title: Risks and adverse outcomes of sexually transmitted diseases. Patients' attitudes and beliefs.
abstract: OBJECTIVE
  To determine women's awareness and level of understanding of the risks and sequelae of sexually transmitted diseases (STDs).
  
  
  METHODS
  The study was a cross-sectional survey of 103 women seen at an urban center. We recruited women from several clinical sites: (1) patients with signs or symptoms of an STD seen in a busy women's urgent care unit, (2) women enrolled in clinical studies for STDs or bacterial vaginosis, (3) patients admitted to the hospital and found to have an STD, and (4) women at high risk based on age and sexual activity. A trained female interviewer administered the survey to women agreeing to participate. The questionnaire assessed the patient's awareness of various STDs and their association with adverse outcomes. The survey also evaluated women's knowledge regarding STD prevention. Descriptive analyses were performed using SAS (Cary, North Carolina) on the 103 patients surveyed.
  
  
  RESULTS
  The median age of our survey population was 23, 66% were nonwhite, and 37% were on public assistance or uninsured. The population was at high risk for STDs based on the reported history of infection with Neisseria gonorrhoeae and Chlamydia trachomatis (6% and 38%, respectively). Of the 103 women surveyed, 33% had never heard of pelvic inflammatory disease (PID), and 79.6% could not identify any adverse sequelae of PID. Sixty-five percent were unaware that PID increases the risk of ectopic pregnancy, and 56.3% were unaware that it could result in chronic pelvic pain. When asked if they knew of any methods to prevent or reduce their risk of STDs, only 18% mentioned barrier contraception (condoms). Over 57% of respondents could not name a way to prevent STDs.
  
  
  CONCLUSIONS
  Increased educational efforts targeted at high-risk individuals are necessary to improve knowledge of STDs and their adverse sequelae. With greater knowledge and awareness, individuals and couples may be more likely to practice protective behaviors, such as reducing high-risk exposure, and to increase preventive measures, such as barrier contraception use.
authors.affiliation: Department of Obstetrics and Gynecology, Women and Infants' Hospital, Brown University School of Medicine, Providence, Rhode Island, USA. jpeipert@wihri
authors.forename: J L
authors.initials: JL
authors.lastname: Whiteside
authors.forename: T
authors.initials: T
authors.lastname: Katz
authors.forename: T
authors.initials: T
authors.lastname: Anthes
authors.forename: L
authors.initials: L
authors.lastname: Boardman
authors.forename: J F
authors.initials: JF
authors.lastname: Peipert
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology; D002692:Chlamydia trachomatis; D017280:Condoms; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income; D017057:Medically Uninsured; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology / Q000382:microbiology; D017699:Pelvic Pain; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000382:microbiology; D044469:Racial Groups; D012307:Risk Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications* / Q000517:prevention & control; D011795:Surveys and Questionnaires