The opinion of medical and biological students on the prevention of sexually transmitted diseases in the context of the COVID-19 pandemic: A social monitoring

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Social monitoring of the opinion of students of medical and biological profile on the prevention of sexually transmitted infections in the context of the COVID-19 pandemic

Introduction The basis of primary prevention of reproductive health disorders, including the prevention of sexually transmitted infections, is information and educational work with young people. The generalized opinion of the expert community assigned the leading role in the spread of sexually transmitted diseases to factors related to personal awareness of the problem, its self-esteem by every young person, the prevailing public opinion and social well-being of citizens [6, 16, 17]. It has been proven that the coronavirus pandemic and nationwide measures to combat it have had an unprecedented impact on these factors, significantly changing the attitude of society towards all medical and social problems [4, 15]. At the same time, the analysis of thematic publications in 2020 - 2021. shows that the opinions of experts about this transformation are divided. A number of both domestic and foreign authors point to positive changes in the perception of public health problems by the population: an increase in awareness of the value of one's health as the basis for all types of achievements [3, 5], an increase in interest in knowledge about health conservation and life safety [2], an increase in readiness to actively participate in public health activities [7, 9, 11, 13]. But the opposite conclusions are heard at the same high level: that interest in medical information is mainly limited to coronavirus topics [1], and restrictive measures are perceived as a source of too significant problems in the economy and the social sphere, activating both political protest moods, and medical dissidence [4, 8, 10, 18]. This indicates that opposite currents are indeed spreading in society, and this occurs against the backdrop of a crisis in the established approaches to the health education of young people. Thus, the transition to distance learning has practically nullified the possibility of holding mass events, lectures, conversations, the effectiveness of which in terms of preventing socially caused diseases was previously proven; at the same time, the use of Internet resources by young people, which were noted as a controversial and dubious channel for preventive work [14], has intensified. prevention of sexually transmitted infections before and during the pandemic of a new coronavirus infection.

Materials and methods of research

As part of the joint project of the Kursk State Medical University and the Administration of the Kursk Region to develop an interdepartmental system for the prevention of socially conditioned diseases among young people, 2 sociological surveys were conducted. In 2017, the study involved 372 students of 1-5 courses studying in institutions of higher and secondary vocational education in the Kursk region in the specialties of medical and biological profile. In 2021, the number of respondents to a similar survey was 574 people. In both samples, the principle of equal representation of age, gender, social and professional groups was observed. The average age of the respondents was 19.1±0.74 years. By sex, the distribution was as follows: in 2017, women - 51.9% (n=193), men - 48.1% (n=179); in 2021 - 50.7% (n=291) and 49.3% (n=283), respectively. Both samples were recognized as sufficient in size to obtain results with an accuracy level of α=0.05 [18] and are comparable in terms of age structure. The survey was conducted according to the author's questionnaire, consisting of 54 closed questions, combined into 5 blocks: the main components of knowledge and attitudes necessary for maintaining a safe sexual life, an objective self-assessment of the risk of infection, readiness to undergo screening examinations, orientation towards timely seeking medical help if health problems and willingness to seek medical help together with a partner. The work uses historical, analytical, statistical, sociological methods. In processing and presenting the data, the calculation of extensive indicators and their comparison with the mathematical assessment of the significance of differences according to the Student's t-test were used. The calculated values ​​of Student's t-test were evaluated by comparison with tabular values, while the differences in indicators were considered statistically significant at a significance level of p<0.05. The confidence interval for the calculated indicators was calculated with a confidence level of at least 0.95.

