The questionnaire was developed after a literature review (9 (link), 12 (link), 21 (link)). Culture-specific items were then added, including polygamy (described as a man having more than one wife as it is legal in Iraq) and circumcision. The questionnaire was then translated into Arabic and pretested on a small sample of 25 medical students and was subjected to expert review by the department of dermatology at Baghdad Teaching Hospital. Candidiasis was initially included as an item similar to a study from Kampala, Uganda (21 (link)). It was removed later as a review revealed that candidiasis is connected to sexual activity itself rather than high-risk behavior or sexual transmission (22 (link), 23 (link)).
The questionnaire (Appendix A) was divided into demographics, knowledge, attitudes, and practices. Each section is further divided into blocks with items related to a single topic; for example, within the knowledge section, there were blocks pertaining to diseases, symptoms, transmission, outcomes, sources of information, risk, and protective factors.
In total, there were 84 items related to sexually transmitted infections. Most were presented as Yes/No questions. Knowledge-related items were each assigned 1 point for a total of 60 points from which respondents' overall knowledge could be extrapolated; with those who answered >50% of questions correctly, regarded as having good knowledge. Items related to attitudes and practices, on the other hand, had no similar scoring. This was due to their innate heterogeneity compared to knowledge-related items, it was therefore judged to be more beneficial and representative to discuss each item or block of items separately instead of calculating an overall score.
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