Consistent condom use among sexually active young adults in Ghana: an analysis of prevalence and associated factors

Consistent and proper condom use offers a safer, economically cheap and practically effective means of preventing HIV infection. Using the 2014 Ghana Demographic and Health Survey with a sample of 2779 sexually active youth (males = 682 and females = 2,097) in the age range 15-24, this study explored the prevalence of, and factors associated with consistent condom use among sexually active young adults in Ghana. Multivariate logistic regression was used to analyse the data. Our results showed that approximately 11% of the respondents reported consistent condom use in their previous sexual activity. Females were more likely than males to have used a condom consistently. The logistic regression results showed that females who had tested for HIV were less likely to use a condom consistently. However, those who have obtained family planning information from print media and those from the northern part of Ghana were more likely to practise consistent condom use. Furthermore, males who professed the Traditional African religion were less likely to use a condom consistently. In contrast, males in the rich wealth category were more likely to use a condom consistently. These findings underscore the need for behavioural change campaigns targeting young adults, particularly those who are sexually active, to encourage consistent condom use. These interventions should target young adults with less family planning knowledge, those who know their HIV status and those who profess the Traditional African religion.

Perceptions of and barriers to uptake of contraceptives in plantation farming communities of Cross River State, Nigeria: A qualitative inquiry

The contraceptive use in Nigeria is relatively low, indicative of the non-adoption of contraceptives by people of reproductive age to curtail the increasing fertility rate with its attendant consequences on the family. The non-use is attributed to numerous factors, including perceptions of and attendant barriers to the uptake of contraceptives. This study was aimed at assessing the perception of and barriers to the uptake of contraceptives among residents of plantation farming communities in Cross River State, Nigeria. It was a multi-sited qualitative descriptive study conducted in three Local Government Areas (Ikom, Yakurr, and Akamkpa) in Cross River State, Nigeria between March and April 2022. Nine Focus Group Discussions (FGDs) and twelve key informant interviews (KIIs) were conducted with respondents from three plantation farming communities. The FGDs were conducted on sexually active unmarried girls, married women within the reproductive age, and married men with spouses of reproductive age. The KIIs were conducted on health care providers, village heads, youth leaders, and women leaders. The generated data were thematically analyzed using both deductive and inductive analytical approaches. Married women were deemed eligible to use contraceptives, which are viewed as a method for preventing pregnancy. The information supplied by healthcare professionals was deemed insufficient for women to make informed decisions. Fear of side effects, dysfunctional health facilities, frequent stock outs, and spousal opposition were the most significant barriers to contraceptive use. Family planning programs should be targeted more at residents of rural areas to increase awareness, dispel misconceptions, and promote contraceptive use.

What Adolescents Say in Text Messages to Motivate Peer Networks to Access Health Care and Sexually Transmitted Infection Testing: Qualitative Thematic Analysis

BACKGROUND

While rates of HIV and sexually transmitted infections (STIs) are extremely high among adolescents and young adults in the United States, rates of HIV and STI testing remain low. Given the ubiquity of mobile phones and the saliency of peers for youths, text messaging strategies may successfully promote HIV or STI testing among youths.

OBJECTIVE

This study aimed to understand the types of messages youths believe were motivating and persuasive when asked to text friends to encourage them to seek HIV or STI testing services at a neighborhood clinic.

METHODS

We implemented an adolescent peer-based text messaging intervention to encourage clinic attendance and increase STI and HIV testing among youths (n=100) at an adolescent clinic in San Francisco, California. Participants were asked to send a text message to 5 friends they believed were sexually active to encourage their friends to visit the clinic and receive STI or HIV screening. Thematic analysis was used to analyze the content of the text messages sent and received during the clinic visit. Member checking and consensus coding were used to ensure interrater reliability and significance of themes.

RESULTS

We identified four themes in the messages sent by participants: (1) calls to action to encourage peers to get tested, (2) personalized messages with sender-specific information, (3) clinic information such as location and hours, and (4) self-disclosure of personal clinic experience. We found that nearly all text messages included some combination of 2 or more of these broad themes. We also found that youths were inclined to send messages they created themselves, as opposed to sending the same message to each peer, which they tailored to each individual to whom they were sent. Many (40/100, 40%) received an immediate response to their message, and most participants reported receiving at least 1 positive response, while a few reported that they had received at least 1 negative response. There were some differences in responses depending on the type of message sent.

