Sexual Abuse among Female Adolescent Hawkers in Selected Markets in Ibadan, Nigeria.

Involvement of a child or adolescent in a sexual activity is a global public health challenge. This cross-sectional study documented experiences of sexual abuse (SA) among Female Adolescent Hawkers (FAHs) in selected markets in Ibadan, Nigeria. Data were collected from 410 FAHs using interviewer-administered questionnaire. Descriptive statistics, chi-square and logistic regression were used to analyze the data at p < .05 significance level. Mean age of respondents was 14.4 ± 1.76 years. The majority (69.0%) have ever experienced at least a form of SA, of which 68.3% occurred 3 months preceding the study. Having had sex and boyfriends were predictors of SA. Male customers (98.6%), traders (98.2%) and peers (69.4%) were major perpetrators. About 67.5% of victims of SA did not seek help. Sexual abuse is a major problem among FAHs. Age-appropriate sexuality education and life-building skills interventions should be targeted at FAHs while advocacy is recommended for caregivers and market stakeholders.

Effects of Training on HIV Risk Perception, Knowledge and Sexual Behaviour Among Fisherfolks in Two Communities in North Central Nigeria.

Fisherfolks participate in unsafe sexual behaviors which can predispose them to HIV infection. This research was designed to assess the effects of training on HIV/AIDS-related knowledge and sexual behavior among fisherfolks in two fishing communities in Nigeria. Respondents were allocated into Experimental Group (EG, n = 103) and Control Group (CG, n = 105). Data were collected at baseline using a questionnaire which included questions on socio-demographic characteristics, sexual behavior among others. A 3-day HIV/AIDS training was conducted for EG. Fisherfolks in EG and CG with good knowledge were 16.5% and 54.3%, respectively at baseline. The number increased to 100.0% in EG than CG (60%) at follow-up. At baseline, fisherfolks in EG and CG with high riskperception scores were 26.2% and 59.0%, respectively; corresponding figures at post intervention for EG and CG were 100.0% and 70.0% respectively. Training increased HIV/AIDS knowledge, improved risk perception and reduced risky sexual practices among fisherfolks.

Sexual and Reproductive Health Research and Research Capacity Strengthening in Africa: Perspectives from the region.

Developing the capacity to effectively carry out public health research is an integral part of health systems at both the national and global levels and strengthening research capacity is recognized as an approach to better health and development in low- and middle-income countries (LMICs). Especially fields such as sexual and reproductive health (SRH) would require inter-disciplinary teams of researchers equipped with a range of methodologies to achieve this. In November 2013, as part of the International Family Planning Conference in Addis Ababa, Ethiopia, a group of African researchers came together to discuss the gaps and strategies to improve sexual and reproductive health research and research capacity strengthening in Africa. This commentary summarizes the three broad areas where the issues and proposed solutions have concentrated around: 1) Addressing research gaps that are most relevant to policies and programmes in SRH, 2) Carrying out high quality and collaborative research, and 3) Translating research findings into SRH policies and programmes. Even though the focus of the discussions was Africa, the issues and proposed solutions can also be applied to other regions facing a high burden of disease with limited resources. The time is now and these can be achieved through synergistic commitment of African and global researchers, funders and organizations.

Knowledge and perceptions of date rape among female undergraduates of a Nigerian university.

This paper focuses on knowledge and perceptions of Date Rape (DR) among female undergraduates of the University of Ibadan. The cross-sectional survey was conducted among 651 female undergraduates selected using a four-stage random sampling technique. A semi-structured questionnaire which included a 6-point knowledge scale and a 21-points perceptions scale was used to collect data. Knowledge scores of 0- 2, 3- 4 and 5- 6 were rated as poor, fair and good respectively. Perception scores of 0-10 and 11-21 were categorized as supportive and non-supportive perception of DR respectively. Data were analyzed using descriptive statistics and Chi-square at p < 0.05. Mean knowledge score was 2.3 +/- 2.1 and 50.0% participants had poor knowledge of DR. Knowledge of DR increased significantly by level of study. Participants' had a mean perception score of 9.1 +/- 2.8 and 66.9% had perceptions supportive of DR. Campus-based educational programme have potentials for addressing the phenomenon.

