Perceptions about sexual abstinence and knowledge of HIV/AIDS prevention among in-school adolescents in a western Nigerian city

Determinants of the utilization of youth-friendly sexual and reproductive health services in public secondary schools of Kogi State, Nigeria: an explorative study

BACKGROUND

This study explored the factors associated with the utilization of Youth-Friendly Sexual Reproductive Health (YFSRH) services among school-going Nigerian adolescents.

METHODS

This cross-sectional study employed a mixed method involving school-going students attending five public secondary schools in Kogi State, Nigeria. Descriptive statistics were used to determine the patterns of utilisation of YFSRH services, whereas inferential statistics were performed to determine factors associated with utilization of YFSRH services. Qualitative data were analysed by thematic analyses of records using an inductive analysis.

RESULTS

One in two secondary school-going students had used the YFSRH services. Most of the participants had poor awareness of YFSRH services and limited access to YFSRH services. While gender positively predicted the utilisation of YFSRH services among secondary school-going students (aOR = 5.7; 95% CI: 2.4-8.95, p = 0.001), we found that age (aOR = 0.94; 95% CI: 0.67-0.99, p = < 0.001), and religious beliefs (aOR = 0.84; 95% CI: 0.77-0.93, p = 0.001) showed a negative relationship with the utilization of YFSRH services.

CONCLUSIONS

Our findings highlight the influence of gender, age, and religion on utilizing YFSRH services. This study recommends the inclusion of sexuality education into secondary school-going student's curricula, in order to create awareness about the benefit of utilization of sexual and reproductive health services, and this is to encourage young people to utilize the YFSRH services.

"It was protected, except, it wasn't [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia

BACKGROUND

A number of previous sex-related studies among international students in Australia and other Western societies may be limited by conflating students from conservative and non-conservative sexual backgrounds. Such conflation leads to situations where nuances and complexities around sex-related experiences are lost or, at most, tangentially investigated. To address this research problem, this study used a mixed-methods design to examine protective practices against blood-borne viruses and sexually transmissible infections (BBVs/STIs) among Sydney-based East Asian and sub-Saharan African international students.

METHODS

This mixed-methods study generated quantitative data using anonymous online survey (n = 149), and qualitative data through in-depth interviews (n = 20). The main recruitment strategy involved advertising the study through paper and electronic flyers. Quantitative data were analysed using logistic regression, while interviews data were analysed using reflexive thematic analysis.

RESULTS

Self-reported BBVs/STIs protective practices in the last 12 months include abstinence (28.7%), consistent condom use (19.9%), occasional condom use (18.7%), single partner fidelity (25.1%), other strategies (1.8%), and nothing (5.8%). Further, findings from the bivariate analysis showed higher BBVs/STIs prevention knowledge, lower acculturation into Australian sexual culture, greater access to sexual health information, less conservative sexual norms, greater emotional social support and older age were significantly associated with increased protective practices. Variables significant at bivariate level were entered into a logistic regression. The model was statistically significant, (X²(6) = 31.33, p < 0.01) and explained 33.1% of the variance in BBVs/STIs protective practices. However, only acculturation to sexual norms in Australia (OR = 0.883, 95% CI = 0.820-0.952) was found to be independent predictor of BBVs/STIs protective practices. The results of the study based on the quantitative data, indicated condom use (consistent and occasional) was the most reported BBVs/STIs protective behaviour among sexually active participants. Therefore, interviews data was used to explore condom-use motives and practices. The interviews results showed participants primary concern as regards condom use was around pregnancy and not BBVs/STIs. Thus, some participants described safe sex largely as contraception, with BBVs/STIs constituting a secondary concern or no concern at all.

CONCLUSIONS

Based on the results of this study, tailored sexual health interventions for international students; which incorporate strategies for modifying perceived sexual norms in Australia, are advocated. In addition, this study recommends sexual health interventions that promote dual protection of condoms for both contraception and BBVs/STIs.

Impact-Oriented Dialogue for Culturally Safe Adolescent Sexual and Reproductive Health in Bauchi State, Nigeria: Protocol for a Codesigned Pragmatic Cluster Randomized Controlled Trial

BACKGROUND

Adolescents (10-19 years) are a big segment of the Nigerian population, and they face serious risks to their health and well-being. Maternal mortality is very high in Nigeria, and rates of pregnancy and maternal deaths are high among female adolescents. Rates of HIV infection are rising among adolescents, gender violence and sexual abuse are common, and knowledge about sexual and reproductive health risks is low. Adolescent sexual and reproductive health (ASRH) indicators are worse in the north of the country.

