Sexual health literacy among Slovenian secondary school students

A descriptive study

Authors

  • Marta Šporin University of Ljubljana, Faculty of Health Sciences, Department of Nursing, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
  • Tina Kamenšek University of Ljubljana, Faculty of Health Sciences, Department of Nursing, Zdravstvena pot 5, 1000 Ljubljana, Slovenia https://orcid.org/0000-0002-6921-7836
  • Marija Milavec Kapun University of Ljubljana, Faculty of Health Sciences, Department of Nursing, Zdravstvena pot 5, 1000 Ljubljana, Slovenia https://orcid.org/0000-0001-5231-3795

DOI:

https://doi.org/10.14528/snr.2024.58.2.3202

Keywords:

sex education, adolescents, sexual health, contraception, sexually transmitted infections

Abstract

Introduction: Sexuality education for adolescents is an important area of education. The aim of this study was to assess the knowledge of Slovenian upper secondary school students about sexuality, as well as theirexperiences, behaviours, and sources of information about sexuality.
Methods: An invitation to complete an online questionnaire for first-year students was sent to all secondary schools in central Slovenia. The responses of 201 participants were included in the analysis. The average age of the respondents was 15.59 years; 57% of the participants were female and 67% attended general upper secondary school. The data were statistically analysed using chi-square, Mann-Whitney U, and t-test.
Results: Respondents cited the internet (67.0%) and friends (60.4%) as the most common sources of information on sexuality. Most respondents expressed a preference for seeking information from healthcare professionals (61.2%) and least from teachers (26.5%). Sexual experiences involving vaginal penetration were found to be more frequent among students enrolled in vocational and technical education programmes than those attending general upper secondary education programmes (χ2 = 7.863, p = 0.005). Knowledge about sexuality was found to differ by gender (U = 2257.500, p = 0.003) and type of secondary school (U = 1943.500, p = 0.001). Knowledge about sexuality was positively associated with the frequency of discussions about various sex-related topics, with the exception of petting. It was, however, not associated with sexual activity or the use of protection.
Discussion and conclusion: More attention needs to be paid to the provision of sexuality education for secondary school students. School nurses can promote information sharing among peers, empower parents to engage in discussions on these topics with their adolescent children, and provide sexuality education in the school setting. Our study findings on the effectiveness of different forms and contents of sexuality education can serve as a basis for enhancing the existing preventive programmes

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

KA (Verzija 21.02.16) [programska oprema]. (2021). Ljubljana:Fakulteta za družbene vede. https://www.1ka.si

Ashcraft, A. M., & Murray, P. J. (2017). Talking to parents about adolescent sexuality. Pediatric Clinics of North America, 64(2), 305–320. https://doi.org/10.1016/j.pcl.2016.11.002 PMid:28292447; PMCid:PMC5517036

Benton, A. D., Santana, A., Aubrey, Vinklarek, A. J., Lewis, C. M., Sorensen, J. M., & Hernandez, A. (2020). Peer-led sexual health education: Multiple perspectives on benefits for peer health educators literature review rationale for the use of peer education. Adolescent Social Work Journal, 37, 487–496. https://doi.org/10.1007/s10560-020-00661-9

Bonjour, M., & van der Vlugt, I. (2018). Comprehensive sexuality education: Knowledge file. https://www.rutgers.international/sites/rutgersorg/files/PDF/knowledgefiles/20181218_knowledge%20file_CSE.pdf

Denford, S., Abraham, C., Campbell, R., & Busse, H. (2017). A comprehensive review of reviews of school-based interventions to improve sexual-health. Health Psychology Review, 11(1), 33–52. https://doi.org/10.1080/17437199.2016.1240625 PMid:27677440

Družinski zakonik (DZ). (2017). Uradni list RS, št. 15 (31. 3. 2017). https://www.uradni-list.si/glasilo-uradni-list-rs/vsebina/2017-01-0729?sop=2017-01-0729

Duberstein Lindberg, L., Maddow-Zimet, I., & Boonstra, H. (2016). Changes in adolescents' receipt of sex education, 2006- 2013. Journal of Adolescent Health, 58(6), 621–627. https://doi.org/10.1016/J.JADOHEALTH.2016.02.004 PMid:27032487; PMCid:PMC4976485

European Expert Group on Sexuality Education. (2016). Sexuality education: What is it. Sex Education, 16(4), 427–431. https://doi.org/10.1080/14681811.2015.1100599

Fang, Y., Zheng, Y., Jin, Y., Yu, C., Zuo, X., Lian, Q., Lou, C., Li, L., Hong, P., & Tu, X. (2022). Sexual-related knowledge, school and family sexuality education and its association with experience of sexual intercourse among vocational secondary school students in China. Children, 9(8), Article 1206. https://doi.org/10.3390/CHILDREN9081206 PMid:36010096; PMCid:PMC9406409

