Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
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ORIGINAL ARTICLE
Year : 2007  |  Volume : 28  |  Issue : 2  |  Page : 83-86
 

Sexual behaviour in adolescents and young people attending a sexually transmitted disease clinic, Ile Ife, Nigeria


Department of Dermatology and Venereology, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State, Nigeria

Correspondence Address:
Olayinka Abimbola Olasode
College of Health Sciences, Obafemi Awolowo University, Ile Ife, Osun State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7184.39010

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   Abstract 

WHO estimates that 20% of persons living with HIV/AIDS are in their 20s and one out of twenty adolescents contract a sexually transmitted disease (STD) each year.
A total of 303 adolescents and youths (10-24 years of age) attending an STD clinic were subjected to a questionnaire to assess sexual behavioural patterns that predisposed them to STD. Scope of the questions included age at initiation of sexual intercourse, partner at first exposure, number of sexual partners, use of condoms, exposure to commercial sex workers (CSWs), previous infection with STDs and role of alcohol. Their diagnosis was based on history, clinical findings and laboratory confirmation.
Adolescents and youths accounted for 30% of the total number of patients attending the STD clinic during this period. The male to female ratio was 1:0.95. Ninety-six percent (290) were single while 4% (13) were married. Seventy-two percent (217) were students. Age at onset of sexual activity was 10-20 years in 80%, 85% practiced risky sexual behaviour, patronising casual partners was frequent especially after alcohol use, 10% had been exposed to CSWs, condom use was poor, number of sexual partners varied between 1 and 5 and previous infections were not professionally treated.
Adolescents and young people are sexually active and practice risky sexual behavioural patterns. Adolescents and youths account for a high percentage of patients patronising the STD clinic. Sexual education and youth friendly reproductive health services are urgently needed to curb the spread of HIV/AIDS/STDs.


Keywords: Sexual behaviour, STD, young people


How to cite this article:
Olasode OA. Sexual behaviour in adolescents and young people attending a sexually transmitted disease clinic, Ile Ife, Nigeria. Indian J Sex Transm Dis 2007;28:83-6

How to cite this URL:
Olasode OA. Sexual behaviour in adolescents and young people attending a sexually transmitted disease clinic, Ile Ife, Nigeria. Indian J Sex Transm Dis [serial online] 2007 [cited 2017 Mar 27];28:83-6. Available from: http://www.ijstd.org/text.asp?2007/28/2/83/39010



   Introduction Top


Public health officials and educators have a long-standing interest in adolescent sexual behaviour and risk prevention - an interest intensified by the spread of HIV. Sexually transmitted diseases (STDs) are a major public health problem among adolescents and young adults. More than 15 million new cases of STDs are diagnosed every year and approximately 65% of these cases are diagnosed in people under the age of 24 years. [1],[2] The STD clinic constitutes a pool of available clients that can be assessed for the risk factors contributing to their infection.

One in five Africans and one in three African adolescents live in Nigeria, the most populous country in Africa. Nigeria's birthrate for adolescence is one of the highest in the world and the prevalence among female adolescents in Nigeria of sexually transmitted infections (STIs), including HIV, is climbing rapidly. [3]

Early sexual debut places young people at increased risk of acquiring STDs. This vulnerability to STDs is because of biological and behavioural factors. The biological factors among young women have more to do with their sexual anatomy being more susceptible to abrasions that can allow organisms to enter the body. The immature reproductive and immune systems make adolescents more vulnerable to infection by STD agents.

There are evidences in developed and in developing countries that acknowledging the sexual activity of young people and meeting their sexual health needs with targeted education and preventive care services can help to reduce risky sexual behaviour and its consequences. [4],[5] Young people who begin sexual activity early appear more likely to have sex with high-risk partners or multiple partners and are less likely to use condoms. [6]

Managing STDs and altering the behaviour that leads to it are the essential elements of any HIV/AIDS prevention and control programme.


