Background
Methods
Search strategy
Inclusion criteria
Exclusion criteria
Methodological assessment of reviewed studies
Number of studies in each assessment category* | |||||||||
---|---|---|---|---|---|---|---|---|---|
Criteria | Y | S | N | NC | NR | PR | NA | NP | P |
Did the study address a clearly focused issue? | 15 | ||||||||
Was/were the study outcome(s) to be measured clearly described? | 15 | ||||||||
Were the questions posed to assess outcome(s) clearly defined? | 14 | 1 | |||||||
Was the study samle clearly defined? | 13 | 2 | |||||||
Were participating schools recruited in an acceptable way? | 4 | 1 | 1 | 1 | 8 | ||||
Were the pupils recruited in an acceptable way? 1
| 11 | 4 | |||||||
Were characteristics of subjects at enrolment reported? | 12 | 1 | 2 | ||||||
Is it clear how data were collected? | 15 | ||||||||
Did the authors mention that the instrument used for data collection was pre-tested or validated? | 8 | 6 | 1 | ||||||
Were the questions posed appropriate to address given outcomes? | 10 | 1 | 4 | ||||||
Was participation rate reported? | 9 | 2 | 4 | ||||||
Was participation rate sufficiently high? | 7 | 1 | 1 | 6 | |||||
Was the data analysis sufficiently rigorous? | 15 | ||||||||
Were other factors accounted for that could affect outcomes?2
| 15 | ||||||||
Were results appropriately reported? 3
| 11 | 1 | 3 | ||||||
Is there a clear statement of findings? | 15 |
Definition of awareness and knowledge
Results
Reference | Study region, country | Year of study conduct | Survey instrument | Reported outcome(s) measured | Age of participants | No. of participants | Gender | Recruitment of pupils | Response rate |
---|---|---|---|---|---|---|---|---|---|
Fogarty [36] | Galway, Ireland | Not available | Classroom-completed questionnaire | Knowledge about AIDS | 15-18 years | 2614 leaving certificate pupils | Male/female | All 50 Galway second-level schools | Not available |
Andersson-Ellström et al. [37] | Not specified, Sweden | 1986 and 1988 | Classroom-completed questionnaire | Knowledge of and attitudes towards STDs | 18-19 years | 1986: 350 1988: 603 upper secondary school pupils | Male/female | Not clear how many schools participated | 100% |
Tyden et al. [38] | Uppsala, Sweden | 1988 | Classroom-completed questionnaire | Knowledge of STDs and attitudes to condom | 16-19 years | 209 year 1 of upper secondary school pupils | Male/female | 5 of 6 upper secondary schools | 98% |
Lunin et al. [39] | St. Petersburg, Russia | 1993 | Classroom-completed questionnaire | Knowledge, attitudes and behaviour relevant to AIDS prevention | 14-17 years | 370 year 10 pupils | Male/female | 14 randomly selected schools | 94% |
Andersson-Ellström et al. [40] | Karlstad, Sweden | 1989-1990 | Questionnaire completed at clinic | Relationship between knowledge about STD, sexual behaviour, contraceptive use, STD protection and social class | 16-18 years | 88 year 1 of upper secondary school pupils | Female | Not clear how many schools participated | 58% |
Eriksson et al.[41]* | Not specified, Sweden | 1994 | Classroom-completed questionnaire | Knowledge on HIV/AIDS and sources of information | 14-16 years | 146 year 9 pupils | Male/female | 1 school | 100% |
Garside et al. [42]** | Devon, England | 1999-2000 | Classroom-completed questionnaire | Knowledge and attitudes towards STDs, their detection and treatment | 13-16 years | 432 year 9 and 11 pupils | Male/female | 1 school | Not reported |
Goodwin et al. [43]1
| St. Petersburg, Russia; | 2000 | Face-face interview in school | Knowledge on HIV/AIDS, sexual behaviour | Mean age 15.6 years | 50 school pupils | Male/female | Not clear how many schools participated | Not clear |
Goodwin et al. [43]2
| St. Petersburg, Russia; Tblisi, Georgia; Kiev, Ukraine | Not available | Face-face interview in school and classroom-completed questionnaire | Knowledge on HIV/AIDS, sexual behaviour | 14-17 years | 102 school pupils | Male/female | Not clear how many schools participated | Not clear |
Macek et al. [44] | Nova Gradiska/Zagreb, Croatia | Not available | Classroom-completed questionnaire | Knowledge on HIV/AIDS, attitudes towards integration of HIV-positive pupils into regular schools | Not available | 108 year 7 and 8 pupils | Male/female | 2 schools | Not reported |
