1
|
Kahsay AG, Mezgebo TA, Gebrekidan GB, Desta BL, Mihretu HG, Dejene TA. Prevalence, Antibiotic Resistance and Associated Factors of Neisseria gonorrhoeae Among Patients Attending Non-Profitable Private Clinics in Mekelle, Tigrai, Ethiopia. Infect Drug Resist 2023; 16:4065-4072. [PMID: 37383604 PMCID: PMC10295600 DOI: 10.2147/idr.s416344] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
Background Globally, Neisseria gonorrhoeae is the second most common cause of bacterial sexually transmitted diseases. The prominent predicament of this bacterium is its complications, non-susceptibility for many drugs, and aggravated transmission of other sexually transmitted infections. There is limited information about the prevalence, antibiotic resistance, and risk factors of N. gonorrhoeae in Tigrai, Ethiopia. Therefore, we aimed to determine the prevalence, antibiotic resistance, and risk factors of N. gonorrhoeae among patients attending non-profitable private clinics in Mekelle, Tigrai, Ethiopia. Methods A cross-sectional study among 229 patients was conducted from February to June 2018. The socio-demographic data and associated factors were gathered using structured questionnaire, and swabs were taken from urethra and cervix of males and females, respectively. Specimens were inoculated on standard bacteriological culture media and antibiotic susceptibility testing was performed using Kirby-Bauer disc diffusion technique following the Clinical and Laboratory Standard Institute. Data were analyzed using Statistical Package for Social Sciences Version 21. The level of significance at p-value <0.05 was considered statistically significant. Results The overall prevalence of N. gonorrhoeae was 23 (10.04%). High prevalence rates of N. gonorrhoeae were observed in females, urban residents and married ones. N. gonorrhoeae had shown statistically significant association with HIV positive, previous history of STIs, shisha users, Khat (Catha edulis) users, condom non-users and having more than two sexual partners. All isolates showed resistance to penicillin followed by tetracycline 16 (69.6%) and ciprofloxacin 8 (34.8%). Four isolates (7.4%) exhibited resistance to azithromycin with no resistance to ceftriaxone. Twelve (52.2%) isolates showed multidrug resistance (MDR). Conclusions The prevalence of N. gonorrhoeae and drug resistance, including multidrug resistance, was high in the study. Multiple factors were associated with the acquisition of N. gonorrhoeae. Therefore, behavioral change and communication should be strengthened.
Collapse
Affiliation(s)
- Atsebaha Gebrekidan Kahsay
- Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia
| | - Tadele Araya Mezgebo
- Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia
| | - Gebregziabher Berihu Gebrekidan
- Department of Health Systems, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia
| | - Birhane Lemlem Desta
- Department of Gynecology and Obstetrics, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia
| | - Hagos Gidey Mihretu
- Department of Gynecology and Obstetrics, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia
| | - Tsehaye Asmelash Dejene
- Department of Medical Microbiology and Immunology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigrai, Ethiopia
| |
Collapse
|
2
|
Parent-young communication on sexual and reproductive health issues and its associated factors: experience of students in Agaro Town, Ethiopia. Reprod Health 2023; 20:11. [PMID: 36609300 PMCID: PMC9824963 DOI: 10.1186/s12978-022-01553-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/15/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Sexual and reproductive health (SRH) is at the base of young people's living and wellbeing. A significant number of young peoples are affected by avoidable SRH problems due to a lack of appropriate knowledge regarding SRH. Parent-young communication on SRH is critical in informing them about risk and protective behaviors which in turn decrease the likelihood of involvement in risky sexual behaviors. Therefore, the purpose of this study was to evaluate the parent-young communication on SRH issues and associated factors among secondary and preparatory school students at Agaro town, Southwestern Ethiopia. METHODS School based cross-sectional study was conducted from April 13 to April 20, 2019 using stratified random sampling technique. A total of 315 students were included to the study. Data were collected using pretested interviewer-administered structured questionnaire entered into Epi data version 3.1; and analyzed using SPSS version 20. A variable having a p-value of < 0.25 in the bivariable logistic regression model was subjected to multivariable logistic regression analysis to avoid the confounding variable's effect. Adjusted odds ratios were calculated at the 95% confidence interval and considered significant with a p-value of < 0.05. RESULTS The mean age of the respondents was 20.2 ± 2.6 years. The study finding showed that 61.3% of the participants were discussed on SRH issues with their parents. According to multivariate analysis; educational status of mother [primary education (AOR = 3.67; 95%CI = 1.93, 6.97),secondary education(AOR:2.86; 95%CI = 1.20, 6.80)],educational status of father[primary education (AOR = 5.8;95%CI = 2.8, 12.3,secondary education (AOR = 3.21; 95%CI = 1.55, 6.59)],having family size of < 5 (AOR = 6.4; 95%CI = 3.36, 12.37) and having boy/girlfriend(AOR = 1.99; 95%CI = 1.0, 3.8) were significantly associated with parent-young people communication. CONCLUSION About two third of the participants communicate with their parents about SRH issues and parents' educational status, family size of < 5 and having boy/girlfriend were significantly associated with it. The main reasons for not communicated was cultural taboos, shame and parents lack of knowledge. Therefore, it is necessary to educate and equip students and parents to address the identified problems.
