Participants' Responses

The research was conducted at the Ekiti State University Teaching Hospital (EKSUTH), which is a referral hospital with patients from urban and rural southwest of Nigeria. The GOPD was chosen because of its high patient turnover, with diverse sample of sexually active adults. Target population was female and male patients aged 18–45 years, a high-risk group for STIs due to sexual behavior patterns (1). Excluded were critically ill, mentally challenged, and unwilling participants.Sampling Technique and Sample Size DeterminationRecruitment was done using a systematic random sampling technique. Cochran's formula was used in cross-sectional studies (22): n=Z2×p(1−p)e2n=e2Z2×p(1−p)​where:Z=1.96Z=1.96 (95% confidence level)p=0.5p=0.5 (estimated proportion of good STI knowledge, to maximize sample size)e=0.05e=0.05 (margin of error)This provided a minimum of 384, which was increased to 400 to cover possible non-response and missing values. Each third patient attending the GOPD throughout the study period (June–August 2023) was approached and asked to participate until the required sample was reached.Data Collection Instrument and ProceduresA structured, pretested questionnaire was administered via face-to-face interviews to ensure clarity and minimize literacy-related biases. The questionnaire used for the survey was adapted from tested STI knowledge and attitude questionnaires used by earlier studies (5, 6) and suited to the local context. The survey consisted of five parts: Socio-demographic factors (age, sex, marital status, education, religion), STI knowledge (transmission, types, prevention), STI attitudes (stigma, comfort with STI conversation with providers), Healthcare-seeking attitudes (test frequency, barriers to healthcare), Preventive attitudes (condom use, partner communication). Responses were captured on Likert scales (e.g., "Very Aware" to "Unaware") or as categorical variables (e.g., "Yes/No"). The pilot test among 20 GOPD patients were used to gauge reliability and legibility; the Cronbach's alpha of attitudes and knowledge score were 0.78 and 0.81, indicating high internal reliability (23).