Prevalence and factors associated with perpetration of non-consensual sex among students of a tertiary institution in Ibadan, Nigeria.

This cross-sectional survey explored the extent to which students of the Polytechnic, Ibadan had perpetrated Non-Consensual Sex (NCS). A total of 594 randomly selected students completed a questionnaire and three perpetrators were interviewed in-depth. Mean age of the survey respondents was 22.7 +/- 2.9 years. Twenty-two percent had ever perpetrated at least a form of NCS, out of which 75.9% reported involvement in this behaviour in the six months preceding the study. Forms of NCS perpetrated included unwanted touch of breast/back side (14.6%), unwanted kiss (9.4%), attempted rape (2.7%) and rape (1.7%). The predictors of perpetration of NCS were alcohol use (OR: 2.2; CI: 1.41-3.33) and cigarette smoking (OR: 2.5, CI: 1.13-5.56). In-depth interview revealed that peer group influence and alcohol consumption contributed to perpetration of NCS. Behavioural change interventions are recommended to prevent perpetration of NCS in this institution.

Youths and non-consensual sex: exploring the experiences of rape and attempted rape survivors in a tertiary institution in Ibadan, Nigeria.

BACKGROUND: Non-consensual Sex (NCS) is a worldwide problem with far reaching effects on the survivors. This study explored the experiences of rape and attempted rape (AR) survivors in a tertiary institution in Nigeria. METHODS: In-depth interviews with fourteen survivors of rape and AR were used to explore the context of experience of NCS, its consequences and help-seeking. Interviewees consisted two males and five females for each form of NCS who were identified during the quantitative aspect of the study. Interviews were subjected to content analysis. RESULTS: Mean age of the respondents was 22.3±2.5 years. Context of non-consensual sexual experiences varied with sex. Female survivors reported use of physical violence on them by their perpetrators while males reported verbal threats, nudity, forceful hugging and kissing. Means of escape adopted by survivors of AR varied between the sexes. Female AR survivors used physical force as a means of escape while males employed deception/plea. Perpetrators were majorly acquaintances of the survivors. Consequences of the experiences reported include physical injuries and pregnancy among females and psychological disturbances among males. Majority, both males and females did not report, nor seek help due to shame and did not know appropriate methods of preventing future experience. CONCLUSION: Although both males and females reported they have experienced rape and AR, the context of the experiences and consequences reported varied between both sexes and most did not know how to prevent future experience. This call for urgent development of gender sensitive sexual violence prevention programmes to address this phenomenon. FUNDING: The study received grant support from The Gates Institute, John Hopkins University Baltimore, USA through The Centre for Population and Reproductive Health, College of Medicine, University of Ibadan, Nigeria.

Outcome of a research ethics training workshop among clinicians and scientists in a Nigerian university.

BACKGROUND: In Nigeria, as in other developing countries, access to training in research ethics is limited, due to weak social, economic, and health infrastructure. The project described in this article was designed to develop the capacity of academic staff of the College of Medicine, University of Ibadan, Nigeria to conduct ethically acceptable research involving human participants. METHODS: Three in-depth interviews and one focus group discussion were conducted to assess the training needs of participants. A research ethics training workshop was then conducted with College of Medicine faculty. A 23-item questionnaire that assessed knowledge of research ethics, application of principles of ethics, operations of the Institutional Review Board (IRB) and ethics reasoning was developed to be a pre-post test evaluation of the training workshop. Ninety-seven workshop participants completed the questionnaire before and after the workshop; 59 of them completed a second post-test questionnaire one month after the workshop. RESULTS: The trainees came from a multi-disciplinary background including medicine, nursing, pharmacy, social science and laboratory science. The mean scores for knowledge of the principles of research ethics rose from 0.67 out of 3 points at pre-test to 2.25 at post-test (p < 0.05). Also, 42% correctly mentioned one international guideline or regulation at pretest, with most of those knowing of the Declaration of Helsinki. Trainees' knowledge of the operations of an IRB increased from 6.05 at pre-test to 6.29 at post test out of 7 points. Overall, participants retained much of the knowledge acquired from the workshop one month after its completion. CONCLUSION: The training improved participants' knowledge of principles of research ethics, international guidelines and regulations and operations of IRBs. It thus provided an opportunity for research ethics capacity development among academic staff in a developing country institution.