CONCLUSIONS

Given the high rates of STI and HIV and low rates of testing among adolescents, peer-driven text messaging interventions to encourage accessing care may be successful at reaching this population. This study suggests that youths are willing to text message their friends, and there are clear types of messages they develop and use. Future research should use these methods with a large, more diverse sample of youths and young adults for long-term evaluation of care seeking and care retention outcomes to make progress in reducing HIV and STI among adolescents and young adults.

Prevalence, Trends, and Factors Associated with Teen Motherhood in Nigeria: An Analysis of the 2008-2018 Nigeria Demographic and Health Surveys

Background: Teen pregnancy and childbearing are common in Nigeria, and understanding the complexities, such as sociodemographics and economic factors including sexual and reproductive health knowledge and awareness among adolescents over time can trigger innovative approaches and interventions. This study intends to capture the patterns and associated factors of teen motherhood among sexually active adolescents (15-19 years) between 2008 and 2018. Methods: The study data was extracted from 2008, 2013, and 2018 Nigeria Demographic and Health Surveys. Descriptive analysis was presented using frequencies and percentages; multivariable analysis was conducted using log-binomial logistic regression at a p-value <0.05. All analyses were performed using Stata 15.0, weighted and adjusted for the complex survey design and population size. Results: The prevalence of teen motherhood increased between the three successive survey waves (50.9% vs. 52.4% vs. 55.2%) from 2008, 2013, and 2018. Although, the pooled adjusted analysis revealed no significant change over the 10-year period. Knowledge of modern contraceptive methods, primary education, non-Catholic Christians, residing in the South-South region, and those currently or formerly married were associated with increased risk of teen motherhood. There was an inverse relationship between teen motherhood and wealth status; lower wealth status was associated with high adolescent pregnancy and childbearing. Conclusion: This study revealed an increase in the proportion of teen pregnancy and childbearing in Nigeria. Notably, there exist variations across age groups, geographic location, educational level, religious belief, marital and economic status. Interventions that ensure comprehensive sexuality education, girl child education, and economic empowerment especially for school dropouts are advocated to reduce teen motherhood.

Adolescent Experience With Dating Violence in Relation to Virginity Status: Findings From a Jamaican Sample

The association between adolescents' involvement in sexual intercourse and their experiences with adolescent dating violence (ADV) is an understudied topic. This study examined this relationship for 178 Jamaican adolescents in Grades 9-11. The expectation that adolescents who reported having had sexual intercourse would report greater victimization and greater perpetration than adolescents who had not had intercourse was consistent only for sexual abuse. Analyses also showed that sexually experienced males perpetrated and experienced more psychological abuse compared to males who were not so experienced. These results suggest different experiences based on adolescents' sex and so support others' calls for ADV research to do more examinations by sex. Also, it endorses the importance of doing research on both victims and perpetrators of intimate abuse. Implications of these findings for sexual and relationship education of adolescents are discussed.

Assessment of Contraceptive Use by Marriage Type Among Sexually Active Men in Nigeria

Marital status, from the perspective of men (and especially sexually active men), as a potential factor that influences contraceptive use for the purposes of fertility control, has received little consideration in the scientific literature. This study thus assesses contraceptive use among sexually active men occupying different marital statuses. The study employed the 2013 Nigeria Demographic and Health Survey dataset. Using a total sample of 11,476 weighted sexually active men, the study revealed that 30% of the sampled population were currently using contraceptives, with condom as the dominant method (65.9%). The unadjusted odds of contraceptive use was significantly higher (9.4; confidence interval [8.1, 10.9]) among single men than married. Other factors include wealth, educational attainment, ethnicity, region, religion, and age. The study concludes that there are significant differences in contraceptive use between the single and married men and, therefore, recommends that policy and programs be put in place to promote consistent use of contraceptives among married men in Nigeria.