EVALUATION OF MEDICAL STUDENTS' AWARENESS AND KNOWLEDGE LEVELS REGARDING SYPHILIS DISEASE

Abstract

Introduction: The incidence of syphilis, a disease with severe long-term morbidities if untreated, has been increasing. This trend mainly concerns young generations, such as medical students, who are at risk. This study aimed to evaluate the knowledge and awareness levels of medical students about syphilis. Materials and Methods: After obtaining written consent, an online questionnaire was applied to students in all grades of medical school. The questionnaire, which was created through a literature review, included demographic questions as well as questions about sexual behavior, STD history, and prevention methods. Students were asked to rate their knowledge of the transmission routes, clinical symptoms, diagnostic methods, treatment, and prevention methods of syphilis on a scale from 1 to 5 and to answer seven multiple-choice questions to assess their knowledge level. Results: A total of 265 students participated, with a median age of 22 years (21-23) and 52.5% (n=134) were male. Of the students, 48.3% were sexually active and 28.3% did not use any protection method, while 51.7% used condoms. Median self-rated knowledge scores were: transmission 3 (2.5-4), symptoms 3 (2-4), diagnosis 2 (1-3), treatment 2 (1-3), and prevention 3 (2-4). The total median score was 14 (10-17). Among knowledge questions, 80.4% identified the causative agent, while correct response rates for transmission, symptoms, diagnosis, treatment, prevention, and HIV screening were 57.7%, 15.5%, 14.3%, 54.7%, 55.1%, and 57%, respectively. The median number of correct answers across all questions was 4 (2-5), with a total correct answer rate of 47.8%. Conclusions: Medical students exhibit critical gaps in syphilis knowledge, with correct response rates below 50%. Given the high rate of sexual activity and inconsistent condom use, enhanced educational interventions are urgently needed to ensure both personal protection and future professional competence.

Keywords

• Syphilis
• Sexually transmitted diseases
• Medical students

Ethical Statement

The research was initiated after obtaining ethical committee approval for non-interventional studies (Decision No: 2024/16-42, Date: 08/05/2024).

References

1. 1. Peeling RW, Mabey D, Chen XS, Garcia PJ. Syphilis. Lancet. 2023;402(10398):336-346. doi: 10.1016/S0140-6736(22)02348-0.
2. 2. CDC. National Overview of STIs in 2023. (12 November 2024). Accessed 13 December 2024. Available from: https://www.cdc.gov/sti-statistics/annual/summary.html
3. 3. T.C. Sağlık Bakanlığı, Bulaşıcı Hastalıklar ve Erken Uyarı Daire Başkanlığı. Sifiliz Enfeksiyonu İstatistikleri, Türkiye. Accessed 13 December 2024. Available from: https://hsgm.saglik.gov.tr/depo/birimler/bulasici-hastaliklar-ve-erken-uyari-db/Dokumanlar/Istatistikler/Sifiliz_Istatistikleri.pdf
4. 4. Wang H, Zhang L, Zhou Y, Wang K, Zhang X, Wu J, Wang G. The use of geosocial networking smartphone applications and the risk of sexually transmitted infections among men who have sex with men: a systematic review and meta-analysis. BMC Public Health. 2018;18(1):1178. doi: 10.1186/s12889-018-6092-3.
5. 5. Ghanem KG, Ram S, Rice PA. The modern epidemic of syphilis. N Engl J Med. 2020;382:845-54.
6. 6. Traeger MW, Cornelisse VJ, Asselin J, et al. Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection. JAMA. 2019;321:1380-90.
7. 7. Azarnoosh M, Johansen IS, Martin-Iguacel R. Incidence of sexually transmitted infections after initiating HIV pre-exposure prophylaxis among MSM in southern Denmark. Am J Men Health. 2021;15:15579883211018917.
8. 8. Sarigül F, Sayan M, İnan D, Deveci A, Ceran N, Çelen MK, et al. Current status of HIV/AIDS-syphilis co-infections: a retrospective multicentre study. Cent Eur J Public Health. 2019;27(3):223-228. doi: 10.21101/cejph.a5467.