Instant messaging and nursing students' clinical learning experience.

BACKGROUND: Although learning in clinical settings is a key element of nursing education, for many learners these are challenging developmental contexts often marked by isolation and a lack of belongingness. Despite the massive appropriation of mobile instant messaging (MIM) platforms and the connective properties attendant to them, very little is known about their role in and impact on nursing students' clinical learning experiences. APPROACH AND METHODS: To address this gap, the study, which was part of a multinational research project on the use of mobile social media in health professions education in developing countries, examined the use of the instant messaging platform WhatsApp by nursing students during placements and potential associations with socio-professional indicators. The survey involved a total number of 196 nursing students from 5 schools in Oyo State, Nigeria. RESULTS: The findings suggest that students used WhatsApp relatively frequently and they perceived that this platform strongly enhanced their communication with other students and nurses. WhatsApp use during placements was positively associated with students' maintained social capital with peer students, the development of a professional identity, placement satisfaction and with reduced feelings of isolation from professional communities. The determinants that influenced WhatsApp use during placements were perceived usefulness and perceived ease of use. No associations were found between WhatsApp use during placement and age, attitude, subjective norms and placement duration. CONCLUSION: This study is one of the first of its kind that points to the relevance of mobile instant messaging as part of nursing students' (inter)personal learning environments in clinical settings and, particularly, in the development setting under investigation. Further research is needed to corroborate these findings, to enhance the understanding of the impact mechanisms, and to evaluate a more systematic use of MIM in clinical learning contexts.

Evaluation of a school-based reproductive health education program in rural South Western, Nigeria.

This quasi-experimental study compared the relative efficacy of teacher instructions alone, peer education alone, and a combination of these two on reproductive health knowledge, attitude, perceived self-efficacy and sexual practices among secondary schools students in the Ibarapa district of Southwestern Nigeria. A baseline questionnaire was administered to a systematic sample of students in four schools that were randomized into four treatment arms: teacher instructions alone (E1), peer education alone (E2), combination of teacher instruction and peer education (E3), and control. The results were used to design the contents of the interventions, which were implemented for one academic session. A follow-up survey using the same sampling procedures as baseline was conducted to measure the outcome of the intervention. The control group had superior reproductive health knowledge at baseline. By follow-up survey however, all three intervention schools showed significant knowledge gains, while the control school students' mean score increased slightly. Increase in knowledge was greatest among E3 (+5.0 points), followed by E2 (+3.4), E1 (+1.4) and C (0.3). The intervention schools showed a significant positive shift in attitude towards use of contraceptives with mean increase of 0.6, 0.5, and 0.9 points in E1, E2 and E3 respectively. Scores that measured the students' perceived self-efficacy for safe sex increased significantly among E1 (from 10.8 to 11.8) and E3 (from 10.4 to 12.6). Reported condom use was significantly higher among E2 (from 16.7 % to 62.8%) (p < 0.05) and E3 (from 22.8% to 53%) (p < 0.05) compared to El (28.6% to 47.40%) (p > 0.05) and control (from 25% to 45.8%) (p > 0.05). Overall, the students from E3 showed more improvement in knowledge, attitude and self-efficacy, than their counterparts from E2 and E3 and control. Multiple intervention strategies have greater potential of improving reproductive health of students.

Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria.

