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Influence of Sexual Health Education on Sexually Transmitted Infection Prevention Practices among Secondary School Students in Nigeria

Abstract

Sexually transmitted infections (STIs) remain an important public health concern among adolescents in Nigeria and may result in complications such as reproductive tract infections, infertility, adverse pregnancy outcomes, and increased vulnerability to HIV infection. Secondary school students are an important population for STI prevention because adolescence is a critical period for the development of sexual health knowledge, attitudes, and behaviours. Sexual health education provides students with accurate information about sexually transmitted infections, modes of transmission, signs and symptoms, prevention methods, safer sexual practices, condom use, testing, treatment, partner notification, and appropriate healthcare seeking. STI prevention practices refer to behaviours adopted by students to reduce the risk of acquiring or transmitting sexually transmitted infections, including abstinence where chosen, consistent and correct condom use, limiting exposure to risky sexual behaviours, STI testing, timely healthcare seeking, and appropriate adherence to treatment and prevention recommendations. In Nigeria, inadequate sexual health knowledge, misconceptions about STIs, peer influence, stigma, limited access to adolescent-friendly health services, and inadequate communication about sexual health may affect STI prevention practices among secondary school students. Effective sexual health education may improve students' knowledge, risk perception, decision-making, and adoption of appropriate STI prevention practices. Against this background, this study investigates the influence of sexual health education on sexually transmitted infection prevention practices among secondary school students in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Theory of Planned Behavior. The Health Belief Model explains preventive sexual health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding students' decisions to adopt STI prevention practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping adolescent sexual health behaviour. The Theory of Planned Behavior explains how attitudes, subjective norms, and perceived behavioural control influence students' intentions and subsequent preventive practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how sexual health education may influence STI prevention practices among secondary school students in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from students in selected secondary schools in Nigeria using a structured anonymous self-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, secondary schools, classes, and eligible students. Where feasible, selected schools or student groups will be assigned to intervention and comparison groups. Students in the intervention group will receive structured sexual health education covering common STIs, modes of transmission, signs and symptoms, prevention methods, safer sexual practices, correct and consistent condom use, STI testing, treatment, partner notification, stigma reduction, and appropriate access to adolescent-friendly health services. STI prevention practices will be assessed using indicators such as knowledge and adoption of appropriate prevention behaviours, condom use among sexually active students, STI testing where appropriate, avoidance of high-risk sexual behaviours, timely healthcare seeking for symptoms, and adherence to recommended treatment and prevention measures. Descriptive statistics will be used to summarize students' sociodemographic characteristics, sexual health knowledge, exposure to education, and STI prevention practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the influence of sexual health education on STI prevention practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that sexual health education has a significant positive influence on sexually transmitted infection prevention practices among secondary school students in Nigeria. Students exposed to structured sexual health education are expected to demonstrate improved knowledge of STI transmission and prevention, greater awareness of personal risk, stronger decision-making skills, and increased adoption of appropriate preventive behaviours. Education may improve condom-use knowledge and practices among sexually active students, encourage appropriate STI testing and healthcare seeking, reduce misconceptions and stigma, and strengthen students' ability to avoid behaviours associated with increased STI risk. However, education alone may not guarantee sustained preventive practices because students may continue to experience peer pressure, stigma, limited access to confidential health services, misinformation, social influences, and barriers to obtaining appropriate prevention resources. Consequently, sexual health education is expected to be most effective when supported by comprehensive school health programmes, trained teachers and counsellors, confidential adolescent-friendly health services, appropriate parental and community support, and accessible STI prevention and treatment services. The study is expected to contribute to the literature on adolescent sexual health, STI prevention, health education, school health, reproductive health, and public health in Nigeria by providing empirical evidence on the influence of sexual health education on STI prevention practices among secondary school students. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency (NPHCDA), state ministries of health and education, secondary school administrators, school health coordinators, counsellors, healthcare providers, development partners, and policymakers regarding strategies for strengthening STI prevention among adolescents. The study will also provide evidence-based recommendations for improving school-based sexual health education, strengthening adolescent-friendly STI services, increasing access to confidential counselling and testing, addressing misinformation and stigma, promoting appropriate prevention practices, and improving sexual health outcomes among secondary school students across Nigeria.

Keywords: Sexual health education, sexually transmitted infection prevention practices, secondary school students, adolescents, sexually transmitted infections, STI prevention, reproductive health, school health, condom use, health education, public health, Nigeria.