Collapse
|
3
|
Mekonnen BD. Early sexual debut and associated factors among students in Ethiopia: A systematic review and meta-analysis. J Public Health Res 2020; 9:1795. [PMID: 32874965 PMCID: PMC7445439 DOI: 10.4081/jphr.2020.1795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/22/2020] [Indexed: 12/02/2022] Open
Abstract
Students with early sexual debut are exposed to risky sexual behaviours. For effective intervention on early sexual debut and its consequences, determination of its magnitude and identifications of associated factors is important. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence and the associated factors of early sexual debut among students in Ethiopia. Relevant articles were identified through databases such as PubMed, Global Health, HINARI, Google advance search, Scopus, and EMBASE from March 10th to April 3rd. The data was extracted using a standardized data extraction form and exported to STATA 11 for analysis. The overall pooled prevalence of early sexual debut among students was estimated using a randomeffects meta-analysis. Presence of association was determined using an odds ratio with a corresponding 95% CI. A total of 9 studies with 4,217 participants were involved in this meta-analysis. The estimated pooled prevalence of early sexual debut among students in Ethiopia was 27.53% (95% CI: 20.52, 34.54). Being female (OR: 3.64, 95% CI: 1.67, 5.61), watching pornography (OR: 3.8, 95% CI: 2.10, 5.50) and having boyfriend or girlfriend (OR: 2.72, 95% CI: 1.24, 5.96) were found to be significantly associated with early sexual debut. More than one fourth of students practiced early sexual debut. The finding suggests the need of strengthening prevention strategies, effective intervention, and programs in educational institutions to reduce early sexual debut and its consequences. Furthermore, special attention should be given to female students and students who watch pornography. Significance for public health Early sexual debut is associated with risky sexual behaviours such as unprotected sexual intercourse, multiple sexual partners and incorrect or inconsistent condom use leading to HIV/AIDS, sexually transmitted infection (STIs), unwanted pregnancies, unsafe abortion, early childbirth, and psychosocial problems. The pooled prevalence of early sexual debut among students in Ethiopia was 27.53% which implies the need of educational institutions based public health interventions. Among many factors, female gender, watching pornography and having boyfriend/girlfriend were identified as factors significantly associated with early sexual debut. Determination of the magnitude of early sexual debut among students and the identification of its associated factors is very important for public health interventions. The findings of this meta-analysis will help to design appropriate interventions and policies that target early sexual debut in educational institutions with collaborative effort of policy makers, stakeholders and other concerned institutions.
Collapse
|
4
|
Shayo FK, Kalomo MH. Prevalence and correlates of sexual intercourse among sexually active in-school adolescents: an analysis of five sub-Sahara African countries for the adolescent's sexual health policy implications. BMC Public Health 2019; 19:1285. [PMID: 31606038 PMCID: PMC6790023 DOI: 10.1186/s12889-019-7632-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 09/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early and unprotected sex with multiple partners among adolescents carries a high risk of acquiring HIV infections, other sexually transmitted infections as well as high rates of teenage pregnancy. Sub-Saharan Africa (SSA) has a higher burden of HIV/AIDS: the leading cause of deaths among adolescents. We estimated the prevalence and examined the correlates of sexual intercourse among in-school adolescents of SSA. The purpose is to inform the public health programs dedicated to tackling the burden of HIV/AIDS. METHODS We did a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from five SSA countries Benin, Mozambique, Namibia, Seychelles, and Tanzania. Our current analysis included a sample of 15,318 in-school adolescents. The primary independent variables were ever had sexual intercourse and sex with multiple partners, while the dependent variables were smoking cigarettes, alcohol use, use of marijuana and amphetamine, and parental connectedness. We performed descriptive statistics, and multivariate logistic regression stratified by gender using SPSS Complex Sample Statistics. A p-value of less than 0.05 was considered statistically significant at 95% confidence intervals. RESULTS Out of 15,318 participants, the overall prevalence of ever had sexual intercourse and sex with multiple partners were 43·5% (6670) and 20·9% (3204), respectively. In overall and across each country, male adolescents had a significantly higher proportion of sex with multiple partners than female adolescents, p < 0·001. The predictors of sexual intercourse with multiple partners in both male and females were smoking cigarettes, alcohol use, and use of marijuana and amphetamine. Female adolescents who smoked cigarettes and used marijuana had a significant likelihood of sex with multiple partners than male adolescents: [aOR 3.6, 95% CI: 2.6-5.1] vs [aOR 2.1, 95% CI: 1.7-2.7] and [aOR 2.4, 95% CI: 1.6-3.7] vs [aOR 1.9, 95% CI: 1·3-2·7], respectively. CONCLUSIONS Adolescents sexual intercourse and more especially sex with multiple partners was prevalent and strongly correlated with substance use. However, the correlation was higher among female adolescents than male adolescents. A customized public health intervention that targets multiple risk factors concurrently may benefit adolescents with clustering of sexual and non-sexual risk-taking behaviors.
Collapse
Affiliation(s)
- Festo K Shayo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania. .,Division of Public Health, Department of Global Health Entrepreneurship, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Mariam H Kalomo
- Department of Non Communicable Disease, Ministry of Health, Community Development, Gender, Elderly, and Children (MoHCDGEC), Dodoma, Tanzania
| |
Collapse
|
5
|
Galárraga O, Shah P, Wilson-Barthes M, Ayuku D, Braitstein P. Cost and cost-effectiveness of voluntary medical male circumcision in street-connected youth: findings from an education-based pilot intervention in Eldoret, Kenya. AIDS Res Ther 2018; 15:24. [PMID: 30497481 PMCID: PMC6264043 DOI: 10.1186/s12981-018-0207-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/08/2018] [Indexed: 01/06/2023] Open
Abstract
Background Voluntary medical male circumcision (VMMC) is a critical component of HIV prevention. VMMC policies have achieved initial targets in adult men yet continue to fall short in reaching younger men and adolescents. Setting We present the cost and scale-up implications of an education-based, VMMC intervention for adolescent street-connected males, for whom the street has become their home and/or source of livelihood. The intervention was piloted as part of the Engaging Street Youth in HIV Interventions Project in Eldoret, Kenya. Methods We used a micro-costing approach to estimate the average cost of a VMMC intervention in 116 street-connected youth. Average cost was estimated per individual and per cohort by dividing total cost per intervention by number of clients accessing the intervention over a 30-day period. Total average costs included direct and support procedure costs, educational costs, and direct research costs. Cost-effectiveness was measured in cost per DALYs averted over a 5 and 10-year period. Results The total cost of the intervention was $12,526 over the 30-day period, with an average cost per individual of $108. The direct VMMC procedure cost was approximately $9 per individual. Personnel costs contributed the greatest percentage to the total intervention cost (38.2%), with mentors and social workers representing the highest wage earners. Retreat-related and education costs contributed 51% and 13% respectively to the total average cost, with surgical equipment costs contributing less than 1%. At a cost of $108 per individual, the intervention averted 60166 DALYs in 5 years resulting in a cost per DALY averted of $267. Conclusion The VMMC intervention was highly cost-effective in Kenya, despite the additional costs incurred to reach SCY. Further scale-up may be warranted to effectively apply this intervention in comparable populations. Electronic supplementary material The online version of this article (10.1186/s12981-018-0207-x) contains supplementary material, which is available to authorized users.
