016; 8 1–7.

[17]  Folasayo AT, Oluwasegun AJ, Samsudin S, Saudi SN, Osman M, Hamat RA. Assessing the knowledge level, attitudes, risky behaviors and preventive practices on sexually transmitted diseases among university students as future healthcare providers in the central zone of Malaysia: a cross-sectional study. Int J Environ Res Public Health 2017; 14 E159
Assessing the knowledge level, attitudes, risky behaviors and preventive practices on sexually transmitted diseases among university students as future healthcare providers in the central zone of Malaysia: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 28208724PubMed |

[18]  Anwar M, Sulaiman SAS, Ahmadi K, Khan TM. Awareness of school students on sexually transmitted infections (STIs) and their sexual behavior: a cross-sectional study conducted in Pulau Pinang, Malaysia. BMC Public Health 2010; 10 47
Awareness of school students on sexually transmitted infections (STIs) and their sexual behavior: a cross-sectional study conducted in Pulau Pinang, Malaysia.Crossref | GoogleScholarGoogle Scholar | 20113511PubMed |

[19]  Ab Rahman A, Ab Rahman R, Ibrahim MI, Salleh H, Ismail SB, Ali SH, Muda WM, Ishak M, Ahmad A. Knowledge of sexual and reproductive health among adolescents attending school in Kelantan, Malaysia. Southeast Asian J Trop Med Public Health 2011; 42 717–25.
| 21706952PubMed |

[20]  Newton-Levinson A, Leichliter JS, Chandra-Mouli V. Sexually transmitted infection services for adolescents and youth in low- and middle-income countries: perceived and experienced barriers to accessing care. J Adolesc Health 2016; 59 7–16.
Sexually transmitted infection services for adolescents and youth in low- and middle-income countries: perceived and experienced barriers to accessing care.Crossref | GoogleScholarGoogle Scholar | 27338664PubMed |

[21]  Ismail K, Abd Hamid SR. Communication about sex-reproductive health issues with adolescents: a taboo among Malaysian parents? Eur J Soc Sci Educ Res 2016; 6 27–41.
Communication about sex-reproductive health issues with adolescents: a taboo among Malaysian parents?Crossref | GoogleScholarGoogle Scholar |

[22]  Wong LP. Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study. Prev Med 2013; 57 S60–3.
Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study.Crossref | GoogleScholarGoogle Scholar | 23583477PubMed |

[23]  Lugova H, Mon AA, Daher AM, Suleiman A. HIV-related stigma and discriminatory attitudes among a semi-urban population. Malays J Med Sci 2015; 22 64–9.
| 28239270PubMed |

[24]  Marton C, Choo CW. A review of theoretical models of health information seeking on the web. J Doc 2012; 68 330–52.
A review of theoretical models of health information seeking on the web.Crossref | GoogleScholarGoogle Scholar |

[25]  Ahadzadeh AS, Pahlevan Sharif S, Ong FS, Khong KW. Integrating health belief model and technology acceptance model: an investigation of health-related Internet use. J Med Internet Res 2015; 17 e45
Integrating health belief model and technology acceptance model: an investigation of health-related Internet use.Crossref | GoogleScholarGoogle Scholar | 25700481PubMed |

[26]  Ajzen I. Constructing a Theory of Planned Behavior questionnaire. Amherst: University of Massachusetts; 1991. Available online at: http://people.umass.edu/aizen/pdf/tpb.measurement.pdf [verified 19 April 2017].

[27]  Ministry of Health. Health facts 2017. Putrajaya: Health Informatics Centre, Ministry of Health Malaysia; 2017. Available online at: http://www.moh.gov.my/images/gallery/publications/HEALTH%20FACTS%202017.pdf [verified May 2017].

[28]  Adam P, de Wit J, Hermans J, Story L, Edwards B, Murray C, Bourne C. Understanding the barriers to STI testing among young people: results from the online survey ‘Getting Down To It’. Sydney: National Centre in HIV Social Research, University of New South Wales; 2011.

[29]  Cleland J. Asking young people about sexual and reproductive behaviours: illustrative questionnaire for interview-surveys with young people. Geneva: World Health Organization; 2015. Available online at: http://www.who.int/reproductivehealth/topics/adolescence/questionnaire.pdf [verified January 2015].

[30]  Zhang D, Pan H, Cui B, Law F, Farrar J, Ba-Thein W. Sexual behaviors and awareness of sexually transmitted infections among Chinese university students. J Infect Dev Ctries 2013; 7 966–74.
Sexual behaviors and awareness of sexually transmitted infections among Chinese university students.Crossref | GoogleScholarGoogle Scholar | 24334944PubMed |

[31]  Fergie G, Hilton S, Hunt K. Young adults’ experiences of seeking online information about diabetes and mental health in the age of social media. Health Expect 2016; 19 1324–35.
Young adults’ experiences of seeking online information about diabetes and mental health in the age of social media.Crossref | GoogleScholarGoogle Scholar | 26647109PubMed |

