What do young adult Italians know about STIs? Evidence from a national survey

Sexually transmitted infections (STIs) represent one of the major challenges for global public health. Across Europe, surveillance data indicate a concerning increase in cases of gonorrhea, syphilis, and chlamydia; in Italy, sentinel surveillance data similarly show an increase in overall STIs reports. Despite this alarming trend, the literature highlights poor awareness of STIs among the Italian population, particularly among young adults. This study aims to investigate the level of knowledge about STIs and protective behaviors among young Italians.

A questionnaire was administered to young Italians aged 16-30 years, residing in four Italian geographical areas (northwest, northeast, center, and south), in December 2023. The questionnaire included 14 items on STIs knowledge with response options "True," "False," or "I don't know." Knowledge was measured using a weighted continuous score and classified into four categories (low, moderate-lower uncertainty recognition, moderate-higher uncertainty recognition, high). Sexual behaviors and condom use were also analyzed.

A total of 2,576 young people responded to the questionnaire. Only 12.5% of participants achieved a high level of STIs knowledge, with an average weighted correct answer rate of 37.07%. Knowledge was significantly lower among males, younger individuals, and those with lower educational levels. Among the 1,653 young people who reported being sexually active in the past year, 33.8% reported always using condoms. The main reasons for non-use were: trust in their partner (40.5%), embarrassment (30%), and the fact that their partner disliked it (30.8%). Among those with high STIs knowledge, condom use remained low due to emotional-relational reasons.

The study highlights a low level of STIs knowledge among young Italians and insufficient condom use. The results suggest that increasing knowledge alone is not sufficient to modify behaviors: it is also necessary to address psychological, cultural, and relational barriers. Multidisciplinary interventions in schools, targeted information campaigns, and sexual and emotional education are recommended.