Effect of sex education programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria

Background

Adolescents display sexual behaviours and developmental characteristics that place them at risk for Sexually Transmitted Diseases (STDs). Because young people experiment sexually and because of the consequences of indiscriminate sexual activities on the youth, there is the need to mount sex education programmes that are geared towards enlightenment and appropriate education about sex and sexuality.

Objective

To determine whether Sex Education Intervention Programme would reduce at-risk sexual behaviours of school-going adolescents.

Design

Pre-test, post-test control group quasi-experimental design

Setting

A randomly selected co-educational school in Ilorin Metropolis, Nigeria

Participants

24 school-going adolescents aged 13–19 years

Intervention

Sex Education Programme (treatment group) versus Control programme (placebo)

Main Outcome Measures

Self-reported exposure to sexually transmitted diseases, multiple sex partners, anal sex, oral sex, non use of condom.

Result

When the treatment (intervention) group was compared with the control group in an intention to treat analysis, there were significant differences in at-risk sexual behaviours of the two groups. Those in the intervention group reported less at-risk sexual behaviours than their counterparts in the control group. The treatment group evaluated the intervention programme positively and their knowledge of sexual health improved. Lack of behavioural effect on the control group could be linked to differential quality of delivery of intervention.

Conclusion

Compared with the control group, this specially designed intervention sex education programme reduced at-risk sexual behaviour in adolescents. Based on this finding, it was recommended that sex education be introduced into the curriculum of secondary school education in Nigeria.     

Contraceptive non-use and associated factors among university students in 22 countries

Background

The aim of this study was to investigate contraceptive non-use and associated factors (socio-demographics, sexual behaviour, internal assets and mental health) among undergraduate university students in 22 countries.

Methods

Using anonymous questionnaires, data was collected from 16979 undergraduate university students (mean age 20.8, SD=2.8) from 23 universities in 22 countries.

Results

Of the total sample of 16979 undergraduate university students, 7032 (41.9%) reported to have been sexually active in the past 12 months. Of those who had been sexually active, 42.6% reported never (42.7% among male and 42.6% among female students) using contraceptives in the past 12 months. In multivariate regression analysis, among both men and women, younger age, religious affiliation (Hindu; and among women only being Muslim), intrinsic religiosity, and sexually protective behaviour were associated with contraceptive non-use. Lack of internal assets (among men, low life satisfaction and lack of personal control, and among women low personal mastery) ; among women not having depressive symptoms and among men having PTSD symptoms were associated with contraceptive non-use.

Conclusion

Low contraceptive use was found and several factors identified as associated with contraceptive non-use may help guide intervention efforts.     

Sexual function in older women with pelvic floor symptoms: a cross-sectional study in general practice

Background

Pelvic floor symptoms are common and are negatively associated with sexual function which, in turn, is an important aspect of quality of life. The majority of older women with pelvic floor symptoms are treated in general practice but evidence from studies in general practice on the sexual functioning of these women is scarce.

Aim

This study examined predictors of sexual inactivity in older women with pelvic floor symptoms in general practice and of sexual functioning in those women who are sexually active.

Design and setting

Cross-sectional study in women (aged ≥55 years) from 20 general practices who screened positive on a pelvic floor symptom questionnaire.

Method

Logistic and linear regression analyses were used to determine predictors of sexual inactivity and sexual functioning (PISQ-12) by assessing their association with patient characteristics, symptoms (PFDI-20) and degree of prolapse (POP-Q).

Results

A total of 639 women were included (sexually active n = 393, sexually inactive n = 246). Predictors of sexual inactivity were increasing age (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.10 to 1.17) and lower education (OR = 2.31; 95% CI = 1.50 to 3.54; Nagelkerke R² = 0.208). In sexually active women, sexual functioning was associated with pelvic floor symptom distress (P<0.001) and pelvic floor surgery (P = 0.018; R² = 0.138).