Results

According to the 2021 survey, the problem of sexual infections is objectively assessed by 87.8% of respondents. Their position is that the threat of the spread of these diseases is global, the risk exists for all those who are sexually active, and certain prevention and vigilance measures are required from everyone, which is confirmed by the epidemiology of sexually transmitted diseases and risk factors for their spread. Opinions about the social specificity of the problem are shared by 9.6% of respondents, with 5.9% linking the risk exclusively with the frequent change of partners, and 4.7% with the social status of patients, declaring the circulation of pathogens exclusively in disadvantaged categories. Despite the allocation in the literature of the concept of "super-distributors" of sexual infections, who really lead a promiscuous sex life and do not always represent prosperous strata of society, the situation with the spread of STIs is characterized by the loss of social specificity of diseases. Knowing young people about this is an important condition for safe behavior. The share of those expressing an opinion about the far-fetchedness and exaggeration of the problem of sexual infections is minimal - 1.6%. Compared to 2017, the proportion of those who have objective ideas about the risk of contracting sexual infections has significantly increased (from 72.8% to 87.8%, p = 0.007) (Fig. 1). At the same time, the association of the threat exclusively with the frequent change of partners began to be noted significantly less frequently (5.9% in 2021 versus 16.7% in 2017, p=0.004). Decreased, albeit slightly, from 8.1% to 4.7% (p=0.061), the share of those linking risks with social status. Thus, a tendency to objectify ideas about the risk of the spread of sexually transmitted infections has been revealed. The increase in the prevalence of objective self-assessment of the risk of contracting sexually transmitted infections has naturally led to an increase in the proportion of students who are aware of the need for screening for STIs: from 65.3% in 2017 to 86.6% in 2021 (p=0.004). So, if in 2017 88% of students demonstrated their willingness to seek help from specialized specialists, then in 2021 - 97.4% (p=0.003), i.e. out of almost 500 respondents, only 13 people declared their intention to be treated on their own without applying to medical organizations. At the same time, the level of trust in the state dermatovenerological service remained practically unchanged (64.8% in 2017 and 66.4% in 2021, p = 0.068), and interest in visiting private clinics increased significantly (from 55.4% in 2017 to 81.5% in 2021, p=0.005) (Fig. 2). At the same time, if in 2017 the desire to receive assistance in state medical organizations prevailed, then the situation in 2021 has changed significantly - this is the first time among young people that a significantly higher desire to go to private clinics than to public ones (81.5% vs. 4% respectively). dispensaries. It should be noted that in 2021, compared to 2017, the level of trust in pharmaceutical workers increased statistically significantly (4.5% are ready to listen to their opinion against 1.1% in 2017, p = 0.003). The share of Internet resources relying on materials, including electronic publications, also increased (5.2% vs. 1.6% in 2017, p=0.004). The proportions of those willing to rely on their own knowledge or trusting traditional medicine remained practically unchanged and rather small. At the same time, the opinions of 13 people focused exclusively on self-treatment (who do not want to go to doctors) are represented by attitudes to the use of Internet resources and their own professional knowledge, and only 1 person indicated their intention to use folk remedies.

Discussion of the results.

In addition to the traditional desire for confidentiality and comfort, with which private medical organizations are associated in the mass consciousness, the desire to limit contacts with a large number of patients in queues at state medical organizations, especially during the COVID-19 pandemic. A number of authors in the recent past have mentioned the activities of non-governmental medical organizations as a factor that negatively affects the completeness of the registration of cases of morbidity [6, 15, 16]. At the same time, our expert assessment showed that the quality of information exchange between authorities and medical organizations of different forms of ownership is no longer among the leading causes of incomplete registration of STI cases, and the main problem remains the lack of appealability of the patients themselves, which corresponds to the data of a number of authors [3, 7, 9, 19]. An important role, according to most authors [9, 14, 15, 16], in the treatment of sexually transmitted infections and the prevention of their further spread is assigned to the joint seeking medical help of both sexual partners, which is confirmed by the data of the study. We found that, as in 2017, as well as in the current study in 2021, they are aware of this and the absolute majority - 95.6% of respondents are ready to undergo medical procedures together. Among the remaining 4.4%, opinions were distributed between unmotivated egoism (answer: “health is a personal matter”) and a specifically expressed fear of losing a partner. In such small values, the changes that have occurred are not statistically significant, but nevertheless a certain trend can be traced: if in 2017 a purely egoistic position was present in 2.4% and it was distributed almost on a par with the share of those who fear a break in relations in 2%, then in 2021 .there has been a preponderance in favor of the fear of losing a partner (3% versus 1.4% with the position of health as a personal secret). about the growing completeness of detection and registration of STIs among students of biomedical profile of education.

Conclusion.

Thus, during the period of the coronavirus pandemic, students of biomedical profile of education have a positive trend in their ideas about the prevention of sexually transmitted infections: against pre-pandemic 2017, it is statistically significant increased prevalence of objective self-assessment of epidemiological environment and the risks of infection associated with it, increased willingness to undergo screening examinations and seek qualified help. At the same time, the proportion of those wishing to undergo treatment in private clinics has significantly increased. Invariably high (over 95%) remains the proportion of respondents who are aware of the need for joint examination and treatment for STIs together with a partner. In general, the data obtained indicate an increase in the level of consciousness and responsibility of students of medical and biological specialties in the prevention, early diagnosis and treatment of sexually transmitted infections.

About the authors

Vladimir I. Timoshilov

Kursk State Medical University

Email: timoshilovvi@kursksmu.net
ORCID iD: 0000-0002-4085-8111
SPIN-code: 6467-1762

PhD, Associate professor, Department of Public health and healthcare of the Institute of continuing education with the training center for lean technologies

Russian Federation, Kursk

Aleksei V. Breusov

Kursk State Medical University; Peoples' Friendship University of Russia

Author for correspondence.
Email: ab69@yandex.ru
ORCID iD: 0000-0003-2335-3338
SPIN-code: 2499-6023
Scopus Author ID: 6508162798

PhD, Professor, Department of Public health, healthcare and hygiene, Head of the Department of Public health and healthcare of the Institute of continuing education with the training center for lean technologies

Russian Federation, Kursk; Moscow

Alesya A. Kuznetsova

Kursk State Medical University

Email: kuznecovaaa@kursksmu.net
ORCID iD: 0000-0002-9166-0770
SPIN-code: 5055-9831

PhD, Associate professor, Vice-Rector for Educational Work, Social Development and Public Relations, Head of the Department of Health psychology and neuropsychology

Russian Federation, Kursk

References

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