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SHORT COMMUNICATION
Year : 2018  |  Volume : 4  |  Issue : 1  |  Page : 65-68

A study on knowledge and protective practices of STIs among patients attending tertiary care center at Bikaner, Rajasthan


1 Deputy CMHO, Sirohi, Rajasthan, India
2 Assistant Professor, Medical College, Churu, Rajasthan, India
3 Assistant Professor, SPMC, Bikaner, Rajasthan, India
4 Senior Demonstrator, Medical College, Churu, Rajasthan, India

Date of Submission11-Apr-2018
Date of Acceptance10-Jun-2018
Date of Web Publication1-Feb-2019

Correspondence Address:
Kavita Choudhary
Department of Community Medicine, SPMC, Churu, Rajhasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2395-2113.251353

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  Abstract 


Introduction: The increased risk of the transmission of HIV is known to be associated with the presence of STIs and despite the presence of the National STI Control Program in India the number of people with STIs remains high. More than 1 million people acquire a STI every day. The true prevalence of STIs can never be known because of inadequate reporting due to secrecy and stigma associated with them and most of them are not even notifiable. Objectives: (1) To study socio-demographic factors of patient's attending STI clinic (2) To assess knowledge of patients about STI/HIV. (3) To assess protective practices of patients towards STIs. Material and Methods: This cross sectional was conducted in STI clinic, PBM hospital, Bikaner from Dec 2014- Jan 2016 using pre-tested and pre-structured questionnaire. The study variables were analyzed using Epi-Info7 software with application of Mean, Proportion and OR, Chi-square. Results: Out of 97 patients 83.5% knew about STIs. 79.4% reported having knowledge about symptoms of STIs and most common symptom reported was itching over genitals and discharge (85.5%). Statistically significant difference was present between male and female patient's knowledge about premarital sex as a factor for acquisition of STIs. 79.3% were using condoms to protect from STIs. The difference was statistically significant between knowledge and practice regarding condom use (χ2 = 6.544, df=1, p=0.01). Statistically significant difference was present between male and female patients practice regarding regular visit to STI clinic. Conclusion: Knowledge of patients regarding protective practices is not matching with their protective behavior.

Keywords: STIs; protective practices; STI clinic, National STI Control Program, Protective behavior


How to cite this article:
Kumawat R, Choudhary K, Shekhawat K, Kumar U. A study on knowledge and protective practices of STIs among patients attending tertiary care center at Bikaner, Rajasthan. Indian J Community Fam Med 2018;4:65-8

How to cite this URL:
Kumawat R, Choudhary K, Shekhawat K, Kumar U. A study on knowledge and protective practices of STIs among patients attending tertiary care center at Bikaner, Rajasthan. Indian J Community Fam Med [serial online] 2018 [cited 2019 Dec 6];4:65-8. Available from: http://www.ijcfm.org/text.asp?2018/4/1/65/251353




  Introduction Top


Sexually transmitted infections (STIs) have long been recognized as a public health dilemma because of their high incidence and major contribution to morbidity and mortality.[1] STIs have a profound impact on sexual and reproductive health world –wide, and rank among top 5 of disease categories for which adults seek health care. More than 1 million people acquire a STI every day[1]. STIs can have serious consequences beyond the immediate impact of infection itself. Some STIs increase the risk of HIV infection 3 fold or more. Mother to child transmission of STIs can result in stillbirth, neonatal death, low birth weight and prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities. The true prevalence of STIs can never be known because of inadequate reporting due to secrecy and stigma associated with them and most of them are not even notifiable[2]. The increased risk of the transmission of HIV is known to be associated with the presence of STIs and despite the presence of the National STI Control Program in India the number of people with STIs remains high.

Objectives

(1) To study socio-demographic factors of patient's attending STI clinic (2) To assess awareness of patients about STI/HIV. (3) To assess protective practices of patients towards STIs.


  Material and Methods Top


This study was a hospital based cross-sectional study and conducted among patients attending STI Clinic at Govt. Medical College Hospital, Bikaner. Prior permission from the college ethical committee was taken. After getting informed consent patients were contacted. A pre-tested and pre-structured questionnaire was administered to all the patients who were willing to participate in the study consecutively. Total 117 patients were ready to answer the questionnaire during the 2 months of study period but we analyzed only 97 patients’ responses leaving those whose answers were incomplete. Male and female patients were interviewed separately and anonymously by male and female interviewer respectively. Information was then entered into Epi-Info7 software and was analyzed using Mean, SD, Proportion and Chi-square test was applied to see the associations.


