Knowledge, Experiences and Coping Mechanisms for Priapism among Persons with Sickle Cell Disease in Ibadan, Nigeria.

BACKGROUND: Priapism is a prolonged, painful penile erection common among males with Sickle Cell Disease (MWSCD) predisposing to erectile dysfunction (ED) when treatment is delayed. Unlike in women with sickle cell disease (SCD), there has been little attention to male reproductive health complications of SCD. OBJECTIVE: To investigate knowledge, experiences and coping mechanisms for priapism among MWSCD in Ibadan, Nigeria. METHODS: This descriptive cross-sectional study employed purposive sampling technique to select 95 consenting MWSCD attending haematology clinics in Ibadan for interview. A semi-structured, interviewer-administered questionnaire was used to collect information on knowledge, coping mechanisms, and experiences of priapism. Knowledge of priapism was measured and categorised as poor and good respectively. Psychosocial Experiences (PEs) were measured and categorised as mild, moderate and severe, while the Sexual Experiences (SEs) were recorded. Coping mechanisms for priapism were grouped into Medical, Psychosocial and Harmful coping mechanisms respectively. Data were analysed using descriptive statistics and Fishers' Exact test at p<0.05. RESULTS: Respondents' mean age was 23.6±8.8 years. Over half (55.8%) had good knowledge of priapism. Thirty-nine respondents (41.1%) had experienced priapism. Sexual Experiences reported include: total ED 10.3% and apathy for sexual intercourse 23.1%. Majority 30(76.9%) developed mild PEs especially fear of reoccurrence of priapism (56.4%) and sleeplessness (43.6%). The most used Medical Coping Mechanism (MCM) was cold shower (46.2%). There was no significant association between age and knowledge of priapism. CONCLUSION: Knowledge of priapism among respondents was good. Psychosocial therapy through appropriate health education, counseling and social support may help improve knowledge among people with SCD.

PREVALENCE, KNOWLEDGE AND PREVENTIVE PRACTICES AGAINST HYPERTENSION AMONG POLICE OFFICERS IN IBADAN.

BACKGROUND: Hypertension is a major global health problem. Armed forces personnel are at increased risk of hypertension due to the nature of their occupation as early responders. There is dearth of data on knowledge and prevalence of hypertension among police officers in Ibadan, Nigeria. This study was conducted to address this gap in knowledge. METHODS: A total of 170 police officers participated in the study. A questionnaire was used to document demographic profile, knowledge and practices to prevent hypertension. Abdominal circumference and blood pressure were measured among study participants. A digital Omron HEM 8712 blood pressure monitor was used to assess BP and a non-stretchable measuring tape was used to determine waist circumference. Hypertension was assessed by ≥140/90 mmHg and abdominal obesity by ≥80cm for female and ≥94cm for male. RESULTS: Mean age of respondents was 36.7±8.4 years; more than half (64.7%) were males. Majority (47.6%) had fair knowledge of hypertension. The prevalence of abdominal obesity and hypertension were 51.7% and 17.5% respectively. About a tenth (11.4%) were both hypertensive and obese. More females than males' respondents had abdominal obesity (p=0.00); while more males (19.3%) than females (14.0%) were hypertensive (p=0.39). About two-third (68.2%) reported involvement in unhealthy preventive practices including consumption of alcohol, foods high in salt and fat content, and tobacco smoking. Older, married and senior officers were significantly at higher risk of being hypertensive than younger, never married, and junior officers. CONCLUSION: Police officers have adequate knowledge of hypertension, but many in this group are hypertensive. Clinical and educational interventions are recommended to address the problem.

ATTITUDE AND WILLINGNESS OF INFERTILE PERSONS TOWARDS THE UPTAKE OF ASSISTED REPRODUCTIVE TECHNOLOGIES IN IBADAN, NIGERIA.