9. 9. Carvalho RXDC, Araújo TME. Knowledge, attitudes and practices of university adolescents about syphilis: a cross-sectional study in the Northeast. Rev Saude Publica. 2020;54:120. doi: 10.11606/s1518-8787.2020054002381.
10. 10. Cogo J, Stefano EAB, Alexandre MM, et al. Prevalence of syphilis cases and other sexually transmitted infections among university students. Concilium. 2023;23(14):635-652. doi: 10.53660/CLM-1002-23C30.
11. 11. Şensoy, E. Hemşirelik öğrencilerinin cinsel yolla bulaşan hastalıklara ilişkin bilgi düzeyleri. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi. 2021;9(1):150-166. https://doi.org/10.33715/inonusaglik.815545
12. 12. Akbaba Ö, Selçuk ED. Health Services Students’ Knowledge of Sexually Transmitted Diseases. Makara Journal of Health Research. 2024;28:75-80.
13. 13. Avcı C, Nazlı A. Tıp ve hemşirelik fakültesi öğrencilerinin cinsel davranışları ve cinsel yolla bulaşan hastalıklar ile ilgili bilgi düzeylerinin değerlendirilmesi. FLORA 2025;30(1):20-30.
14. 14. Satyaputra F, Hendry S, Braddick M, Sivabalan P, Norton R. The Laboratory Diagnosis of Syphilis. J Clin Microbiol. 2021;59(10):e0010021. doi: 10.1128/JCM.00100-21.
15. 15. Tuddenham S, Ghanem KG. Management of Adult Syphilis: Key Questions to Inform the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines. Clin Infect Dis. 2022;74(Suppl_2):S127-S133. doi: 10.1093/cid/ciac060.
16. 16. Orbe-Orihuela YC, Sánchez-Alemán MÁ, Hernández-Pliego A, Medina-García CV, Vergara-Ortega DN. Syphilis as Re-Emerging Disease, Antibiotic Resistance, and Vulnerable Population: Global Systematic Review and Meta-Analysis. Pathogens. 2022;11(12):1546. doi: 10.3390/pathogens11121546.
17. 17. Ramchandani MS, Cannon CA, Marra CM. Syphilis: A Modern Resurgence. Infect Dis Clin North Am. 2023;37(2):195-222. doi: 10.1016/j.idc.2023.02.006.
18. 18. Bonnewell J, Magaziner S, Fava JL, Montgomery MC, Almonte A, Carey M, Chan PA. A survey of syphilis knowledge among medical providers and students in Rhode Island. SAGE Open Med. 2020;8:2050312120902591. doi: 10.1177/2050312120902591.
19. 19. Yıldırım F, Erbil N. Knowledge level of university students about sexually transmitted diseases in Turkey: A systematic review. Andrology Bulletin. 2021;23(3):179-86. doi:10.24898/tandro.2021.70893
20. 20. Warner C, Carlson S, Crichlow R, Ross MW. Sexual Health Knowledge of U.S. Medical Students: A National Survey. J Sex Med. 2018;15(8):1093-1102. doi: 10.1016/j.jsxm.2018.05.019.
21. 21. Tetik Metin H, Narin Balsak H, Demirtaş Ş. The Effect of Education Given to University Students on Knowledge of Sexually Transmitted Diseases. STED. 2025;34(1):46-55.
22. 22. Garcia-Romo GS, Pozo-Molina G, Reyes-Reali J, Mendez-Catala CF, Garrido E, Mendez-Cruz AR, et al. Prevalence of sexually risky behaviors among Mexican medical students. PLoS One. 2024;19(5):e0302570. doi: 10.1371/journal.pone.0302570.
23. 23. Fickweiler F, Keers JC, Weijmar Schultz WC. Sexual health of Dutch medical students: nothing to worry about. J Sex Med. 2011;8(9):2450-60. doi: 10.1111/j.1743-6109.2011.02344.x.
24. 24. Subotic S, Vukomanovic V, Djukic S, Radevic S, Radovanovic S, Radulovic D, et al. Differences Regarding Knowledge of Sexually Transmitted Infections, Sexual Habits, and Behavior Between University Students of Medical and Nonmedical Professions in Serbia. Front Public Health. 2022;9:692461.