   Materials and Methods Top


Adolescents and youth between the ages of 10 and 24 years presenting to a sexual disease clinic as a part of their risk assessment were subjected to a pretested open-ended questionnaire to identify the sexual behaviour that predisposed them to STDs. Scope of questions, included personal history, age at initiation of sexual intercourse, partner at first exposure, number of sexual partners, use of condoms, exposure to commercial sex workers, previous STDs and treatment, indulgence in alcohol and one night stands. Their diagnosis was based on history, clinical findings and laboratory confirmation. They all had counselling sessions.


   Results Top


Adolescents and youth accounted for 30% of the total number of patients attending the STD clinic during this period. Sexual activity was documented in this series of young people as early as 10-12 years of age.

Seventy-two percent (217) of this group of young people were students at various level of education [Table - 1]. Ninety-six (96%) were single and only 13 (4%) were married. All the married in this series were females. Vaginal intercourse was reported in all the sexually active youth in this series.

Age at onset of sexual activity was 10-20 years in 80%, 85% practiced risky sexual behaviour, patronising casual partners was frequent especially after alcohol use, 10% had been exposed to CSWs, consistent condom use was poor, number of sexual partners varied between 1 and 5 and previous infections were not professionally treated [Table - 2].

There are gender-based differences in the age-related progression in sexual activity with a larger number of girls initiating sexual activity before the age of 18 years of age [Table - 2]. There was a progressive increase in the number of young people engaging in sexual activity with gradual increase in age documented with a peak between 18 and 24 years in both sexes. Onset of sexual activity was earlier in females with 23.6% having initiated sexual intercourse before the age of 18 years as compared to 12.9% among the males. However, the average number of sexual partners was higher in the males. Condom use was higher in males and only the males were documented to have had exposure to CSWs.

Previous symptoms of STI were found to have occurred in 27.7% of males as compared with 19% of females.


   Discussion Top


The adolescent age is a stage of life between puberty and adulthood. It is characterised by profound body changes due to hormonal influence causing biological, physiological and morphological alterations. These body changes lead to progressive sexual impulse. Initiation of sexual activity due to this impulse has biological and social consequences. Early sexual intercourse is commonly associated with a higher number of lifetime sexual partners and, consequently, a higher risk of contracting STIs. [7]

In a study carried out by Fawole et al. [8] in Ibadan, Nigeria, results revealed that adolescents constituted between 3.3% and 4.8% of the total number of patients seen in the STI clinic each year. A total of 54 (38.3%) were aged 19 years, 133 (94.3%) were single, 79 (53.2%) were females and 103 (73.0%) were students. As in Fawole's study, the majority of young people in our study were students (71.6%) and a high percentage (95.7%) were single. However, males were more in current series (51.1%). Vaginal intercourse was reported in all the sexually active youths in our series. Fawole also reported vaginal intercourse in all the sexually active youth, but two (1.71%) reported oral sex, while 10 (8.41%) admitted that they had multiple sexual partners.

The number presenting with STI was noticed to gradually increase with increasing age with a peak at the age of 24 years. There was an increasing sexual exposure with increasing age and increasing number presenting with STI.

There was a gender difference in the time of initiation of sexual intercourse with a higher percentage of girls initiating intercourse before age of 18 years. Girls are more likely to be exposed to older male counterparts and cross-generational sex. The female child is also prone to sexual abuse at a very early age and the initiation of sexual activity may have been non-consensual. Between 2% and 20% of adolescents and young women are subject to the experience of forced sexual relations over the course of their lifetime. [9] A review of over 45 studies of cross-generational and transactional sexual relations in sub-Saharan Africa reports that engaging in sexual relations with older partners is the norm among adolescent girls in some settings. [10],[11] Some of the female youths were married. In fact all the married in this study were females.

