Abstract
Objective:
The study tried to identify predictors of good knowledge of contraceptive methods and use of condoms at the last sexual act with a girl/boyfriend by adolescents aged 10–19 years in Nigeria. It also tried to find the association between age, sex and HIV status with the study outcomes.
Methods:
This was a cross sectional study that recruited a geographically representative sample of 749 adolescents living with HIV (ALHIV) and 825 HIV negative/untested adolescents aged 10–19 years in Nigeria. A face to face interviewer-administered questionnaire was used to collect information on their socio-demographic profile, awareness of contraceptive methods, and use of contraceptives. Study participants were recruited from six of the 36 states in Nigeria and the Federal Capital Territory. Chi-square was used to establish association between self-reported HIV status, age and sex, and awareness of contraceptive methods and condom use during last sex act. Significant predictors of ‘good knowledge of modern contraceptive’ and ‘use of condoms by sexually active adolescents at last sex act’ were also determined using logistic regression.
Results:
Being a student significantly reduced the odds of having good knowledge about modern contraceptives (OR: 0.46; CI: 0.32–0.65; p<0.001). Having a tertiary level of education (OR: 1.36; CI: 1.12–1.64; p=0.002) and being HIV negative (OR: 2.92; CI: 1.98–4.32; p<0.001) increased the odds of having good knowledge of modern contraceptives. The only significant predictor for use of condoms at last sexual intercourse with a boy/girlfriend is self-efficacy about being about to negotiate condom use with a boy/girlfriend (OR: 141.01; CI: 14.99–1326.36; p<0.001).
Conclusion:
The study findings reiterate the need to introduce adolescents in general and ALHIV specifically to condom use in early adolescence prior to commencing sexual activities; and the need to provide adolescent friendly sexual and reproductive health services in Nigeria.
Acknowledgments
The authors would like to acknowledge the contributions of Janet Kayita of UNICEF, Kike Osinusi of University College Hospital, Nigeria, Gbenga Sumola, the Chair of the National HIV/AIDS Research Reference Group, Oliver Ezechi of the Nigerian Institute of Medical Research, Friday Okonofua of Ford Foundation for their review of this manuscript. The contributions and support of Adam Garner and Georgina Caswell of GNP+ is also acknowledged.
Funding statement: Ford Foundation, Nigeria provided the funding to support the conduct of a study on the sexual, reproductive and socio-developmental needs of adolescents living with HIV of which this manuscript is an extract. BIARI, Brown University, USA provided support for the corresponding author to spend time in the university to conduct data analysis and manuscript writing.
References
1. Adewole IF, Oye-Adeniran BA, Iwere N, Oladokun A, Gbadegesin A, et al. Contraceptive usage among abortion seekers in Nigeria. West Afr J Med 2002;21:112–4.Search in Google Scholar
2. World Health Organisation. Global Health Observatory Data Repository: country statistics. Available at: http://apps.who.int/ghodata/?vid=15000&theme=country. (Accessed 12th December, 2012).Search in Google Scholar
3. Federal Office of Statistics. Nigeria Demographic and Health Survey (DHS), Lagos, Nigeria: Office of Statistics, and Institute for Resource Development/Macro International, 1990.Search in Google Scholar
4. Federal Office of Statistics. Nigeria Demographic and Health Survey (DHS), Lagos, Nigeria: Office of Statistics, and Institute for Resource Development/Macro International, 2003.Search in Google Scholar
5. Federal Office of Statistics, Nigeria Demographic and Health Survey (DHS), Lagos, Nigeria: Office of Statistics, and Institute for Resource Development/Macro International, 2008.Search in Google Scholar
6. Federal Ministry of Health. National HIV & AIDS and Reproductive Health Survey, 2012 (NARHS Plus). Federal Ministry of Health Abuja, Nigeria. 2013.Search in Google Scholar
7. United Nations Population Fund (UNFPA). The state of the world population. New York: UNFPA, 1997.Search in Google Scholar
8. Population Reference Bureau (PRB). Adolescent women in sub-saharan Africa: a chart book on marriage and childbearing. Washington, DC: PRB, 1992.Search in Google Scholar
9. National Agency for the Control of AIDS, Nigeria. Joint Annual Review of the national response to HIV/AIDS. 2011.Search in Google Scholar
10. Joint United Nations Programme on HIV/AIDS (UNAIDS). UNAIDS Report on the Global AIDS Epidemic. 2012.Search in Google Scholar
11. Federal Ministry of Health. Technical Report 2010, National HIV Zero-prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria. Department of Public Health and National AIDS/STI Control Programme, Nigeria. 2010.Search in Google Scholar
12. Charles E. Nigeria: UCTH Runs Out of HIV Test-Kits, Appeals for Funds. Daily Trust. 8th September 2011. Available at: http://allafrica.com/stories/201111080355.html. (Accessed 6th December, 2012).Search in Google Scholar
13. Iklaki CU, Inaku JU, Ekabua JE, Ekanem EI, Udo AE. Perinatal outcome in unbooked teenage pregnancies in the University of Calabar Teaching Hospital, Calabar, Nigeria. ISRN Obstet Gynecol 2012:246983. Epub 2012 Mar 4.10.5402/2012/246983Search in Google Scholar PubMed PubMed Central
