HAWASSA UNIVERSITY COLLEGE OF HEALTH SCIENCE SCHOOL OF NURSING

A RESEARCH PAPER SUBMITTED TO CBE COORDINATING OFFICE FOR PARTIAL FOR FULFILLMENT OF OF THE IN

REQUIREMENTS NURSING

BACHELOR

SCIENCE

INVESTIGATOR:1. MINLIKALEW DEJENE 2. TEMESGEN ASHINE 3. YOHANNES TESHOME 4. YONAS ALEMAYEHU 5. YETIMEORK DEMEKE

ADVISOR: - ATO WONDWOSEN T. (MPH)

MAY, 2001/9 ETHIOPIA

HAWASSA UNIVERSITY COLLEGE OF HEALTH SCIENCE SCHOOL OF NURSING

ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE TOWARD SEXUALLY TRANSMITTED DISEASES IN BODITI HIGH SCHOOL STUDENTS

INVESTIGATOR:1 MINLIKALEW DEJENE 2 TEMESGEN ASHINE 3. YOHANNES TESHOME 4. YONAS ALEMAYEHU 5. YETIMEORK DEMEKE

ADVISOR: - ATO WONDWOSEN T/S

MAY, 2001/9 ETHIOPIA

TABLE OF CONTENT
Content Page

Table of content ....................................................................................... i Acknowledgment .................................................................................... iii List of Acronyms .................................................................................... iv List of tables.v List of figure.vi Abstract .................................................................................................. vii

UNIT ONE
1.1. Back ground ...................................................................................... 1 1.2. Statement of the problem ................................................................. 2 1.3. Significance of the study ................................................................... 3 1.4. Literature review .............................................................................. 4

1.5. Objectives
1.5.1. General objective ...................................................................... 7 1.5.2. Specific objectives .................................................................... 7

UNIT TWO 2.1. Methodology

2.1.1. Study area .................................................................................. 8 2.1.2. Study period............................................................................... 9 2.1.3. Study design .............................................................................. 9 2.1.4. Target population ....................................................................... 9 2.1.5. Study population 9 2.1.6. Study subject 9 2.1.7. Sampling unit 9 2.1.8. Sampling frame 9 2.1.9. Sampling method9. 2.1.10. Sample size determination....................................................... 10 2.1.11. Sampling criteria .................................................................... 10 2.1.11.1. Inclusion criteria ............................................ 10

2.1.11.2. Exclusion criteria ......................................... 10 2.1.12. Study variable ......................................................................... 10 2.1.12.1. Dependent variable ................................ 10 2.1.12.1. Independent variable ............................ 10 2.1.13. Method of data collection ........................................................ 11 2.1.14. Data management.................................................................... 11 2.1.15. Data analysis ........................................................................... 11 2.1.16. Ethical issue (consideration) ................................................... 11 2.1.17. Operational definition ............................................................. 11

UNIT THREE
3.1. Result ................................................................................................ 13 3.2. Discussion ......................................................................................... 28 3.3. Conclusion ........................................................................................ 31 3.4. Limitation ......................................................................................... 32 3.5. Recommendation ............................................................................... 32

UNIT FOUR

4.1. Budget plan ...................................................................................... 33 4.2. Work plan.......................................................................................... 34 Reference..35 Annex ..................................................................................................... 36 1. Questionnaire 1a.Socio demographic characteristics ................. 37 1b.Knowledge questionnaire .............................. 39 1c.Attitude questionnaire ................................... 42 1d.Practice questionnaire ................................... 43

ACKNOWLEDGMENT
We would like to express our deepest graduate to our advisor Ato wondosen for his valuable constructive advice and comments. We would like to express our especially thank, to Bodtti high school officials and teacher, who facilitate our data collection our last but not least thanks to go to Hawassa university college of health science for preparing this research project as course for all of graduating students.

LIST OF ACRONYMS
AIDS BSC CDC EDHS HIV KAP MMWR STDs STIs YRBSS
O

Acquired Immune Deficiency syndrome Bachelor of Science Communicable Disease Control Ethiopian Demographic Health Survey Human Immunodeficiency Virus Knowledge, Attitude and Practice Morbidity and Mortality Weekly Report Sexually Transmitted Diseases Sexually Tranmisstted Infections Youth Risk Behavior Surveillance System Degree Centigrade Ethiopia Calendar Kilometer Serial number Number Millimeter Figure World health organization Team Training Program Community Based Education chi-square degree of freedom

E.C Km S.No N
o

mm Fig WHO TTP CBE X

2

df

LIST OF TABLE

Title

Page

Table. 1. Sociodemoggraphic characteristics of Bodditti high school students in may 2001E.C-----------------------------------------------------------------------------------13 Table.2. Assessment of knowledge toward STDs in Boditti high school students in May 2001 E.C.---------------------------------------------------------------------------------16 Table .3.Assessment of attitude of Boditti high school student toward STDs in May 2001 E.C.----------------------------------------------------------------------------------------19 Table.4. Assessment of practice to ward STDs in Boditti high school students in May 2001 E.C.----------------------------------------------------------------------------------23 Table.5.Association of Socio demographic characteristics and history of sexual intercourse in Boditti high school students in May 2001 E..24 Table.6. Association of Socio demographic characteristics and history of STDs Boditti high school students in May 2001 E.C.-----------------------------------------------25 Table.7.Association of knowledge towards SIDs, and sex in Boditti high school student in May 2001 E.C.---------------------------------------------------------------26 Table.8.Associations of cause for sexual commitment and sex in Boditti high school student in May 2001 E.C.-----------------------------------------------------------------27 Table.9.Association of place of sexual commitment and sex in Boditti high school student in May 2001 E.C.----------------------------------------------------------------27 Table.10.Budget required for undertaking the research project in May 2001E.c. 33 Table .11. Work plan for the study conducted in May 2001 E.C ---------------------------34

LIST OF FIGURE

Title

Page

Fig 1.Source of information for students about STDs in Boditti high school students in May 200E.C.------------------------------------------------------------------------15

Fig.2. Mode of treatment for known individuals who were sick by STDS by Boditti high school student in May 2001 E.C.---------------------------------------------------------21 Fig .3. Use of Condom for a person who is at risk for having STDs in Boditti high school students in May 2001.E.C.--------------------------------------------------------------22 Fig.4.Frequency of condom use for a person who is at risk for having STDs in Boditti high school students in May 2001 E.C.--------------------------------------------------22

ABSTRACT
Background:- The issue of adolescent is being recognized as one of the major determinant of human development concerning physical, psychological, emotional, social, economical, sexual health as well at its associated problems. Therefore, adolescent sexual health (sexually transmitted disease) deserve as a special attention.