OBJECTIVE

In Bauchi State, northern Nigeria, the project will document the nature and extent of ASRH outcomes and risks, discuss the findings and codesign solutions with local stakeholders, and measure the short-term impact of the discussions and proposed solutions.

METHODS

The participatory research project is a sequential mixed-methods codesign of a pragmatic cluster randomized controlled trial. Focus groups of local stakeholders (female and male adolescents, parents, traditional and religious leaders, service providers, and planners) will identify local priority ASRH concerns. The same stakeholder groups will map their knowledge of factors causing these concerns using the fuzzy cognitive mapping (FCM) technique. Findings from the maps and a scoping review will inform the contextualization of survey instruments to collect information about ASRH from female and male adolescents and parents in households and from local service providers. The survey will take place in 60 Bauchi communities. Adolescents will cocreate materials to share the findings from the maps and survey. In 30 communities, randomly allocated, the project will engage adolescents and other stakeholders in households, communities, and services to discuss the evidence and to design and implement culturally acceptable actions to improve ASRH. A follow-up survey in communities with and without the intervention will measure the short-term impact of these discussions and actions. We will also evaluate the intervention process and use narrative techniques to assess its impact qualitatively.

RESULTS

Focus groups to explore ASRH concerns of stakeholders began in October 2021. Baseline data collection in the household survey is expected to take place in mid-2022. The study was approved by the Bauchi State Health Research Ethics Committee, approval number NREC/03/11/19B/2021/03 (March 1, 2021), and by the Faculty of Medicine and Health Sciences Institutional Review Board McGill University (September 13, 2021).

CONCLUSIONS

Evidence about factors related to ASRH outcomes in Nigeria and implementation and testing of a dialogic intervention to improve these outcomes will fill a gap in the literature. The project will document and test the effectiveness of a participatory approach to ASRH intervention research.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN18295275; https://www.isrctn.com/ISRCTN18295275.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/36060.

Determinants of the Community Knowledge and Attitude Towards HIV Prevention Methods in Majang Zone, Southwest Ethiopia

BACKGROUND

Although in Ethiopia there is a high burden of HIV/AIDS, the community knowledge and attitude towards HIV/AIDS prevention has not been investigated adequately. Thus, this study assessed the determinants of the community knowledge and attitude towards HIV/AIDS prevention in the Majang zone which is the zone with the highest HIV prevalence in Ethiopia.

METHODS

A community-based cross-sectional study was conducted in the Majang zone, southwest Ethiopia from March 1st to May 31st, 2019 by including randomly selected 845 adults. Knowledge and attitude towards HIV prevention methods were dependent variables. The independent variables include socio-demographic characteristics and behavioral factors. A binary logistic regression was employed to determine the association using the odds ratio at 95% confidence intervals. A p-value of less than 5% was considered to declare the final significance.

RESULTS

Of 845 respondents recruited, 772 participated yielding a 91.4% response rate. Not sharing contaminated sharp materials (63.4%), consistent condom use (61.2%), and abstinence (57.9%) were the prevention methods mentioned by majority of the respondents. Only two of five respondents (39.6%) had good HIV prevention knowledge. More than half [412 (53.4%)] of the respondents had a positive attitude towards HIV prevention. The independent determinants of HIV prevention knowledge were secondary educational status (AOR=1.84; 95% CI=1.04, 3.24), tertiary and above educational status (AOR=2.01; 95% CI=1.07, 3.75) and positive HIV prevention attitude (AOR=1.89; 95% CI=1.39, 2.57). Similarly, age of greater than 27 years (AOR=2.13; 95% CI=1.55, 2.95) and good HIV prevention knowledge (AOR=1.83; 95% CI=1.35, 2.48) were significantly associated with a positive HIV prevention attitude.

CONCLUSION

This study revealed insufficient HIV prevention knowledge and attitude in the community with the highest HIV prevalence. To achieve the goal of ending the HIV epidemic, health education should be considered using different innovative approaches especially by prioritizing young and less educated individuals.

Alcohol Consumption, Risky Sexual Behaviors, and HIV in Nigeria: A Meta-Analytic Review

BACKGROUND

Alcohol consumption is associated with risky sex, which increases the risk of acquiring and transmitting HIV.

