Risk perception of sexually transmitted infections (STIs) among university students and men who have sex with men (MSM) in the Netherlands

Sexually transmitted infections (STIs) are on the rise across Europe, with the Netherlands experiencing a marked increase. The present research explores how STI risk perception is understood and experienced among two high-incidence populations: men who have sex with men (MSM) and heterosexual university students. Sixteen semi-structured interviews (8 MSM, 8 students) were conducted and analyzed by reflexive thematic analysis. Four central themes were identified: risk behaviors, risk awareness, perceived severity, and affective responses. Both samples reported behaviors that elevate STI risk, including casual sex, inconsistent condom use, and infrequent testing. However, their perceptions of risk diverged notably. MSM participants demonstrated higher perceived susceptibility and more emotionally charged responses. In contrast, heterosexual students often underestimated their risk and minimized STI severity, shaped by cognitive dissonance, limited knowledge, and peer norms. These findings show that STI risk perception extends beyond factual awareness, shaped instead by emotional, cognitive, and social dynamics. Public health interventions must therefore be tailored to these group-specific influences to promote accurate risk appraisal and improve sexual health outcomes.