INTRODUCTION: In most developing countries, the joy of every married man and woman is to procreate and raise children of their own. However, this desire does not always find fulfilment among some couples because of primary or secondary infertility. The majority who experience this condition live in developing countries where fertility services including Assisted Reproductive Technologies (ARTs) are not always available. This study, therefore, investigated the attitude and willingness of infertile persons to uptake ARTs. METHODS: The study was a descriptive cross-sectional survey; a three-stage multi-stage sampling technique was adopted to select 202 married persons receiving fertility services at a gynaecological clinic in Ibadan, Nigeria. A validated interviewer-administered semi-structured questionnaire was used for data collection. Data were analysed using SPSS with descriptive and inferential statistics with the level of the significant set at ≤0.05. RESULTS: Respondents' age was 34.3 years (SD ± 6.5); 88.6% were female; 55.5% had tertiary education; 54.5% reported a history of primary infertility. The negative attitude towards ARTs was observed among many of the respondents; however, some were willing to use ART services. In vitro fertilization (IVF) was the most preferred method; only 15.0% were optimistic of non-complications. The cost was the most mentioned barrier to use of ART. Positive association existed between attitude and willingness to use ART. Females are three times more likely than males to have a positive attitude toward the uptake of ART. CONCLUSION: Public enlightenment and advocacy are recommended to influence negative attitude towards ARTs.

Intimate partner violence among women of child bearing age in Alimosho LGA of Lagos State, Nigeria

In this study, the extent to which married women had experienced physical, sexual, psychological and economic forms of violence by their intimate partners was determined. The study was descriptive and cross-sectional. It was conducted in Alimosho Local Government Area (LGA) of Lagos State. Data were collected using a pre-tested, semi-structured, interviewer-assisted questionnaire from married women. The questionnaire explored demographic characteristics, experience of physical, sexual, psychological and economic forms of violence from their spouses, the perceived reasons for these acts and their health seeking behaviour. The respondents were selected through a systematic random technique from all the eight districts of the LGA. Of the 704 women contacted, 606 consented to participate in the study (response rate 86%). The ages of women ranged from 22 ­ 49 years with a mean of 35.9years (±6.48). Majority of the respondents were Yoruba 452 (74.6%) whose main occupation was trading 309 (51%). One hundred and sixty-one (26.6%) had secondary school education. Five hundred and thirty-nine (88.9%) had experience at least one form of violence. The prevalence of physical, sexual, psychological and economic forms of violence were 45.9%, 55.9%, 71.1% and 51.2% respectively. The most common forms of violent behaviours experienced by the women were slaps (41.9%), insistence on having sex (33.3%), verbal insults (41.3%) and not providing money for the needs of the family (38.4%). Full time housewives, women without formal education, women in polygamous marriages and women whose husbands drank alcohol were more likely than others to have experienced at least one form of violent behaviour. The most common perceived reason for physical, psychological and economic forms of violence were argument about money 37.4%, 32.9% and 27.1% respectively and refusal to have sex 34.2%. The proportions of women who had experienced physical, sexual, psychological and economic forms of violence but did not seek outside help were 59.0%, 62.2%, 67.5% and 73.5% respectively. In conclusion, a high proportion of women surveyed had suffered from different kinds of violence and only few sought for help. Interventions including providing conflict resolution skills training and referral to agencies were recommended to address these problems

Effects of peer education on the knowledge and use of HIV counselling and testing services among young persons in Ibadan, Nigeria

