Knowledge, attitudes and practices on sexually transmitted infections among university students in Albania

Abstract

Sexually transmitted infections (STIs) continue to pose a significant global health burden, particularly among young adults aged 18-24 years, including university students. These infections can lead to serious reproductive and sexual health complications, yet knowledge gaps, inconsistent protective behaviors, and limited access to health education and services persist in this demographic. University students are at increased risk due to a combination of behavioral, cultural, and systemic factors. This study aimed to evaluate STI-related knowledge, attitudes and practices among health-science students enrolled at the University of Medicine, Tirana (FTMS/FMD) and University “Aleksandër Moisiu” of Durrës, Albania. A descriptive cross-sectional survey was carried out in May 2025 among 475 students enrolled in Bachelor and Master-level programs at two universities: The University of Medicine in Tirana and University “Aleksandër Moisiu” of Durrës. Participants completed a psychometrically validated self-administered questionnaire. The tool measured multiple dimensions including knowledge about STIs transmission and prevention, attitudes toward condom use and counseling, and self-reported sexual practices. Descriptive statistics and chi-square tests were used to analyze the data, while thematic analysis was applied to open-ended responses. Findings revealed that while awareness was high – 83.4% of students recognized that STIs may cause female infertility and 74.1% identified male infertility risk – only 26.3% reported using any form of contraception and condom use was reported by only a small minority of students. A large proportion of both female (58.9%) and male (60.6%) students did not use any birth control method. The data also indicated a strong gender disparity in responsibility and knowledge related to reproductive risks. A notable 6.6% of female respondents reported a history of abortion, highlighting possible consequences of inconsistent contraceptive use and limited access to sexual health counseling. In conclusion, although general awareness regarding STIs is present, significant gaps in protective practices remain. There is a critical need for targeted, gender-sensitive, and skills-based sexual health education programs that address the knowledge-behavior disconnect and promote youth-friendly services. These efforts must be embedded within university systems to foster a supportive environment for behavioral change and improved reproductive health outcomes.