Condom use was higher in males. This is not surprising as male condom negotiation is mainly controlled by males. This is so in the previous studies. In one study done in Uganda, the independent predictors of condom use included being a man, not having a regular partner, having had sex with a casual partner, being able to read English, having at least secondary education and using electricity for lighting. [12] Only the males were documented to have had exposure to commercial sex workers and they had a higher number of sexual partners. Obviously this can be linked to why there were more males with symptoms of previous STI. Symptoms of pelvic inflammatory disease may actually be absent in females.

A study examined the association between sexual risk behaviour and STI testing in a sample of homeless youth and found 50% had been sexually active in the past 3 months. In that study, high-risk sexual behaviour did not predict STI testing. [13]

The reproductive health needs of young age group are poorly understood and yet have far reaching implications on the future of any country and the world at large. Sexual content is regularly marketed to young people and this affects their sexual activity and beliefs about sex. TV, movies, music and the Internet provide teens with seemingly unlimited access to information on sex as well as a steady supply of people willing to talk about sex with them. The consequence of these exposures is increased stimulation to sexual activity with resultant consequences including sexually transmitted illnesses.

 
   References Top

1.Godin G, Fortin C, Mahnes G, Boyer R, Nadeau D, Duval B, et al . University students' intention to seek medical care promptly if symptoms of sexually transmitted diseases were suspected. Sex Transm Dis 1993;20:100-4.  Back to cited text no. 1    
2.Institute of Medicine. In : Eng TR, Butler WT, editor. The hidden epidemic: Confronting Sexually Transmitted Diseases. National Academy Press: 1997.  Back to cited text no. 2    
3.Joint United Nations Programme on HIV/AIDS. Nigeria: Epidemiological fact sheet on HIV/AIDS and sexually transmitted infections. UNAIDS and WHO: Geneva; 2000.  Back to cited text no. 3    
4.Allan Guttmacher Institute. Can more progress be made? Teenage sexual and reproductive behavior in developed countries (executive summary). Allan Guttmacher Institute: Washington, DC; 2001.  Back to cited text no. 4    
5.Kirby D. Emerging answers: Research findings on programs to reduce teen pregnancy (summary). National Campaign to Prevent Teen Pregnancy: Washington, DC; 2001.  Back to cited text no. 5    
6.World Health Organization. The content of young people's sexual relations. Prog Reprod Health Res 2000;53:2-4.  Back to cited text no. 6    
7.Santelli JS, Brener ND, Lowry R, Bhatt A, Zabin LS. Multiple sexual partners among US adolescents and young adults. Fam Plann Perspect 1998;30:271-5.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]
8.Fawole OI, Ajaiyi IO, Babalola TD, Oni AA, Asuzu MC. Socio-demographic characteristics and sexual behaviour of adolescents attending the STC, UCH, Ibadan: A 5 year review. West Afr J Med 1999;18:165-9.  Back to cited text no. 8    
9.Jejeebhoy SJ, Bott S. Non-consensual sexual experiences of young people: A review of the evidence from developing countries. Regional Working Papers; Population Council: New Delhi, India; 2003. p. 6.  Back to cited text no. 9    
10.Luke N. Age and economic asymmetries in the sexual relationships of adolescent girls in sub-Saharan Africa. Stud Fam Plann 2003;34:67-86.  Back to cited text no. 10  [PUBMED]  
11.Luke N, Kurz K. Cross-generational and transactional sexual relations in sub-Saharan Africa: Prevalence of behaviour and implications for negotiating safer sexual practices. ICRW and PSI: Washington DC; 2002.  Back to cited text no. 11    
12.Nuwaha F, Faxelid E, Hojer B. Predictors of condom use among patients with sexually transmitted diseases in Uganda. Sex Transm Dis 1999;26:491-5.  Back to cited text no. 12    
13.Solorio MR, Milburn NG, Rotheram-Borus MJ, Higgins C, Gelberg L. Predictors of sexually transmitted infection testing among sexually active homeless youth. AIDS Behav 2006;10:179-84.  Back to cited text no. 13  [PUBMED]  [FULLTEXT]



 
 
    Tables

  [Table - 1], [Table - 2]


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[Pubmed] | [DOI]



 

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