Feldman Farb, A., & Margolis, A. L. (2016). The teen pregnancy prevention program (2010-2015): Synthesis of impact findings. American Journal of Public Health, 106(S1), S9–S15. https://doi.org/10.2105/AJPH.2016.303367 PMid:27689501; PMCid:PMC5049454

Garzon-Orjuela, N., Samaca-Samaca, D., Moreno-Chaparro, J., Ballesteros-Cabrera, M. D. P., & Eslava-Schmalbach, J. (2021). Effectiveness of sex education interventions in adolescents: An overview. Comprehensive Child and Adolescent Nursing, 44(1), 15–48. https://doi.org/10.1080/24694193.2020.1713251 PMid:32048888

Goesling, B., Colman, S., Trenholm, C., Terzian, M., & Moore, K. (2014). Programs to reduce teen pregnancy, sexually transmitted infections, and associated sexual risk behaviors: A systematic review. Journal of Adolescent Health, 54(5), 499–507. https://doi.org/10.1016/J.JADOHEALTH.2013.12.004 PMid:24525227

Gonzalez-Ortega, E., Vicario-Molina, I., Martinez, J. L., & Orgaz, B. (2015). The Internet as a source of sexual information in a sample of spanish adolescents: Associations with sexual behavior. Sexuality Research and Social Policy, 12(4), 290–300. https://doi.org/10.1007/S13178-015-0196-7

Greenberg, J. S., Bruess, C. E., & Oswalt, S. B. (2014). Intoducing the dimensions of human sexuality. In Exploring the Dimensions of Human Sexuality (5th ed., pp. 2–29). Jones & Bartlett Learning books.

Herat, J., Plesons, M., Castle, C., Babb, J., & Chandra-Mouli, V. (2018). The revised international technical guidance on sexuality education: A powerful tool at an important crossroads for sexuality education. Reproductive Health, 15(1), Article 185. https://doi.org/10.1186/s12978-018-0629-x PMid:30400902; PMCid:PMC6220458

Herdt, G., & Polen-Petit, N. C. (2020). Human sexuality: Self, society, and culture (2nd ed.). McGraw-Hill.

Inchley, J., Currie, D., Budisavljevic, S., Torsheim, T., Jastad, A., Cosma, A., Kelly, C., & Arnarsson, A. C. (2020). Spotlight on adolescent health and well-being: Findings from the 2017/2018 Health Behaviour in school-aged Children (HBSC) survey in Europe and Canada. International report. In Health Behaviour in School-aged Children. WHO, Regional office for Europe. https://iris.who.int/bitstream/handle/10665/332091/9789289055000-eng.pdf

Jefferson, I. S., Robinson, S. K., Tung-Hahn, E., Schumann, R., Marrero-Conti, S., Walton, J. M., Golden, E., Poon, E., Alam, M., &Tung, R. (2021). Assessing and improving the knowledge of sexually transmitted infections among high school adolescents. Dermatology Research and Practice, 2021, Article 6696316. https://doi.org/10.1155/2021/6696316 PMid:33953742; PMCid:PMC8057898

Jeriček Klanšček, H., Roškar, M., Drev, A., Pucelj, V., Koprivnikar, H., Zupanič, T., & Korošec, A. (2019). Z zdravjem povezana vedenja v šolskem obdobju med mladostniki v Sloveniji. Nacionalni inštitut za javno zdravje. https://www.nijz.si/sites/www.nijz.si/files/publikacije-datoteke/hbsc_2019_e_verzija_obl.pdf

Khodakarami, N. (2019). The impact of sex education on sexual activity, pregnancy, and abortion. In arXiv 1903.08307v1. https://doi.org/10.48550/arXiv.1903.08307

Kiphut, S., & Hafner, A. (2019). Mladostnik in doživljanje spolnosti. In V. Pucelj (Ed.), Priročnik za izvajalce vzgoje za zdravje v okviru primarnega zdravstvenega varstva odnos do telesa (pp. 33–47). Nacionalni inštitut za javno zdravje. https://nijz.si/wp-content/uploads/2022/07/za_boljse_zdravje_otrok_in_mladostnikov_nova_verzija_13_10_2015.pdf

Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije. (2014). Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.

