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Cologne – 60 percent of people over 16 in Germany are unaware of the human papilloma virus (HPV), and 40 percent of people are unaware of chlamydia. Miriam Gerlich presented the data from the representative survey conducted by the Federal Center for Health Education (BZgA) at the German STI Congress last Friday.

HIV and AIDS, on the other hand, are far more well-known, at 89 percent. More than 80 percent of those surveyed also knew about gonorrhea and syphilis. However, far fewer participants were able to spontaneously name the infectious diseases: while 56 percent of people spontaneously thought of HIV/AIDS, this was the case for syphilis and gonorrhea in just under 30 percent. Chlamydia and HPV, on the other hand, were only mentioned by eleven and six percent of people respectively.

“The new study shows that awareness that every sexually active person can potentially become infected with an STI is not sufficiently anchored in the population,” said Johannes Nießen, acting head of the BZgA.

Screening offers also unknown

Only 16 percent of participants were aware of the free chlamydia test for women under 25. However, the screening offer was somewhat more common in the target group of 16- to 25-year-old women: 43 percent knew about it.

For the “LIEBESLEBEN study – knowledge, attitudes and behavior towards sexual health and sexually transmitted infections (STIs)”, the BZgA surveyed more than 4,600 people aged 16 and over in December 2023 about their sexual health behavior and their knowledge of sexually transmitted diseases.

The HPV vaccination was also not very well known: while about a third of those surveyed did not know that girls can receive a free HPV vaccination, two thirds of those surveyed did not know that the same applies to boys.

This is also reflected in the low HPV vaccination rate: Compared to 2015, the rate in 2022 has fallen by 37 percent, according to the Barmer drug report published last week. The Professional Association of Gynecologists (BVF) then called for vaccination programs in schools, among other things.

Although condoms are the most commonly used contraceptive in Germany, only about half of those without a steady relationship who had sex in the past 12 months used condoms. A WHO study published last week reached a similar conclusion, recording a decline in condom use in recent years.

According to the BZgA survey, many people assume that they and their sexual partners are healthy. “When asked why they did not use a condom to protect against STIs during their last sex, 62 percent said ‘I am sure that we are both healthy’,” said Gerlich, a consultant in the Sexual Health, Prevention of HIV and other STIs department at the BZgA, the German Medical Journal.

In addition, some gynecological practices lack knowledge about billing for STI tests and refer patients to the health department. “We are currently working on an information package for medical practices,” said Gerlich at the congress.

Doctors play an important role in promoting sexual health and preventing STIs. “But the taboo surrounding STIs does not stop at doctors’ offices,” says Gerlich. Both patients and doctors are uncertain about talking about the topic.

Spreading knowledge about TikTok

“In addition to raising awareness of and removing the taboo surrounding STIs in the general population, the BZgA also specifically addresses young adults to illustrate the importance of protection against STIs and to inform them about services such as chlamydia screening,” said Nießen.

The BZgA is trying to raise awareness of STIs with various measures. For example, with the influencer campaign “#WissenWasRumgeht” on Tiktok and Instagram to raise awareness of chlamydia. The campaign has led to an increase in knowledge and more clicks on the liebesleben.de website, reported Gerlich.

According to Gunda Waldmann from LMU Munich, social media is the second most common source of information for schoolchildren. This is the result of a survey on knowledge about HIV and AIDS conducted between November 2023 and February 2024 among more than 2,000 schoolchildren with an average age of 15 from different schools. Waldmann presented the as yet unpublished data at the STI conference. Respondents named school even more frequently as a place to obtain information.

Massive misjudgment of HIV and AIDS among schoolchildren

According to Waldmann, this revealed many misjudgments or ignorance about HIV and AIDS. “We were more than shocked by these results,” said Waldmann. For example, more than 28 percent of students said they would rather not share a toilet with a person living with HIV.

If faced with the possibility of being infected with HIV, one in four said they would not go to a doctor. 30 percent would prefer to do an HIV test at home. The students cited not knowing where to get a test, the possibility of finding out about an HIV infection, and financial reasons as barriers to testing.

According to Waldmann, vulnerable groups are male adolescents and middle school students. “We need to remove the barriers to access to the medical system,” said Waldmann. To do this, young people need to be informed about their rights, the visibility of contact points needs to be increased and inhibitions need to be removed.

Targeted education of young people

The “Walk In Ruhr” (WIR) project in Dortmund aims to create a low-threshold educational offering. In the interdisciplinary center, young people have the opportunity to receive advice on sexual health from so-called health advisors during an open consultation. If they need medical help after the consultation, they can get a doctor’s appointment at the center either immediately or within a few days, reported Deniz Durak from WIR.

Between September 2021 and June 2024, a total of 600 consultations were carried out in a four-hour consultation hour per week, of which 471 were referred medically. To this end, the employees specifically seek contact with adolescents and young adults. “We have already carried out over 3,300 consultations at events, such as festivals,” says Durak. © mim/aerzteblatt.de