Knowledge Gaps and Preventive Practices Related to Sexually Transmitted Infections among Female Secondary School Students in Rivers State, Nigeria

Abstract

Background: Adolescent girls in sub-Saharan Africa are disproportionately affected by sexually transmitted infections (STIs), yet region-specific evidence on their knowledge and preventive behaviours remains limited. Aims: This study aimed to assess gaps in STI knowledge and preventive practices among female secondary school students in Rivers State, Nigeria. Methods: A school-based cross-sectional survey was conducted from March to May 2025 among 640 female students in Senior Secondary School (SSS) 1–3, recruited through multistage sampling. After 12 incomplete questionnaires were excluded, 626 participants were included in the final analysis. A structured, validated questionnaire was used to assess STI knowledge (20 items) and preventive practices (12 items). Good knowledge and adequate practice were defined as scores of at least 70%. Data were analysed using SPSS version 27.0 through descriptive statistics, Mann–Whitney U and Kruskal–Wallis tests, and multivariable logistic regression to identify factors associated with good knowledge. Results: Participants had a mean age of 15.4 ± 1.8 years (median = 15.0, IQR = 14.0–17.0); most were aged 15–17 years and enrolled in SSS 2. Only 34.8% demonstrated good STI knowledge (median score = 11.0/20, IQR = 8.0–14.0), and 31.2% reported adequate preventive practices. Misconceptions were common: 41.5% believed that STIs could be transmitted through toilet seats, while recognition of chlamydia was particularly low (22.5%). Overall, 23.2% reported having had sexual intercourse. Among sexually active respondents, 44.8% reported consistent condom use, while only 18.5% of all respondents had ever undergone STI/HIV testing. Factors independently associated with good knowledge were age 15–17 years (AOR = 2.45), enrolment in SSS 3 (AOR = 3.12), maternal tertiary education (AOR = 2.08), and school as the primary source of information (AOR = 1.89). Conclusion: STI knowledge and preventive practices were low among the female secondary school students studied. The findings support multilevel interventions that combine comprehensive sexuality education, skills-based training, and accessible youth-friendly testing services for adolescent girls in Rivers State.