Objective:- To assess the knowledge, attitude and practice toward sexually transmitted disease in adolescent

Methodology:- A descriptive quantitative cross sectional study was conducted at Boditti high school to assess the KAP of adolescent to ward sexual health (sexually transmitted diseases). Total of 384 subjects was selected using to phase of selection. In phase one

we used a stratified proportionate sampling technique to select adolescent from each strata. In phase to we used systematic random sampling methods; a self administered anonymous questionnaire was prepared.

Result: - All of the selected sample students 384 (100%) field the self administered questionnaire properly. So that the non response rate is zero.

Out of 384(100%) sample students who fill the self administered questionnaire 306 (79.69%) know the sign and symptom of the STDs and 78(20.31%) not know about STDs in addition out of 384 , 336 (87.50%) know the route of transmission of STDs and rest 48(12.50%) not know the route of transmissions. From the total sample

229(59.63%) students had history of sexually transmitted infections and 155(40.37%) had no history of STIs. From those students who had history STIs 204(49.88%) was treated at home, 164 (40.09%) was treated at health institution and 41(10.03%) was treated at other place. Out of those students who had history of STIs and treated at home, 75 (52.45%) was treated by animal product, 27(18.88%) was treated by plant root 23(16.08%) was treated by stem bark and 18(12.59%) was treated by leaf.

Discussion: - The majority have heard about SIDs from different source of informant from source of information are elector media such as television and radio (60%), school teacher (30%) and other (10%). This result probably because of student in Boditti town aware for information from electro media is available in each students house.

Conclusion:- Most of the student has good knowledge about the sign and symptom, route of transmission, method of prevention of STDs. Ethnicity and religion plays major role for the history of sexual intercourse and STDs.

Recommendation: - Finally at the end of project and after the result obtained recommendation will be forward to the concerned body to take responsibility.

A total of 1463.25 birr will be required to do this research project.

10

11

UNIT ONE
1.1. BACKGROUND

STDs are a group of infectious diseases which are all transmitted commonly through sexual contact, Although, the etiology of STDs involves a No of microorganisms, the disease present themselves mainly in four syndromes. These are: - genital ulcer, urethral discharge, vaginal discharge and lower abdominal pain. STDs are major public health problems in all countries but are especially prevalent in developing countries where access to adequate diagnostic and treatment facilities are limited or not existed. WHO reported that, there are approximately 333 million infected people and 68.5 thousand people are infected daily with STDs .In sub Saharan Africa, 65 million new cases of curable STDs exists per anima. A great majority of HIV infected adults in Sub-Saharan Africa are believed to have acquired virus through heterosexual intercourse and infected women. Out number the men by 6 to 5 one reason appears to be the frequent presence of other STDs, which facilitate HIV transmission. (1)

The problem of STDs in Ethiopia is generally believed to be similar to that of other developing countries. But to dates, there are no students in this country indicating the current magnitude of STDs.

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1.2. STATEMENT OF THE PROBLEM

In STDs, formally known as venereal disease, more than 25 of the infections are transmitted from person to person primarily during sexual contact. STDs are among the most common and known infection in the world. More than 15 million people in the United States become infected with one or more STDs every year. The united states have the highest STDs rate in industrialized world. Roughly half of all Americans become infected with STDs before the age of 35 (2).

Adolescent especially in developing countries are exposed to unsafe and early sex. Poverty and lack of appropriate information which is very common in developing countries makes adolescents more vulnerable to STDS including HIV /AIDS, .Globally, more than half of all new HIV infections are among 15-24 years of age. In Ethiopia, among men of age 15-19 and 20-24 nearly 5% and 2% had experienced STDs or associated symptoms respectively. Taking all age groups, only one in two with an STIs or associated symptoms have got treatment or medical advice.(3)

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1.3. SIGNIFICANCE OF THE STUDY

Our research finding will help us to know the knowledge, Attitude and practice of adolescent to wards sexually transmitted disease. The result of this investigation will help any concerned body or sector or individual to know the problem in the study area and carryout intervention activities for reduction of the problem.

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1.4. LITERATURE REVIEW

STDs infection can lead to life long health problems, including infertility. An approximately 333 million cases of curable STD occur each year. Available data suggest that 1/3 of STD infection in developing countries occur among 13-20 years. In rural Kenya 41% of women aged 15-24 attending maternal and child health or family planning clinics had an STD, compared to about 16% of all women of reproductive age. Adolescent also are at increased risk of contracting HIV/AIDS. Recent estimates are that over 40% of HIV infections occur in young people age 15-24; 7,000 of 16,000 new infections each day. New infections among females outnumber males by a ratio of 2:1 Young people tend to be high risk of contracting STD, including HIV/AIDS, for several reasons. Intercourses often are unplanned or unwanted. Even when she is consensual adolescents often do not plan head for condom or other contraceptive use and inexperienced users are more likely to use methods incorrectly A survey in Guatemala city found that 40% of 143 street children surveyed had their first sexual intercourse with some one they didnt know, all had exchanged sex for money, all had been sexually abused and 93% had been infected with an STD. In Thailand an estimated 800,000 prostrates are under age 20 of these, 200,000 are younger than 14. Some ages old into prostitution by parents to support other family members. (2)

A study published in the August 14,1998, issue of the center for disease control and preventions (CDC) morbidity and mortality weekly report ( MMWR) should large numbers of high school students in the limited states engaged in behaviors that increase their risk of death and disease . The study was part of an on going survey known as the Youth Risk Behavior Survicellance System (YRBSS), developed by health and education officials to design programs aimed at reducing high risk behavior among teenagers. Since 1990 YRBSS has monitored behavior in sex categories. From this sexual activity is one of the behaviors. The most recent data were collected form national, state, and local surveys administered to more than 16,000 students in grade 9 through 12 between February and May 1997. (4)

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The findings in this study which is published by the CDC are : 48.4% reported having had sexual intercourse at least once in their life time , 7.2% had sexual intercourse before age 13,16% had 4 or more than sexual partners in their life time, 56.8% of sexually active students had used condom during their more recent sexual intercourse, 16.6% of sexually active students said, they or their partner had used birth control pills proportion their most recent sexual intercourse and 6.5% said they had been pregnant or had impregnated some one (4).