Lee, E. J., Lee, H. Y., & Chung, S. (2017). Age differences in health literacy: Do younger Korean adults have a higher level of health literacy than older Korean adults. Health & Social Work, 42(3), 133–142. https://doi.org/10.1093/hsw/hlx026 PMid:28859424

Liškova, K., Jarska, N., & Szegedi, G. (2019). Sexuality and gender in school-based sex education in Czechoslovakia, Hungary and Poland in the 1970s and 1980s. The History of the Family, 25(4), 550–575. https://doi.org/10.1080/1081602X.2019.1679219

Madden, T., Cortez, S., Kuzemchak, M., Kaphingst, K. A., & Politi, M. C. (2016). Accuracy of information about the intrauterine device on the internet. American Journal of Obstetrics and Gynecology, 214(4), P499.E1-499.E6. https://doi.org/10.1016/J.AJOG.2015.10.928 PMid:26546848; PMCid:PMC4808607

Ministrstvo za izobraževanje, znanost in šport RS (n.d.). Evidenca vzgojno-izobraževalnih zavodov in vzgojnoizobraževalnih programov (2004–2009). https://paka3.mss.edus.si/registriweb/Seznam2.aspx?Seznam=3010

Ministrstvo za vzgojo in izobraževanje RS (2023) Število dijakov 1. letnika v š. l. 2020/2021, z letniki rojstva od 2003 do 2006, v srednjih šolah Osrednjeslovenske regije (stanje CEUVIZ za 15. 6. 2021, š. l. 2020/2021). Centralna evidenca udeležencev vzgoje in izobraževanja.

Patterson, S. P., Hilton, S., Flowers, P., & Mcdaid, L. M. (2019). What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet. Implications for policy and practice from a qualitative study. Sexually Transmitted Infections, 95(6), 462–467. https://doi.org/10.1136/SEXTRANS-2018-053710 PMid:31040251; PMCid:PMC6706277

Pavelova, L., Archalousova, A., Slezakova, Z., Zrubcova, D., Solgajova, A., Spacilova, Z., Krištofova, E., & Slamkova, A. (2021). The need for nurse interventions in sex education in adolescents. International Journal of Environmental Research and Public Health, 18, Article 492. https://doi.org/10.3390/ijerph18020492 PMid:33435342; PMCid:PMC7827239

Phongluxa, K., Langeslag, G., Jat, T. R., Kounnavong, S., Khan, M. A., & Essink, D. R. (2020). Factors influencing sexual and reproductive health among adolescents in Lao PDR. Global Health Action, 13(Suppl. 2), Article 1791426. https://doi.org/10.1080/16549716.2020.1791426 PMid:32741350; PMCid:PMC7480507

Pivač, S., & Kalender Smajlović, S. (2018). Vloga staršev in vzgoje za zdravje pri oblikovanju odgovornega spolnega vedenja: raziskava med učenci osnovne šole. Obzornik zdravstvene nege, 52(3), 160–167. https://doi.org/10.14528/snr.2018.52.2.180

Pucelj, V. (2019). Priročnik za izvajalce vzgoje za zdravje v okviru primarnega zdravstvenega varstva odnos do telesa. Nacionalni inštitut za javno zdravje. https://www.nijz.si/sites/www.nijz.si/files/publikacije-datoteke/za_boljse_zdravje_otrok_in_mladostnikov_nova_verzija_13_10_2015.pdf

Ramirez-Villalobos, D., Monterubio-Flores, E. A., Gonzalez- Vazquez, T. T., Molina-Rodriguez, J. F., Ruelas-Gonzalez, M. G., & Alcalde-Rabanal, J. E. (2021). Delaying sexual onset: Outcome of a comprehensive sexuality education initiative for adolescents in public schools. BMC Public Health, 21(1), Article 1439. https://doi.org/10.1186/S12889-021-11388-2 PMid:34289834; PMCid:PMC8296525

Rose, I. D., Boyce, L., Murray, C. C., Lesesne, C. A., Szucs, L. E., Rasberry, C. N., Parker, T., & Roberts, G. (2019). Key factors influencing comfort in delivering and receiving sexual health education: Middle school student and teacher perspectives. American Journal of Sexuality Education, 14(4), 466–489. https://doi.org/10.1080/15546128.2019.1626311 PMid:33897308; PMCid:PMC8064695

Santelli, J. S., Kantor, L. M., Grilo, S. A., Speizer, I. S., Lindberg, L. D., Heitel, J., Schalet, A. T., Lyon, M. E., Mason-Jones, A. J., McGovern, T., Heck, C. J., Rogers, J., & Ott, M. A. (2017). Abstinence-only-untilmarriage: An updated review of U. S. policies and programs and their impact. Journal of Adolescent Health, 61(3), 273–280. https://doi.org/10.1016/J.JADOHEALTH.2017.05.031 PMid:28842065

Şirin Akca, M. (2020). High school student's thoughts about sexual education. Cukurova Universitesi Eğitim Fakultesi Dergisi, 49(2), 1211–1235. https://doi.org/10.14812/cufej.566168