Conclusion

In older women with pelvic floor symptoms, increasing age and lower educational level are predictors of sexual inactivity. Many of these older women are sexually active and pelvic floor symptom distress is negatively associated with sexual functioning. These results may encourage GPs to ask about sexual problems in women with pelvic floor symptoms.     

"We have our own special language." Language, sexuality and HIV/AIDS: a case study of youth in an urban township in South Africa

Background

Despite the fact that most South African youth know about HIV / AIDS and how it can be prevented, there is a high prevalence of HIV / AIDS amongst youth in South Africa. Generally youth do not practice safe sex, and youth sexuality is characterised by multiple sexual partners, not using condoms and transactional sex.

Objectives

To minimize the risk of HIV infection, it is necessary to understand youth sexuality. In this paper I explore youth sexuality with a specific focus on how language influences sexuality.

Methods

I use discourse analysis and qualitative research techniques. Purposive sampling, a form of non-probability sampling was used. I interviewed seventy youth individually or in groups and used in-depth semi-structured interviews.

Results

The use of language influences youth sexuality. Youth have developed a specialised language to talk about sex and sexuality and this language has become part of the daily discourse, so that unsafe sexual practices become norms and are justified.

Conclusions

The realm of language can be a creative way for peer and HIV / AIDS educators to work with youth towards creating a healthier sexuality. However, as language always occurs in a material context, it is also necessary to work towards changing the material environment, such as poverty. This environment not only facilitates the development of a particular language but it also encourages unsafe sexual practices such as transactional sex.     

Sexual behavior of medical students: A single institutional survey

Objective

We investigated the sexual practices of medical students as they are positioned to serve as peer educators in the fight against HIV/AIDS.

Methods

This was a cross sectional study, where self- administered questionnaires were distributed to consenting 4^th to 6^th year medical students in Jos, Nigeria with a view of elucidating information regarding sexual practices and condom utilization. Safe sex practice was defined as the use of condoms and being in a monogamous relationship.

Results

Of a total of 400 questionnaires distributed, 365 respondents (249 males and 116 females) had adequate data for analysis. A large proportion (62%) of our students have never had sex before and less than 30% of them are sexually active. Only 6.1% had multiple sexual partners and homosexuality was uncommon (1.9%). Condom utilization amongst the sexually active was high (65%) and similar among male and female students (71.3% vs. 51.9% respectively, p = 0.08).

Conclusion

There exists safe sexual practice among medical students in our setting. This group could be recruited as peer educators in the war against HIV/AIDS.     

Perception and practice of contraception among male soldiers in Sobi barracks,Ilorin, Nigeria

Background

There is a popular belief among the general population that Nigerian soldiers tend to have large families but this has not been substantiated with evidence-based research. The Nigerian military health authority implements female-targetted contraception strategies, with less focus on their husbands; who are the dominant fertility determinants.

Objective

To determine the perception and practice of contraception among male soldiers of Sobi Cantonment, Ilorin, Nigeria, with a view to instituting male-targeted contraceptive/family planning strategies.

Methodology

A cross-sectional survey of 334 male soldiers using multistage sampling technique and pre-tested interviewer administered questionnaires.

Results

The respondents'' approval of contraception (73.6%) and willingness to discuss it with their spouses/partners (71.6%) were high. Fear of wives/partner''s sexual promiscuity (55.7%), cultural and religious beliefs (43.2%), fear of the side effects of contraceptives (29.5%) and the desire for more children (21.6%) were reported reasons for the non-approval of contraception. The prevalence of contraceptive use among the respondents was low (12.3%). There was a significant relationship between the respondents'' educational level and contraceptive use (p< 0.05).

Conclusion

The study revealed a high approval and willingness to discuss contraception with their spouses/partners but low contraceptive use.     

Sexual, reproductive health needs and rights of young people with perinatally acquired HIV in Uganda

Background

Numbers of young people with perinatally acquired HIV is growing significantly. With antiretroviral drugs, children who get infected at birth with HIV have an opportunity to graduate into adolescence and adulthood. This achievement notwithstanding, new challenges have emerged in their care and support needs. The most dynamic being, their sexual and reproductive health needs and rights (SRHR).