Although HIV counselling and testing (HCT) service plays important roles in prevention and control of AIDS; many young Nigerians under-utilize it. A peer education intervention was implemented to promote use of HCT among secondary school students and apprentices in Ibadan; Nigeria. Baseline data were collected from 1281 students from six schools and 100 apprentice workshops in four Local Government Areas of Ibadan. A total of 897 students from four schools and apprentices from 25 workshops were assigned as experimental group while 682 students from two schools and apprentices from 25 workshops were the controls. Three intervention activities were implemented: a one-day sensitization workshop for 31 apprentice instructors and 20 secondary school teacher-supervisors; training of 75 students and 46 apprentices as Peer Educators (PE); and development of Behaviour Change Communication (BCC) materials including posters and handbills. Six months after implementing these interventions; a follow-up survey was conducted to assess the effects of the PE on young person's knowledge of HIV and HCT and reported use of HCT services. Follow-up data were collected from 760 respondents from the experimental sites and 298 from the control areas using the same questionnaire administered during the baseline survey. PE educated a total of 1;917 persons with information on HIV/HCT-related issues. In addition; at follow-up; records of use of HCT services were obtained from two HCT centres situated in the experimental sites and one from the control. Data were analysed using descriptive statistics and t-tests. The results showed significant increase in knowledge of HCT among experimental (1.3 to 7.5) (p0.05) and control groups (0.6 to 6.8) (p0.05) at follow-up. At baseline; 29.0% of the experimental and 36.0% of control knew of the location of a HCT centre; at follow-up the percentage of experimental groups who could do so increased to 62.0%; while the number dropped to 34.0% among controls. Records at HCT centres showed that a greater number (309) of experimental groups used HCT services than control (43). PE were successful in influencing behaviour of their peers to use HCT services

Sexual behaviour and serostatus disclosure among persons living with HIV in Ibadan, Nigeria

The study aimed at assessing the practice of HIV status disclosure, sexual behaviour and knowledge of disclosure and safe sex practices among HIV seropositive individuals attending the President's Emergency Plan for AIDS Relief (PEPFAR) Clinic at the University College Hospital, Ibadan. Systematic random sampling technique was used to select 392 HIV positive adults at the PEPFAR clinic. Data were collected using a validated interviewer-administered questionnaire containing a 12-point knowledge scale. The mean age of respondents was 35.6 ± 9.6 years. Majority (69.9%) were females and 59.4% were married. The overall mean safe sex knowledge score of the respondents was 8.3 ± 2.4. Majority (70.9%) were aware that disclosure of HIV status to a partner before having sex could reduce HIV transmission, while 92.7% knew that consistent and correct use of condom could prevent its spread. However, only 39% of respondents had disclosed their status to all their sexual partners. More married respondents (48.5%) disclosed their status than the unmarried (27.0%) (p<0.05). The proportions of female and male respondents who disclosed their status were 40.3% and 37.1% respectively. Hindrances to disclosure included fear of stigmatization (46.4%) and fear of abandonment (26.4%). Majority of respondents (75.5%) who had disclosed their status to all sexual partners practiced safe sex than those who had not disclosed (59.2%) (p<0.05). Positive attitude towards the disclosure of one's serostatus to sexual partners and safe sex was exhibited by 62.8% and 58.4% of the respondents respectively. Non-usage of condom was more among the unmarried (38.6%) than the married (23.2%) (p<0.05); it was also more among females (33.8%) than males (28.7%), (p<0.05). High rates of non-disclosure of HIV status and unsafe sexual practices were noted. HIV/AIDS educational programmes and media campaigns should be intensified to promote the adoption of serostatus disclosure and safe sexual practices among HIV positive persons

Knowledge and perceptions of reproductive rights among female postgraduate students of the University of Ibadan, Nigeria

The knowledge and perceptions of reproductive rights among female postgraduate students of the University of Ibadan were assessed. The study was a cross-sectional survey of 480 FPGS in three female halls in the University. A validated questionnaire which contained a 20-point knowledge scale was used for data collection while eight in-depth interviews (IDI) were conducted with the aid of an IDI guide. Thematic approach was used for the analysis of the IDI while the quantitative data were analyzed using descriptive statistics; Chi-square and ANOVA. Respondents' mean age was 29.7+ 6.4 years and 75.4% were singles. Sixty - +seven percent of the respondents had heard about RRs with the mass media constituting their major sources of information (54.2%). Respondents' mean knowledge score was 3.3 + 2.9 on a 20 point scale. The mean knowledge scores by age group were not significantly different. There was however assignificant difference in the mean scores by marital status as follows: married (3.3+ 2.4); divorced (7.5+ 0.0); widowed (2.0 + 1.5) and single 3.2 + 3.0 (p0.05). Fifty- one percent of the respondents were not aware of any form of RRs violations. Sixty-six percent of the respondents were opposed to married women's right to bodily autonomy while 77.3% rejected the idea that a wife on her own could access family planning services. Majority of the respondents (77.9%) were of the belief that RR enforcement would not lead women to disrespect their husbands or be promiscuous (78.5%). Most of the IDI participants were against making marital rape an offence punishable by law. All the IDI participants saw gender equality as unrealistic. The respondents had a huge knowledge deficit of reproductive rights. Most of the students' perceptions of these rights rotate around the right to decide number and spacing of children and the right to bodily autonomy. Public enlightenment programs on reproductive rights are strongly recommended using multiple intervention approaches. There is also a need for the review of the University curricula nationwide to integrate topics on reproductive health and gender equality across faculties