OBJECTIVE

To examine the prevalence of, and associations among alcohol, risky sex, and HIV, in Nigeria.

METHODS

We searched electronic databases and reviewed reference sections of relevant papers to locate studies that sampled people living in Nigeria and assessed both alcohol and sexual risk behavior. We calculated effect sizes to determine (a) prevalence of alcohol and sex behaviors and (b) associations between alcohol consumption and risky sex, and examined moderators to determine if sample characteristics predicted behavioral or biological outcomes.

RESULTS

Of the 696 unique records identified, 35 manuscripts reporting on 42 separate studies met the inclusion criteria. Participants in these studies (N = 83,350; M age = 26 years; 48% women; 10% HIV-infected) reported high rates of heavy drinking (63%) and low rates of consistent condom use (24%). One-third of participants (30%) also reported using alcohol before sexual activity. Participants who consumed alcohol were more likely to report sexual activity (OR = 3.66, 95% CI = 3.09, 4.33), multiple partners (OR = 3.22, 95% CI = 2.38, 4.36), and condomless sex or inconsistent use of condoms (OR = 2.30, 95% CI = 1.54, 3.43).

CONCLUSION

High rates of heavy drinking and low rates of condom use have been well-documented in Nigeria. Results from this meta-analysis can be used to inform critically needed alcohol-related HIV interventions.

Knowledge gaps of STIs in Africa; Systematic review

Sexually Transmitted Infections (STIs) are ambiguous burden of tremendous health, social and economic consequences. The current systematic review was conducted in order to determine awareness and knowledge of Africans toward sexually transmitted infections, not only concerning HIV/AIDS, but also other STIs such as gonorrhea, syphilis, HBV, HCV and HPV. A systematic review of literature was conducted, studies were retrieved and selected after fulfilling the inclusion criteria as well as passing the assessment procedure. Related data was extracted, quantitative analysis was conducted among participants who responded to questions related to HIV, HBV, HCV, HPV or STIs knowledge, sensitivity analysis as well as subgroup analysis were also conducted. Seventy four articles addressing knowledge among 35 African countries were included and 136 questions were analyzed and synthesized. The question "does using condom reduces HIV transmission?" was answered by 1,316,873 Africans in 35 countries, 66.8% [95% Cl; 62.6, 70.9] answered yes. While the question "is sexual contact a possible route of HBV transmission?" was answered by 7,490 participants in 5 countries; 42.5% [95% Cl; 20.4, 64.7] answered yes. The differences observed among populations are highlighting the possibility for improvement by directing light toward specific populations as well as addressing specific awareness knowledge to ensure that the general as well as the related specific preventive knowledge is improved.

Religiosity and sexual abstinence among Nigerian youths: does parent religion matter?

BACKGROUND

Religion plays an important role in youth behaviours, making it a significant factor in the discourse on youth sexuality in sub-Saharan Africa. Several studies have found that religion and religiosity play an important role in the sexual behaviours of young people. However, little research in Nigeria has examined the mechanisms through which religiosity influences youth sexual behaviour and if parents' religion moderates this relationship. Guided by the social control theory, this paper contributes to the existing literature by examining the relationship between religiosity and youth sexual behaviour.

METHODS

Data for the study came from 2399 male and female youth aged 16-24 years in four states purposively selected from four regions in Nigeria. Abstinence was the sexual behaviour of interest. Logistic regression was used to examine this relationship.

RESULTS

Results showed that 68% of the youth had never had sex. Religiosity was a protective factor for youth sexual behaviour and this positive association was still evident even after controlling for other covariates. Youth who were highly religious (OR - 1.81, CI- 1.13-2.88) had significantly higher odds of abstaining compared to their counterparts who were not religious.

CONCLUSION

Religiosity is a protective factor for sexual abstinence among youth in Nigeria. Policy makers can work around using religious institutions for behavioural change among youth in Nigeria.

Highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon

INTRODUCTION

Cameroon has a high prevalence of out-of-school youths. Therefore, research relating to out-of-school youths and HIV/AIDS is imperative, since they might engage in high risk sexual behaviours. The current study investigated the highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon.

METHODS

A cross-sectional design was adopted using a self-administered questionnaire to collect data from a cluster sample of 405 out-of-school youths, aged 15-24 years. Statistics was calculated using SPSS version 20 at the level 0.05.