Collapse
|
6
|
Mekonen MT, Dagnew HA, Yimam TA, Yimam HN, Reta MA. Adolescent-parent communication on sexual and reproductive health issues and associated factors among high school students in Woldia town, Northeastern Ethiopia. Pan Afr Med J 2018; 31:35. [PMID: 30918561 PMCID: PMC6430853 DOI: 10.11604/pamj.2018.31.35.13801] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/21/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction Sexual and reproductive health (SRH) communication is most likely to promote healthy sexual practices and to reduce risky sexual behavior among adolescents. Communication is the principal means for parents to transmit sexual values and knowledge to their children. This study aimed to assess adolescent-parent communication on SRH issues among high school students in Woldia town. Methods A cross-sectional study was conducted from December 15-31, 2016. Systematic random sampling technique was used to select 693 students from Grades 9 and 10. Data were entered into Epi-info version 3.5.1 and analyzed by using SPSS version 20. Logistic regression with Odds Ratios (OR) and 95% Confidence intervals (CI) was used to identify the independent predictors of adolescent-parent communication. Results 674 students accepted to participate in this study giving a response rate of 97.3%. Only 205(30.4%) had discussed on two or more SRH topics with their parents. In logistic regression analyses, mothers who could read and write [AOR=2.0; 95% CI=1.3-3.1] and had diploma certificate [AOR=2.0; 95% CI=1.4-2.9] were more likely to discuss on SRH issues with their children. Adolescents who agreed on the importance of discussion on SRH issues [AOR=2.5; 95% CI=1.3-4.5], whoever got SRH information [AOR=2.0; 95% CI=1.4-2.9] and those whoever had sexual intercourse [AOR=1.7; 95% CI=1.1-2.6] were more likely to discuss on different SRH issues with their parents. Conclusion This study revealed that parent-adolescent communication on SRH issues was inadequate. Therefore, there is a need to equip and educate parents on different adolescents' SRH issues.
Collapse
Affiliation(s)
- Molla Temere Mekonen
- Department of Nursing, Faculty of Health Science, Woldia University, Woldia, Ethiopia
| | - Hana Abebe Dagnew
- Department of Nursing, Faculty of Health Science, Woldia University, Woldia, Ethiopia
| | - Tesfay Ambaye Yimam
- Department of Nursing, Faculty of Health Science, Woldia University, Woldia, Ethiopia
| | - Hayat Nuradis Yimam
- Department of Nursing, Faculty of Health Science, Woldia University, Woldia, Ethiopia
| | - Melese Abate Reta
- Department of Medical Laboratory Science, Faculty of Health Science, Woldia University, Woldia, Ethiopia
| |
Collapse
|
7
|
Yeshanew AG, Geremew RA. Neisseria Gonorrhoae and their antimicrobial susceptibility patterns among symptomatic patients from Gondar town, north West Ethiopia. Antimicrob Resist Infect Control 2018; 7:85. [PMID: 30026943 PMCID: PMC6050735 DOI: 10.1186/s13756-018-0376-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 07/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background Neisseria gonorrhoeae, the causative agent of gonorrhoea, is a Gram negative, coffee-bean shaped facultative intracellular diplococcus bacterium, the classical sexually transmitted bacteria. Nowadays, N. gonorrhoeae has developed high-level resistance to all traditional antimicrobials used for the treatment of gonorrhoea and makes the treatment complicated. So, the aim of this study was to determine magnitude and antimicrobial resistance patterns of N. gonorrhoeae. Methods A cross sectional study was conducted between April and August 2016 among STI clinic clients in Gondar town hospitals and health centers. Urethral swab and cervical swab specimens were inoculated to Thayer Martin media (OXOID, UK) plates. Observation of Gram-negative intracellular diplococcic was a presumptive diagnosis of gonococcal infection. Finally, antimicrobial susceptibility was assessed by using a modified Kirby-Bauer disk diffusion test, with results indicating susceptible, intermediate or resistant. Data were entered and analyzed using SPSS version 20. Results The overall prevalence of laboratory confirmed N. gonorrhoeae was 25(20.8%). The isolated N. gonorrhoeae was resistant 100% to tetracycline, penicillin and 80% percent was multidrug resistant. Conclusion Prevalence and drug resistance of N. gonorrhoeae were high in the study area. A large study is needed in order to know the magnitude in the community as well as to increase awareness of both regional health bureaus and the Ministry of Health about the treatment guide-lines.