Contraceptive knowledge and compliance with guidelines for providing contraceptive services by patent medicine vendors in Ibadan North Local Government Area, Nigeria

Previous studies conducted in Nigeria have shown that Patent Medicine Vendors (PMVs) provide a substantial proportion of contraceptive services. The Federal Ministry of Health (FMOH) provided guidelines for the delivery of contraceptive services by PMVs. This study was therefore designed to identify types of contraceptives dispensed by PMVs and determine their compliance with the FMOH guidelines in Ibadan North Local Government Area. An observational check-list and a validated interviewer administered questionnaire containing a 47- point knowledge scale were used for data collection. Data were analysed using descriptive and Chi-square statistics. Respondents' mean age was 32.8±7.0 years, 80.9% were females, 63.5% were West African School Certificate holders. Most respondents (98.2%) were trained through the apprenticeship system. Only 17.4% were formally trained on the provision of contraceptive services. Contraceptive- related services offered by PMVs as stipulated by the guidelines were: counselling (96.5%), community sensitization (46.3%) and referral (96.4%). Virtually all (98.6%) respondents had ever dispensed contraceptives. A large proportion (72.7%) of respondents dispensed oral contraceptives contrary to the FMOH guidelines. The contraceptives ever dispensed by respondents included: male condoms (96.1%), female condoms (4.3%), doufem (72.3%), pregnon (18.8%), spermicide (4.9%) and intrauterine device (1.8%). Respondents' mean knowledge score was 25.9±5.8. Mean knowledge score on the provision of contraceptives services among males and females were 27.7±5.9 and 25.6±5.7 respectively. On compliance 3.7% of respondents complied fully with the FMOH guidelines on contraceptive service delivery. Compliance with stipulated guidelines by the Federal Ministry of Health on the provision of contraceptive services was low among the study population. The patent medicine licensing authorities should ensure that all patent medicine vendors are provided with the Federal Ministry of Health guidelines relating to the dispensing of contraceptives. Patent Medicine Vendors should be trained on the effective use of the guidelines

Quality-of-life and visual function after manual small incision cataract Surgery in South Western Nigeria.

BACKGROUND: Outcome studies after cataract surgery should focus on functional status and quality of life instead of visual acuity measurement alone. OBJECTIVE: To assess patients' quality of life (QoL) and overall visual function (VF) after manual small incision cataract surgery (SICS) with intraocular lens (IOL) implantation. METHODS: A prospective hospital based study which evaluated the preoperative and postoperative visual function and vision related QoL among patients presenting with first eye cataract at an eye hospital in South Western Nigeria using the VF-14 questionnaire and the vision related QoL questionnaire. RESULTS: One hundred and eighty two patients were enrolled for the study with a mean age of 66.5 ± 10.46. The mean preoperative visual function (VF) score was 40.17 ± 33.59 (range 0 to 82.14) and postoperatively it was 88.79 ± 20.15 (range 0 to 100) p value <0.001. Prior to surgery, 50 (27.6%) patients had visual function score. 75% however after surgery 161 (88.2%) patients had a visual function score of over 75%. (p value <0.001). Using the vision related QoL questionnaire, the highest impact of visual recovery after cataract surgery was improvement with mobility in almost 80% of the patients. CONCLUSION: This study has demonstrated improvement in vision related quality of life and visual function, resulting in rapid recovery of the patient's functional independence and health status following manual SICS. Small incision cataract surgery should therefore be offered to more patients in the African sub-region.