  Results Top


The mean age was 32.9±8.66 years. Out of 97 patients 46 (47.4%) were males and 51(52.6%) were females. Majority of them were Hindu by religion (78.3%). Majority of them belonged to 26-35 years of age group (34.05%) [Table 1] shows the socio-demographic profile of participants. [Figure 1] shows the knowledge of patients about STI. About 83.5 % patients have heard about STIs. 88.7% had knowledge that condom can protect from getting STIs. [Table 2] shows the knowledge of factors predisposing to acquisition of STIs. The most common predisposing factor said by male patients was multiple sexual partners followed by unprotected sex. Female patients reported multiple sexual partners and premarital sex as main predisposing factors for acquisition of STIs. Statistically significant difference was present between male and female patient's knowledge about premarital sex as a factor for acquisition of STIs. [Table 3] shows the knowledge of symptoms of STIs. The main symptom mentioned by female patients was discharge while male patients mentioned itching over genitals and genital ulcers as main symptoms. Statistically significant difference was present between male and female patient's knowledge regarding fever, lower abdominal pain, discharge, and painful micturition as symptoms of STIs. [Table 4] shows protective practices followed by the study participants. Condom use was mentioned by 34 (73.9%) males and 43 (84.3%) females (by their partners). Statistically significant difference was present between male and female patients practice regarding regular visit to STI clinic. Statistically significant difference (χ2 =6.54, df=1, p=0.01) was present between knowledge regarding condom to prevent STI and its practice [Table 5].
Figure 1: Knowledge tuf patients about STIs

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Table 1: Socio-demographic profile of participants.

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Table 2: Knowledge of factors predisposing to acquisition of STIs

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Table 3: Knowledge of symptoms of STIs

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Table 4: Protective Practices followed by participants

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Table 5: Difference in knowledge and practice regarding condom use

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  Discussion Top


In present study 25% population was below 25 years of age which represents a big share. Other study by Ram, et al reported that a significant no of STI were reported among adolescents.[3] This study finding may have implication on designing interventions at an early age. The majority (38%) of respondents were laborers (factory workers, construction workers) by occupations. Laborers can be at higher risk of developing STIs due to their high risk behavior (sexual promiscuity). This finding suggests that migrants and laborers should be counseled and should get sex education at the site of their work as well as clinic with special attention. Majority of patients were from urban area (60%) this could be due to that most of the laborers may be staying near the city areas. This finding is similar with other study by Mishra A et al.[4]

In present study knowledge about condom use to prevent STIs was fair (88.7%) but it did not match with their real life practices.[5] This finding is in contrast with the finding by Anwar M, and co-authors in their study. Continuous motivation is needed to change their knowledge into practices effectively. The most common symptom reported by female patients was abnormal vaginal discharge and the similar was found by Mishra A et al.[4] Further community based studies are needed to confirm these findings.

Recommendations

Appropriate policy decisions are required for inculcating reproductive health education as an important part of adolescent education as it will have positive impact to decrease STI prevalence and increased awareness regarding STI/HIV among general population.

Limitations of the study

It was a hospital base study and conducted in the STI clinic so that the sample may be biased and could be the cause of fair knowledge about STIs.

Public Health Relevance

This study has relevance in present time because even after the introduction of National STD Control Programme by Govt. of India we have got less success in motivating high risk people to use barrier methods to prevent the spread of STIs. So there is urgent need of change in counseling services at STD clinics so as to bring change in behavior in a sustained manner.

Conflict of Interest: None

Source of Funding: None



 
  References Top

1.
Dallabetta GA, Field ML, Laga M, Islam QM: Control of Sexually Transmitted Diseases Section I: Management of STD Programs. http://www.fhi.org/en/hivaids/pub/guide/ stdhandbook/ chap1.htm (accessed March17, 2018).  Back to cited text no. 1
    
2.
Park K. Park's Textbook of Preventive and Social Medicine. 23rd edition. , Banarasidas Bhanot Publishers, Jabalpur.2015:330.  Back to cited text no. 2
    
3.
Ram R, Bhattacharya S K, Bhattacharya K, Baur B, Sarkar T, Bhattacharya A, Gupta D. Reproductive tract infection among female adolescents. Indian J Community Med [serial online] 2006 [cited 2018 Apr 10];31:32-3. Availablefrom: http://www.ijcm. org.in/text.asp?2006/31/1/32/54931  Back to cited text no. 3
    
4.
Mishra A, Verma P, Marathe N, Srivastava D. Study of the profile of patients with STDs attending an STD clinic in J.A.H., Gwalior. Indian J Community Med [serial online] 2008 [cited 2018 Apr 10 ];33:263-264 Available from: http://www.ijcm.org.in/text. asp?2008/33/4/263/43235  Back to cited text no. 4
    
5.
Anwar M, Sulaiman SA, Khan TM. A Survey of Knowledge of Sexually Transmitted Infections among Patients at a Public Hospital in Pulau Pinang, Malaysia. Med Princ Pract 2010;19:312-318  Back to cited text no. 5
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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Abstract
Introduction
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