RESULTS

By age less than 16 years, more females, 90.2% than males, 71.8% had experienced sex (p < 0.001); more females, 40.4% than males, 23.2% used condoms during first sex (p < 0.01); more males, 70.8% than females, 46.0% had multiple sequential sexual partners during the last one year prior to this study (p < 0.001); more males, 42.6% than females, 18.0% had multiple concurrent sexual partners during the study period (p < 0.01); more youths who did not belong to a well-defined social network, 80.8% had experienced sex than those who belonged, 55.8% (p < 0.001); more youths who did not belong to a well-defined social network had multiple sequential sexual partners, 46.7% than those who belonged, 32.3% (p < 0.01); more youths who belonged to a well-defined social network, 24.3% used condoms consistently than those who did not belong, 15.4% (p < 0.01).

CONCLUSION

Sexual risk behaviours exist among out-of-school youths in urban Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change especially among those with low socioeconomic status. Youths should be encouraged to join well-defined social networks.

Modelling self-assessed vulnerability to HIV and its associated factors in a HIV-burdened country

BACKGROUND

Globally, individuals' self-assessment of vulnerability to HIV infection is important to maintain safer sexual behaviour and reduce risky behaviours. However, determinants of self-perceived risk of HIV infection are not well documented and differ. We assessed the level of self-perceived vulnerability to HIV infection in Nigeria and also identified its risk factors.

METHODS

We explored a recent nationally representative data with self-reported vulnerability ('high', 'low' and 'no risk at all') to HIV infection as the outcome of interest. Data were weighted and association between the outcomes and the risk factors determined. We used simple ordered logit regression to model relationship between the outcome variable and risk factors, and controlled for the significant variables in multiple ordered logistic regression at 5% significance level.

RESULTS

About 74% had good knowledge of HIV transmission and 6% had experienced STI recently. The likelihood of assessing oneself as having 'no risk at all' was 50% and for 'high chances' was 1.6%. Self-perceived high risk of HIV was higher among those who recently experienced STI (5.6%) than those who did not (1.7%), and also higher among those who recently engaged in transactional sex and had multiple sexual partners. The odds of good knowledge of HIV transmission on high self-perceived vulnerability to HIV was 19% higher than poor knowledge (OR = 1.19, 95% CI: 1.12-1.27). Also, respondents who recently had multiple sexual partners were 72% (OR = 1.72, 95% CI: 1.60-1.86) more likely to report self as having high risk. Younger respondents aged 14-19 years had higher odds of 41% (OR = 1.41, 95% CI: 1.29-1.55) to perceive self as having high vulnerability to HIV than older respondents.

CONCLUSION

High vulnerability to HIV infection was reported among younger respondents, those with history of STIS and those who engage in multiple sexual relations. Despite high level of risky sexual behaviour and good knowledge of HIV transmission and prevention found in this study, self-perceived vulnerability to HIV generally is low. For the low perception found in this study to translate to low chance of HIV infection, there is need for all stakeholders to embark on risk reduction initiatives through sexual education that would minimise risky sexual practices and ensuring availability and affordability of HIV prevention methods.

Perceptions of sexual abstinence among Muslim adolescent girls in southern Thailand

Background Sex before marriage among Muslim adolescents is becoming a serious issue in Muslim societies exemplified by an increasing incidence of teenage pregnancy. Sexual abstinence is an optimal goal for adolescent health from an Islamic perspective. Muslim adolescent girls' perceptions have not been investigated, therefore, we lack understanding of their strengths and the risks that may contribute to outcomes such as pregnancy or sexually transmitted infections. Objective The purpose of this investigation was to characterize Muslim adolescent girls' perceptions of sexual abstinence. Methodology This participatory action study was conducted at an Islamic school in southern Thailand. Twenty-five girls, ages 12-14 years old, were purposively selected to participate in the study. Content analysis was used for data analysis. Results Two salient themes were discovered that characterize Muslim adolescent girls' perceptions about sexual abstinence: sexual abstinence is a means of self-protection and sex outside marriage is restricted by Islam, but it seems to be difficult to adhere to. Conclusions Religious values, family and peers play a central role in shaping thoughts and decisions about abstaining from sex. The integration of religious principles with building practical refusal skills, is needed to promote Muslim adolescent health.