An appraisal of the process of protocol review by an ethics review conmmittee in a tertiary institution in Ibadan.

It is a well established norm that biomedical research involving human participants must conform to acceptable scientific principles and international codes of research ethics. The University of Ibadan/University College Hospital Health Research Ethics Committee (UI/UCH HREC) is the body that plays an oversight role and performs the function of a third party independent review of research protocols submitted by staff and students of the two institutions. A 6-year (2002-2007) retrospective audit of the protocols submitted to the HREC was performed to determine the profile of the lead investigator, sources of funding for the research and the duration for review using a 25 item questionnaire. A total of 752 protocols were submitted, 618 protocols (82%) were approved while 38 protocols were not approved. The principal investigators were mainly postgraduate students (67.1%) while academic staff constituted 21.3%. The average time from submission to approval was approximately 21 weeks (95% CI: 20-23 weeks). The period from submission to approval is significantly affected by the number of revision required and the funding agent (p < 0.05); it took a shorter time to review internationally funded research.

Sexual and reproductive health knowledge, behaviour and education needs of in-school adolescents in northern Nigeria.

Adolescence is marked by progression from the appearance of secondary sexual characteristics to sexual and reproductive maturity. Curiosity about bodily changes is heightened. However, adolescents' perceived sexuality education needs have been poorly documented. A survey of 989 adolescents from 24 North-Eastern Nigerian secondary schools yielded information on socio-demographic characteristics, reproductive health knowledge, sexual activities and sexuality education needs. Of the interviewed respondents, 72% of females had experienced menstruation. Overall, 9% were sexually active, 3.1% knew when ovulation occurs, 47% knew pregnancy could result from first coitus and 56% knew of contraception. 84% opined that adolescents should be given sexuality education but only 48.3% had received any. Sexuality education should be provided for in-school adolescents through their preferred and reliable sources of information.

Ethical issues in HIV/AIDS research, counselling and testing in Nigeria.

HIV/AIDS is a major pubic health problem in Nigeria. This paper identifies the ethical issues involved in HIV/AIDS biomedical and behavioural research, counselling and testing in the country. These concerns are discussed in the context of the three universal ethical principles of respect for persons, beneficence, and justice. Written informed consent, which is a component of respect for persons, is a challenge in Nigeria because of skepticism to documentation, sensitivity of sexual practices often explored in behavioural research, and a tradition that discourages patients from questioning medical authority. Although monetary inducement of research participants is ethically acceptable, the high levels of poverty in Nigeria raise concerns that payment of money may unduly induce indigent participants to enroll in research. The disclosure of results in situations when married HIV positive persons insist that their status should not be revealed to their spouse illustrate the dilemma that health workers face in adhering to the ethical norm of keeping confidentiality and the public health obligation of preventing HIV transmission in a third party. Some recommendations are offered to address these concerns.

Outcome of interventions to improve the quality of reproductive health services provided by private health facilities in selected states in Nigeria.