BACKGROUND: Interest in the reproductive health of adolescents continues to grow throughout the world. Few studies had explored the reproductive health knowledge, sexual behavior and experience of sexual coercion among secondary school students in North Eastern states of Nigeria. The objectives of this descriptive survey were to collect data to plan appropriate interventions that meet the reproductive health knowledge, service and skills needs of students in Bauchi, Borno and Gombe states. METHODS: Face-to-face interviews were conducted for 624 consenting students who were randomly selected from eighteen secondary schools using an 83-item structured questionnaire. Data were collected on demographic profile, reproductive health knowledge, sexual behavior and experience of sexual coercion. RESULTS: The mean age of the respondents was 16.5 years. There were slightly more males (52%) than females (48%). Students' knowledge about reproductive health was generally low even though girls had better knowledge than boys. Thirteen percent of the entire students had had sexual experience; significantly more males (19%) than females (6%) had done so (p < 0.001). Among boys the age at sexual debut ranged from 10-26 with a mean of 15.7 and median of 16. By contrast, the age at first sex among girls ranged from 10 to 18 years with a mean and median of 16.1 and 17 years respectively. Only 24% of those who were sexually active used a condom during their last sexual encounter. Overall 11% of the students reported that they had been tricked into having sex, 9% had experienced unwanted touch of breast and backside, and 5% reported rape. CONCLUSION: Students low reproductive health knowledge and involvement in risky sexual activities predispose them to undesirable reproductive health outcomes.

Effects of problem-solving interventions on aggressive behaviours among primary school pupils in Ibadan, Nigeria.

BACKGROUND: Aggressive patterns of behavior often start early in childhood, and tend to remain stable into adulthood. The negative consequences include poor academic performance, disciplinary problems and encounters with the juvenile justice system. Early school intervention programs can alter this trajectory for aggressive children. However, there are no studies evaluating the feasibility of such interventions in Africa. This study therefore, assessed the effect of group-based problem-solving interventions on aggressive behaviors among primary school pupils in Ibadan, Nigeria. METHODS: This was an intervention study with treatment and wait-list control groups. Two public primary schools in Ibadan Nigeria were randomly allocated to an intervention group and a waiting list control group. Teachers rated male Primary five pupils in the two schools on aggressive behaviors and the top 20 highest scorers in each school were selected. Pupils in the intervention school received 6 twice-weekly sessions of group-based intervention, which included problem-solving skills, calming techniques and attribution retraining. Outcome measures were; teacher rated aggressive behaviour (TRAB), self-rated aggression scale (SRAS), strengths and difficulties questionnaire (SDQ), attitude towards aggression questionnaire (ATAQ), and social cognition and attribution scale (SCAS). RESULTS: The participants were aged 12 years (SD = 1.2, range 9-14 years). Both groups had similar socio-demographic backgrounds and baseline measures of aggressive behaviors. Controlling for baseline scores, the intervention group had significantly lower scores on TRAB and SRAS 1-week post intervention with large Cohen's effect sizes of 1.2 and 0.9 respectively. The other outcome measures were not significantly different between the groups post-intervention. CONCLUSIONS: Group-based problem solving intervention for aggressive behaviors among primary school students showed significant reductions in both teachers' and students' rated aggressive behaviours with large effect sizes. However, this was a small exploratory trial whose findings may not be generalizable, but it demonstrates that psychological interventions for children with high levels of aggressive behaviour are feasible and potentially effective in Nigeria.

Maternal depression and child psychopathology among Attendees at a Child Neuropsychiatric Clinic in Abeokuta, Nigeria: a cross sectional study.