Knowledge of HIV and Intention to Engage in Risky Sexual Behaviour and Practices among Senior School Adolescents in Ibadan, Nigeria

A high proportion of adolescents still engage in risky sexual behaviours that put them at risk of infection complications of risky sexual behaviours including Human Immunodeficiency Virus (HIV) infection despite the different interventions already in place. This study was designed to determine the adolescents' knowledge of HIV, intention to engage in risky sexual behaviour and sexual practices. A 3-stage sampling technique was used to select 240 adolescents in senior secondary schools in Ibadan, Nigeria. Data were obtained using a pretested, semi-structured, self-administered questionnaire. Data were analysed using descriptive statistics and Chi-square test at 5% level of significance. The mean age of the respondents was 16.3±1.4 years and 126(52.5%) were females. Only 34.3% had good knowledge of HIV and there were misconceptions about its transmission. Most of the respondents (95.0%) had intention to engage in risky sexual behaviour and those with good knowledge of HIV were willing to engage in risky sexual behavour with familiar people. Good knowledge was associated with intention to engage in low risk sexual behaviour. Seventy-nine (32.9%) were sexually active and they had better knowledge of HIV. Knowledge of HIV was low among this study group and was not associated with their intention to engage in risky sexual behaviour. There is need for more effective and appropriate school and community-based intervention programmes which can impact positively on the adolescents' sexual behaviour.

Perception and Practice of HIV/AIDS Counseling and Testing Among Secondary School Adolescents in Ogun Waterside Local Government Area, Ogun State, Southwest Nigeria

A large proportion of Nigerian adolescents are sexually active and the country has one of the highest HIV prevalence among youths globally. This study was done to assess the perception and practice of HIV/AIDS counseling and testing (HCT) among secondary school adolescents in a rural community in Southwest Nigeria. A cross-sectional descriptive study was carried out using multistage sampling method. The results showed that despite high level of HCT awareness, majority of the adolescents (62.9%) had negative attitude toward it. The practice of HCT was poor among majority of the respondents as less than 15% of the adolescents had ever done HCT. This study recommends that adolescents should be better informed on the locations of the health centers within the community and services rendered by them. Peer education on HCT should also be intensified in schools to promote positive healthy sexual lifestyles among adolescents.

Systematic review: a review of adolescent behavior change interventions [BCI] and their effectiveness in HIV and AIDS prevention in sub-Saharan Africa

BACKGROUND

Despite sub-Saharan Africa [SSA] constituting just 12% of the world's population, the region has the highest burden of HIV with 70% of HIV infection in general and 80% of new infections among young people occuring in the region. Diverse intervention programmes have been implemented among young people but with minimal translation to behavior change. A systematic review of Behavior Change Interventions [BCI] targeting adolescents in SSA was therefore conducted with the objective of delineating this intervention vis-a-vis efficacy gap.

METHODS

From April to July 2015 searches were made from different journals online. Databases searched included MEDLINE, EBSCOhost, PsychINFO, Cochrane, and Google Scholar; Cambridge and Oxford journal websites, UNAIDS and WHO for studies published between 2000 and 2015. After excluding other studies by review of titles and then abstracts, the studies were reduced to 17. Three of these were randomized trials and five quasi-experimental. Overall interventions included those prescribing life skills, peer education [n = 6] and community collaborative programmes. The main study protocol was approved by the University of Malawi College of Medicine Ethics Committee on 30th June 2016 [ref #: P.01/16/1847. The review was registered with PROSPERO [NIH] in 2015.

RESULTS

The review yielded some 200 titles and abstracts, 20 full text articles were critically analysed and 17 articles reviewed reflecting a dearth in published studies in the area of psychosocial BCI interventions targeting adolescents in SSA. Results show that a number of reviewed interventions [n = 8] registered positive outcomes in both knowledge and sexual practices.

CONCLUSIONS

The review demonstrates a paucity of psychosocial BCI studies targeting adolescents in SSA. There are however mixed findings about the effectiveness of psychosocial BCI targeting adolescents in SSA. Other studies portray intervention effectiveness and others limited efficacy. Peer education as an intervention stands out as being more effective than other psychosocial regimens, like life skills, in facilitating HIV risk reduction. There is therefore need for further research on interventions employing peer education to substantiate their potential efficacy in HIV risk reduction among adolescents.

PROSPERO REGISTRATION NUMBER

CRD42015019244, available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015019244 .