A study conducted in 1990 E.C reported that history STDs was more frequent in HIV positive ( 71.4%) than in HIV negative (39.4%) patients and the , HIV so prevalence rate was 12% among subjects treated for STDs in 1991 E.C in Ethiopia. Across-sectional survey on sexual activity of out of schools youth ( 15-24 years) and their knowledge and attitude to wards STDs and HIV was done in Awassa in then 1995 . Most of the ( 94.4%) of study subjects knew about STDs and HIV/AIDS where as a lesser proportion of them ( 5.6%) knew common STDs other than HIV/AIDS. 49% of respondents claimed to have started sex before study date , 27.6% reported condom use during their most recent coitus. A study of awareness of STDs/ AIDS and their preventive method across sectional survey of 305 summer students attending jimma teachers training college was conducted form 15 July to 5 October 1998 E.C , 46.3% of respondents have knowledge about STDs and their applications 65,4% have knowledge about AIDS . A majority of the students (88.4%) believed that STDS/AIDS is a serve as said and the most series diseases facing the country at the present. The respondents are aware that AIDS/STDs transmitted by sexual route, majority (96.3%) know that it is transmitted through blood contact and 86.4% know that predispose to HIV infection, history of sexual partner (multiple) and history of repeated STDs are found to be present in 6.3% and 80% respondents respectively. In general respondents had inadequate knowledge about different type of STDS. (1).

16

According to background characteristics of Ethiopia, 2000, 37% of women and 90% of men in Ethiopia have no knowledge of STDs, and once in two men with STI, or associated with didnt seek medical advice, Surveillance also show that 54% of men with STI, or associated symptom dont inform their partner. A descriptive quantitative cross sectional study carried out to assess KAP to ward STDs among high school students of Shashemene town from may to June 2007. Out of a total 353 (male 241, Female 112) students majority (91%) of students have heard of STD. The major source of information for STDs, related information for students is school teachers (79%) and electro media such as television (71%), student mentioned sharing of sharp object (80.3%) and receiving transfusion of infected blood (75.2%) a major route of transmissions. Majority (79%) of respondents believes that STDs are preventable, Almost half (49%) of students mentioned faith fullness as a method of STD prevention, condom use (45%) and abstinence (40%) were the next major method of STD prevention (1).

About (41%) of the students admitted that they had sexual intercourse in the past, while the remaining (59%) of high school students reported they didnt have had sexual intercourse in the past. There age at the time of sexual debut was between 15 and 19 years of age. Another cross sectional study was carried out to determine KAP about STDs /HIV/AIDS among employees of Jimma towns from June to February 2001. Out of 520 government employees 502 (98.6%) of respondents are knowledge about STDs /HIV/AIDS. But very few (26.1%) those with un safe practice considered them serves to high risk for acquiring STDs and HIV and more than of respondents had favorable response to most of the attitude statement (1).

A ST1s is useful marker for un protected sex and also as a co-factor for HIV transmission. The 2005 EDHS reports quite low rates of STIs prevalence among those ages 15-19 and 20-24. Sexually active girls ages 15-19 are three times (1.4%) more likely to report an STI than sexually active boys in the same age group (0.5%). Thus young girls are at increased risk of contacting STI, as they probably engage in unprotected sex due to the limited control they may have over their sexual lives. (3).

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1.5. Objectives

1.5.1. General objective

To assess the Knowledge, Attitude and Practice of adolescent toward sexually transmitted disease.

1.5.2. Specific objectives

To assess knowledge toward sexually transmitted disease in adolescent in Bodditti high school.

To assess attitude toward sexually transmitted disease in adolescent in Bodditti high school.

To assess practice toward sexually transmitted disease in adolescent in Bodditti high school.

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UNIT TWO
2.1. Methodology
2.1.1. Study area

Boditti is a town which was established in 1945 E.C. The town is 370 kms far from Addis Ababa, 142, km far from Awassa and 10 kms far from Sodo. It is a woreda town in Wolita zone Damot Gale Woreda which have two Kifle ketemas misrak and mirab with a total of five kebeles.

The climatic condition of Boditti is woniadega with an altitude of 1975 meters above sea level. The average annual rainfall and the average daily temperature is 930.8 mm and 19.110C respectively.

Based on the information from the recent census, the town have a total population of 27,486 person having 13,468 male population and 14,017 female population. And the male to female population ratio is about 1:1

Many of the services including educational activities, economical sources, infrastructure services, water supply and sanitary services are some what sufficient to the inhabitants in the town.

The potential health converge of the town is about 90%. There are some health institutions in the town including one health center, three health posts and six pharmacies. But there is no hospital in the town.

The health center was established in 1991 E.C as clinic but it is currently widened and found as a health center. It is setted in both administrative and technical arrangement that give many services to the community with the available infrastructures.

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2.1.2. Study period

The study period was range form April June 2001 E.C.

2.1.3. Study design This Study used descriptive quantitative cross sectional method 2.1.4. Target population
All adolescent the high school student in Boditti town.

2.1.5. Study population

Those high school students in the age group of 15-19 years who are include in the study Boditti. 2.1.6. Study subject /unit Single high school students whose it is 15-19 years.

2.1.7. Sampling Size 384 students

2.1.8. Sampling frame list of students from the registrar 2.1.9. Sampling methods
A multi stage sampling method was used; first a probability stratified proportionate sampling method was used. By using this percentage is calculated in relation to size of students in each class to know the studied needed out of total 384 sample students. Secondly, systematic random sampling method is used to select the sample student needed in the class by calculating K, K=N/n=5445/385=14.

The first sample student was selected by closing the eye and dot on the sample frame by sharp pencil then every K th student was selected.

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2.1.10. Sampling size determination

The sample size is determined by the formula n= Z2 P(1-P) d

2

where:- n- sample size P- Proportion = 50% Z- Significance level (95%) d- 0.05 ( margin error )

By calculating by the above formula the sample size 384 adolescent

2.1.11. Sampling criteria

2.1.11.1. Inclusion criteria Those adolescent high school students with the age group of 15 to 19 were included in the sample. If the sample is absent the students before or after the sample was selected. Volunteers.

2.1.11.2. Exclusion criteria Those who are not full filled the inclusion criteria.

2.1.12. Study variables

2.1.12.1. Independent variables Age , sex, , religion , educational status ,ethnicity, place of living. 2.1.12.2. Dependent variables Knowledge Attitude Practices

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2.1.13. Method of data collection

A structured, standardized, self administered questionnaire which is modified contextually was used to assess KAP of adolescent to ward STD in Bodity high school. During preparation of our questionnaire we will tried to fellow the logical order from simple to complex and put sensitive question at the end of the questionnaire. During data collocation was tried to show good approach to get the required information.