In Nigeria, as in many developing countries, the private health sector provides a significant proportion of reproductive health services. However, there are concerns about the quality of the reproductive health services provided by personnel operating in this sector. Few interventions exist to improve the quality of reproductive health services being provided by private practitioners. This three year intervention project, which was implemented in Oyo, Ogun and Gombe States, was designed to improve the capacity of personnel working in the private sector to deliver quality reproductive health services to their clients. One hundred and thirty nine privately owned health facilities participated in the project. Baseline data were collected from staff and clients using these facilities through self-completed questionnaires. A total of 458 nurses/auxiliaries were trained to improve their counseling and service delivery skills; 138 proprietors/proprietresses were trained on total quality management to enhance the quality of reproductive health services; and 84 physicians' knowledge were updated on reproductive health/family planning, and post-abortion care. Provision of contraceptives, drugs for treatment of sexually transmitted infections, supply of equipment and development of educational materials were the other components of the intervention. A follow-up survey was conducted three years after implementing the interventions to gauge outcomes. At baseline, only 35.2% managed postpartum sepsis compared to 97.8% at follow-up. Thirty-nine percent provided post-abortion care at baseline; the figure rose to 97.2% at follow-up. The proportion of respondents who reportedly provided family planning services increased from 39.5% at baseline to 43.0% at follow-up. Report of management of persons living with HIV/AIDS increased from 16.0% to 24.3% while counseling services increased from 36.1% to 37.6%. At baseline, only 55% of the health workers reported that they had male condoms in stock, the figure rose to 88.2% at follow-up. Sixty-one percent of clients reported that it took 1- 5 minutes before being attended at follow-up, compared to 95% who claimed they spent about an hour before receiving care at baseline. The interventions improved availability and quality of reproductive health services provided by private health facilities. Similar interventions should be replicated to scale up the proportion of private health facilities that provide quality reproductive health services in the country.

Reproductive health knowledge and use of contraceptives among adolescent mothers in a sub-urban community in Oyo State, Nigeria.

This survey explored the reproductive health knowledge and use of contraceptives among 316 young mothers in Ogbere, a sub-urban community in Oyo State, Nigeria. A cluster sampling technique was used to recruit the respondents and data were collected from them through face-to-face interviews using questionnaires. The ages of the respondents ranged from 17-20 with a mean of 18.9. The majority (76.9%) of the respondents were married and had primary school education (72.8%). Fivepercent had lost a pregnancy due to abortion, miscarriage or still birth. Forty-three percent had fair, 34.5% poor, and 22.5% good knowledge of contraceptives; 53% did not know any of the routes for HIV transmission. A large majority (70%) had never used any contraceptives, 29% had done so. Eighty percent of those who had ever used any contraceptive were using one at the time of the survey. The most popular contraceptives used were condoms (44.4%) and pills (16.1%). Interventions to improve the economic status and promote use of contraceptives are recommended for this population.

Violence and HIV/AIDS prevention among female out-of-school youths in southwestern Nigeria: lessons learnt from interventions targeted at hawkers and apprentices.

Between 1997 and 2003, four studies on hawkers and apprentices in motor parks and work shops in south west, Nigeria were carried out to evaluate the effectiveness of interventions aimed at preventing HIV infection and gender based violence (GBV). The studies were in 3 phases namely baseline survey, intervention and end line survey. Interventions consisting of:--development and distribution of education materials and training programmes for the police, judiciary, instructors, drivers, traders and apprentices/hawkers, including micro-credit facilities were implemented in some of the studies. The major lessons learnt were that: Young girls working in the informal sector of the Nigerian economy face dual risks of HIV infection and GBV and yet they are seldom targets of intervention; Many had been victims of GBV and did not seek redress either because they accept it is their lot, are afraid of being stigmatized or are put off the prolonged legal system; Perpetrators tend to deny their involvement in violence; Despite the challenges involved, interventions implemented among female apprentices and hawkers, especially those that involve multiple stakeholders, made a difference in protecting this group from dual risks of GBV and HIV/AIDS infection. We recommend more intervention programmes for this population, and regulation of activities in the informal sector of the Nigerian economy.

Beliefs and perceptions of ear, nose and throat-related conditions among residents of a traditional community in Ibadan, Nigeria.

ENT-related conditions constitute a major burden of disease in Nigeria. The bulk of the available studies on these conditions are derived from hospital-based studies that underestimate the extent of the problem. Few studies have explored the perceptions of community residents on the causes and treatment of these conditions. This article describes findings of a qualitative study that explored the perception of residents of Foko, a traditional community in Ibadan, Nigeria. Five traditional healers were interviewed in-depth while four focus group discussions were conducted for men and women to determine perception of types, causation and treatment modalities for ENT-related conditions. The healers mentioned seven ENT-related conditions including ear discharge, deafness, epistaxis, nasal catarrh, sore throat, neck swelling and hoarseness. Informants and discussants attributed mainly spiritual attack as the cause of many of these conditions. Many of the treatment remedies used are topical, including use of effirin leaf (Occimum gratissium) for nose bleeding and using cold red oil or honey to treat ear discharge. These procedures are dangerous and could aggravate the conditions. We discuss the implications of these findings for further research and clinical practice.

