Sexuality-related attitudes significantly modulate demographic variation in sexual health literacy in Tasmanian university students.

BACKGROUND It has previously been shown that there is a significant demographic variation in sexual health literacy (SHL) in university-level students in Tasmania, Australia. AIMS The aim of this study was to evaluate the effect of statistical adjustment for sexuality-related attitudes on this demographic variation in SHL. METHODS Iterated principal-factor analysis was used to evaluate latent variable grouping of responses to 21 attitudinal questions regarding sexuality and sexual behaviour. Linear regression was used to evaluate the distribution and determinants of attitudinal patterns and thence the relationship of these patterns to SHL. RESULTS Three patterns - conservative, anti-persons-living-with-HIV and sexually responsible - were identified as explaining variation in sexual attitudes; the former two being associated with significantly lower SHL and the latter associated with significantly higher SHL. Adjustment for these patterns significantly attenuated much of the differences in SHL by birthplace/ethnicity and religion, including among South and South-East Asian and Protestant, Islamic and Hindu students. However, some differences in SHL persisted, suggesting they are partly or fully independent of the attitudinal questions. CONCLUSIONS As hypothesised, differences in attitude significantly explained much of the demographic differences in SHL found previously. These results suggest that sexual education and orientation efforts need to bear cultural framing in mind to enhance uptake by students.