A photo voice perspective on factors contributing to the resilience of HIV positive Yoruba adolescent girls in Nigeria

There is a growing discourse worldwide on the impact of the Human Immunodeficiency Virus (HIV) on "at risk youths". In response, five HIV-positive Nigerian adolescent girls were qualitatively investigated in collaboration with a non-governmental organisation (NGO) in Ibadan, an urban settlement in Nigeria in 2013. Using a secondary data analysis from a photo voice component of the research, combined with narratives, we show that participants possess the capacity to overcome their adversities from the effects of HIV infection and remain resilient. Few studies have used photovoice - a visual participatory approach - and its impact on this group. The theories of Bourdieu, Piaget and Erikson were used as tools to interpret and document, resilience, social capital and coping among participants. Findings reveal participants frame positive goals, use social competence, coping skills, and express personal challenges. These have serious implications for policy makers, researchers and programmer in strengthening adolescents' resilience.

Promoting the sexual and reproductive health of adolescent females in Ijebu-Ode, southwest, Nigeria: a study of sexual risk-taking

Sexual risk-taking among adolescents, leads to several negative sexual and reproductive health outcomes such as unwanted pregnancies and sexually transmitted infections (STIs). This study assessed sexual risk behaviours and associated factors among in-school adolescent females in Ijebu-Ode, Nigeria. A cross-sectional study was carried out among 131 female adolescents selected via multi-stage sampling from senior secondary schools in Ijebu-Ode, southwest Nigeria. Data was collected using a validated, semi-structured, self-administered questionnaire and analysed using SPSS 17.0. Relevant descriptive and inferential statistics were calculated, with p set at <0.05. Participation was fully voluntary. The mean age of respondents was 16±1.3 years. Thirty-eight (14.5%) of respondents were sexually exposed with the mean age of sexual debut being 13.4±2.8 years. Participants with sexual exposure reported vaginal sex (89.5%), digital sex (36.8%) and oral sex (5.3%). A total of 42.1% had multiple sexual partners, 47.4% used condoms during sex. Only 13% of the respondents were engaged in sexual risk-taking. Factors associated with sexual risk-taking include: age, type of school, father being alive, having a boyfriend, age of boyfriend, low self-esteem and a history of non-consensual sex. Sexually-active adolescents engaged in risky sexual behaviours. Comprehensive sexuality education, behaviour change communication and adolescent-friendly services will adequately address the situation.

Sexual abstinence and HIV knowledge in school-going adolescents with intellectual disabilities and non-disabled adolescents in Nigeria

OBJECTIVE

The study compared sexual practices and predictors of sexual abstinence among adolescent learners with mild/moderate intellectual impairments and their non-disabled peers in Nigeria.

METHOD

This was a comparative, cross-sectional survey that assessed sexual practices of learners with mild/moderate intellectual impairments (N = 300) and non-disabled learners (N = 300), aged 12-19 years, in Oyo State, Nigeria. Data were analysed using SPSS 15.0.

RESULTS

Findings indicated that learners with mild/moderate intellectual impairments abstained from sex less than non-disabled adolescents (p = 0.002). Girls with intellectual disabilities were almost four times more likely to report history of rape than non-disabled girls. There was no significant difference between sexually abstinent and sexually experienced learners with intellectual disabilities (p = 0.671) and non-disabled adolescents (p = 0.181) in their mean HIV transmission knowledge scores. Many factors, including being male, social supports and self-efficacy determined sexual abstinence among adolescents.

CONCLUSIONS

Although sexual abstinence is the recommended HIV-prevention strategy in HIV prevention curriculum in Nigerian schools, findings of this study suggested that sexual abstinence alone may not be effective for adolescent learners with intellectual disabilities. Interventions targeting youth with intellectual disabilities should consider all these factors.

Parents' perceptions of timing of initiation of sexuality discussion with adolescents in Anambra State, South Eastern Nigeria

STUDY OBJECTIVE

This study was aimed at determining the perception of the timing and practice of sexuality discussion among parents in South Eastern Nigeria.

DESIGN

A cross-sectional, descriptive, community-based study.

SETTING

The study was carried out in 3 randomly selected Local Government Areas in Anambra State, South Eastern Nigeria.

PARTICIPANTS

The study participants were parents with adolescent children resident in the study areas for at least 2 years.

