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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 29  |  Issue : 4  |  Page : 1085-1091

Knowledge and attitude as regards sexual health among medical students of Menoufia University, Egypt


1 Department of Dermatology and Venereology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Family Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Department of Internal Medicine, Faculty of Medicine, Tanta, Egypt

Date of Submission24-Jan-2016
Date of Acceptance07-Mar-2016
Date of Web Publication21-Mar-2017

Correspondence Address:
Tamer A El-Gamel
Internal Medicine Department, Faculty of Medicine, Tanta 31111, El-Garbia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.202513

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  Abstract 

Objective
The aim of this study was to assess knowledge and attitude as regards sexual health among medical students in Menoufia University.
Background
Sexual health promotion is a worthwhile activity to prevent reproductive health hazards, sexual dysfunction, marital distress, divorce, and family breakdown. This will save the society and allow people to enjoy life.
Materials and methods
This cross-sectional study was conducted in the Faculty of Medicine, Menoufia University, during the period from March 2015 to December 2015. The sample size was 300 students. The students were selected from the last 3 academic years. Students were selected from each grade through the proportional allocated method. A questionnaire was designed to assess overall knowledge and attitude of students as regards different sexual health items.
Results
The majority of the students had low knowledge on sexual health problems (91.7%) and their total attitude as regards different items of sexual health issues was equivalent (53.7%). There was a highly significant difference among students of the last 3 years in the overall knowledge (χ2 = 34.4;P= 0.000) as regards sexual health and a significant difference in their overall attitude (χ2 = 10.8;P= 0.03). There was a nonsignificant difference between male and female students as regards their overall knowledge (χ2 = 0.9;P= 0.6). There was a nonsignificant difference between urban and rural students as regards their overall knowledge (χ2=2.9;P= 0.2) and their overall attitude (χ2 = 1.5;P= 0.5).
Conclusion
Menoufia undergraduate medical students' knowledge on sexual health was inadequate. Overall, students expressed equivalent attitude toward different items of sexual health issues. Students would benefit from courses on sexuality to prepare them for challenging lives as medical practitioners.

Keywords: attitude, knowledge, medical student, sex


How to cite this article:
Maraee AH, Elmoselhy HM, El-Gamel TA. Knowledge and attitude as regards sexual health among medical students of Menoufia University, Egypt. Menoufia Med J 2016;29:1085-91

How to cite this URL:
Maraee AH, Elmoselhy HM, El-Gamel TA. Knowledge and attitude as regards sexual health among medical students of Menoufia University, Egypt. Menoufia Med J [serial online] 2016 [cited 2020 Sep 21];29:1085-91. Available from: http://www.mmj.eg.net/text.asp?2016/29/4/1085/202513


  Introduction Top


The WHO, in concert with the General Assembly of the World Association of Sexology, put forth a report outlining 11 sexual rights. These include the following: the right to sexual pleasure; the right to sexual freedom; the right to sexual autonomy, sexual integrity, and the safety of the sexual body; the right to sexual information based on scientific inquiry; the right to comprehensive sexuality education; the right to sexual healthcare; and the right to sexually associate freely, etc., [1].

The need among Egyptian youths for sexuality education can no longer be ignored. Youth surveys conducted in the 1990s and 2000s indicate a consistently poor level of awareness among Egyptian adolescents and youths about human development, physiology, sexually transmitted infections, and protection from HIV/AIDS [2].

Throughout the world, medical students and practicing physicians receive variable, nonstandardized, or inadequate training in sexual history taking and sexual medicine assessment and treatment [3].

The diagnosis, evaluation, and treatment of sexual problems are no longer a subject that patients avoid approaching their physician for help as it prevalent in a significant proportion of men and women [4].

Adequate knowledge and positive attitudes toward sex are essential for doctors so that they can take a meaningful sexual history and give effective sexual counseling with a supportive, nonjudgmental attitude toward patients [5].


