Sexual Health: sexual knowledge, behavior and social determinants in the students of the University of Porto –a cross sectional study

Abstract Background: When considering sexual health, the youth is a particularly susceptible group. In Portugal, structured sexual education is available, however, 23.5% of new HIV cases in 2017 occurred in a population aged 15-29 years old. We attempt to understand the range of sexual health knowledge in youth, along with sexual behaviors and their influencing characteristics. Our main aim is to describe the relation between knowledge and sexual health-related behavior. Methods: This observational cross-sectional study involved an online questionnaire covering different areas of sexual health applied to students from the University of Porto, Portugal. This was used to create a knowledge and behavior score. Socio-demographic characteristics were used to examine associations with the scores. The relationship between the scores was assessed with Pearson’s bivariate correlation. Results: Out of 1815 questionnaires, 988 (54%) were validated. The mean score for knowledge was 3.74 out of 5 (95% confidence intervals [CI]: 3.69-3.77) and 3.4 out of 5 (95% CI: 3.38-3.44) for the behavior score. The knowledge score was influenced significantly by age and whether students frequented degrees in health-related studies. Only gender influenced sexual behavior. The correlation between knowledge and behavior was statistically significant with p<0.01 and a coefficient of +0.127. Conclusion/Discussion: Knowledge is an essential but insufficient determinant for health literacy. We urge the development of a sexual health prevention/education program which considers the interacting factors and motivates participants to integrate the assimilated information on a daily basis.