Sexual and reproductive health knowledge and behaviors and prevalence of sexually transmitted infections among adolescents and young adults from Angola.

Abstract

Background and objective: There is little information on sexual and reproductive health knowledge (SRHK) and practices in Angola and no data on the prevalence of sexually transmitted infections. The objective of this study was to assess the SRHK and behaviors, and estimate the prevalence of four sexually transmitted infections (STIs) among adolescents and young adults from 4 municipalities in Benguela province, Angola prior to an educational intervention.

Material and methods: We performed a cross-sectional study to assess SRHK and sexual behavior using a structured questionnaire among adolescents and young adults aged 15 to 25 years old from two urban and two rural municipalities of Benguela province. We also evaluated the prevalence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis using rapid tests.

Results: A total of 1400 youths were included in the study. Overall, 818 (58.4%) participants had adequate SRHK. Urban origin [odds ratio (OR) 1.52, 95% confidence interval (CI) 1.35-2.04], older age (OR 1.14, 95% CI 1.09-1.20), being female (OR 2.06, 95% CI 1.57-2.71) and having journals and internet as the main sources of information (OR 1.37, 95% CI 1.00-1.86 and OR 2.33, 95% CI 1.69-3.21, respectively) were significantly associated to a good SRHK in the multivariate analysis. Four hundred and fifty-three [45.9% of those who have had sexual intercourse (n = 986)] reported risky sexual behavior. We observed that risky sexual behavior was associated with male gender (OR 2.89 95% CI 2.13-3.92, P< .001). Prevalence of STI was: 5 (0.35%) for HIV, 190 (13.6%) for HBV, 4 (0.3%) for HCV, and 20 (1.4%) for syphilis.

Conclusion: SRHK was higher than expected although in-depth knowledge was uncommon, especially in men from rural areas with lack of access to journals or the internet. Unsafe sexual behavior was widespread among our sample. Prevalence of HBV was higher than expected. Sexual education campaigns using both digital and non-digital approaches should be focused on reaching the young population dispersed in rural areas where internet connection is difficult and should be accompanied by HBV vaccination promotion.