2.1.14. Data management

We gave great care not to miss any information during data collection. The data collected was tally in each work day for the chosen variables and cheek for its completeness and consistency. After finishing the process of tallying for each variable the data will be analyzed by using scientific calculator and manually by group members. We presented our findings by using descriptive statistics, averages, percentages graphs, charts and tables.

2.1.15. Data analysis

The data was analyzed by using pencil, paper and scientific calculator. Descriptive statistics was used to illustrate the socio- economic and demographic sties of the study population. The response of respondent for the questions, which assess their knowledge, attitude and practices to ward sexual health (STDS), was calculated.

2.1.16. Ethical consideration

First letter was written from CBE office to the school of nursing, the school of nursing to the director of Bodiiti high school before the day of data collection. Then the director introduce to all community in the school.

2.1.17. Operational definition Knowledge- level of educational difference about the mode of transmission, sign and symptoms and way of prevention as well as control.

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Attitude- the value of adolescent to ward STDs, Adolescent- people in age group of 15 to 19 Investigator those individual who perform the research Other- those possibilities other than the listed choice. Good knowledge Answering >75% of the knowledge question.

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UNIT THREE
3.1. Result 3.1.1. Sociodemographic characteristics
All of the selected sample students 384 (100%) filled the self administered questionnaire properly. So that the non response rate is zero.

Table. 1. Sociodemographic characteristics of Bodditti high school students in may 2001E.c.

S.No. 1 Categories of characteristics Sex Male Female Age 10-14 15-19 20-24 25-29 Ethnicity Wolayita Amhara Sidama Oromo Gedieo Other Religion Orthodox Protestant Muslim Other Place of living Relative house Rental house Family house Other Supporter of the student Parent Brother/Sister Other relative Self supporter No. 384 220 164 384 165 195 22 2 384 314 25 22 3 4 16 384 103 195 27 59 384 74 75 219 16 384 210 53 23 50 % 100 57.3 42.7 100 42.97 50.78 5.73 0.52 100 81.70 6.50 5.70 0.80 1.04 4.40 100 26.80 50.78 7.03 15.40 100 19.30 19.50 57.00 4.20 100 54.68 13.80 5.99 14.58 Remark

24

10

11

12

13

14

Voluntary organization Other Educational level of father Literate Illiterate Only write and read Educational level of mother Literate Illiterate Only write and read Father occupation Farmer Merchant Teacher Day worker other Mother occupation Farmer Merchant Teacher Day worker other Current grade level 9th 11th School drop YES No Grade level of school drop 9th 10th 11th Below 9th Rank in class 1-3 4-5 6-10 11-15 >15

30 20 384 180 90 114 384 158 108 118 384 170 70 88 26 30 384 73 100 73 70 68 384 266 118 384 134 250 142 93 9 13 27 384 73 56 98 74 82

7.80 5.20 100 41.15 28.13 30.72 100 46.88 23.44 29.69 100 44.27 18.23 22.90 6.77 7.80 100 19.01 26.04 19.01 18.23 17.70 100 69.27 30.73 100 34.90 65.10 100 65.50 6.30 9.20 19.00 100 19.01 14.58 25.52 19.53 21.35

As indicated in the table above 220 (57.3%) of the total sample are male students, 195(50.78%) are from the age 15-19 years, 314(81.70%) of students are 25

Wolayita by ethnicity, 195(50.78%) Protestant by religion, 219(51.00%) of sample student live in family house, 210(54.68%) sported by parents, 180(41.15%) of student educational liver father is literate, 250(65.1%) of students have no school drop. Farther information see the above table.

3.1.2. KNOWLEDGE
From the student included in the sample 320 (83.33%) heard about STDs but 64 (16.67%) not heard about STDs.

70% 60% 60% 50%

Percentage (%)

Keys Radio/TV School Teacher 25% 20% Other source

40% 30% 20% 10% 10% 0% Radio/TV School Teacher Other source source of information

Fig 1.Source of information for students about STDs in Boditti high school students in May 200E.c. As indicated above figure 60% of the source of information about STDs for the student radio /TV source.

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Out of 384(100%) sample students who fill the self administered questionnaire 306 (79.69%) know the sign and symptom of the STDs and 78(20.31%) not know about sign and symptom STDs.336 (87.50%) know the route of transmission of STDs and

48(12.50%) not know the route of transmissions. Table.2. Assessment of knowledge toward STDs in Boditti high school students in May 2001 E.C.

S.No. Categories 1 Route of transmission of STDs Sexual intercourse Contact with contaminated blood Contact with contaminated needle Heredity Breast feeding Other 2 Sign and symptom of STDs in female Abdominal pain Vaginal discharge Burning pain on urination Reddeness in genital area Swelling in genital area Genital ulcer Genital wart Blood in urine Loss of weight In ability to give birth Other 3 Sign and symptom of STDs in male Abdominal pain Burning pain on urination

No.

Remark

234 101 70 22 39 12

61.1 26.5 18.3 5.7 10.2 3.5

78 158 138 45 44 37 22 35 54 38 8

20.1 41.3 36.2 12.4 11.5 9.6 5.7 9.1 14.1 10.1 2.1

89 72

23.2 18.7

27

Urethral discharge Reddeness in genital area Swelling in genital area Genital ulcer Genital wart Blood in urine Loss of weight In ability erect Other 4 Method of prevention of STDs Abstain from sex Use condom Limit sex to one partner Avoid sex with prostitutes Avoid sex with person who have many sexual partner Avoid sex with homosexuals Avoid blood transfusion Other 5 Curable STDs Gonorrhea Syphilis AIDS Genital warts Trichomoniasis Genital herpes Candidiasis Other

93 29 28 33 26 77 55 30 19

24.2 7.4 7.3 8.6 6.8 20.1 14.3 7.8 5.0

83 158 80 48 69 28 43 16

22.0 41.1 21.0 12.5 18.0 7.3 11.2 4.2

127 121 73 57 57 39 43 16

33.0 31.5 19.0 14.8 14.8 10.2 11.2 4.2

At observed in the above table 234(61.1%) of sample students Said STDs transmitted through route of sexually inter course, 158(41.3%) of the sample students said vaginal

28

discharge is the sign and symptom of STDs in female, 93(24.2%) said that urethral discharge is sign and symptom of STDs male. For further information you can see the above table.

