A Survey on Knowledge, Prevention, and Occurrence of Sexually Transmitted Infections among Freshmen from Four Italian Universities.

Background. The peak of sexually transmitted infections (STI) among adolescents/young adults suggests a low level of prevention. In order to assess whether the level of sexual health education (SHE), received by several channels, was effective at improving sexual behaviors, we conducted a survey among freshmen from four Italian universities. Methods. This observational cross-sectional study was carried out with an anonymous self-reported paper questionnaire, administered during teaching lectures to university freshmen of the northern (Padua, Bergamo, and Milan campuses) and southern (Palermo campus) parts of the country. Knowledge of STI (a linear numerical score), knowledge of STI prevention (dichotomous variable: yes vs. no) and previous STI occurrence (polytomous variable: "no"; "don't know"; "yes") were the outcomes in the statistical analysis. Results. The final number of freshmen surveyed was 4552 (97.9% response rate). The mean age of respondents was 21.4 ± 2.2 years and most of them (70.3%) were females. A total of 60% of students were in a stable romantic relationship. Only 28% respondents knew the most effective methods to prevent STI (i.e., condom and sexual abstinence), with a slightly higher prevalence of correct answers among females (31.3%) than males (25.8%). Students with history of STIs were 5.1%; they reported referring mostly to their general practitioner (GP) (38.1%) rather than discussing the problem with their partner (13.1%). At multivariable analysis, a significantly higher level of STI knowledge was observed in older students (25+ years of age), biomedical students, and those from a non-nuclear family; lower levels were found among students of the University of Palermo, and those who completed a vocational secondary school education. Those who had less knowledge about the most effective tools to prevent STIs included males, students from the University of Palermo, students registered with educational sciences, economics/political sciences, those of foreign nationality, and those whose fathers had lower educational levels. The risk of contracting a STI was significantly lower only in students not in a stable relationship (relative risk ratio, RRR = 0.67; 95% confidence interval, 95%CI = 0.48; 0.94), whereas such risk was significantly higher in students with higher STI knowledge (RRR = 1.15; 95%CI = 1.08; 1.22). Discussion and Conclusions. University freshmen investigated in this study had poor knowledge of STIs and their prevention. Unexpectedly, those with higher levels of knowledge had an increased risk of STIs. There have been no educational interventions-with good quality and long-term follow-ups-that increased the confidence that such SHE programs could have population level effects. A new high-quality study is therefore recommended to assess the effectiveness of an intervention generating behavioral changes; increasing only STI knowledge may not be sufficient.

Tattoo removal in the typical adolescent.

BACKGROUND: Although popular tattoos are often regretted later on for different reasons. Nevertheless, tattoo removal is a complicated and costly procedure seldom providing satisfactory results. The aim of this study was to investigate the awareness of the implications of tattoo removal among a substantial sample of Italian secondary school adolescents. FINDINGS: Students were recruited by a stratified convenience sample and surveyed by a self administered questionnaire. Logistic regression analysis was performed, reporting adjusted Odds Ratios (OR), with 95% Confidence Interval (CI).4,277 pupils returned a usable questionnaire. Piercings were more frequently undertaken than tattoos. Only 40% of the respondents were aware of the issues related to tattoo removal. Males and pupils with younger fathers were less likely to be aware, whereas students satisfied with their physical appearance and those with a positive attitude towards body art were more likely to be aware. CONCLUSIONS: Male adolescents with younger fathers can be regarded as the ideal target of corporate health education programs driven by school counsellors and primary care physicians.

Characteristics of adolescents who expressed indifference or no interest towards body art.

BACKGROUND: This study examines the underlying characteristics of adolescents attending Italian secondary school who expressed indifference towards or no interest at all in body art. METHODS: A convenience sample of 4,277 secondary school students from the North Eastern Italy were surveyed with a self-reported questionnaire collecting extensive socio-demographic information. Multivariable logistic regression analysis was employed to investigate the characteristics of those who were not interested or indifferent towards piercing and tattoo, reporting adjusted Odds Ratios (aOR) with a 95% confidence interval (CI). RESULTS: Prevalence of tattoo was 6%, whereas body piercing was 20%; 66% (= 558/840) of those with a piercing were underage (<18 years of age), the equivalent for tattoo being 62% (= 159/258). 166 individuals reported having both piercing and tattoo and 152 of these (92% = 152/166) were <18 years of age. The factors found to be predominantly higher in those indifferent or who did not indicate interest in body art were: lower school year, increasing father's education and a greater perception of the associated health risks. DISCUSSION: Proactive health education campaigns by school educators and family physicians should focus on adolescents of less educated fathers and pupils less aware of the health risks associated with body art. In this respect junior secondary school students can be regarded as the ideal target of such campaigns.

Body art in 4,277 Italian secondary school adolescents: prevalence and associations with personal and family characteristics.

BACKGROUND AND OBJECTIVES: This study's purpose was to investigate, in a large cohort of adolescents, the prevalence and association of personal and family characteristics with having or considering body piercing or tattoo. METHODS: We surveyed students from the Veneto Region of northeast Italy with a self-administered questionnaire that asked about body piercing and tattoo and about personal and family characteristics. Multinomial weighted regression analysis was used to generate adjusted relative risk ratios with 95% confidence interval (CI) for piercing and tattooing separately. RESULTS: A total of 4,277 of 4,524 surveyed students completed and returned a usable questionnaire. For piercing, the prevalence was 20%. Girls, students with a less educated father, and those dissatisfied with their physical appearance were more likely to be interested in and to have undergone this procedure. For tattooing, the prevalence was 6%. Boys and students whose father was younger than 48 were more likely to have experienced tattooing. A strong association was found between having a piercing and having a tattoo. Fify-six percent of pierced students and 48% of tattooed students were underage (<18 years). CONCLUSIONS: We found that male gender (for tattoo), female gender (for piercing), dissatisfaction with physical appearance, positive attitudes toward either piercing or tattoo, and having a younger and less educated father were associated with having or desiring body modification. These factors could be considered for targeted patient education.