  Patients and Methods Top


The sample size was calculated using Epi-Info program version (7) depending on the total number of students of the last 3 academic years registered in the Faculty of Medicine of Menoufia University in Shebin El-Kom city during year 2015–2016, which was 950. The sample size was 270 students. It was increased to 300 students to be rounded. The sample was determined according to the percentage of students out of the total number of registered students. The students were selected from the last three grades, as students from fourth grade were exposed to topics related to sexually transmitted infections and contraceptive methods in community department and fifth grade students were exposed to topics on sexual health issues in the Dermatology and Venereology Department, and sixth grade students were exposed to courses on contraceptive methods in the Obstetrics and Gynecology Department. However, the first three grades were not exposed to any clinical courses related to sexual health issues in their curriculum. Students were selected from each grade through the proportional allocated method according to the total number of students in each grade. Each grade is divided into four clinical rounds. Each clinical round contains 150 students and each clinical round is divided into four groups. From the last three grades one clinical round was selected randomly from each grade.

Data were collected using self-administered anonymous questionnaires assessing students' knowledge and attitudes toward various issues about sex. A total of 80% of respondents returned the questionnaires. A total of 15 questions were used to assess the knowledge. The overall knowledge score was calculated based on the number of questions answered correctly:

  • More than 75% of the questions are correctly answered, good knowledge
  • 60–75% of the questions are correctly answered, fair knowledge
  • Less than 60% of the questions are correctly answered, bad knowledge.


The number of questions used to assess the attitude as regards different items of sexual health issues was 21 questions. The overall attitude score was calculated on the basis of the number of questions answered correctly:

  • More than 75% of the questions are correctly answered, positive attitude
  • 60–75% of the questions are correctly answered, equivalent attitude
  • Less than 60% of the questions are correctly answered, negative attitude.


Statistical design

This included the statistical analysis of the collected data. The data were tabulated and analyzed using Statistical Package of Social Science (SPSS) (SPSS Inc., Chicago, Illinios, USA) version 20 (using IBM personal computer).

Quantitative data were expressed as mean and SD (X ± SD) and analyzed applying Student's t-test.

Qualitative data were expressed as number and percentage and analyzed applying the χ2-test.

  • P value greater than 0.05 was considered statistically nonsignificant
  • P value less than 0.05 was considered statistically significant
  • P value less than 0.005 was considered statistically highly significant.


Ethical consideration

The study was approved by the Ethical Committee of the Faculty of Medicine, Menoufia University; an official permission letter was obtained and directed to the administrators in the faculty. Informed consent was obtained from all participants after simple and clear explanation of the research objectives. The consent form was developed according to the standard of Quality and Improvement System in Ministry of Health in Egypt.


  Results Top


The majority of the students had low knowledge on sexual health problems (91.7%), and their total attitude as regards different items of sexual health issues was equivalent (53.7%). There was a highly significant difference in the total knowledge as regards sexual health among three grades (χ2 = 34.4; P = 0.000). The total knowledge included knowledge about behavior and needs (χ2 = 16.9; P = 0.002), method of contraception (χ2 = 21.3; P = 0.000), mode of action of contraceptive method (χ2 = 58.6; P = 0.000), and knowledge about HIV and sexually transmitted diseases (χ2 = 29.6; P = 0.000) ([Table 1]).
Table 1 Comparison between students of studied groups as regards their knowledge toward sexual health