Objectives

This paper aimed at establishing the gaps at policy, program and health systems level as far as addressing sexual and reproductive health needs of young people who have lived with HIV since infancy is concerned.

Methods

This paper is based on a desk review of existing literature on sexual and reproductive health needs and rights of young positives.

Results

The results indicate young positives are sexually active and are engaging in risky sexual encounters. Yet, existing policies, programs and services are inadequate in responding to their sexual and reproductive health needs and rights.

Conclusion

Against these findings, it is important, that policies specifically targeting this subgroup are formulated and to make sure that such policies result in programs and services that are youth friendly. It is also important that integration of Sexual Reproductive Health (SRH) and HIV services is prioritized.     

Knowledge on Osteoporosis of Prescriber According to Level of Medical Institute

Purpose

There are gaps between the treatment guideline and clinical practice of osteoporosis showing low compliance. Although attitude and knowledge of prescriber have been known to be associated with the low compliance in real clinical practice, no study has assessed the knowledge of prescriber regarding osteoporosis in accordance to the level of medical institution. We compared the knowledge on osteoporosis of general practitioners with that of practitioners in a tertiary referral hospital.

Materials and Methods

In May 2012, 40 general practitioners and 40 practitioners in a tertiary referral hospital were evaluated using a modified Facts on Osteoporosis Quiz.

Results

The level of knowledge of general practitioners was similar with that of practitioners in a tertiary referral hospital (p=0.386). And, both groups were lack of knowledge of effect of physical exercise.

Conclusion

The level of knowledge on osteoporosis was not associated with the level of medical institute, and the effect of physical exercise should be stressed in an educational program on osteoporosis for practitioners.     

Counselling at primary health facilities and level of knowledge of antenatal attendees and their attitude on prevention of Mother to Child Transmission of HIV in Dar-es salaam,Tanzania

Background

Children living with HIV worldwide majority are infected through mother to child transmission of HIV (MTCT) acquired during pregnancy. Knowledge, attitude and behavioral changes are pivot tools towards success of any interventions.

Objectives

To determine the effectiveness of counseling on HIV done in primary health facilities (PHF), level of knowledge gained and attitude changes towards PMTCT.

Methods

A cross sectional study assessing pregnant women''s knowledge and their attitude towards PMTCT was conducted in Temeke district from October 2010 to Jan 2011 using a structured questionnaire.

Results

A total of 383 antenatal attendees were referred to Temeke district for management after counselled and tested for HIV in PHFs. Majority (86.9%) had primary education and good knowledge on MTCT. Correct timing of ARVs prophylaxis (15.7%) as preventive measures for MTCT was poor. Education and employment were associated with good knowledge on MTCT of HIV. Women had positive attitudes towards HIV counseling and testing, but stigma was a barrier to disclosure of one''s serostatus.

Conclusion

There is knowledge gap in routine PMTCT counseling among antenatal attendees in our PHFs. Effective counseling on PMTCT in the PHFs will bridge the identified knowledge gap and help in reduction of pediatric HIV.     

Correlates of misperceptions in HIV knowledge and attitude towards People Living With HIV/AIDS (PLWHAs) among in-school and out-of-school adolescents in Ghana

Background

A quarter century into the HIV pandemic, knowledge about sexual transmission and sharing of needles remain high just as misperceptions relating to casual contact.

Objectives

To assess HIV knowledge, misperceptions, and attitude towards people living with HIV/AIDS (PLWHAs) among adolescents.

Methods

A cross sectional quantitative and qualitative study was conducted among adolescents aged 10–19 (n = 483; mean age, 16.6) in the Ashanti region of Ghana.

