STD-related knowledge, beliefs and attitudes of Xhosa-speaking patients attending STD primary health-care clinics in South Africa

The primary aim of this study was to describe patients at sexually transmit ted disease (STD) clinics in Care Town, South Africa, in terms of gender, e ducation and age differences relative to their STD knowledge and beliefs, t heir condom use, as well as their attitudes towards condom use and their co ndom-use behaviour. The information was collected with a view to developing a health education intervention. Structured interviews were conducted with 2978 randomly sampled Xhosa-speak ing STD clinic attenders about their knowledge, beliefs and practices regar ding STDs and related behaviours. More males (75%) than females (25%) presented for STD treatment. The majori ty of patients (92%) were younger than 35 years. Female patients were found to be more aware than male patients of the sexual nature of STD transmissi on, valued personal autonomy in sexual behaviour and expressed a greater ne ed to use condoms. Males perceived STD symptoms to be more serious, had mor e misconceptions about the cause of STDs and also more negative beliefs and attitudes towards condom use. Only 34.9% of the patients reported using co ndoms in the last 6 months while only 24.5% reported regular use. Those who reported condom use were more knowledgeable about the sexual transmission of STDs and the effects of STDs on the neonate. They also had fewer misconc eptions about the causes of STDs and perceived STD symptoms to be more seri ous, attached greater value to personal autonomy in sexual behaviour and co ndom use and had more positive outcome expectancies of refusing sex than th ose who never used condoms. The data suggest that targeted interventions directed at males will have to address their inadequate knowledge regarding STDs in terms of transmission , causes, consequences, prevention and cure. Their negative beliefs and att itudes towards condoms will need special attention, especially in view of t heir multiple partner behaviour. Interventions directed at females will nee d to improve their knowledge regarding STD consequences, causes, recognitio n of symptoms as well as improve their knowledge of aspects of prevention a nd cure. All interventions must facilitate personal autonomy in decision ma king about sexual behaviour and condom use for both men and women, through skills development programmes that promote self-efficacy in the individual and instil a culture of mutual respect of such in the community.