[32]  Selkie EM, Benson M, Moreno M. Adolescents’ views regarding uses of social networking websites and text messaging for adolescent sexual health education. Am J Health Educ 2011; 42 205–12.
Adolescents’ views regarding uses of social networking websites and text messaging for adolescent sexual health education.Crossref | GoogleScholarGoogle Scholar | 22229150PubMed |

[33]  Stellefson M, Hanik B, Chaney B, Chaney D, Tennant B, Chavarria EA. eHealth literacy among college students: a systematic review with implications for eHealth education. J Med Internet Res 2011; 13 e102
eHealth literacy among college students: a systematic review with implications for eHealth education.Crossref | GoogleScholarGoogle Scholar | 22155629PubMed |

[34]  Kim SU, Syn SY. Credibility and usefulness of health information on Facebook: a survey study with US college students. Inform Res 2016; 21 727

[35]  Malaysian Communications and Multimedia Commission. Captivated by Facebook. Putrajaya: Malaysian Communications and Multimedia Commission; 2012. Available online at: https://www.mcmc.gov.my/skmmgovmy/media/General/pdf/Shanthi-Balraj-USM.pdf [verified January 2018].

[36]  Talib J, Mamat M, Ibrahim M, Mohamad Z. Analysis on sex education in schools across Malaysia. Procedia Soc Behav Sci 2012; 59 340–8.
Analysis on sex education in schools across Malaysia.Crossref | GoogleScholarGoogle Scholar |

[37]  Korhonen T, Kylma J, Houtsonen J, Valimaki M, Suominen T. University students’ knowledge of, and attitudes towards, HIV and AIDS, homosexuality and sexual risk behaviour: a questionnaire survey in two Finnish universities. J Biosoc Sci 2012; 44 661–75.
University students’ knowledge of, and attitudes towards, HIV and AIDS, homosexuality and sexual risk behaviour: a questionnaire survey in two Finnish universities.Crossref | GoogleScholarGoogle Scholar | 22739116PubMed |

[38]  Kopecky BT. Education and HIV: evidence from Sub-Saharan Africa [Master’s thesis]. Prague: Charles University in Prague; 2017.

[39]  Vikash Kumar KC, Karki SB, Niraula BR. Correlates of knowledge about sexually transmitted diseases (STDs) among youths in Nepal. JJIS 2017; 2 101–9.
Correlates of knowledge about sexually transmitted diseases (STDs) among youths in Nepal.Crossref | GoogleScholarGoogle Scholar |

[40]  Awang H, Wong LP, Jani R, Low WY. Knowledge of sexually transmitted diseases and sexual behaviours among Malaysian male youths. J Biosoc Sci 2014; 46 214–24.
Knowledge of sexually transmitted diseases and sexual behaviours among Malaysian male youths.Crossref | GoogleScholarGoogle Scholar | 23480474PubMed |

[41]  Ezeonyido JC. HIV knowledge, intoxication, risky behaviors, and sexual communication among Nigeria university students [PhD Dissertation]. Minneapolis: Walden University; 2016.

[42]  Arogundade OT, Faloore OO. HIV/AIDS awareness as a predictor of university students’ dating behaviour in South - Western Nigeria. Int J Psychol Behav Sci 2012; 2 9–14.
HIV/AIDS awareness as a predictor of university students’ dating behaviour in South - Western Nigeria.Crossref | GoogleScholarGoogle Scholar |

[43]  Scott-Sheldon LAJ, Carey MP, Carey KB, Cain D, Simbayi LC, Mehlomakhulu V, Kalichman SC. HIV testing is associated with increased knowledge and reductions in sexual risk behaviors among men in Cape Town, South Africa. Afr J AIDS Res 2013; 12 195–201.
HIV testing is associated with increased knowledge and reductions in sexual risk behaviors among men in Cape Town, South Africa.Crossref | GoogleScholarGoogle Scholar |

[44]  Wigfall LT, Friedman DB. Cancer information seeking and cancer-related health outcomes: a scoping review of the health information national trends survey literature. J Health Commun 2016; 21 989–1005.
Cancer information seeking and cancer-related health outcomes: a scoping review of the health information national trends survey literature.Crossref | GoogleScholarGoogle Scholar | 27466828PubMed |

[45]  Dimmit Champion J, Harlin B, Collins JL. Sexual risk behavior and STI health literacy among ethnic minority adolescent women. Appl Nurs Res 2013; 26 204–9.
Sexual risk behavior and STI health literacy among ethnic minority adolescent women.Crossref | GoogleScholarGoogle Scholar |

[46]  Byron P, Albury K, Evers C. “It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information. Reprod Health Matters 2013; 21 35–44.
“It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information.Crossref | GoogleScholarGoogle Scholar | 23684185PubMed |

[47]  Moghavvemi S, Binti Sulaiman A, Ismawati Binti Jaafar N, Kasem N, editors. Facebook and YouTube addiction: the usage pattern of Malaysian students. International Conference on Research and Innovation in Information Systems; 16–17 July 2017; Langkawi, Malaysia. New York: Institute of Electrical and Electronics Engineers Xplore Digital Library; 2017.

