Knowledge, attitude and preventive practices regarding sexually transmitted infections among reproductive-age adults in rural Malappuram district, Kerala: a cross-sectional study

Narayanan Namboothiri G.; Ashwin Raj K. K.; Asiya S. R.; Ashiya Kasim; Aswin K. B.

doi:10.18203/2394-6040.ijcmph20262247

Authors

Narayanan Namboothiri G. Department of Community Medicine, MES Medical College, Perinthalmanna, Kerala, India
Ashwin Raj K. K. Department of Community Medicine, MES Medical College, Perinthalmanna, Kerala, India
Asiya S. R. Department of Anatomy, AIIMS, New Delhi, India
Ashiya Kasim MBBS, Kerala, India
Aswin K. B. MBBS, Kerala, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20262247

Keywords:

HIV, Reproductive health, Condoms, Risk-taking, Sexual behaviour, Health knowledge attitudes practice, Sexually transmitted diseases

Abstract

Background: STIs remain a major global public health problem due to high incidence, complications and impact on reproductive health. In India, STIs contribute significantly to reproductive morbidity, while awareness regarding STIs other than HIV and their prevention remains limited. Assessing KAP regarding STIs among reproductive-age adults is essential to improve prevention strategies and reduce disease burden.

Methods: A hospital-based descriptive cross-sectional study was conducted among individuals aged 15-49 years attending OBG OPDs in Malappuram district, Kerala. A total of 300 participants were selected using stratified random sampling with systematic selection and data were collected through face-to-face interviews using a semi-structured questionnaire assessing socio-demographic variables and STI KAP. Data were analyzed using SPSS v26 with chi-square test for bivariate analysis (p≤0.05).

Results: Among 300 participants, good STI knowledge was observed in 37% while 63% had poor knowledge. Good attitude was present in 42% while 58% had poor attitude. Only 24% demonstrated good preventive practices while 76% had poor practices regarding STIs.

Conclusions: KAP regarding STIs among reproductive-age adults was inadequate, indicating important gaps in awareness and adoption of preventive behaviours. Strengthening targeted health education and improving access to reliable sexual health information are essential to improve KAP and enhance STI prevention and control.

References

WHO. Sexually transmitted infections (STIs). Geneva: World Health Organization. 2025. Available at: https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis). Accessed on 14 February 2026.

Wu Z, Yue L, Chu Z, Jiang Y, Hu Q. Global, regional, and national burden of HIV and other sexually transmitted infections, 1990–2021, and forecasts to 2030: a population-based analysis based on the Global Burden of Disease Study 2021. Chin Med J (Engl). 2025;138(24):3434-42.

Deng M, Chen J, Wang Z, Zheng R, Pang W, Sun R, et al. Trends in the incidence of common sexually transmitted infections at the global, regional and national levels, 1990-2021: results of the Global Burden of Disease 2021 study. Trop Med Health. 2025;53(1):70.

Garcia MR, Wray AA. Sexually transmitted infections. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024.

Sahay MR, Samant KD, Singh AK, Sahu S, Das S, Das H, et al. Prevalence of Sexually Transmitted Infections (Syphilis, N. Gonorrhea, and Chlamydia) in Odisha and Andhra Pradesh: A Systematic Review and Meta-analysis. Indian J Public Health. 2025;69(1):S62-70.

Verma A, Sirohi P, Garg A. Prevalence of sexually transmitted infections in symptomatic women of reproductive age group in a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2025;14:473-8.

Jain V, Aggarwal S, Nigam K, Kamble B, Kundapur R, Konda D, et al. Risk at the Crossroads: Evaluating the Risk of Sexually Transmitted Infections in High-Risk Groups. Cureus. 2025;17(6):e86459.

Ravi RP, Kulasekaran RA. Care seeking behaviour and barriers to accessing services for sexual health problems among women in rural areas of Tamilnadu state in India. J Sex Transm Dis. 2014;2014:292157.

Paul S, Sharma A, Dayal R, Mehta M, Maitra S, Seth K, et al. Vulnerability to sexually transmitted infections (STI) / human immunodeficiency virus (HIV) among adolescent girls and young women in India: a rapid review. PLoS One. 2024;19(2):e0298038.

Vasudev MB, Ballambat SP, Shetty VM. A Study on Knowledge, Attitude, and Practice Related to Sexually Transmitted Infections Among Students of Nonmedical Background in Manipal, India. Indian Dermatol Online J. 2023;15(1):39-44.

Sunil G, Prathap P, Asokan N, Sajna MV. Assessment of knowledge regarding sexually transmitted infections among high school students in an educational sub-district in southern India: a cross-sectional study. Indian J Dermatol Venereol Leprol. 2024;90(3):419.

Rizwan S, Rath RS, Vivek G, Nitika, Anant G, Farhad A, et al. KAP Study on Sexually Transmitted Infections/Reproductive Tract Infections (STIs/RTIs) among married women in rural Haryana. Indian Dermatol Online J. 2015;6(1):9-12.