Collapse
Affiliation(s)
- Addisu Gize Yeshanew
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Rozina Ambachew Geremew
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| |
Collapse
|
8
|
Masese LN, Wanje G, Kabare E, Budambula V, Mutuku F, Omoni G, Baghazal A, Richardson BA, McClelland RS. Screening for Sexually Transmitted Infections in Adolescent Girls and Young Women in Mombasa, Kenya: Feasibility, Prevalence, and Correlates. Sex Transm Dis 2017; 44:725-731. [PMID: 28876312 PMCID: PMC5685875 DOI: 10.1097/olq.0000000000000674] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION As adolescents and young women become sexually active, they are at risk of adverse reproductive health outcomes including sexually transmitted infections (STIs). We assessed feasibility and acceptability of STI screening among 15- to 24-year-old women in Mombasa, Kenya. METHODS After sensitization activities, participants were recruited from 3 high schools and 1 university. Study staff conducted informational sessions. Students interested in participating were given consent forms to take home, and invited to visit our clinic for STI screening. During clinic visits, participants completed a self-administered questionnaire and provided a urine specimen for STI testing using a nucleic acid amplification test. RESULTS Between August 2014 and March 2015, 463 high school and 165 university students collected consent forms. Of these, 293 (63%) from high schools versus 158 (95%) from university attended clinic for STI screening (P < 0.001). Of the 150 (33%) who reported any history of insertive vaginal sex, 78 (52.0%) reported condom use at the last sex act, 31 (20.7%) reported using modern nonbarrier contraceptive methods, and 37 (24.7%) reported not using any contraception at the last sex act. Twenty-six (5.8%) participants were diagnosed with STIs (7 [1.6%] Neisseria gonorrhoeae, 16 [3.6%] Chlamydia trachomatis, 3 [0.7%] Trichomonas vaginalis). In multivariable analyses, reporting receptive vaginal sex without a condom was associated with having a laboratory confirmed STI (odds ratio, 6.21; 95% confidence interval, 1.72-22.28). CONCLUSIONS These findings support the need for reproductive health interventions to reduce the risk of STIs in a population of adolescent girls and young women in East Africa.
Collapse
Affiliation(s)
- Linnet N Masese
- From the *Department of Medicine, University of Washington, Seattle, WA; †University of Nairobi Institute of Tropical & Infectious Disease (UNITID), Nairobi; ‡Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa; §School of Nursing Sciences, University of Nairobi, Nairobi; ¶Mombasa County Department of Health, Mombasa, Kenya; ∥Department of Global Health, **Biostatistics, University of Washington; ††Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center; and ‡‡Department of Epidemiology, University of Washington, Seattle, WA
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Berhanu D, Diener-West M, Ruff A, Davis WW, Celentano DD, Go VF. Associations Between Khat Use and HIV Risk and Status Among Voluntary Counseling and Testing Center Clients in Addis Ababa, Ethiopia. J Addict Med 2017; 11:320-327. [PMID: 28353466 PMCID: PMC6076545 DOI: 10.1097/adm.0000000000000304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Ethiopia is 1 of 15 countries that account for nearly 75% of all people living with HIV. Khat use, a common practice in Ethiopia and sub-Saharan Africa, has gained attention as a potential risk factor for HIV. Our objective was to evaluate associations between khat use and demographic and risk-taking characteristics (alcohol use, sexual behavior), and also associations between HIV status and these characteristics among voluntary counseling and testing clients in Addis Ababa, Ethiopia. METHODS This cross-sectional study was conducted among Pro Pride voluntary counseling and testing center clients, aged 18 to 49 years, from November 2009 to March 2010. All clients were approached, and 98.8% of these (684) completed a self-administered questionnaire. Associations between khat use, alcohol use, multiple sexual partners, and HIV status were assessed using logistic regression models. RESULTS Using khat in the past 90 days (current khat use) was significantly associated with being Muslim, being male, alcohol use, and having a greater number of sex partners in one's lifetime. The adjusted odds of current khat use was almost 7-fold higher in those having 4 or more sexual partners in their lifetime (adjusted odds ratio 6.89, 95% confidence interval 3.87, 12.25) as compared with those with 1 or none. HIV-positive status was significantly associated with age, employment, marital status, number of sex partners in one's lifetime, and khat use. Having used khat in one's lifetime, but not currently, past khat use, was associated with over a 2-fold increased adjusted odds (adjusted odds ratio 2.64, 95% confidence interval 1.13, 6.19) of being HIV-infected. CONCLUSIONS Our findings highlight associations between current khat use and the modifiable factors of number of lifetime sexual partners and alcohol use. In addition, we observed the association between HIV status and past khat use after adjusting for age, marital status, and number of sex partners in one's lifetime.
Collapse
Affiliation(s)
- Della Berhanu
- Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK (DB); Department of Biostatistics (MD-W); Department of International Health (AR); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (WWD, DDC); and Department of Health Behavior, University of North Carolina, Gillings School of Global Public Health, NC (VFG)
| | | | | | | | | | | |
Collapse
|
10
|
SURVEY OF SEXUAL ACTIVITY AND CONTRACEPTIVE USE AMONG UNMARRIED YOUNG SCHOOL AND COLLEGE DROP-OUTS IN A DEFINED NIGERIAN POPULATION. J Biosoc Sci 2016; 49:675-684. [PMID: 27692002 DOI: 10.1017/s002193201600050x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study sought to characterize sexual behaviour, contraceptive use and contributory upbringing factors among young people who had dropped out of school or college in a Nigerian setting. A community-based, cross-sectional sexual survey of 161 young people aged between 15 and 35 who had dropped out of school or college was performed in Ado-Ekiti, south-west Nigeria, in April 2015. One hundred and nineteen of the respondents (73.9%) had had sexual intercourse. Mean age at sexual debut was 19.08±3.5 years. Of those with sexual experience, 79 (66.4%) had their sexual debut with a previous boy/girlfriend and 33 (27.7%) had it in their current relationship. Three (2.5%) respondents had first sex with a stranger. About 90% were still having sexual intercourse within 12 months of the survey; more males had had sex than females (81.1% versus 67.8%). Around 80% of those with sexual exposure practised a form of contraception, mainly use of the male condom, but fewer than 25% were all-time contraceptive users. Coming from a single-parent family (p=0.04) or from a family of poor economic status (AOR: 7.41; 95% CI: 0.69-0.83) were found to be associated with sexual debut by the age of 19 and premarital sex, respectively, in these young people. Unprotected sexual intimacy was found to be high among young school/college drop-outs in this region of Nigeria. This group of young people need targeted reproductive health intervention as they represent a potent route for HIV transmission in the region.