278(72.39%) say yes, 65(16.94%) say no, and 41(10.63%) say not know for the question that the use of condom decrease the transmission of STDs. For the question presented to the sample students about knowledge that decreasing sexual partner

decrease the chance to be infected by STIs 259(67.45%) say yes ,66(17.19%) say no ,and 59(15.36%) say not know.227(72.66%) students say that a person can do to avoid getting infected by STDs,46(11.98%) say nothing can do and 59(15.36%) say not

known. For the question about knowing of curable STDs 247(64.33%) say yes, 100(26.04%) say no, and 37(9.63%) say not known

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3.1.3 Attitude
Table .3.Assessment of attitude of Boditti high school student toward STDs in May 2001 E.C.
S. No 1 Categories What do you think about STDs? A. It is disease B. It s a curse C. It is a syndrome D. Other 2 Do you think that STDs are more prevalent in the community? A. Yes B. No 3 Do you think that STDs can be transmitted through methods other than sexual intercourse? A. Yes B. No 4 Do you think that adolescents are more exposed to STDs? A. Yes B. No 5 Do you think that STDs can be transmitted in homosexual? A. Yes B. No 6 Do you think that a person with STD can easily be identified from the community? A .Yes B. No 227 157 59.11 40.89 216 168 384 56.25 43.75 100.00 271 113 384 70.57 29.43 100.00 252 132 384 65.62 34.38 100.00 30.2 82 384 78.65 21.35 100.00 238 58 81 28 384 61.9 15.1 21.1 7.3 100.00 No % Remark

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7.

Do you think that STDs increase the risk of acquiring HIV /AIDS? A. Yes B. NO

384

100.00

255 129 384 209 115 384 295 89 384

66.40 33.49 100.00 70.05 29.95 100.00 76.82 23.18 100.00

Do you think that STDs are preventable? A. Yes B. No

Do you think that condom prevent STDs? A. Yes B. No

10

Do you think that health education can reduce transmission of STDs? A. Yes B. No

292 92 384

76.04 23.96 100.00

11

Do you think that having single sexual partner can prevent STDs? A. Yes B. No

277 107 384

72.13 27.97 100.00

12

Do you think that persons who have got STDs go to health institution for treatment? A. Yes B. No

254 330 384

66.15 33.85 100.00

13

Do you think that STDs can cause social stigma and discrimination? A. Yes B. No

255 129

66.40 33.49

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3.1.4. Practice
From 384 students, 247 (64.32%) know a person who is sick by STDs and the rest 137(35.68%) not know a person who is sick by STDs.

50 45 40
Percentage (%)

45

35 30 25 20 15 10 5 0 Home treatment Surgery in Medication Hopsital in health center Other 10 Home treatment 25 20 Surgery in Hopsital Medication in health center Other

Fig.2. Mode of treatment for known individuals who were sick by STDs by Boditti high school student in May 2001 E.C. As observed in the above graph 45% sample students said that percent who is sick was treated in by medication in health center.

From sample students 229(59.63%) of student had history of sexually transmitted infections and 155(40.37%) had no history of STIs. From those students who had history STIs 204(49.88%) was treated at home, 164 (40.09%) was treated at health institution and 41(10.03%) was treated at other place. Out of those students who had history of STIs and treated at home, 75 (52.45%) was treated by animal product, 27(18.88%) was treated by root 23(16.08%) was treated by stem bark and 18(12.59%) was treated by leaf.

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11.63%

Only female 52.59% 23.32% Only male Both

Fig .3. Use of Condom for a person who is at risk for having STDs in Boditti high school students in May 2001.E.C.

25.50% As avaibable 52.59% Alw ays sometimes 21.90%

Fig.4 .Frequency of condom use for a person who is at risk for having STDs in Boditti high school students in May 2001 E.C.

33

Table.4. Assessment of practice to ward STDs in Boditti high school students in May 2001 E.C.
S.No Categories 1 Did you have history of sex? Yes No Sexual partner Girl /boy friend Class fellow students Prostitute Teacher Unknown person Other Place of sexual commitment Street School House Hotel Other The reason for committing sex Peer pressure Girl/ boy friend pressure Sexual imitation because of age Economical gain Other What do you taken for person who is at risk for having STDs? Advice for abstinence from sex Advice for to be being faith full Advice to use condom Advice to wash his/her genitalia before sex Advice to decrease sexual partner Other What was your plan in the future? Abstinence Being faith full Using condom Other No 384 190 194 106 46 18 15 27 13 22 69 59 57 14 51 46 80 36 11 % 100 49.5 50.5 27.6 12.0 4.7 3.9 7.03 3.1 5.7 18.1 15.4 14.7 3.65 13.3 12.1 20.8 9.4 2.9 Remark

101 86 177 71 54 25 54 76 60 15

26.3 22.1 46.1 18.5 14.1 6.5 14.1 19.8 15.6 3.9

6.

As observed in the above table, 190 (49.5%) have history of sexual intercourse, 106 (27.6%) commit sex with girl /Boy friend, 69(18.1%) commit sex in the school, for further information observe the above table.

34

Table.5.Association of Socio-demographic characteristics and history of sexual intercourse in Boditti high school students in May 2001 E.C.
S.No. Sociodemographic characteristics 1 Sex Male Female Total 2 Age 10-14 15-19 20-24 25-29 Total 3 Ethnicity Wolaiyta Amhara Sidama Oromo Gedieo Gurage Other Total 4 Religion Orthodox Protestant Muslim Other Total 5 Place of living Relative house Rental house Family house Other Total 6 Current grade 9th level 11th Total history of sexual intercourse Yes(Expected) No(Expected) 105(112) 104(97) 100(93) 75(82) 205 197 20(23) 20(17) 168(165) 126(128) 25(25) 20(20) 3(2) 1(2) 216 167 178(184) 147(140) 17(13) 6(10) 7(7) 6(6) 1(0.6) 0(0.4) 1(1) 1(0.9) 2(1) 0(0.9) 12(10) 6(8) 218 166 71(57) 36(47) 92(101) 98(84) 11(11) 10(9) 30(29) 25(24) 204 169 42(42) 38(38) 43(42) 107(107) 12(7) 204 140(145) 69(64) 209 37(38) 94(94) 2(7) 180 126(121) 49(54) 175 Total X2Value 209 2.065 175 384 40 2.005 294 45 4 384 325 6.73 23 13 1 2 2 18 384 107 9.32 190 21 55 384 80 7.19 80 201 14 384 266 118 384 Df P-Value 1 P=0.1 (p>0.05) P=0.1 (p>0.05 Remark

P=0.1 (p>0.05

P=0.025 (P<0.05)

P=0.05 (P=0.05)