St. George, M., Niemela, D. R. M., & Zeglin, R. J. (2022). Parents talking to middle school children about sex: A protective factor against suicide in sexually active teens. American Journal of Sexuality Education, 18(2), 282–299. https://doi.org/10.1080/15546128.2022.2095315

Statistični urad Republike Slovenije. (2022). Dijaki po: Vrsta izobraževanja, letnik, starost šolsko leto, spol. https://pxweb.stat.si/SiStatData/pxweb/sl/Data/-/0953221S.px

Telford A., Taylor, C. C., Wood, H. M., & Gusnanto, A. (2019). Properties and approximate pvalue calculation of the Cramer test. Journal of Statistical Computation and Simulation, 90(11), 1965-1981. https://doi.org/10.1080/00949655.2020.1754820

Univerza v Ljubljani. (2014). Etični kodeks za raziskovalce Univerze v Ljubljani. https://www.uni-lj.si/mma/eticni_kodeks_za_raziskovalce_ul/20141211104120/?m=1418290880

United Nations Educational Scientific and Cultural Organization (UNESCO). (2018). International technical guidance on sexuality education: An evidence-informed approach. UNESCO Publishing. https://www.unesco.org/open-access/terms-use-ccbyncnd-en

Vilhar, B., Zupančič, G., Gilčvert Berdnik, D., Vičar, M., Zupan, A., Sobočan, V., Devetak, B., & Sojar, A. (2011). Učni načrt, Program osnovna šola, Biologija. Ministrstvo za šolstvo in šport, Zavod RS za šolstvo. https://www.gov.si/assets/ministrstva/MIZS/Dokumenti/Osnovna-sola/Ucni-nacrti/obvezni/UN_Biologija.pdf

Vilhar, B., Zupančič, G., Bičar, M., Sojar, A., Devetak, B., Gilčvert Berdnik, B., & Sobočan, V. (2008). Učni načrt, Biologija: gimnazija: splošna gimnazija. Ministrstvo za šolstvo in šport, Zavod RS za šolstvo. Retrieved September 9, 2021 from http://eportal.mss.edus.si/msswww/programi2010/programi/media/pdf/ucni_nacrti/UN_BIOLOGIJA_gimn.pdf

Waling, A., James, A., Lim, G., & Power, J. (2022). Building young people's sexual literacy in digital spaces. Australian Research Centre in Sex, Health and Society (ARCSHS). https://doi.org/10.26181/19776016

WHO Regional Office for Europe, & Bundeszentrale fur gesundheitliche Aufklarung. (2010). Standards for Sexuality Education in Europe: A frameworkfor policy makers, educational and health authorities and specialists. Bundeszentrale fur gesundheitliche Aufklarung. https://www.bzga-whocc.de/fileadmin/user_upload/BZgA_Standards_English.pdf

WHO Regional Office for Europe, & Bundeszentrale fur gesundheitliche Aufklarung. (2013). Standards for Sexuality Education in Europe: Guidance for Implementation. Bundeszentrale fur gesundheitliche Aufklarung. https://www.bzga-whocc.de/fileadmin/user_upload/Dokumente/BZgA_GuidanceImplementation_EN.pdf

World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053 PMid:24141714

Wong, J. Y. H., Zhang, W., Wu, Y., Hang Choi, E. P., Ming Lo, H. H., Wong, W., Chio, J. H. M., Tam, H. L. C., Ngai, F. W., Tarrant, M., Wang, M. P., Ngan, G. Y.-S., & Fong, D. Y. T. (2021). An interactive web-based sexual health literacy program for safe sex practice for female Chinese university students: Multicenter randomized controlled trial. Journal of Medical Internet Research, 23(3), Article e22564. https://doi.org/10.2196/22564 PMid:33709941; PMCid:PMC7998327

Žalar, A., Leskovšek, E., Čeh, F., & Cugmas, M. (2013). Spolna vzgoja v okviru vzgoje za zdravje v slovenskih srednjih šolah. Inštitut za varovanje zdravja Republike Slovenije. https://nijz.si/wp-content/uploads/2022/07/spolna_vzgoja_v_okviru_vzgoje_za_zdravje_v_slo_srednjih_solah.pdf

Downloads

Published

2024-06-15

How to Cite

Šporin, M., Kamenšek, T., & Milavec Kapun, M. (2024). Sexual health literacy among Slovenian secondary school students: A descriptive study. Slovenian Nursing Review, 58(2), 88–104. https://doi.org/10.14528/snr.2024.58.2.3202

Issue

Section

Original scientific article

Most read articles by the same author(s)

1 2 > >>