Woodhall et al.[45]*** | Tampere, Finland | 2005 | Home-completed questionnaire | Knowledge of and attitudes towards STDs, esp. HPV | 14-15 years | 397 year 9 pupils | Male/female | All households in Tampere with adolescents born in 1990 and in year 9 contacted | 21.5% |
Gottvall et al. [46] | Not specific, Sweden | 2008 | Classroom-completed questionnaire | Knowledge of and attitudes towards HPV vaccination and condom use | 15-16 years | 608 year 1 of upper secondary school pupils | Male/female | 7 schools | 86% |
Höglund et al. [47] | Uppsala, Sweden | Not available | Classroom-completed questionnaire | Knowledge of and attitudes to STDs, focus on HPV | 15-20 years | 459 year 1 of upper secondary school pupils | Male/female | 5 schools | 98% |
Pelucchi et al.[48]*** | Milan area and Varese, Italy | 2008 | Home-completed questionnaire | Knowledge of HPV, prevention, and attitudes towards vaccination | 14-20 years | 863 high school pupils | Male/female | 8 schools | 79% |
Sachsenweger et al.[49]#
| Mecklenburg-Western Pomerania, Germany | 2005 | Classroom-completed questionnaire | Knowledge on HIV/AIDS | 11-18 years | 769 year 7-9 pupils | Male/female | Not clear how many schools participated | Not available |
Methodological summary of studies included in the review
Awareness and knowledge of HPV
Awareness and knowledge of HIV/AIDS
Question/Item assessed in studies | Females % (reference) | Males % (reference) | Females and males % (reference) |
---|---|---|---|
HPV | |||
Heard of HPV (identification from list of STDs or direct question, 'Have you heard of HPV?') | 71.6% (Pelucchi et al.) [49] 16.4% (Gottvall et al.) [46] | 51.2% (Pelucchi et al.) [49] 9.6% (Gottvall et al., 2009) [46] | 66.6% (Pelucchi et al.)** [49] 13.5% (Gottvall et al.)** [46] 5.4% (Höglund et al.) [47] 33% (Woodhall et al.) [45] |
Heard of HPV (open question - 'Which STDs do you know/have you heard of?') | 0.2% (Höglund et al.) [47] | ||
Heard of HPV vaccine | 9.2% (Gottvall et al.) [46] | 1.1% (Gottvall et al.) [46] | 5.8% (Gottvall et al.)** [46] 1.1% (Höglund et al.) [47] |
Participants who knew that HPV is sexually transmitted | 64.9% (Pelucchi et al.) [49] 12.1% (Gottvall et al.) [46] | 47.4% (Pelucchi et al.) [49] 5.4% (Gottvall et al.) [46] | 60.6% (Pelucchi et al.) [49] 9.2% (Gottvall et al.)** [46] 2.9% (Höglund et al.) [47] |
Participants who knew that HPV is a risk factor for cervical cancer (closed question) | 11.8% (Gottvall et al.) [46] | 3.1% (Gottvall et al.) [46] | 8.1% (Gottvall et al.) [46] 1.2% (Höglund et al.) [47] |
Participants aware that aim of HPV vaccination is to prevent cervical cancer | 53.9% (Pelucchi et al.) [49] | 32.1% (Pelucchi et al.) [49] | 48.6% (Pelucchi et al.)** [49] |
Participants who thought that aim of HPV vaccination is to prevent an STD | 8.6% (Pelucchi et al.) [49] | 7.2%(Pelucchi et al., 2010) [49] | 8.3% (Pelucchi et al.) [49] |
Subjective rating of risk of contracting HPV | 45% perceived at risk (Pelucchi et al.) [49] 11.8% do not believe will be infected (Gottvall et al.) [46] | 26% perceived at risk (Pelucchi et al.) [49] 24.5% do not believe will be infected (Gottvall et al.) [46] | 17.3% do not believe will be infected (Gottvall et al.)** [46] |
HIV
| |||
Heard of HIV (identification from list of STDs or direct question) | 97.2% among year 9 and 100% among year 11 pupils (Garside et al.) [42] | 97.0% among year 9 and 96.2% among year 11 pupils (Garside et al.) [42] | 97.7% (Garside et al.) [42] 100% (Tyden et al.) 91% [38] (Fogarty) [36] |
Heard of HIV (open question - which STDs do you know/have you heard of?) | 88% (Höglund et al.) [47] | ||
Participants who knew that you can not tell by looking at someone if they have HIV | Overall 53% (Goodwin et al.)2 [43] | ||
Participants who knew that HIV is caused by a virus | 91% (Eriksson et al.) [41] 88% (Fogarty) [36] | ||
Participants who knew that HIV is sexually transmitted | 99% (Sachsenweger et al.) # [49] 97% (Goodwin et al.)1[43] | 99% (Sachsenweger et al.) #[49] 86% (Goodwin et al.)1[43] | 99% (Sachsenweger et al.) #[49] 81% (Höglund et al.) [47] 92% (Goodwin et al.)1[43] 99% (Eriksson et al.) [41] 95% (Fogarty) [36] |
Participants who knew that sharing a needle with an HIV infected person may lead to infection with the virus | 91% (Sachsenweger et al.) #[49] 72% (Goodwin et al.)1[43] | 91% (Sachsenweger et al.) #[49] 62% (Goodwin et al.)1[43] | 91% (Sachsenweger et al.) #[49] 68% (Goodwin et al.)1[43] 95% (Eriksson et al.) [41] 99% (Fogarty) [36] |