[48]  Walsh AM, Hamilton K, White KM, Hyde MK. Use of online health information to manage children’s health care: a prospective study investigating parental decisions. BMC Health Serv Res 2015; 15 131
Use of online health information to manage children’s health care: a prospective study investigating parental decisions.Crossref | GoogleScholarGoogle Scholar | 25889493PubMed |

[49]  Chisolm DJ, Hardin DS, McCoy KS, Johnson LD, McAlearney AS, Gardner W. Health literacy and willingness to use online health information by teens with asthma and diabetes. Telemed J E Health 2011; 17 676–82.
Health literacy and willingness to use online health information by teens with asthma and diabetes.Crossref | GoogleScholarGoogle Scholar | 21943161PubMed |

[50]  Mustanski B, Lyons T, Garcia SC. Internet use and sexual health of young men who have sex with men: a mixed-methods study. Arch Sex Behav 2011; 40 289–300.
Internet use and sexual health of young men who have sex with men: a mixed-methods study.Crossref | GoogleScholarGoogle Scholar | 20182787PubMed |

[51]  Schalet AT, Santelli JS, Russell ST, Halpern CT, Miller SA, Pickering SS, Goldberg SK, Hoenig JM. Invited commentary: broadening the evidence for adolescent sexual and reproductive health and education in the United States. J Youth Adolesc 2014; 43 1595–610.
Invited commentary: broadening the evidence for adolescent sexual and reproductive health and education in the United States.Crossref | GoogleScholarGoogle Scholar | 25200033PubMed |

[52]  Pingel ES, Thomas L, Harmell C, Bauermeister J. Creating comprehensive, youth centered, culturally appropriate sex education: what do young gay, bisexual and questioning men want? Sex Res Social Policy 2013; 10 293–301.
Creating comprehensive, youth centered, culturally appropriate sex education: what do young gay, bisexual and questioning men want?Crossref | GoogleScholarGoogle Scholar |

[53]  Kubicek K, Carpineto J, McDavitt B, Weiss G, Kipke MD. Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men. Arch Sex Behav 2011; 40 803–16.
Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 20809373PubMed |

[54]  Mowlabocus S, Haslop C, Dasgupta RK. From scene to screen: the challenges and opportunities of commercial digital platforms for HIV community outreach. SM + S 2016; 2 1–8.
From scene to screen: the challenges and opportunities of commercial digital platforms for HIV community outreach.Crossref | GoogleScholarGoogle Scholar |

[55]  Ministry of Health. The Global AIDS Response Progress Report 2015. Putrajaya: HIV/STI Section, Ministry of Health Malaysia; 2015.

[56]  Fiksdal AS, Kumbamu A, Jadhav AS, Cocos C, Nelsen LA, Pathak J, McCormick JB. Evaluating the process of online health information searching: a qualitative approach to exploring consumer perspectives. J Med Internet Res 2014; 16 e224
Evaluating the process of online health information searching: a qualitative approach to exploring consumer perspectives.Crossref | GoogleScholarGoogle Scholar | 25348028PubMed |

[57]  Johnson AK, Mikati T, Mehta SD. Examining the themes of STD-related Internet searches to increase specificity of disease forecasting using Internet search terms. Sci Rep 2016; 6 36503
Examining the themes of STD-related Internet searches to increase specificity of disease forecasting using Internet search terms.Crossref | GoogleScholarGoogle Scholar | 27827386PubMed |

[58]  McCarthy O, Carswell K, Murray E, Free C, Stevenson F, Bailey JV. What young people want from a sexual health website: design and development of Sexunzipped. J Med Internet Res 2012; 14 e127
What young people want from a sexual health website: design and development of Sexunzipped.Crossref | GoogleScholarGoogle Scholar | 23060424PubMed |

[59]  Wong LP. Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research. PLoS One 2012; 7 e51745
Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research.Crossref | GoogleScholarGoogle Scholar | 23272156PubMed |

[60]  Garcia JR, Reiber C, Massey SG, Merriwether AM. Sexual hookup culture: a review. Rev Gen Psychol 2012; 16 161–76.
Sexual hookup culture: a review.Crossref | GoogleScholarGoogle Scholar | 23559846PubMed |

[61]  Syn SY, Kim SU. The impact of source credibility on young adults’ health information activities on Facebook: preliminary findings. ASIST 2013; 50 1–4.
The impact of source credibility on young adults’ health information activities on Facebook: preliminary findings.Crossref | GoogleScholarGoogle Scholar |

[62]  Nicholas A, Bailey JV, Stevenson F, Murray E. The Sexunzipped trial: young people’s views of participating in an online randomized controlled trial. J Med Internet Res 2013; 15 e276
The Sexunzipped trial: young people’s views of participating in an online randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 24334198PubMed |

[63]  Eysenbach G. Correction: improving the quality of web surveys: the checklist for reporting results of Internet e-surveys (CHERRIES). J Med Internet Res 2012; 14 e8
Correction: improving the quality of web surveys: the checklist for reporting results of Internet e-surveys (CHERRIES).Crossref | GoogleScholarGoogle Scholar |