Collapse
|
11
|
Ayehu A, Kassaw T, Hailu G. Young people's parental discussion about sexual and reproductive health issues and its associated factors in Awabel woreda, Northwest Ethiopia. Reprod Health 2016; 13:19. [PMID: 26955810 PMCID: PMC4782353 DOI: 10.1186/s12978-016-0143-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 02/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Ethiopia besides the very low health seeking behavior of young people, they do not have access to sexual and reproductive health information and even the existing health services are adult-centered. Furthermore, health providers are not well equipped in addressing young people sexual and reproductive health needs. Therefore, parent-young people discussion about sexual and reproductive health issues are crucial in increasing their awareness and reduces their risky sexual behaviors. This study was aimed to assess young people's parental discussion about sexual and reproductive health issues and its associated factors in Awabel woreda, Northwest Ethiopia. METHODS A community based cross-sectional study was conducted among 781 young people aged 10-24 years in Awabel Woreda, Northwest Ethiopia. A pre-tested structured interview administered questionnaire was used for the data collection. The collected data were entered using Epi Data 3.1 and analyzed using SPSS for windows version 21. RESULTS In the past 6 months, about one quarter, 25.3% of young people had a parental discussion about sexual and reproductive health issues. Young people who reside in urban areas were more likely to discuss on sexual and reproductive health issues with their parents [AOR = 2.44, 95% CI: 1.54-3.89]. Similarly, being male was more likely to have a parental discussion about sexual and reproductive health issues than females [AOR = 1.63, 95% CI: 1.11-2.38]. Furthermore, the odds of parent-young people discussion about SRH matters was more likely among young people aged 20-24 years [AOR = 4.57, 95% CI: 2.13-9.82], living with fathers [AOR = 2.46, 95% CI: 1.20-5.04] and had attained a primary level of education [AOR = 2.89, 95% CI: 1.22-6.87]. Parents lack of interest to discuss, feeling ashamed and culturally not acceptable to talk about sexual matters were found to deter young people's in discussing sexual and reproductive health matters. CONCLUSION Parent-young people discussion about sexual and reproductive health is very low and there are different hindering factors. And therefore, young people's sexual and reproductive health programs or policies should be designed in addressing the cultural and societal factors besides the individual or behavioral factors.
Collapse
Affiliation(s)
- Atitegeb Ayehu
- Students Clinic, Debre Markos University, PO Box: +251-269, Debre Markos, Ethiopia.
| | - Teketo Kassaw
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, PO Box: +251-269, Debre Markos, Ethiopia.
| | - Getachew Hailu
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, PO Box: +251-269, Debre Markos, Ethiopia.
| |
Collapse
|
12
|
Molla M, Emmelin M, Berhane Y, Lindtjørn B. Readiness of youth in rural Ethiopia to seek health services for sexually transmitted infections. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2015; 8:135-46. [PMID: 25875565 DOI: 10.2989/ajar.2009.8.2.2.854] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Studies pertaining to sexually transmitted infections (STIs) among rural young adults in Ethiopia are limited. This study provides information on knowledge about common STIs, and the perceptions, preferences and use of health services for STIs, among youths and healthcare providers in predominately rural Butajira, a town in south-central Ethiopia. We performed mixed-method research, using a cross-sectional survey among 3 743 randomly selected youths aged 15-24 years, in 2004, and in-depth interviews with ten healthcare providers, in 2006. Less than 38% of the youths knew the common STIs. Among the sexually active youths (n = 802), 3.9% reported having at least one STI symptom in the past 12 months, and one-half of those who had had an STI symptom did not seek care from any source. The healthcare providers reported that the stigma associated with premarital sexual activity, the shamefulness of having an STI, and a perceived lack of confidentiality and uneasiness with the public health services were impediments to treatment-seeking in the study area. The youths in this study preferred to consult with healthcare providers of the same gender who were young, friendly and had a reputation for being empathetic. Embarrassment about having an STI and fear of being noticed by a familiar individual were perceived barriers to healthcare-seeking among the youths. The results suggest that young people are vulnerable to HIV exposure due to lack of knowledge about STIs and especially as a result of having an untreated STI. Health services that are uncoordinated and unable to handle youths' sexual and reproductive health problems, as well as judgemental health professionals and prevailing sexual taboos, were also reported as impediments to youths seeking healthcare. Reorientation of the public health services and healthcare providers could improve youths' healthcare-seeking for STIs.
Collapse
Affiliation(s)
- Mitike Molla
- a Centre for International Health , University of Bergen , PO Box 7804 , Bergen , 5020 , Norway
| | | | | | | |
Collapse
|
13
|
Winston SE, Chirchir AK, Muthoni LN, Ayuku D, Koech J, Nyandiko W, Carter EJ, Braitstein P. Prevalence of sexually transmitted infections including HIV in street-connected adolescents in western Kenya. Sex Transm Infect 2015; 91:353-9. [PMID: 25714102 PMCID: PMC4518741 DOI: 10.1136/sextrans-2014-051797] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 12/07/2014] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The objectives of this study were to characterise the sexual health of street-connected adolescents in Eldoret, Kenya, analyse gender disparity of risks, estimate the prevalence of sexually transmitted infections (STIs), and identify factors associated with STIs. METHODS A cross-sectional study of street-connected adolescents ages 12-21 years was conducted in Eldoret, Kenya. Participants were interviewed and screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus-2, syphilis and HIV. Descriptive statistics and logistic regression were used to identify factors associated with having any STI. RESULTS Of the 200 participants, 81 (41%) were female. 70.4% of females and 60.5% of males reported sexual activity. Of those that participated in at least one STI test, 28% (55/194) had ≥1 positive test, including 56% of females; 14% (28/194) had >1 positive test. Twelve females and zero males (6% overall, 14.8% of females) were HIV positive. Among females, those with HIV infection more frequently reported transactional sex (66.7% vs. 26.1%, p=0.01), drug use (91.7% vs. 56.5%, p=0.02), and reported a prior STI (50.0% vs. 14.7%, p<0.01). Having an adult caregiver was less likely among those with HIV infection (33.3% vs. 71.0%, p=0.04). Transactional sex (AOR 3.02, 95% CI (1.05 to 8.73)), a previous STI (AOR 3.46 95% CI (1.05 to 11.46)) and ≥2 sexual partners (AOR 5.62 95% (1.67 to 18.87)) were associated with having any STI. CONCLUSIONS Street-connected adolescents in Eldoret, Kenya are engaged in high-risk sexual behaviours and females in particular have a substantial burden of STIs and HIV. There is a need for STI interventions targeted to street-connected youth.
