Strengthening Adolescent Sexual Health Literacy through Targeted Educational Interventions in German Secondary...

Adolescents are a key population in STI prevention, yet many lack foundational knowledge and access to reliable information. This study aimed to evaluate the impact of a targeted sexual health education lecture on knowledge about STIs and HPV vaccination as well as behavioral intentions in Bavaria, Germany. We conducted a prospective, anonymized survey with students from secondary schools across Bavaria. An online questionnaire was completed before (t = 1; n = 5,988) and after (t = 2; n = 4,739) a standardized, extracurricular sexual health lecture. Participants were aged 14-20 years (mean age 16.1), from diverse school types. Key outcomes included self-assessed knowledge, ability to explain specific STIs, awareness of the HPV vaccine, and willingness to receive the vaccination. Self-reported STI knowledge increased significantly: only 29.1% of students felt well-informed at baseline, compared to 85.96% after the lecture. The average number of STIs students could explain rose from 1.91 to 6.49 (p < 0.001). HIV/AIDS was the most well-understood STI pre-intervention (69.9%), rising to 89.3% post-intervention. Uncertainty about STI transmission decreased from 20.3% to 5.0%. HPV vaccine awareness increased from 75.1% to 95.3%. Among those not vaccinated, willingness to receive the vaccine significantly improved (mean score 2.95 to 3.53 on a 5-point scale, p < 0.001). A single, structured sexual health lecture significantly improved adolescent knowledge of STIs, reduced misinformation, and increased willingness to engage in preventive behaviors, including HPV vaccination. These findings support integrating educational interventions into broader public health strategies targeting youth to reduce long-term infection risks and promote informed decision-making.