Sexually transmitted infection testing among heterosexual Maritime Canadian university students engaging in different levels of sexual risk taking

OBJECTIVES: Individuals aged 15-29 years have the highest rates of diagnosed sexually transmitted infection (STI), and in Canada routine STI testing is recommended for sexually active individuals under 25 years of age. Despite its being readily available to most Canadian university students, testing is not accessed by all sexually active students. This study examines correlates of STI testing among sexually active heterosexual university students. Specifically, we sought to determine: i) the lifetime incidence of STI testing overall and stratified by biological sex; ii) whether those most at risk of STI are being tested; and iii) which other characteristics are associated with ever having been tested for STI. METHODS: A cross-sectional survey of undergraduate students at eight universities in Maritime Canada was carried out in 2012, gathering information on student demographic characteristics, sexual behaviours and use of sexual health services. We conducted a sex-stratified descriptive analysis of each covariate and of STI testing at three levels of STI risk. We then performed multiple logistic regressions to determine the factors associated with lifetime STI testing. RESULTS: Only 34% of the study population and 51% of those at higher risk of STI acquisition had ever been tested for STI. Individuals at moderate or higher risk of STI were more likely to be tested than those at lower risk. In both sexes, older students, those who reported experiencing non-consensual sex while enrolled at university and those with more sexual health knowledge were more likely to be tested. Higher perceived risk was associated with STI testing only among females. CONCLUSIONS: Individuals at higher risk of STI acquisition are more likely to be tested; however, STI testing rates are low in this sample. Health promotion with campaigns designed to increase general sexual health knowledge may be more effective in increasing testing when targeting younger students.