14. Akani CI, Osaro E, Allagoa DO. Human immunodeficiency virus prevalence in an unbooked obstetric population in the Niger Delta. HIV AIDS (Auckl) 2010;2:179–84.Search in Google Scholar
15. Kancheva Landolt NT, Lakhonphon S, Ananworanich J. Contraception in HIV-positive female adolescents. AIDS Res Ther 2011;8:19.10.1186/1742-6405-8-19Search in Google Scholar PubMed PubMed Central
16. Birungi H, Mugisha JF, Obare F, Nyombi JK. Sexual behavior and desires among adolescents perinatally infected with human immunodeficiency virus in Uganda: implications for programming. J Adolesc Health 2009;44:184–7.10.1016/j.jadohealth.2008.06.004Search in Google Scholar PubMed
17. Yahaya LA, Jimoh AA, Balogun OR. Factors hindering acceptance of HIV/AIDS voluntary counseling and testing (VCT) among youth in Kwara State, Nigeria. Afr J Reprod Health 2010;14: 159–64.Search in Google Scholar
18. Okpani AOU, Okpani JU. Sexual activity and contraceptive use among female adolescents: a report from Port-Harcourt, Nigeria. Afr J Reprod Health 2000;4:40–7.10.2307/3583241Search in Google Scholar
19. Finer LB, Philbin JM. Sexual initiation, contraceptive use, and pregnancy among young adolescents. Pediatrics 2013;131: 886–91.10.1542/peds.2012-3495Search in Google Scholar PubMed PubMed Central
20. Federal Ministry of Health. National HIV & AIDS and reproductive health survey, 2007 (NARHS Plus). Nigeria: Federal Ministry of Health Abuja, 2008.Search in Google Scholar
21. Laws of the Federation of Nigeria. The criminal code act cap 77 volume 5 Section 218. 1999.Search in Google Scholar
22. Rotermann M. Trends in teen sexual behaviour and condom use. Health Rep 2008;19:53–7.Search in Google Scholar
23. Godfrey EM, Chin NP, Fielding SL, Fiscella K, Dozier A. Contraceptive methods and use by women aged 35 and over: a qualitative study of perspectives. BMC Women’s Health 2011;11:5.10.1186/1472-6874-11-5Search in Google Scholar PubMed PubMed Central
24. FHI360. Adolescents Living with HIV in Zambia: an examination of HIV care and treatment and family planning. 2013. Available at: http://www.fhi360.org/sites/default/files/media/documents/zambia-adolescents-living-hiv-integration-family-planning.pdf. Accessed 14th March, 2014.Search in Google Scholar
25. Credé S, Hoke T, Constant D, Green MS, Moodley J, et al. Factors impacting knowledge and use of long acting and permanent contraceptive methods by postpartum HIV positive and negative women in Cape Town, South Africa: a cross-sectional study. BMC Public Health 2012;12:197.10.1186/1471-2458-12-197Search in Google Scholar PubMed PubMed Central
26. Shafii T, Stovel K, Holmes K. Association between condom use at sexual debut and subsequent sexual trajectories: a longitudinal study using biomarkers. Am J Public Health 2007;97:1090–5.10.2105/AJPH.2005.068437Search in Google Scholar PubMed PubMed Central
27. Harrison A, Smit J, Hoffman S, Nzama T, Leu CS, et al. Gender, peer and partner influences on adolescent HIV risk in rural South Africa. Sexual Health 2012;9:178–86.10.1071/SH10150Search in Google Scholar PubMed PubMed Central
28. Magnani R, MacIntyre K, Karim AM, Brown L, Hutchinson P, et al. Transitions Study Team. The impact of life skills education on adolescent sexual risk behaviors in KwaZulu-Natal, South Africa. J Adolesc Health 2005;36:289–304.10.1016/j.jadohealth.2004.02.025Search in Google Scholar PubMed
29. Federal Ministry of Health. National strategic framework on the health and development of adolescents and young people in Nigeria. 2007–2011. Federal Ministry of Health, Federal Republic of Nigeria. Available at: http://nigeria.unfpa.org/pdf/ayhdfFramework.pdf. (Accessed 12th December, 2012).Search in Google Scholar
30. Federal Ministry of Health. National Adolescent Health Policy. 1995. Federal Ministry of Health, Federal Republic of Nigeria.Search in Google Scholar
31. Adekunle AO, Arowojolu AO, Adedimeji AA, Roberts OA. Adolescent contraception: Survey of attitudes and practice of health professionals. Afr J Med Med Sci 2000;29:247–52.Search in Google Scholar
32. Babalola S, Fatusi A. Determinants of use of maternal health services in Nigeria – looking beyond individual and household factors. BMC Pregnancy Childbirth 2009;9:43.10.1186/1471-2393-9-43Search in Google Scholar
33. Hill K, Thomas K, AbouZahr C, Walker N, Say L, et al. Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data. Lancet 2007;370:1311–9.10.1016/S0140-6736(07)61572-4Search in Google Scholar
34. Federal Ministry of Health. Road map for accelerating the attainment of the millennium development goals related to maternal and newborn health in Nigeria. Federal Ministry of Health, Nigeria. 2005.Search in Google Scholar
35. The Alan Guttmacher Institute. Reducing unwanted pregnancies in Nigeria. Available at: http://www.guttmacher.org/pubs/rib/2005/10/04/rib4-05.pdf. (Accessed 12th December, 2012).Search in Google Scholar
36. Adebajo S, Obianwu O, Eluwa G, Vu L, Oginni A, et al. Comparison of audio computer assisted self-interview and face-to-face interview methods in eliciting HIV-related risks among men who have sex with men and men who inject drugs in Nigeria. PLoS One 2014;9:e81981.10.1371/journal.pone.0081981Search in Google Scholar PubMed PubMed Central
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