Risk perceptions of chlamydia and gonorrhoea among Dutch youth prior to a new sexually transmitted infection testing policy: a cross-sectional survey study.

BACKGROUND

Perceptions of chlamydia and gonorrhoea may influence sexually transmitted infection (STI) testing and prevention. Understanding these perceptions is essential, as many countries are considering more restrictive chlamydia testing. This study compared perceived susceptibility and severity of chlamydia and gonorrhoea among young heterosexuals in the Netherlands and explored underlying determinants and reasons.

METHODS

An online cross-sectional survey (April-June 2024) among young people (16-34 year-old) was distributed via social media and sexual health clinics. Multivariable logistic regression identified determinants of perceived susceptibility and severity. Thematic analysis explored underlying reasons.

RESULTS

Among participants (n = 1605), perceived susceptibility was low for chlamydia (75%) and gonorrhoea (81%), but both were considered severe (chlamydia 76%; gonorrhoea 82%). Determinants of perceived susceptibility differed by partner type. For those with steady partners, low impulsivity was associated with low perceived susceptibility, while multiple partners and low health goals were associated with high susceptibility. Among those with casual partners, multiple partners, no condom use at last sex, and low health goals were associated with high susceptibility. Perceived severity was lower among those with university education, low health goals, and multiple partners. Reasons for susceptibility related to sexual behaviour; severity to relationship concerns and STI aversion.

CONCLUSIONS

Most young heterosexuals perceive chlamydia and gonorrhoea as severe, but many underestimate their personal risk, even when engaging in behaviours associated with increased risk of acquiring an STI. Misconceptions and limited awareness contribute to gaps between risk perception and preventive action. Targeted interventions and clear, infection-specific communication are needed as STI testing policies evolve.