Results

Knowledge score ranged 0 to 38 (mean = 26.64; sd ± 6.74). To prevent AIDS, 78.1% mentioned sexual abstinence, condom use (72.7%), fidelity to partner (72.5%), not sharing needles (76.4%), and reducing sexual partners (56.7%). Statistically significant associations were found in high misperception scores and having negative attitude towards PLWHAs (0.001 < p < 0.009). Out-of-school adolescents were less likely to be willing to take care of HIV/AIDS relatives (p = 0.004); allow PLWHAs conceal their status (p < 0.001); allow PLWHAs to work with others (p = 0.007); more likely to let PLWHAs have less healthcare (p = 0.026); and indicate that PLWHAs should be isolated (p < 0.001).

Conclusion

Out-of-school adolescents constitute hard-to-reach population and mechanisms should be developed to reach them to reduce misperceptions which may fuel stigma and discrimination.     

Effectiveness of counseling at primary health facilities: Level of knowledge of antenatal attendee and their attitude on Prevention of Mother to Child Transmission of HIV in primary health facilities in Dar es salaam,Tanzania

Background

Children living with HIV worldwide majority are infected through mother to child transmission of HIV (MTCT) acquired during pregnancy. Knowledge, attitude and behavioral changes are pivot tools towards success of any interventions.

Objectives

To determine the effectiveness of counseling on HIV done in primary health facilities (PHF), level of knowledge gained and attitude changes towards PMTCT.

Methods

A cross sectional study assessing pregnant women''s knowledge and their attitude towards PMTCT was conducted in Temeke district from October 2010 to Jan 2011 using a structured questionnaire.

Results

A total of 383 antenatal attendees were referred to Temeke district for management after counselled and tested for HIV in PHFs. Majority (86.9%) had primary education and good knowledge on MTCT. Correct timing of ARVs prophylaxis (15.7%) as preventive measures for MTCT was poor. Education and employment were associated with good knowledge on MTCT of HIV. Women had positive attitudes towards HIV counseling and testing, but stigma was a barrier to disclosure of one''s serostatus.

Conclusion

There is knowledge gap in routine PMTCT counseling among antenatal attendees in our PHFs. Effective counseling on PMTCT in the PHFs will bridge the identified knowledge gap and help in reduction of pediatric HIV.     

Gender issues in contraceptive use among educated women in Edo state, Nigeria

Background

While traditional contraception is widely used, in southern Nigerian modern contraception is a relatively recent phenomenon. Modern contraception is more wide spread among the educated and sexually active youth in Nigeria. Few studies have been done on contraception among educated women in Nigeria

Objectives

This study was carried out in December 2000 to determine factors that influence the choice of contraceptives among female undergraduates at the University of Benin and Edo State University Ekpoma.

Methods

Data was collected from a sample of 800 female undergraduates matched ethnic group, socio economic status, religion and rural urban residence. Subjects were selected by proportional representation and the instrument used was closed ended questionnaire.

Results

The responses obtained were analysed using Spearman Rank Correlation co-efficient and regression analysis. Findings revealed the highest correlation for availability (r = .96) vis a vis the use of various types of artificial contraceptive and cost (r =.96), next was safety (r = .95) and effectiveness (r = .95). Others were peer group influence (r = .80) and convenience (r = .77).

Conclusion

An important step in improving women''s reproductive health is the involvement of men. Health programmes should conduct campaigns to educate men about reproductive health and the role they can assume in family planning.     

Adolescent pregnancy and associated factors in South African youth

Background

Adolescent pregnancy, occurring in girls aged 10–19 years, remains a serious health and social problem worldwide, and has been associated with numerous risk factors evident in the young people''s family, peer, school, and neighbourhood contexts.

Objective

To assess the prevalence of adolescent pregnancy and associated factors in the South African context, as part of a population-based household survey that formed part of an evaluation of the impact of loveLife, South Africa''s national HIV prevention campaign for young people.

Methods

A cross-sectional population-based household survey was conducted using a multi-stage stratified cluster sampling approach. The total sample included 3123 participants, aged 18–24, 54.6% men and 45.4% women, from four of nine provinces in South Africa (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga).