Collapse
Affiliation(s)
- Susanna E Winston
- Division of Pediatric Infectious Diseases, Rhode Island Hospital/Hasbro Children's Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA
| | | | - Lauryn N Muthoni
- Moi Teaching and Referral Hospital, Eldoret, Kenya Aga Khan University Hospital, Nairobi, Kenya
| | - David Ayuku
- Department of Behavioral Sciences, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya
| | - Julius Koech
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Winstone Nyandiko
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya Department Child Health and Pediatrics, Moi University, School of Medicine, Eldoret, Kenya
| | - E Jane Carter
- Department of Pulmonary and Critical Care, The Miriam Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA Department of Medicine, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya
| | - Paula Braitstein
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya Department of Medicine, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA Division of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Canada Regenstrief Institute, Inc., Indianapolis, Indiana, USA
| |
Collapse
|
14
|
Melaku YA, Berhane Y, Kinsman J, Reda HL. Sexual and reproductive health communication and awareness of contraceptive methods among secondary school female students, northern Ethiopia: a cross-sectional study. BMC Public Health 2014; 14:252. [PMID: 24628909 PMCID: PMC4234022 DOI: 10.1186/1471-2458-14-252] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 03/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent girls continue to fall victim to unintended pregnancy and its consequences, with particular problems arising in low income countries. Awareness about methods of contraception is an important step towards gaining access and using suitable contraceptive methods. However, studies assessing the relationship between sexual and reproductive health communication and awareness of contraceptive methods among secondary school female students are lacking. METHODS A cross sectional study was conducted among 807 female students in six secondary schools in Mekelle town, Ethiopia. Study participants were selected with a stratified cluster sampling technique. Data collection was carried out using a structured, self-administered questionnaire, and data entry was done using EPI Info Version 3.3.2 software. The data were then cleaned and analyzed using SPSS version 20. Bivariate and multivariate logistic regressions were used to determine factors associated with awareness of female students on methods of contraception. RESULT Of all the students, 127(15.8%) reported ever having had sex, of whom 109(85.8%) had ever used contraceptives. Twenty (16%) of the sexually active students reported having been pregnant, of whom 18(90%) terminated their pregnancies with induced abortion. Discussion on sexual and reproductive health matters with their parent/s and peer/s in the six months prior to the study was reported by 351(43.5%) and 493(61.1%) of the students respectively. 716(88%) students were aware of different methods of contraception. Discussing sexual and reproductive health issues with parents (AOR=2.56(95% CI: 1.45, 4.50)) and peers (AOR=2.46(95% CI: 1.50, 4.03)) were found to be independent predictors for contraceptive awareness among students. CONCLUSIONS Discussion on sexual and reproductive health issues with family and peers has a positive effect on contraceptive awareness of students. Therefore, strategies to improve open parent-child communication, and appropriate peer-to-peer communication in schools on sexual and reproductive health should be established and strengthened.
Collapse
Affiliation(s)
- Yohannes Adama Melaku
- Department of public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | | | | | | |
Collapse
|
15
|
Seif SA, Kohi TW. Caretaker-Adolescent Communication on Sexuality and Reproductive Health: My Perceptions Matter; A Qualitative Study on Adolescents’ Perspectives in Unguja-Zanzibar. Health (London) 2014. [DOI: 10.4236/health.2014.621329] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
16
|
Tesso DW, Fantahun MA, Enquselassie F. Parent-young people communication about sexual and reproductive health in E/Wollega zone, West Ethiopia: implications for interventions. Reprod Health 2012; 9:13. [PMID: 22898627 PMCID: PMC3495660 DOI: 10.1186/1742-4755-9-13] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 08/07/2012] [Indexed: 11/14/2022] Open
Abstract
Objectives This study aims at examining parent-young people communication about sexual and reproductive health related topics and factors associated with it from both young people’s and parents’ perspectives. Methods A cross-sectional study was conducted among 2,269 young people aged 10–24 years in Nekemte town and semi urban areas, western Ethiopia. Chi-square and multivariate logistic regression analyses were conducted using SPSS for windows version 16. The qualitative data was coded, and categorized in to emerging themes using the open code software version 3.4. Result About a third of young people-32.5% (32.4% of females and 32.7% males) engaged in conversation about sexual and reproductive health topics with their parents/parent figures during the last six months. In logistic regression analyses, young people who were aged 15–19 years were more likely to report parent-communication compared to the other age groups (AOR = 1.57; 95%CI = 1.26-1.97). Female young people are more likely to discuss with their mothers, (AOR = 1.89, 95% CI = 1.13-3.2), sister (AOR = 2.16, 95% CI = 1.19-3.9) and female friends (AOR = 11.7, 95% CI = 7.36-18.7) while males are more likely to discuss with male friends (AOR = 17.3, 95%CI = 10-4-28.6). Educated young people were more likely to parent-communicate(AOR = 1.70, 95%CI = 1.30-2.24). Fear of parent, cultural taboos attached to sex, embarrassments, and parents’ lack of knowledge related to sexual and reproductive health were found to be barriers for parent communication. Parent-communication takes place not only infrequently but also in warning, & threatening way. Conclusion Parent-young people communication about sexual health is occurring rarely in the family and bounded by certain barriers. Programmes/policies related to young people’s reproductive health should address not only individual or behavioral factors but also cultural and social factors that negatively influence parent-communication about reproductive health.