Participants who knew that use of condoms can protect against contraction of HIV | 83%(Goodwin et al.)1[43] 42% (Lunin et al.) [39] | 86% (Goodwin et al.)1[43] 60% (Lunin et al.) [39] | 99% (Sachsenweger et al.) #[49] 76% (Höglund et al.) [47] 84% (Goodwin et al.)1[43] 99% (Eriksson et al.) [41] 51% (Lunin et al., 1995)** [39] 94% (Fogarty) [36] |
Participants who knew where to go for diagnosis/treatment/advice on HIV | 22% aware of STD clinic and 32% of AIDS telephone service (Fogarty) [36] | ||
Subjective rating of risk of contracting HIV | 11% perceived themselves 'not at risk' (Lunin et al.) [39] | 19% perceived themselves 'not at risk' (Lunin et al.) [39] | 15% perceived themselves 'not at risk' (Lunin et al.)** [39] |
Chlamydia
| |||
Heard of chlamydia (identification from list of STDs or direct question) | 41.4% among year 9 and 22.7% among year 11 pupils (Garside et al.) [42] 79% (Tyden et al.) [38] | 36.7% among year 9 and 13.2% among year 11 pupils (Garside et al.) [42] 60% (Tyden et al.) [38] | 34% (Garside et al.)*** [42] 70% (Tyden et al.) [38] 91% in 1986, and 96% in 1988 survey (Andersson-Ellström et al.) [37] |
Heard of chlamydia (open question - which STDs do you know/have you heard of?) | 86% (Höglund et al.) [47] | ||
Participants who knew that chlamydia can be symptom-free | 51% in 1986, and 68% in 1988 survey (Andersson-Ellström et al.) [37] | 28% in 1986, and 45% in 1988 survey (Andersson-Ellström et al.) [37] | 46% (Höglund et al.) [47] 40% in 1986, and 56% in 1988 survey (Andersson-Ellström et al.)** [37] |
Syphilis
| |||
Heard of syphilis (identification from list of STDs or direct question) | 45.5% among year 9 and 47.0% among year 11 pupils (Garside et al.) [42] | 43.4% among year 9 and 45.3% among year 11 pupils (Garside et al.) [42] | 45% (Garside et al.) [42] |
Gonorrhoea
| |||
Heard of gonorrhoea (identification from list of STDs or direct question) | 51.0% among year 9 and 53.0% among year 11 pupils (Garside et al.) [42] | 52.4% among year 9 and 60.4% among year 11 pupils (Garside et al.) [42] | 53% (Garside et al.) [42] ≥ 84% (Tyden et al.) [38] 98%, 1986 survey (Andersson-Ellström et al.) [37] |
Heard of gonorrhoea (open question - which STDs do you know/have you heard of?) | 50% (Höglund et al.) [47] | ||
Herpes
| |||
Heard of herpes (identification from list of STDs or direct question) | 52.4% among year 9 and 75.8% among year 11 pupils (Garside et al.) [42] | 53.6% among year 9 and 71.7% among year 11 pupils (Garside et al.) [42] | 59.1% (Garside et al.)*** [42] 90%, 1986 survey (Andersson-Ellström et al.) [37] 56% (Tyden et al.) [38] |
Heard of herpes (open question - which STDs do you know/have you heard of?) | 64% (Höglund et al.) [47] | ||
STDs in general
| |||
Participants who knew that STDs in general can be symptom-free | 53.8% among year 9 and 60.0% among year 11 pupils (Garside et al.) [42] | 64.2% among year 9 and 60.4% among year 11 pupils (Garside et al.) [42] | 59.7% (Garside et al.) [42] |
Participants who knew that use of condoms can protect against contraction of STDs in general | 15%, 1986 survey (Andersson-Ellström et al.) [37] 34%, 1988 survey (Andersson-Ellström et al.) [37] 100% (Andersson-Ellström et al.) [40] | 27%, 1986 survey (Andersson-Ellström et al.) [37] 52%, 1988 survey (Andersson-Ellström et al.) [37] | 20%, 1986 survey (Andersson-Ellström et al.)** [37] 43%, 1988 survey (Andersson-Ellström et al.)** [37] 100% (Tyden et al.) [38] |
Subjective rating of risk of contracting an STD in general | 32%, 1986 survey (Andersson-Ellström et al., 1991) [37] 24%, 1988 survey (Andersson-Ellström et al.) [37] | 16%, 1986 survey (Andersson-Ellström et al.) [37] 24%, 1988 survey (Andersson-Ellström et al.) [37] | 55% "low" perceived susceptibility (Woodhall et al.)* [45] |
Reported use of condoms
| |||
Participants who reported using condoms at first sexual intercourse | 50% (Tyden et al.) [38] 65% (Gottvall et al.) [46] | 40% (Tyden et al.) [38] 65% (Gottvall et al.) [46] | 45% (Tyden et al.) [38] 65% (Gottvall et al.) [46] 61% (Höglund et al.) [47] |
Participants who reported using condoms at last sexual intercourse | 26% (Tyden et al.) [38] | 38% (Tyden et al.) [38] | 31% (Tyden et al.) [38] |