Substance use and sexual behaviour among female students in Nigerian universities

Sexual risk-taking behavior amongst emerging adults in a tertiary institution of learning in Coastal Kenya: A qualitative study of stakeholders' perspectives using causal loop mapping

BACKGROUND

It is known from previous studies that university students in sub-Saharan Africa (sSA) engage in sexual risk-taking behaviour (SRTB). However, there is paucity of data on factors contributing to SRTB among university students (emerging adults) at the Kenyan Coast thus hindering intervention planning. This study seeks to provide an in-depth qualitative understanding of the factors contributing to SRTB and their interconnectedness among university students at the Kenyan Coast combining qualitative research with a systems thinking approach.

METHODS

Using the ecological model, and employing in-depth interviews, we explored the perceptions of twenty-six key informants (twenty-one emerging adults and five other stakeholders) on what constitutes and influences SRTB among emerging adults at a tertiary institution of learning in Coastal Kenya. Data were analysed using a thematic framework approach. A causal loop diagram (CLD) was developed to map the interconnectedness of the correlates of SRTB.

RESULTS

Our findings show that unprotected sex, transactional sex, cross-generational sex, multiple sex partnerships, gender-based violence, sex under influence of alcohol/drugs, early sex debut, and sharing sex toys were common SRTBs. Based on the ecological model and CLD, most of the reported risk factors were interconnected and operated at the individual level.

CONCLUSION

Our study shows that emerging adults are frequently engaging in unprotected sex. Enhancing sexuality education programs for students in Kenyan universities and strengthening support systems including counselling for those using alcohol/drugs may help reduce SRTB among emerging adults in Kenyan universities.

Perception of Substance Abuse Amongst Adolescents and Young Adults in Ikenne Local Government, Ogun State, Nigeria

Substance abuse describes the unsafe use of psychoactive substances. It leads to dependence on the abused substance with subsequent development of health disorders and mortality. Globally, millions of adolescents and young adults from low and middle income countries are prone to substance abuse with consequent far reaching impact on national development. This study was done to assess the perception of substance abuse amongst the adolescents and young adults in Ikenne local government area, Ogun State, Nigeria. A cross sectional descriptive qualitative study was conducted. Information was gathered via nine focus group discussions. Systematic Analysis of data was done. Ninety-three youths (31 males and 62 females) aged 19.5 ± 3.9 years participated. Majority of the participants showed high level of awareness on substance abuse and its effects. They stated that it was commonplace in the community, with peer pressure being the major influencing factor. Alcohol was perceived to be the commonest abused substance. Others include cigarettes, marijuana and codeine. None were aware of existing laws against substance abuse. The major factor responsible for the negative perception in the abuse of substance was peer influence and low level of awareness of the National regulations on substance abuse. It is recommended that more education, increase in awareness of the national regulations and peer-modelling technique should be strengthened within the community to correct the negative perception by these group of people.

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.

Cannabis Normalization Among Young Adults in a Nigerian City

Drug normalization has been researched extensively in the West. Yet, we know little about how drug use is normalized in non-Western contexts. Drawing on interviews with young adults, this study is the first to explore illicit drug normalization in Nigeria. Cannabis was widely available and easy to access and students were part of the supply chain. Citing therapeutic and functional benefits, participants normalized cannabis consumption, using it to prepare soup, noodles, and birthday cakes. Unlike women, who may give up cannabis use due to stigmatization and marriage, men had no plans to stop its use. Gender determined drug-taking practices and social accommodation of drug users, suggesting differentiated normalization. Men who used cannabis were accommodated by their peers, unlike women, who were stigmatized by female non-users. In general, the findings highlight a shift in illicit drug use practices and noticeable gendered and differentiated social accommodation among peers, although cultural acceptance of illegal recreational drugs remains at the margin.

Tobacco use in Nigerian youth: A systematic review

Background

Tobacco use is the most important preventable cause of premature death and major risk factor for non-communicable diseases. Due to strict tobacco legislation in the western hemisphere, many African nations like Nigeria have shifted from being a tobacco-producing nation to a tobacco-consuming one. The purpose of this study was to systematically review existing literature on tobacco use among Nigerian adolescents and young people and identify the prevalence, distribution and factors influencing of tobacco smoking. These data are necessary to formulate and adapt control measures aimed at tobacco cessation among young people, and preventing long-term smoking behaviors.

Methods

Three databases (African Journals Online, PsychInfo, PubMed) were searched for peer-reviewed publications, published between January 2000 and March 2017. Additional searches were completed on Google Scholar, and other documents and reports of the Nigerian government and the Global Youth Tobacco Survey were consulted. Using the PRISMA guidelines to evaluate studies, we included studies that reported prevalence of tobacco use in adolescents or youths, aged 10 to 24, and excluded evaluations of tobacco-related medical conditions.

Results

A total of 30 studies with a total population of 26,709 were reviewed. Prevalence rates of tobacco smoking ranged from 0.2% to 32.5%. Among the gender-specific studies, the prevalence of smoking among females ranged between 2.2% to 10% while that of males ranged from 1% to 32.5%. Gender distribution among these studies was mixed (80.0%), males only (13.3%) and females only (6.7%). Smoking prevalence was higher among males than females. The most common risk factors for tobacco use included peer influence, family conditions, psychosocial factors and male gender. Additional risk factors included concomitant substance abuse, media advertisements and increasing age.

Conclusions

Tobacco smoking poses a huge burden to Nigerian youths and various determinants were highlighted in this review. It is imperative that all stakeholders engage in concerted efforts to target both in-school and out-of-school youths in tobacco control strategies.

Risk perception and correlates of alcohol use among out-of-school youth in motor parks in Lagos State, Nigeria

BACKGROUND AND AIM

The prevalence of alcohol use has increased globally. Out-of-school youth are a vulnerable group who might have missed opportunities for learning healthy behaviours in a formal school environment. The purpose of this study was to determine the risk perception, pattern of use, and correlates of alcohol use among out-of-school youth in Lagos, Nigeria.

METHODS

A cross-sectional study was conducted among 380 out-of-school youth in motor parks in Lagos State, Nigeria, using interviewer administered questionnaires.

RESULTS

The lifetime prevalence of alcohol use was 61.1%, while 55.5% were current drinkers. Beer (57.3%) was the most consumed type of alcohol, followed by distilled spirits (29.8%). Using the CAGE scoring system, more than half (57.8%) of the current drinkers had a drinking problem. Almost three quarters (70.1%) had experienced at least one episode of alcohol intoxication within the past month. A considerable number of current drinkers (63.5%) desired to reduce their alcohol intake or stop drinking, while 45.5% had made unsuccessful attempts to do so within the past year. Only 28.9% had received assistance to quit or reduce their drinking and of these less than half (39.3%) received assistance from a professional or healthcare worker. Males were more likely to be current drinkers and to have experienced episodes of alcohol intoxication. Parental and peer drinking were associated with alcohol use but not with intoxication.

CONCLUSIONS

It is important to design specific programmes to reduce alcohol use among out-of-school youth in these settings.