Results

Among female youth 19.2% said that they had an adolescent pregnancy, while 5.8% of male youth indicated that they had impregnated a girl when they were an adolescent (12–19 years), 16.2% of the women indicated that they ever had an unwanted pregnancy and 6.7% had ever terminated a pregnancy. In multivariable analysis among women it was found that being employed or unemployed, greater poverty, having higher sexually permissive attitudes and scoring higher on the contraceptive or the condom use index was associated with adolescent pregnancy, and among men wanting the pregnancy and having a sense of the future were associated with adolescent pregnancy.

Conclusion

Adolescent pregnancy was found to be high in this sample of South African youth. Multiple factors contributing to adolescent pregnancy have been identified which can be used in targeting young people on the prevention of adolescent pregnancy.     

Family communication about HIV/AIDS and sexual behaviour among senior secondary school students in Accra,Ghana

Background

Sexually active adolescents in Ghana are increasingly at risk of HIV and other sexually transmitted infections. As a primary agent of socialization, the family can exert a strong influence on adolescent sexual behaviour. Therefore, to aid in the design and implementation of effective prevention programmes, it is important to understand the role of the family in influencing sexual behaviour among school-going adolescents.

Objectives

To evaluate the relationship between family communications about HIV/AIDS and sexual activity and condom use among school-going adolescents in Accra, Ghana.

Method

A sample of 894 students (56.9% girls, 43.1% boys; mean age = 17.4 years, SD = 1.40) at two senior secondary schools in Accra completed a modified version of the Youth Risk Behavior Survey (YRBS) questionnaire, a self-administered instrument developed by the Centers for Disease Control and Prevention. Analytical techniques utilized included logistic regression and chisquare.

Results

Twenty-five percent of the participants reported being sexually experienced, and 73.6% had talked about HIV/AIDS with parents or other family members. Of the sexually experienced students, 64.7% initiated first sexual intercourse by age 16; and 55.7% did not use a condom at last sexual intercourse. Bivariate analysis showed significant gender differences in sexual activity, condom use, and family communication about HIV/AIDS. Logistic regression analysis showed that student-family communication about HIV/AIDS was not associated with sexual activity. However, communication about HIV/AIDS between students and parents or other family members increased the odds of using a condom at last sexual intercourse.

Conclusions

The findings of this study suggest that prevention programmes that seek to educate Ghanaian school-going adolescents about sexual risk behaviour must strongly encourage communication about HIV/AIDS between students and family members.     

Medical students and interns’ knowledge about and attitude towards homosexuality

Background and Rationale:

Medical professionals’ attitude towards homosexuals affects health care offered to such patients with a different sexual orientation. There is absence of literature that explores the attitudes of Indian medical students or physicians towards homosexuality.

Aim:

This study aimed to evaluate Indian medical students and interns’ knowledge about homosexuality and attitude towards homosexuals.

Materials and Methods:

After IEC approval and written informed consent, a cross-sectional study was conducted on a purposive sample of undergraduate medical students and interns studying in one Indian medical college. The response rate was 80.5%. Only completely and validly filled responses (N = 244) were analyzed. The participants filled the Sex Education and Knowledge about Homosexuality Questionnaire (SEKHQ) and the Attitudes towards Homosexuals Questionnaire (AHQ). SEKHQ consisted of 32 statements with response chosen from ‘true’, ‘false’, or ‘don’t know’. AHQ consisted of 20 statements scorable on a 5-point Likert scale. Multiple linear regression was used to find the predictors of knowledge and attitude.

Results:

Medical students and interns had inadequate knowledge about homosexuality, although they endorsed a neutral stance insofar as their attitude towards homosexuals is concerned. Females had more positive attitudes towards homosexuals. Knowledge emerged as the most significant predictor of attitude; those having higher knowledge had more positive attitudes.

Conclusion:

Enhancing knowledge of medical students by incorporation of homosexuality related health issues in the curriculum could help reduce prejudice towards the sexual minority and thus impact their future clinical practice.KEY WORDS: Attitude, homosexuality, India, knowledge, medical students