Perceptions of sexual coercion: learning from young people in Ibadan, Nigeria.

This study explored the problem of sexual coercion from the perspectives of 77 young people aged 14-21 in Ibadan, Nigeria, the behaviours they perceive to be sexually coercive and the contexts in which these occur through four narrative workshops. Participants were drawn from two secondary schools and 15 apprentice workshops. All four groups identified similar coercive behaviours and developed narratives of the events that typically lead up to them. Behaviours included rape, unwanted touching, incest, assault, verbal abuse, threats, unwanted kissing; forced exposure to pornographic films, use of drugs for sedation and traditional charms for seduction, and insistence on abortion if unwanted pregnancy occurs. Men were typically the perpetrators and young women the victims. Perpetrators included acquaintances, boyfriends, neighbours, parents and relatives. All the narratives revealed the inability of young people to communicate effectively with each other and resolve differences. The results suggest the need for life-skills training that facilitates communication, seeks to redress gender power imbalances, teaches alternatives to coercion as a means of resolving conflict over sexual relations and respect for sexual and reproductive rights, and provides victims with information on appropriate services, support and referral.

Experience of sexual coercion among adolescents in Ibadan, Nigeria.

This study surveyed 1,025 adolescent students and apprentices in Ibadan, Nigeria, to document their sexual behaviour and experience of sexual coercion including verbal threats, unwanted touch, unwanted kiss, assault, deception, drugging, attempted rape, and rape. Sixty five per cent of male and 48% of female apprentices were sexually experienced, compared to 32% of male and 24% of female students. More males than females reported sex with multiple partners and contact with a sex worker while females had exchanged sex for money and gifts. Fifty five per cent of all the subjects had been victims of at least one type of sexual coercion, the commonest being unwanted kiss and touch of breasts (47%). Although both males and females were victims of coercion, females were disproportionately affected--68% of female students and 70% of apprentices had experienced one coercive behaviour, compared to 42% of male students and 40% of apprentices. Female apprentices fared worst, with 19% of them raped. The main perpetrators of the coercion were persons well known to the victims including neighbours, peers and boy/girlfriends. We recommend multiple intervention programs including skills training for young persons, sensitisation workshop for training health workers, and media advocacy for the public to challenge stereotypes that favour sexual coercion of adolescents.

Sexual behaviour and negotiation of the male condom by female students of the University of Ibadan, Nigeria.

This study explored the sexual behaviour of unmarried female students of the University of Ibadan, Nigeria, and assessed the extent to which those who were sexually active negotiated and used the male condom. Four focus group discussions were conducted followed by a survey of 354 students. The results show that the mean age of the students was 22.5 years 55.1% had had sexual intercourse; the mean age at first intercourse was 16.5 years. The number of lifetime sexual partners ranged from 1 to 20 with a mean of 3.4; 75% of those who had had sex reported ever using condom; 16.9% and 39% used it during their first and last sexual episodes respectively; only 34.3% used it consistently. Seventy-three per cent had ever negotiated condom use with a partner, but only 41% did so during their last sexual encounter. A significant association was found between condom negotiation and number of sexual partners: Students with fewer life time partners (3.2) had less frequently negotiated condom use than those with more partners (4.3) (P<0.05). Condom negotiators also scored significantly higher (4.6) on a 6-point AIDS Knowledge Score than those who had never done so (4.0) (P<0.05). About a quarter (26.7%) had ever bought a condom, while 38.5% had ever carried it. We conclude that although many female students had sometimes used a condom only a few used it consistently and are therefore at risk of the unintended outcomes of unprotected sex. We propose appropriate interventions to address the problem.