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There was a significant difference among three grades as regards their total attitude toward different items of sexual health issues (χ2 = 10.8; P = 0.03) ([Table 2]). There was a highly significant difference among the three grades as regards their attitude toward discussion of topics related to sexuality and sex (χ2 = 36.6; P = 0.000). However, there was no significant difference as regards their attitude toward discussion of topics related to sexually transmitted diseases (χ2 = 6.2; P = 0.2) and sexual health issues. (χ2 = 3.9; P = 0.4) ([Table 2]). There was a nonsignificant difference between urban and rural students as regards their overall knowledge (χ2 = 2.9; P = 0.2) ([Table 3]) and their overall attitude (χ2 = 1.5; P = 0.5) ([Table 4]) toward sexual health. There was a nonsignificant difference between male and female students as regards their total knowledge (χ2 = 0.9; P = 0.6) ([Table 5]). There was a significant relationship between sex of students and their attitude toward discussion of sexual health issues (χ2 = 2.2; P = 0.03). There was no significant relationship between sex of students and their attitude toward sexually transmitted diseases (χ2 = 0.4; P = 0.7) and their attitude as regards sexuality and sex (χ2 = 1.7; P = 0.09) ([Table 6]).
Table 2 Comparison between students of studied groups as regards their attitude toward sexual health

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Table 3 Comparison between students of rural and urban regions as regards their knowledge on sexual health

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Table 4 Comparison between students of rural and urban regions as regards their attitude toward sexual health

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Table 5 Comparison between male and female students as regards their knowledge toward sexual health

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Table 6 Comparison between male and female students as regards their attitude toward sexual health

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  Discussion Top


Sexual health is an integral aspect of general health and quality of life, constituting a fundamental component of holistic healthcare delivery [6].

A range of physiological and psychological problems can have a detrimental effect on patients' sexual function. Thus, the need for sexual health consultations may occur in a variety of clinical settings [7].

This study focused mainly on medical students because their beliefs and attitudes will affect their future choices in life.

The results of this study clearly showed that medical students have low knowledge (91.7%) as regards sexual health problems. This finding is similar to other studies such as the study by Sidi et al. [5] in Malaysia, which showed that only 54.9% of medical students had satisfactory level of knowledge on sexual health. The study by Chan [8] in Hong Kong, which revealed that medical students have low knowledge as regards sexual health, especially in topics related to social or cultural data, and this might be due to the lack of a specific sexual health module for students to learn about sexual issues and counseling skills as regards sexual issues.

As we expected, medical students from sixth grade (19%) were more knowledgeable on sexual health compared with fourth (0.8%) and fifth (0.7%) grade students as they had learned more and had greater exposure to sexual health compared with other grade students. Most of their knowledge was obtained during clinical postings in the Obstetrics and Gynecology Department and the Dermatology Department. Moreover, in the present study, the knowledge level as regards sexual health is increased with the increment in the year in medical school, and this consistent with other studies such as the study conducted at Medical School of Virginia University, McGarvey et al. [9]. They found that the knowledge increased with the increment in the year in medical school. It is not surprising that, as one gets older, sexual curiosity and one's own sexual development leads one to explore and seek for more information pertaining to sexual issues [10].

In our study, residency and family income had no significant relationship with knowledge level of students (P = 0.2). This finding is consistent with a similar study conducted by Sidi et al. [5] (P = 0.370), which revealed that residency and family income do not influence medical students' level of knowledge on sex. In contrast McKelvey et al. [11] (P < 0.001) found that background factors influenced knowledge on sex. One possible reason for this is that all respondents received the same level of education, regardless of sex, residency, and family income. In the present study there was an association between sex and medical students' overall attitude toward sexual health (P < 0.05). Male students had a greater positive attitude compared with female patients toward discussion of topics related to sexuality and sex and discussion of sexual health issues with patients. These results are also consistent with previous reports stating that sex difference is significant in terms of attitude toward premarital sex [7].

The result of this study also showed that male students had more knowledge (27.7) as regards sexually transmitted diseases and HIV compared with female students (25.7). This result is consistent with the findings of Agrawal et al. [12], who found that boys had better knowledge compared with girls, and their explanation for this finding was that boys feel freer compared with girls to talk about matters relating to sex and HIV/AIDS. This result is not in agreement with other studies such as the study by Tavoosi et al. [13], who showed that female students demonstrated a slightly higher level of knowledge in comparison with male students, and also Svensson et al. [14], who showed that there was no significant difference between men and women (P = 0.189) as regards knowledge on sexually transmitted diseases.