1.226

P=0.1 (p>0.05

35

Table.6. Association of Soicodemographic characteristics and history of STDs Boditti high school students in May 2001 E.C.
S.No. Sociodemographic characteristics 1 Sex Male Female Total 2 Age 10-14 15-19 20-24 25-29 Total 3 Ethnicity Wolaiyta Amhara Sidama Oromo Gedieo Gurage Other Total 4 Religion Orthodox Protestant Muslim Other Total 5 Place of living Relative house Rental house Family house Other Total 6 Current grade 9th level 11th Total history of STDs Yes(Expected) 115(123) 111(103) 226 26(24) 173(175) 28(27) 2(2) 229 200(190) 16(13) 3(8) 0(0.6) 1(0.6) 1(0.6) 4(10) 224 66(63) 122(112) 8(12) 31(33) 227 46(47) 60(53) 118(120) 8(7) 232 147(145) 63(65) 210 Total X2Value No(Expected) 94(86) 209 2.71 64(72) 175 158 384 14(16) 40 0.606 121(118) 294 17(18) 45 2(2) 4 154 384 125(135) 325 22.13 7(9) 23 10(5) 13 1(0.4) 1 1(0.4) 1 1(0.4) 1 14(8) 18 159 384 41(41) 107 6.707 68(73) 190 13(8) 21 25(21) 56 147 384 31(31) 77 2.27 34(35) 88 80(78) 198 7(5) 12 152 384 119(121) 266 0.19 55(53) 118 174 384 df P-Value 1 P=0.1 (p>0.05) P=0.1 (p>0.05 Remark

P=0.005 (P<0.05)

P=0.05 (P=0.05)

P=0.1 (p>0.05

P=0.1 (p>0.05

36

Table.7.Association of knowledge towards STDs, and sex in Boditti high

school student in May 2001 E.C.

No 1 Categories Routes of transmission of STDs Sexual intercourse Contact with contaminated blood Contact with contaminated needle Heredity Breast feeding Others Signs and symptoms of STDs in female Abdominal pain Vaginal discharge Burning pain on urination Readiness in Genital area Swelling in the genital area Genital ulcer Genital wart Blood in urine Loss of weight Inability to give birth Other Signs and symptoms of STDs in male Abdominal pain Burning pain on urination Urethral discharge Redness in genital area Swelling in genital area Genital ulcer Genital wart Blood in urine Loss of weight Inability to give birth Others Modes of prevention of STDs Abstain for sex Use of condom Limit sex to one partner Avoid sex with prostitutes Avoid sex with person who have many sexual partner Male No 131 54 35 10 14 4 63 51 67 25 22 24 19 51 39 21 11 65 77 34 22 26 30 15 41 36 22 10 41 65 40 27 31 % 52.82 21.77 14.11 4.03 5.65 1.61 16.03 12.98 17.05 6.36 5.59 6.11 4.83 12.98 9.92 5.34 2.79 17.19 20.37 8.99 5.82 6.88 7.94 3.97 10.85 9.582 5.82 2.65 16.01 25.39 15.63 10.54 12.11 Female No 107 47 37 10 17 3 46 54 42 28 23 20 16 48 25 12 9 38 99 27 32 24 23 14 35 25 26 14 38 75 40 21 29 % 47.14 20.7 16.3 3.61 7.49 1.32 14.24 16.72 13.01 8.67 7.12 6.19 4.95 14.86 7.74 3.71 2.79 10.64 27.73 7.56 8.96 6.72 6.44 3.92 9.80 7.01 7.28 3.92 15.70 30.99 19.53 8.68 11.98

37

Avoid sex with homosexuals Avoid blood transfusion Others Which of the following STDs is curable Gonorrhea Syphilis AIDS Genital warts Trichomoniasis Genital herpes Candidiasis Others

18 25 9

7.0 3 9.76 3.53

14 17 8

5.79 7.02 3.31

47 39 36 23 24 17 11 4

23.38 19.40 17.91 11.44 11.94 8.46 5.47 1.99

56 55 26 42 22 19 16 7

23.04 22.63 10.69 17.28 9.05 7.82 6.58 2.88

Table.8.Associations of cause for sexual commitment and sex in Boditti high school student in May 2001 E.C.
S.No. Cause of sexual commitment Male No 1 2 3 4 5 Peer pressure Girl /Boy friend pressure Sexual initiation because of age Economical gain Others 19 23 23 15 4 % 22.62 27.38 27.38 17.86 4.76 Sex Female No 17 29 40 14 6 % 10.04 27.36 37.73 13.59 5.66 Remark

Table.9.Association of place of sexual commitment and sex in Boditti high school student in May 2001 E.C.
S.No. Place of sexual commitment Male No 1 2 3 4 5 Street School House Hotel Other 13 30 27 17 12 % 13.14 30.30 27.27 17.17 12.12 Female No 15 44 29 25 7 % 12.93 37.93 25.00 18.10 6.04 sex Remark

38

3.2. DISCUSSION
Socio demographic characteristics (sex) of sampled population indicate that male are almost one and half times that of female.

The majority have heard about STDs from different source of information. The major source of information are electronic media such as television and radio (60%), school teacher (30%) and other (10%). A cross sectional study to assess KAP towards STDs among high school students of shashemene town shows that, the major source of information about STDs, and related issues for students was school teachers( 79%) and electronic media 71% this because of student in boditti town have available electronic media in their house .

A cross -sectional survey conducted on 305 summer students attending Jimma teacher training collage shows that, majority of the students (96.3%) believed that STDs

including is AIDS transmitted through contaminated blood (89.5%) unprotected sexual contact and (80.3%) thorough sharing of sharp objects A study of awareness of

STDS/AIDS and there prevention method across sectional survey 305 summer students attend jimma teacher training collage was conducted from 15 July to 5 October in 1998 E.C The majority of students (96.3%) believed that STD transmitted through un protected sexual contact (89.5%) sharing of sharp object (80.3%). In our survey, 234(61.1%) of the study participant believed that STDs transmitted through sexual intercourse, 101(26.5%). By contact with contaminated blood and 70(18.3%) reported contact with contaminated needle. The gap of knowledge of transmission of STDs happened due to teaching organization like religious, Ngos may focus on sexual intercourse due to fearing of current issue HIV/AIDS in boditti town.

A descriptive quantitative cross sectional study carried out to assess KAP toward STDs among high school student of shashemene town form May to June ( 1997 E.C) indicate

39

that, the majority 79% of respondents believes that STDs are preventable. Almost half (49%) of students mentioned faith fullness as method of prevention, condom use (45%) and abstinence (40%). in our study 209 (70.05%) of the sample student believe that STDs is preventable. The majority of participant reported as use of condoms 158 (30.1%), abstain from sex and limit sex with one partner 83(15.8%).