Agarwal AK, Mishra J, Verma PK, Mahore R, Verma R. Knowledge, attitude and treatment seeking behaviour for reproductive tract infections (RTI) and sexually transmitted infections (STIs) among married women attending Suraksha Clinic, Madhya Pradesh, India. Glob J Med Public Health. 2022;11(2).

National Centre for Disease Control. State action plan on climate change and human health: Kerala. New Delhi: Ministry of Health and Family Welfare, Government of India. 2024. Available at: https://ncdc.mohfw.gov.in/wpcontent/uploads/2024/05/12.SAPCCHH-VERSION-1-KERALA.pdf. Accessed on 14 February 2026.

Patel NJ, Mazumdar VS. The Current Status of Sexually Transmitted Infections/Reproductive Tract Infections in Vadodara City: Health-care Provider Perspective. Indian J Community Med. 2019;44(3):247-51.

Kumar A, Narlawar U. Knowledge, attitude, healthcare-seeking behaviour and barriers related to reproductive tract infections/sexually transmitted infections among married women residing in urban slums of central India: a cross-sectional study. Ann Med Med Sci. 2026;27-32.

Winarto H, Habiburrahman M, Kusuma F, Nuryanto KH, Anggraeni TD, Utami TW, et al. Knowledge, attitude, and practice towards sexually transmitted infections among women of reproductive age in an urban community health centre in Indonesia. Open Public Health J. 2023;16:e187494452301050.

Di Gennaro F, Segala FV, Guido G, Poliseno M, De Santis L, Belati A, et al. Knowledge, attitudes, and practices about HIV and other sexually transmitted infections among High School students in Southern Italy: A cross-sectional survey. PLoS One. 2024;19(4):e0301297.

Moname EJ, Al Azad G, Chowdhury NR, Nazmin F, Hani U. Knowledge, attitudes, and practices regarding sexually transmitted infections among students of public university in Bangladesh. Asia Pac J Med Innov. 2024;1(2):55-60.

Zin NM, Ishak I, Manoharan K. Knowledge, attitude and practice towards sexually transmitted diseases amongst the inmates of women shelter homes at Klang Valley. BMC Public Health. 2019;19(4):639.

Bakhoum AY, Bachmann MO, El Kharrat E, Talaat R. Assessment of knowledge, attitude and practice of risky sexual behavior leading to HIV and sexually transmitted infections among Egyptian substance abusers: a cross-sectional study. Advances in Public Health. 2014;2014:701861.

Subbarao NT, Akhilesh A. Knowledge and attitude about sexually transmitted infections other than HIV among college students. Indian J Sex Transm Dis AIDS. 2017;38(1):10-4.

Lal SS, Vasan RS, Sarma PS, Thankappan KR. Knowledge and attitude of college students in Kerala towards HIV/AIDS, sexually transmitted diseases and sexuality. Natl Med J India. 2000;13(5):231-6.

Hemalatha R, Kumar RH, Venkaiah K, Srinivasan K, Brahmam GN. Prevalence of knowledge, attitude and practices towards HIV and sexually transmitted infections among female sex workers in Andhra Pradesh. Indian J Med Res. 2011;134(4):470-5.

Rai T, Aggarwal P, Kandpal SD. Knowledge, awareness and practices among adolescents regarding sexually transmitted diseases in urban slums. Indian J Community Health. 2011;23(1):26-8.

Khalil SN, Ross MW, Rabia M, Hira S. Knowledge and attitudes towards HIV/STDs among Indian adolescents. Int J Adolesc Youth. 2005;12(2):149-68.

Kaur W, Balakrishnan V, Zhi Wei IN, Chen AY, Ni Z. Understanding women’s knowledge, awareness, and perceptions of STIs/STDs in Asia: a scoping review. Healthcare (Basel). 2023;11(19):2643.

Rani V, Dixit AM, Singh NP, Kariwala P. Knowledge, attitude and practice study on reproductive tract infections among married women aged 15–44 years in a rural area of Etawah, Uttar Pradesh. Indian J Community Health. 2016;28(1):78-83.

Choudhury K, Mallik S, Sarkar A. A study on awareness and practice regarding reproductive tract infection/sexually transmitted infection (RTI/STI) among mothers attending immunization clinic of a medical college, Kolkata, West Bengal. IOSR J Dent Med Sci. 2019;18(1):58-64.

Jindal M, Naik VR, Kulkarni M. Awareness, perceptions, attitudes, and practices among antenatal mothers in Goa towards reproductive tract infections/sexually transmitted infections. Int J Sci Study. 2020;8(1):14-8.

Folasayo AT, Oluwasegun AJ, Samsudin S, Saudi SN, Osman M, Hamat RA. Assessing the knowledge level, attitudes, risky behaviors and preventive practices on sexually transmitted diseases among university students as future healthcare providers in the central zone of Malaysia: a cross-sectional study. Int J Environ Res Public Health. 2017;14(2):159.