Collapse
Affiliation(s)
- Dessalegn W Tesso
- Department of Reproductive Health, Population and Nutrition, Addis Ababa University, P,O, Box 9086, Addis Ababa, Ethiopia.
| | | | | |
Collapse
|
17
|
Stroeken K, Remes P, De Koker P, Michielsen K, Van Vossole A, Temmerman M. HIV among out-of-school youth in Eastern and Southern Africa: a review. AIDS Care 2011; 24:186-94. [PMID: 21780993 DOI: 10.1080/09540121.2011.596519] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The overall decline of the HIV epidemic in Sub-Saharan Africa conceals how the HIV burden has shifted to fall on areas that have been more difficult to reach. This review considers out-of-school youth, a category typically eluding interventions that are school-based. Our review of descriptive studies concentrates on the most affected region, Southern and Eastern Africa, and spans the period between 2000 and 2010. Among the relatively small but increasing number of studies, out-of-school youth was significantly associated with risky sexual behavior (RSB), more precisely with early sexual debut, high levels of partner concurrency, transactional sex, age-mixing, low sexually transmitted infection (STI)/HIV risk perception, a high lifetime number of partners, and inconsistent condom use. Being-in-school not only raises health literacy. The in-school (e.g., age-near) sexual network may also be protective, an effect which the better-studied (and regionally less significant) variable of educational attainment cannot measure. To verify such double effect of being-in-school we need to complement the behavioral research of the past decade with longitudinal cohort analyses that map sexual networks, in various regions.
Collapse
|
18
|
Wang B, Li X, Stanton B, Kamali V, Naar-King S, Shah I, Thomas R. Sexual attitudes, pattern of communication, and sexual behavior among unmarried out-of-school youth in China. BMC Public Health 2007; 7:189. [PMID: 17672903 PMCID: PMC1965477 DOI: 10.1186/1471-2458-7-189] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Accepted: 07/31/2007] [Indexed: 11/21/2022] Open
Abstract
Background In recent years, more adolescents are engaging in premarital sex in China. However, only a limited number of studies have explored out-of-school youth's sexual attitudes and behaviors, critical for prevention intervention development. Methods Using data from the baseline survey of a comprehensive sex education program that was conducted in a suburb of Shanghai in 2000–2002, this study describes sexual attitudes, patterns of communication on sexual matters, and premarital sexual behavior among 1,304 out-of-school youth. Multivariate logistic regression analysis was conducted to examine the factors associated with youth's premarital sexual intercourse. Results The majority (60%) of out-of-school youth held favorable attitudes towards premarital sex. Males were more likely to have favorable attitudes compared with females. Male youth generally did not communicate with either parent about sex, while one-third of female youth talked to their mothers about sexual matters. Both males and females chose their friends as the person with whom they were most likely to talk about sexual matters. About 18% of the youth reported having engaged in sexual intercourse. One-fifth of sexually active youth had always used a contraceptive method, and one-quarter had been pregnant (or had impregnated a partner). There were no gender differences in rate of premarital sex or frequency of contraceptive use. Multivariate analysis revealed that age, education, family structure, parent's discipline, attitudes towards premarital sex, pattern of communication and dating were significantly associated with youth premarital sex. Conclusion A substantial proportion of out-of-school youth engage in risky sexual behaviors. Prevention programs that empower communication and sexual negotiation skills, and promote condom use should be implemented for this vulnerable group.
Collapse
Affiliation(s)
- Bo Wang
- Department of Community Health Sciences, the University of Southern Mississippi, Hattiesburg, MS, USA
| | - Xiaoming Li
- The Carman and Ann Adams Department of Pediatrics Prevention Research Center, Wayne State University, Detroit, MI, USA
| | - Bonita Stanton
- The Carman and Ann Adams Department of Pediatrics Prevention Research Center, Wayne State University, Detroit, MI, USA
| | - Vafa Kamali
- Department of Community Health Sciences, the University of Southern Mississippi, Hattiesburg, MS, USA
| | - Sylvie Naar-King
- The Carman and Ann Adams Department of Pediatrics Prevention Research Center, Wayne State University, Detroit, MI, USA
| | - Iqbal Shah
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Ronald Thomas
- The Carman and Ann Adams Department of Pediatrics Prevention Research Center, Wayne State University, Detroit, MI, USA
| |
Collapse
|
19
|
Råssjö EB, Mirembe FM, Darj E. Vulnerability and risk factors for sexually transmitted infections and HIV among adolescents in Kampala, Uganda. AIDS Care 2007; 18:710-6. [PMID: 16971279 DOI: 10.1080/09540120500302934] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Three hundred and six sexually experienced adolescents participated in a study on sexually transmitted infection (STI) prevalence and associated risk factors. The prevalence of Neisseria gonorrhoea (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV) and syphilis was 4.5%, 9%, 8% and 4% for females and 4.7%, 5.7%, 0% and 2.8% for males. HIV-seropositivity was found in 15.2% of females and 5.8% of males. Structured face-to-face interviews were used to obtain information about social background, sexual experience and genital symptoms. Four focus-group discussions were used in order to validate the interview data. Females were more likely to be infected by the four treatable STIs and HIV, despite risky behavior being more common among males. Unemployment, little formal education, the presence of bacterial STIs and post-coital bleeding or a bad smell from the vagina was highly associated with the risk for HIV in females. The higher prevalence of STIs, including HIV, among adolescent girls cannot be explained by sexual behavior only, as boys reported more risk behavior and were still less affected by STIs. Biological and social factors are definitely of importance.