In our study 27(70.50%) of the total sample student believes that adolescent are more exposed to STDs. This it may be due to self experienced of disease by oneself, absence of health education, due to knowledge gap about sign and symptom, mode of transition, method of prevention less involvement of the topic about STDs in high school lesson and other factor.

About 49.5% of student admitted that they had sexual intercourse in the past, while the remains (51.5%) of high school student didnt have had sexual intercourse in the past. the age at time of sexual debut majority of them are in b/n 15 and 19 years of age. From this sexual active girl age 15-19 who had history of sex reported, almost the same result of STI; girls (18.5%) to that of male (17.7%) of same age group. But, EDHS (2005) reported that sexual active girls age of sample 15-19 are three times more likely to report STI than sexual active boys of same age. This probably due to increase of teaching on this area, working non-governmental organization, religious organization etc.. to increase awareness of female and to control their limited control of sexual lives in the past.

Most of the students 204(49.88%) who had history of STDs was treated at home. This may because of less affordability of the health service activity, poor economy of parent , poor attitude toward modes of treatment method such as at health institution absence or poor health education to ward STD at school at community and may be due to culture that is not to exposed means freeing not to expose genital area .

In our study, from the total sample size of 384 students 142 of them have committed sexual intercourse and developed STDS. But the number of students who have history of

40

STDs with out having history of sexual are about 86, in this study, the number of students who have committed sex and didnt develop STDs are 58 which is less than the number of student who have no history of sex as well as STDs, which accounts 98 of the total sample.

As indicated in table 6.sex,age, place of living and current grade level have no associociation with history of STDs because P-value(0.1) is greater than confidence interval and religion have also have no association with the history of STDs in the students because the P-value is equal to the confidence interval. As also in table 5.sex, age, ethnicity and current grade level have no association with the history of sexual intercourse because P=-value(0.1) is greater than and place of living have no

association with history of sexual intercourse because P-value(0.05) equals to the confidence interval .This implies that these variables has no contribution to exposure of sexual intercourse and STDs but religion have an association with sexual intercourse and ethnicity have an association with the history of STDs because P-value is less than the confidence interval the P-value 0.025 for religion and 0.005 for ethnicity. P-value is calculated by using X2- chart and by calculating the expected value of each observation..

41

3.3. CONCLUSION
Religions have an association with history of sexual intercourse. That means students of protestant religion start sex age than other or student of orthodox religion start early or student of Muslim religion start early. But religion has no association with history STDs, this means that student of protestant religion orthodox religion and Muslim have equal chance to the history of STDs. This is may be due to variation of identification of risk during sexual intercourse from religion to religion, knowing of sign and symptom of the disease knowing of method of prevention and safe application of this and others.

On scientific back ground STDs is transmitted around 100 % by sexual intercourse but in our finding only 234(61.1%) of the sample student sexual intercourse is the route of transmission of STDs. This gap occurred may be due to concern of different sector like non governmental organization, religions organization, school organization toward our current problem HIV/AIDS and involvement is STDs.

When we compared our study with the study conducted on STDs in Shashemene high school students there is variation on the percentage of respondents about the

preventability and mode of prevention of STDs. This variation may be occur due to difference of teachers educational back ground and educational level, the variation of student talent to read and egearity to know more, the involvement of topic about STDs in related biology subjects, the community attitude towards STDs, other factors like knowledge toward each mode of prevention, the availability of health education in the community and others. In our find from the sample respondents 86 of the student have history of STDs with out having history sexual intercourse and 58 of student with having a history of sex have no history of STDs. On the scientific ground the most common route of transmission is sexual intercourse but our finding shows there is other thing behind this that expose to STDs with out sexual intercourse and not developing STDs with sexual intercourse. So may concerned body who wants to identify or know this factor can able to do other study on this area.

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3.4 LIMITATION
Shortage of stationary Language barrier Shortage of time

3.5. RECOMMENDATIONS

Based on the finding of study, the following recommendation can draw to decrease the risk and transmission of STDs in high school youth students.

To the high school

Continuous education and awareness activity should be considered for example, health education.. The educational approaches have to entertaining and appealing of the interest of the youth. Some creative mode of teaching like competitive question and answer session, drama and play writing, music etc can be employed. Establishing and strengthening clubs like ACA and giving education related to STDS is also mandatory.

To CBE coordinating office

We would like to recommend to college as health science that research program should not be with TTP.

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4.1. BUDGET PLAN

Table.10. Budget required for undertaking the research proposal in May 2001E.C.

No

List of items

Unit

Required in number

Cost per unit Birr 2 15 2 Cent 0.25 0.05 00 00 Birr 11 13 75 10

Total Cent 0.25 -

1 2 3 4

Pen ( Blue) Dot pencil Binder Pencil sharper ( hard)

Pieces Pieces Pieces Pieces

5 6 5 5

Paper ( nova, 80mg)

gram

80

80

00

80

6 7

Ruler To prepare questionnaire

pieces

2 2

00 0.45

2 1032

8 9

For transport To print final report 50

20 3

00 00

100 150

10 11

To bind the report For data collector coffee Tec, coffee 5

10 10

00 00

10 50

12

Grand total cost

1463

0.25

44

4.2. WORK PLAN

Table .11. Work plan for the study conducted in May 2001 E.C.
Activity Responsibility
WK1

April
WK2 WK3 WK4 WK1

May
WK2 WK3 Wk4 WK1

June
WK2 WK3 WK2

I. Protocol development for School preparation and collection II. Pretest III. Data collection Investigator and Investigator for data nursing

of

arrangement for analysis IV. Data Analysis and Group member

interpretation V. Report writing first draft VI. Final\l drift writing VII report VIII. Presentation of the finding in research submission of final Group member

presentation to the dept

45

REFERENCE
1. Solomon Ashagre et. al. Un published source, Hawassa University college of health science Health officer students .number one. 2007. 2. National adolescent and youth reproductive Health strategy : 2007-2015 3. Marrazzo, Jeanne M. Sexually transmitted infections Microsoft R Encarta R 2007 ( DVD), Remond, WA, Microsoft corporation, 2006 4. Center for Disease Control and prevention. Microsoft R Encarta R 2007 (DVD) . Remond, WA: Microsoft Corporation, 2006.

