Knowledge, Preventive Practices and the Knowledge–Behaviour Gap for Sexually Transmitted Infections among Youths in a Rural Community in South-West Nigeria
This study of rural Nigerian youth reveals that while awareness of sexually transmitted infections is high, there are significant gaps in accurate knowledge and a disconnect between knowledge and preventive behaviors, necessitating comprehensive, context-specific interventions that address misconceptions, behavioral barriers, and social stigma.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In the quiet corners of rural Nigeria, a silent public health challenge plays out among young people. Sexually transmitted infections, or STIs, are illnesses passed from one person to another through intimate contact. They can be caused by bacteria, viruses, or parasites, and while some can be cured with medicine, others can lead to long-term health problems like infertility or increased risk of other diseases. For decades, public health campaigns have focused heavily on HIV, a specific and severe type of STI, raising general awareness across the continent. However, knowing that a disease exists is different from understanding how it spreads, what it feels like, or how to stop it. This gap between simply hearing a name and truly understanding the mechanics of a disease is where many prevention efforts stumble. When young people know a risk exists but lack the specific tools to avoid it, or when they hold onto false ideas about how infections travel, they remain vulnerable. The question for health experts is not just whether young people are aware of these risks, but whether that awareness translates into real, protective actions in their daily lives.
A team of researchers from Bowen University and Kaduna State University set out to explore this exact disconnect in a rural community called Oko, located in Oyo State, south-west Nigeria. They wanted to see what young people aged 15 to 29 actually knew about STIs, what they believed about how these infections spread, and whether that knowledge helped them stay safe. The researchers did not just ask if the youths had heard of STIs; they dug deeper, asking if the young people could identify symptoms, name the specific ways infections are passed on, and describe the steps needed to prevent them. They also looked at the young people's actual behaviors, such as whether they used protection during sex or sought medical testing when worried. To get a clear picture, the team interviewed 456 young residents, selecting them carefully from different parts of the town to ensure a fair representation of the community.
The results painted a complex picture of awareness without action. When asked if they had heard of sexually transmitted infections, nearly nine out of ten young people said yes. However, this high level of awareness was mostly limited to HIV. When the researchers asked about other common infections like gonorrhea, syphilis, or chlamydia, the knowledge dropped sharply. Fewer than half of the respondents could demonstrate a solid understanding of the topic. A significant number of young people could not name a single symptom of an STI, and many held onto dangerous misconceptions. For instance, a large portion of the group believed that infections could be spread through mosquito bites, sharing eating utensils, or casual contact like shaking hands. These false beliefs are critical because they lead people to worry about the wrong things while ignoring the real risks, or to feel falsely safe when they are not.
Perhaps the most striking finding was the gap between what the young people knew and what they did. Even among those who had accurate information, the knowledge did not automatically lead to safer behavior. The study found that while many young people understood that STIs were serious and that prevention methods existed, very few actually used them. Nearly half of the respondents reported using no protection during their most recent sexual encounter. Furthermore, only about one-quarter of the participants had ever been screened for an STI, and it was rare for someone to ensure their sexual partner also received treatment if they were diagnosed. This suggests that knowing the facts is not enough to change habits. The barriers were not just a lack of information, but a mix of other factors, including the difficulty of accessing confidential health services, the influence of social norms, and the fear of being judged.
The researchers also looked at what factors helped young people understand STIs better. They found that education was a powerful tool; those with secondary or tertiary education were significantly more likely to have accurate knowledge than those with little or no formal schooling. Age also mattered, with older young adults knowing more than teenagers. Interestingly, the study found that young people living with disabilities actually had better knowledge than those without, a finding that surprised the researchers and suggests that specific support programs for this group may be working. However, simply living closer to a hospital or being religious did not guarantee better knowledge. The study also highlighted that while young people often felt they could protect themselves if they wanted to, they frequently felt that the barriers to doing so—such as cost, distance, or shame—were too high to overcome.
This study, conducted in a single rural community, offers a clear view of a widespread issue. It shows that in this part of Nigeria, the battle against STIs cannot be won by simply telling young people that the diseases exist. The high awareness of HIV has not spilled over into a deep understanding of other infections, and the knowledge that does exist is often mixed with myths. The disconnect between knowing the risks and acting to avoid them is real and stubborn. To fix this, the researchers suggest that future efforts must go beyond basic awareness campaigns. They call for programs that provide accurate, detailed information about all types of STIs, not just HIV, and that actively work to correct the false beliefs about transmission. Most importantly, these programs must address the practical barriers that stop young people from getting tested or using protection, ensuring that the path to staying healthy is not just understood, but also accessible and safe to walk.
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