Knowledge and attitudes towards sexually transmitted infections and their associated factors among late adolescents in Kota Bharu, Kelantan: A cross-sectional study

ABSTRACT

Introduction: Sexually transmitted infections (STIs) represent a significant health challenge, particularly for late adolescents in conservative regions including Kota Bharu, Kelantan, where cultural norms may influence health literacy. This study aimed to determine the levels of knowledge and attitudes towards STIs and identify their associated factors among late adolescents in Kota Bharu.
Methods: A cross-sectional study was conducted among 228 late adolescents (aged 18–21 years) from four higher-educational institutions. A validated bilingual online questionnaire was used to assess sociodemographic characteristics, high-risk behaviours, religiosity (Malay version of the Duke University Religiosity Index) and knowledge and attitudes towards STIs. Multiple linear regression (MLR) was utilised to identify independent predictors of attitudes.
Results: A total of 228 completed responses were analysed. Most participants were women (68.9%) and Muslim (84.2%). The mean knowledge score was 15.15/26 (standard deviation [SD]=5.17), with the human immunodeficiency virus awareness score being high (94.7%); significant gaps existed regarding other STIs. The mean attitude score was 57.10/65 (SD=6.51), indicating a generally protective mindset. MLR identified four independent factors significantly associated with positive attitudes: higher knowledge level (adjusted b=0.616, P<0.001), non-organisational religious activity (adjusted b=0.679, P=0.010), non-Malay ethnicity (adjusted b=–3.205, P=0.002) and maternal primary educational level (adjusted b=–4.085, P=0.021).
Conclusion: While late adolescents possess protective values, their functional knowledge of STIs remains superficial. Knowledge and internalised religious practices may contribute to positive attitudes. Targeted culturally sensitive health education and adolescent-friendly primary care services are essential to improve reproductive health outcomes.