Baseline Reproductive and Sexual Health Knowledge Among Undergraduate Students in Manitoba, Canada

Abstract Many undergraduate students are newly sexually active adults with unsafe sexual practices. While sexual education curriculums exist, students’ understanding of reproductive and sexual health is unknown. We sought to assess undergraduate students' knowledge and attitudes on reproductive and sexual health. Our aim was to identify variables associated with knowledge deficiencies. A novel, cross-sectional questionnaire assessing knowledge and attitudes on reproductive and sexual health was distributed online from January to March 2021 to undergraduate students at two universities. Local ethics board approval was obtained, participation was voluntary, and data was anonymized. Categorical variables and continuous variables were analyzed with Chi-squared tests and Kruskal-Wallis tests, respectively. Univariable and multivariable-adjusted logistic regression analysis were used to assess variables associated with knowledge differences. There were 309 respondents out of approximately 28,816 possible undergraduate students (n=309, response rate 1.1%). There were significant differences in knowledge scores with age (p=0.012), location of high school completion (p=0.004), and university attended (p=0.044). On multivariate analysis, higher knowledge scores were associated with identifying as female (male OR: 0.39, 95% CI: 0.18–0.87; p=0.021), older age (age ≥22 years OR: 4.07, 95% CI: 1.35–12.26; p=0.012), and university attended (University of Manitoba OR: 1.97, 95% CI: 1.11–3.49; p=0.021). On subgroup analysis, family SES was associated with higher sexually transmitted infection (STI) knowledge scores (OR: 2.19, 95% CI: 1.07–4.48; p=0.032). Few felt that their post-secondary education on contraception/family planning (26.2%), STIs (34.6%), and infertility (4.5%) was adequate. Undergraduate students face unique barriers in obtaining adequate reproductive and sexual health knowledge. In particular, younger males who attend smaller universities, and possibly those who are from lower SES, may be at greater risk of negative outcomes. We highlight the need for improved access to education and supports to assist undergraduate students in making more informed decisions.