BACKGROUND: Children with recognized, diagnosable mental and neurological disorders are in addition prone to emotional and behavioral problems which transcend their specific diagnostic labels. In accessing care, these children are almost invariably accompanied by caregivers (usually mothers) who may also have mental health problems, notably depression. The relationship between child and maternal psychopathology has however not been sufficiently researched especially in low and middle income countries. METHODS: Mothers (n = 100) of children receiving care at the Child and Adolescent Clinic of a Neuropsychiatric Hospital in Abeokuta, Nigeria took part in the study. To each consenting mother was administered a sociodemographic questionnaire and the Patient Health Questionnaire, while information regarding their children (n = 100) was obtained using the Strengths and Difficulties Questionnaire. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 16. RESULTS: The mean ages of the mothers and children were 40.4 years (SD 4.7) and 11.6 years (SD 4.1), respectively. Among the children, 63 % had a main diagnosis of seizure disorder. Regardless of main diagnosis, 40 % of all the children had a comorbid diagnosis. Among the mothers, 23 % had major depressive disorder. A quarter (25 %) of the children had abnormal total SDQ scores. A diagnosis of major depressive disorder in mothers was associated with poor total SDQ scores and poor scores in all SDQ domains except the emotional domain for the children. Major depressive disorder among the mothers was associated with not being married (p = 0.004; OR = 0.142, 95 % CI 0.037-0.546) and longer duration of the child's illness (p = 0.039, OR = 1.165, 95 % CI 1.007-1.346). CONCLUSION: The study showed notable rates of depressive illness among mothers of children with neuropsychiatric disorders. Marked rates of emotional and behavioral disorders were also found among the children. Associations were found between maternal and child psychopathology. Mothers of children with neuropsychiatric disorders should be screened for depressive illness.

Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.

OBJECTIVES: Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. METHODS: We analyzed data from 436 sexually active 10-19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman's conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. RESULTS: Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14-11.87), and transactional sex (OR: 2.80; 95% CI: 1.56-4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96-1.11) and loss and grief (OR: 1.34; 95% CI: 0.73-2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49-1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced sexual initiation and HIV-negative status were significantly less likely to use religion as a coping strategy (OR: 0.28; 95% CI: 0.09-0.83). CONCLUSION: History of forced sexual initiation and HIV status affected perception of events as stressors and use of specific coping strategies. Our study findings could inform best practice interventions and policies to prevent and address forced sexual initiation among adolescents in Nigeria and other countries.

Influence of Exposure to Sexually Explicit Films on the Sexual Behavior of Secondary School Students in Ibadan, Nigeria.

Young people in secondary schools who are prone to engage in risky sexual behaviors spend considerable time watching Television (TV) which often presents sex scenes. The influence of exposure to sex scenes on TV (SSTV) has been little researched in Nigeria. This study was therefore designed to determine the perceived influence of exposure to SSTV on the sexual behavior of secondary school students in Ibadan North Local Government Area. A total of 489 randomly selected students were surveyed. Mean age of respondents was 14.1 ± 1.9 years and 53.8% were females. About 91% had ever been exposed to sex scenes. The type of TV program from which most respondents reported exposure to sexual scenes was movies (86.9%). Majority reported exposure to all forms of SSTV from secondary storage devices. Students whose TV watching behavior was not monitored had heavier exposures to SSTV compared with those who were. About 56.3% of females and 26.5% of males affirmed that watching SSTV had affected their sexual behavior. Predictor of sex-related activities was exposure to heavy sex scenes. Peer education and school-based programs should include topics to teach young people on how to evaluate presentations of TV programs.

Knowledge of AIDS and HIV risk-related sexual behavior among Nigerian naval personnel.

BACKGROUND: The epidemic of HIV continues to grow in Nigeria. Personnel in the military are at increased risk of HIV infection. Although HIV-risk related sexual behavior of Nigerian police officers has been studied, little is known about the sexual behavior of their counterparts in the Navy. This study describes knowledge of AIDS, and HIV-risk sexual behavior of naval personnel in Lagos Nigeria. METHODS: Four hundred and eighty personnel of the Nigerian Navy completed a 70-item questionnaire in 2002. Group discussion and in-depth interviews of four key informants were also conducted to gain insights into the context of risky sexual behaviors and suggestions for feasible HIV primary prevention interventions. RESULTS: The mean age of the respondents was 34 years. Although the overall mean AIDS knowledge score was 7.1 of 10 points, 52.1% of respondents believed that a cure for AIDS was available in Nigeria and that one can get HIV by sharing personal items with an infected person (25.3%). The majority (88.1%) had had lifetime multiple partners ranging from 1-40 with a mean of 5.1; 32.5% of male respondents had had sexual contact with a female sex worker, 19.9% did so during the six months preceding the survey. Forty-one percent of those with sexual contact with a female sex worker did not use a condom during the most recent sexual encounter with these women. Naval personnel who have been transferred abroad reported significantly more risky sexual behaviors than others. Group discussants and key informants believed that sex with multiple partners is a tradition that has persisted in the navy even in the era of AIDS because of the belief that AIDS affects only foreigners, that use of traditional medicine provides protection against HIV infection, and influence of alcohol. CONCLUSION: Many naval personnel report participating in high-risk sexual behavior which may increase their risk of acquiring and spreading HIV. Naval personnel live and interact freely with civilian population and are potential bridging group for disseminating HIV into the larger population. Interventions including sustained educational program, promotion of condoms, changes in transfer policies are recommended to address this problem.