  Conclusion Top


We can thus conclude that Menoufia undergraduate medical students' knowledge on sexual health was inadequate and clinical status was the main predictor of their level of knowledge. Overall, students expressed equivalent attitude towards different items of sexual health issues. Education aimed at increasing sex knowledge, and modifying negative attitudes may increase students' ability to function more effectively as sexual history takers and sex counselors. Students would benefit from courses on sexuality to prepare them for challenging lives as medical practitioners who must be able to manage issues on sexuality in a holistic and balanced manner.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
WHO. Education and treatment in human sexuality: the training of health professionals. Report of a WHO Meeting. Q Corporation, Albany, NY 2000.  Back to cited text no. 1
    
2.
Population Council. Survey of young people in Egypt (2009). Available at: http://www.popcouncil.org/pdfs/2010PGY_SYPEFinalReport.pdf. [Accessed January 2011].  Back to cited text no. 2
    
3.
Sharon J, Parish M, Anita H, Clayto M. Sexual medicine education: review and commentary. J Sex Med 2007; 4:259–268.  Back to cited text no. 3
    
4.
Laumann E, Paik A, Rosen R. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281:537–544.  Back to cited text no. 4
    
5.
Sidi H, Loh S, Mahadevan R, Puteh S, Abidin M, Das S, et al. Knowledge and attitude on sex among medical students of a Malaysian university: a comparison study. Asia Pac Psychiatry 2013; 5:103–111.  Back to cited text no. 5
    
6.
Pynor R, Weerakoon P, Jones M. A preliminary investigation of physiotherapy students' attitudes towards issues of sexuality in clinical practice. Physiotherapy 2005; 91:42–48.  Back to cited text no. 6
    
7.
Papaharitou S, Nakopoulou E, Moraitou M, Tsimtsiou Z, Konstantinidou E, Hatzichristou D. Exploring sexual attitudes of students in health professions. J Sex Med 2008; 5:1308–1316.  Back to cited text no. 7
    
8.
Chan D. Sex knowledge, attitudes, and experience of Chinese medical students in Hong Kong. Arch Sex Behav 1990; 19:73–93.  Back to cited text no. 8
    
9.
McGarvey E, Peterson C, Pinkerton R, Keller A, Clayton A. Medical students' perceptions of sexual health issues prior to a curriculum enhancement. Int J Impot Res 2003; 15:58–66.  Back to cited text no. 9
    
10.
Low W. Impact of sexual health course on Malaysian University students. Med J Malaysia 2004; 59:1–10.  Back to cited text no. 10
    
11.
McKelvey R, John A, Loretta V, Suzanne MR, Geoff R. Sex knowledge and sexual attitudes among medical and nursing students. Aust N Z J Psychiatry 1999; 33:260–266.  Back to cited text no. 11
    
12.
Agrawal HK, Rao RS, Chandrashekar S, Coulter JB. Knowledge of and attitude to HIV/AIDS of senior secondary school pupils and trainee teachers in Udupi District, Karnataka, India. Ann Trop Pediatr 1999; 19:143–149.  Back to cited text no. 12
    
13.
Tavoosi A, Zaferani A, Enzevaei A, Tajik P, Ahmadinezhad Z. Knowledge and attitude towards HIV/AIDS among Iranian students. BMC Public Health 2004; 4:17.  Back to cited text no. 13
    
14.
Svensson L, Waern S, Lundberg P, Maneesriwongul W, Edlund B. Knowledge of and attitudes to sexually transmitted diseases among Thai University students: a questionnaire study [thesis in caring science], 15 ECTScredits. Bangkok, Thai, from 2011-2013: The Bachelor Programme of Science in Nursing 180 ECTS; 2013.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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