RESULTS

Most parents opined that sexuality discussion should be initiated after puberty. Only 20% of them discussed reproductive health issues often with their adolescents, while another 20% never discussed such issues with their adolescent children. Topics most commonly discussed bordered on the adverse consequences of sex rather than measures for preventing them. About half of parents were willing to discuss contraception with their adolescent child. Predictors of parent-child communication were age, gender, and educational status.

CONCLUSION

Common reasons for low parental involvement in sexuality discussions were due to their lack of capacity and the perception that discussing such issues before puberty is ill timed. Therefore, measures should be taken to improve the capacity of parents to engage in such conversations to provide sexuality information to their teens.

Factors associated with pre-marital sexual debut among unmarried high school female students in bahir Dar town, Ethiopia: cross- sectional study

Background

Pre-marital sexual debut increase the risk of sexually transmitted infections (STIs) including HIV/AIDS and unwanted pregnancy. It may also affect their school performance and completion rate. In spite of this fact, number of unmarried female students who started sexual debut is increasing from time to time. However, information on the extent of pre-marital sexual debut and associated factors were not well studied and documented in the study area where pre-marital sexual debut is largely condemned. Therefore this study was conducted to assess the magnitude and associated factors of pre-marital sexual debut.

Methods

School based cross-sectional survey was conducted from May 10-13/2012. A total of 1123 unmarried high school female students were selected by multi- stage sampling technique. Data were collected using structured, self administered questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used to identify factors associated with pre-marital sexual debut.

Results

Among unmarried high school female students 30.8% reported pre-marital sexual debut. The major associated factors were frequent watching of pornographic video [AOR = 10.15, 95% CI: (6.63, 15.53)], peer pressure [AOR = 2.98, 95% CI: (1.57, 5.67)] and chewing khat [AOR = 8.99, 95% CI: (3.84, 21.06)].

Conclusion

Significant proportion of unmarried high school female students have started pre-marital sexual debut. The finding suggests the need for communicating and supporting school students to help them make informed and safer decisions on their sexual behavior. Therefore, Bahir dar city administration health and education bureau should design persistent and effective health education to decrease pre-marital sexual debut in unmarried female students.

Myths and misconceptions about HIV transmission in Ghana: what are the drivers?

Biomedical and social cognitive models driving HIV preventive activities in sub-Saharan Africa are mostly premised on factual and accurate knowledge of the disease. While knowledge about HIV exists in most parts of Africa, there is widespread belief in myths that often contradict and undermine preventive efforts. Using the 2008 Demographic and Health Survey and applying logit models, we examined what influences belief in myths and misconceptions surrounding HIV transmission among Ghanaian men and women. Results indicate that respondents with high knowledge of how HIV may be transmitted had lower odds of endorsing myths about the disease. Compared to the less educated and poorer Ghanaians, educated and wealthier Ghanaians were less likely to endorse myths about HIV. Also, compared to the Akan people, respondents identifying with other ethnic groups were significantly less likely to endorse myths. The findings suggest that policy makers provide accurate information about how the disease is spread to counter myths surrounding HIV transmission.

HIV knowledge and sexual risk behavior among street adolescents in rehabilitation centres in Kinshasa; DRC: gender differences

BACKGROUND

Street children, common in Africa, are increasingly vulnerable to alcohol and drugs of abuse and lack access to both healthcare and knowledge about HIV and AIDS. Hence, this study assessed the level of knowledge about sexually transmitted infections (STIs), including HIV, among street adolescents in the Democratic Republic of the Congo (DRC).

METHODS

A random sampling of 200 street children (10-25 years of age) were selected from 17 rehabilitation centres in Kinshasa, and a structured questionnaire was administered to all participants in their respective centres. High knowledge, knowledge or awareness of condom was defined when a participant gave more than 67% of correct responses. Chi square analysis was used to test differences between sexes.

RESULTS

The knowledge level of respondents was high. 54.3% of males and 45.7% of girls have heard about HIV), and few participants cited unprotected sex as mode of transmission (42.9% for males and 57.1% for females). A high number of children reported a previous sexual experience. Satisfying a natural bodily need was the main reason for having sex. However, the use of condoms is still low in both genders (26.2 versus 59.3%, p<0.01). Neither gender reported a reason why they are not using a condom.

CONCLUSION

This study highlights the high knowledge about HIV, which contrasts with low condom use and high past sexual experiences with the high number of sexual partners and sexual contacts. Policies targeting these findings are warranted to reverse such trends.