Journalists' knowledge of AIDS and attitude to persons living with HIV in Ibadan, Nigeria.

This study surveyed 254 journalists from the seven media organisations in Ibadan, Nigeria, to assess their knowledge of acquired immune deficiency syndrome (AIDS), attitude to persons living with HIV/AIDS (PLWA) and reports of AIDS-related issues. The journalists' overall mean AIDS knowledge score was 10.6 out of 14 points. About one third (29%) believed that the bite of a mosquito could transmit HIV and 28% thought that AIDS could be cured if detected early. Although 75.2% agreed that the rights of PLWAs to employment should be protected, 49.6% believed AIDS patients should be detained in hospital to prevent the spread of HIV. About a quarter (25.2%) had received training about HIV/AIDS, while 74.8% had not. The majority (65.4%) had never written any report on HIV/AIDS-related issues, while 35.6% had done so. Journalists in Ibadan do not have adequate knowledge of AIDS, and many of them show negative attitude to PLWAs, thus undermining their potential ability to educate the public about AIDS. Advocacy and training workshops are recommended to address this problem.

Interventions for violence prevention among young female hawkers in motor parks in south-western Nigeria: a review of effectiveness.

An intervention study was carried out among hawkers, drivers, instructors, police and judicial officers to reduce the incidence of violence against young female hawkers in three states of south-western Nigeria. Knowledge and experience of violence among the hawkers before and after the interventions were then compared. Findings show that they had greater knowledge of the different types of violence (p < 0.05), were more aware of their vulnerability to violence (99.4% after compared to 82.7% before intervention) and sought help or redress (76.3% after compared to 45.8% before intervention) following violent acts. Sexual violence was the commonest type experienced (30.4% and 15.7% at base line and end line respectively). The rate of violence also decreased. We conclude that multidisciplinary interventions that empower women economically and educationally and involve all stakeholders are effective in preventing violence against women.

Integrating mental health into primary health care in Nigeria: management of depression in a local government (district) area as a paradigm.

BACKGROUND: In Nigeria, the primary health care (PHC) manned by non-physician health workers, forms the bedrock of the health care system. And mental health care has not yet been integrated into primary health care system. OBJECTIVE: To demonstrate how the training of primary health care workers in the recognition and management of depression can form an example of systematic integration of mental health into primary health care. METHODS: The training needs and knowledge of 62 primary health care workers were assessed through focus group discussions and structured self-administered questionnaire. A two-day training program on the recognition and management of depression was conducted using an adapted version of the World Psychiatric Association (WPA) guidelines for the management of depression in primary health care. The trainees completed a pre and post-training assessments to determine the immediate outcome of the training. RESULTS: Pre-training, the health workers had very poor knowledge of depression. None of the participants could mention any antidepressant. There were significant improvements in knowledge post training, with the greatest gain in knowledge occurring in drug management of depression. General outcome evaluation showed significant increase in knowledge and skills for the recognition and management of depression. CONCLUSIONS: The training increased PHC workers knowledge about the concept, recognition and management of depression. And the methods adopted could be helpful means of integrating mental health into PHC.