Collapse
Affiliation(s)
- E-B Råssjö
- Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University, Kampala, Uganda.
| | | | | |
Collapse
|
20
|
Kebede D, Alem A, Mitike G, Enquselassie F, Berhane F, Abebe Y, Ayele R, Lemma W, Assefa T, Gebremichael T. Khat and alcohol use and risky sex behaviour among in-school and out-of-school youth in Ethiopia. BMC Public Health 2005; 5:109. [PMID: 16225665 PMCID: PMC1274331 DOI: 10.1186/1471-2458-5-109] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2005] [Accepted: 10/14/2005] [Indexed: 11/24/2022] Open
Abstract
Background Khat (an evergreen plant with amphetamine-like properties) and alcohol are widely consumed among the youth of Ethiopia. However, their relationship to risky sexual behaviour is not well described. This study was conducted to describe the magnitude of risky sexual behaviour (unprotected sex and early initiation of sexual activity) and its association with Khat and alcohol consumption in Ethiopian youths. Methods A probabilistic national sample of 20,434 in-school and out-of-school youths aged between 15 and 24 years of age was selected and interviewed regarding their sexual behavior and substance use. Results Over 20% of out-of-school youth had unprotected sex during the 12-month period prior to interview compared to 1.4% of in-school youth. Daily Khat intake was also associated with unprotected sex: adjusted OR (95% CI) = 2.26 (1.92, 2.67). There was a significant and linear association between alcohol intake and unprotected sex, with those using alcohol daily having a three fold increased odds compared to those not using it: adj. OR (95% CI) = 3.05 (2.38, 3.91). Use of substances other than Khat was not associated with unprotected sex, but was associated with initiation of sexual activity: adj. OR (95% CI) = 2.54 (1.84, 3.51). Conclusion A substantial proportion of out-of-school youth engage in risky sex. The use of Khat and alcohol and other substances is significantly and independently associated with risky sexual behaviour among Ethiopian youths.
Collapse
Affiliation(s)
- Derege Kebede
- Department of Community Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Atalay Alem
- Department of Psychiatry, Addis Ababa University, P.O.Box 9086 Addis Ababa, Ethiopia
| | - Getnet Mitike
- Department of Community Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fikre Enquselassie
- Department of Community Health, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Reta Ayele
- Ministry of Defence, Addis Ababa, Ethiopia
| | - Wuleta Lemma
- Family Health International, Addis Ababa, Ethiopia
| | | | | |
Collapse
|
21
|
Lee SJ, Cho YH, Kim CS, Shim BS, Cho IR, Chung JI, Lee JG, Kim ME. Screening for Chlamydia and gonorrhea by strand displacement amplification in homeless adolescents attending youth shelters in Korea. J Korean Med Sci 2004; 19:495-500. [PMID: 15308836 PMCID: PMC2816879 DOI: 10.3346/jkms.2004.19.4.495] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We conducted the screening of sexually transmitted infections to define the prevalence of genital Chlamydia trachomatis and Neisseria gonorrhoeae infections and status of sexual risk behavior among homeless adolescents (10-19 yr old) in Korea. Adolescents who ran away from home and are under the care of youth shelters in ten cities in Korea served as the study population. Participants filled out a self-administered questionnaire related to sexuality. First-void urine was analyzed for chlamydial and gonococcal infection by strand displacement amplification (BDProbTec ET, BD Diagnostic Systems, MD, U.S.A.). A total of 175 adolescents from 15 youth shelters took part in the study. Their median age was 16 yr, and 54.9% of them reported having sexual intercourse at least once. The prevalence of C. trachomatis and N. gonorrhoeae among homeless adolescents was 12.6% and 15.4%, respectively. Factors significantly associated with the infections were number of sexual partners during the past year and lifetime. This is the first community-based sexually transmitted infection (STI) screening among adolescent in Korea. Screening programs targeting sexually active adolescents are important for detection of STIs. They should be considered an alternative population-based surveillance system in order to control STIs nationally.
Collapse
Affiliation(s)
- Seung-Ju Lee
- Department of Urology, Catholic University College of Medicine, Seoul, Korea
| | - Yong-Hyun Cho
- Department of Urology, Catholic University College of Medicine, Seoul, Korea
| | - Chul Sung Kim
- Department of Urology, Chosun University College of Medicine, Gwangju, Korea
| | - Bong Suk Shim
- Department of Urology, Ewha Women's University College of Medicine, Seoul, Korea
| | - In Rae Cho
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | - Jae Il Chung
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | - Jeong Gu Lee
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Min Eui Kim
- Department of Urology, Soonchunhyang University College of Medicine, Seoul, Korea
| |
Collapse
|
22
|
Taffa N, Sundby J, Bjune G. Reproductive health perceptions, beliefs and sexual risk-taking among youth in Addis Ababa, Ethiopia. PATIENT EDUCATION AND COUNSELING 2003; 49:165-169. [PMID: 12566211 DOI: 10.1016/s0738-3991(02)00090-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Appropriate knowledge and beliefs about sexuality and necessary life skills do not often precede sexual behaviours among young people. This study outlines a profile of sexual risk factors and the underlying sexual and reproductive health perception and beliefs among youth (aged 15-24 years) in Addis Ababa, Ethiopia. Five hundred and sixty-one youth residing in two of the six zones of Addis Ababa filled a self-administered questionnaire. Three outcome variables: history of sexual activity in the past, use of condom during recent sexual intercourse and use of alcohol, were used to construct a pyramid of sexual risk categories. Being a female, age group of 20-24 years and out-of-school significantly increased the likelihood of belonging to the most vulnerable category. Although young people were heterogeneous in their sexual risk-taking, they were equally uninformed on reproductive health matters related to puberty and sexuality. Their respective beliefs also tended to be flexible and unstable to consistently predict their behaviour. Possible reasons for such heterogeneity and its practical implications in sex education strategies are discussed.
Collapse
Affiliation(s)
- Negussie Taffa
- Institute of General Practice & Community Medicine, Oslo University, Oslo, Norway.
| | | | | |
Collapse
|