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Annex HAWASSA UNIVERSITY COLLEGE OF HEALTH SCIENCE SCHOOL OF NURSING

Name of Investigator ___________________________ Date __________________________ Signature ______________________ Name of Supervisor ________________

Dear respondents!
We, final graduating students, needs information to ward STDs sexually transmitted diseases to do a research. This research result only indicate to these sexually transmitted disease and generalization is made only to this high school. The questionnaire take only 15-30 minutes to answer. So we need your genuine co-operation. Every information keep confidentiality, no one observe except the investigator /data collector. If you require any clarification do not hesitate to ask the investigator assigned for you. If you agree by this encircle yes , it you are not agree encircle No. Yes No

Thank you for your genuine co- operation!!

May 2001/9 Ethiopia

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1.a Questionnaire on Sociodemogtaphic characteristics

1. Sex __________ A Male B. Female 2. Age ___________ 3. Ethnicity A. Wolayita B. Amahara C Sidama D. Oromo E Gedioe F. Gurage G. Other (specify) 4. Religion A. Orthodox B. Protestant C. Muslim D. Other (specify) 5. Where do you live? A. In relative house B. In rental house C. In family house D. Other (specify) 6. Who supports you? A. Parent B. Brother /sister C. Other relatives D. Self supporter E. Voluntary organization F. Other (specify)

48

7. Educational level of father A. Literate B. Illiterate C. Only write and read D. Other (specify) 8. Educational level of Mother A. Literate B. Illiterate C. Only write and read D. Other (specify) 9. Father occupation A. Farmer B. Merchant C. Teacher D. Day worker E. Other (specify) 10. Mother occupation A. Farmer B. Merchant C. Teacher D. Day worker E. Other (specify) 11. Current grade level A. 9th B. 11th 12. Did you have any school drop? A Yes B. No 13. If Yes in Q#6, at which grade level ? A. 9th B. 10th C. 11th D. below 9th

49

14. Rank in class A. 1-3 B. 4-5 C. 6-10 D. 11-15 E. >15

1.b Questionnaire to asses knowledge

1. Do you heard about sexually transmitted disease? A. Yes B. No 2. If yes, what is the source of information? A. Radio /TV B. School C. Teacher D. Others (specify) 3. Do you know about sign and symptom of sexually transmitted disease? A. Yes B. No 4. If yes, which of the sign and symptom in female? A. Abdominal pain B. Vaginal discharge C. Burning pain on urination D. Redness in genital area E. Swelling in genital area F. Genital ulcer G. Genital wart H. Blood in urine I. Loss of weight J. Inability to give birth H. Other (specify)

50

5. Which of the sign and symptom in male A. Abdominal pain B. Burning pain an urination C. Urethral discharge D. Redness in genital area E. Swelling in genital area F. Genital ulcer G. Genital wart warts H. Blood in urine I. Loss of wt J. Inability to erect (impotence) K. Others (specify) 6. Do you know that the use of condom decrease the transmissions of sexually transmitted diseases? A. Yes B. No C. Not know 7. Do you know that decreasing sexual partner decrease the chance to be infected by sexually transmitted diseases? A. yes B. No C. Not know

8. Do you know the route of transmission for sexually transmitted diseases? A. Yes B. No

9. If yes, which of the following are the right route of transmission? A. Sexual intercourse B. Contact is contaminated blood C. contact with contaminated needle

51

D. Heredity E. Breast feeding F. Other ( specify )

10. Is there any thing a person can do to avoid getting infected by sexually transmitted Diseases? A. Yes B. No C. Not know

11. If yes, what a Person can do? A. Abstain form sex B. Use condom C. Limit sex to one partner D. Avoid sex with prostitutes E. Avoid sex with person who have many partner F. Avoid sex with homosexual G. Avoid blood transfusion H. Others ( specify ) 12. Do you know any curable STDs? A. Yes B. No C. Not know 13. If yes, which of the following is curable? A. Gonorrhea B. Syphilis C. AIDS D. Genital warts E. Trichomoniasis F. Genital herpes G. Canididiasis H. Others ( specify)

52

1.c Questionnaires to Assess Attitude

1. What do you think about STDs? A. It is a disease B. It is a curse C. It is syndrome D. Others ( specify)________________

2. Do you think that STDs are more prevalent in the community?

Yes
intercourse ?

No No

3. Do you think that STDs can be transmitted through methods other than sexual?

Yes

4. Do you think that Adolescent are more exposed to STDs?

Yes Yes Yes Yes

8. Do you think that STDs are preventable?

No No No No No No No

5. Do you think that STDs can be transmitted in homosexuals?

6. Do you think that persons with STDs can easily be identified from the community?

7. Do you think that STDs increase the risk of acquiring HIV/AIDS?

Yes Yes Yes

9. Do you think that condom prevents STDs ?

10. Do you think that health education can reduce transmission of STDs?

53

11. Do you think that having single partner can prevent STDs ?

Yes
treatment?

No

12. Do you think that persons who have got STDs can go to health institution for

Yes Yes

No No

13. Do you think that STDs can cause social stigma and discrimination?

1.d Questionnaires to assess practice

1. Do you know a person who is sick by STDs? A. Yes B. No 2. If Yes in Q#1, how he/she was treated ? A. Home treatment B. Surgery in hospital C. Medication in health center D. Cured by itself E. Other( specify) 3. Do you have a history of sexually transmitted infection? A. Yes B. No 4. If yes Q#3, how did you treat? A. Home treatment B. Health institution C. Other ( specify) 5. If Home treatment in Q#4, how did you treat? A. Animal product B. Root C. Steem D. Leaf E. Other ( specify)

54

6. What measure do you take for a person who is at risk for having STDs? A. Advice for abstinence form sex B. Advice for to be being faith full C. Advice to use condom D. Advice to wash his/her genitalia before sex E. Advice to wash his/her genitalia before sex F. Advice to decrease sexual partner G. Other ( specify) 7. If C for Q# 6, who use the condom? A. Only female B. Only male C. Both 8. How often he/she use? A. As available B. Always C. Some times 9. Did you have a history of sex? A. Yes B. No 10. If yes in Q# 9, what was your age at that time? 11. If Yes in Q#9, with whom? A. Girl friend/ boy friend B. Class fellow student C. Prostitute D. Teacher E. Unknown persons F. Other ( specify )

55

12. If Yes in Q# 9, where is the place? B. Street C. School D. House E. Hotel F. Other ( specify)

13. If Yes in Q#9, what was the cause? B. peer pressure C. Girl /boy friend pressure D. Sexual initiation because of age E. Economical gain F. Other ( specify)

14. If No in Q#9, what was your plan in the future? A. Abstinence B. Being faith full C. Using condom D. Other ( specify )

56