![15 and 24 years (Shiferaw K, et al, 2014, Fikre M, 2009). According to NDHS (2013), about
3.2% of unmarried women in the past 12 months reported to have STI while about 2.5% of
unmarried men in the past 12 months reported to have STI.
According to John Imaledo et al ( 2012), reported that more young people in higher
institutions are getting sexually active and most lack the necessary reproductive health
information to practice safe sexual practices.( John Abdulrahman Imaledo et al, 2012)
Several research have confirmed the assertion that sex is a phenomenon currently ravaging
higher institution in Nigeria as a lot of students are engaged in premarital and heterosexual
relationships on campus [Magnus O.O,et al 2009].
In Nigeria, several studies across the regions have shown that sexual activity among
youths is high and increasing. (NPC [Nigeria] and ORC Macro. NDHS 2008 and 2009, Bankole
A et al. 2006. MOH (Nigeria). National HIV/AIDS Reproductive Health Survey 2005).
Studies confirmed that having multiple sexual partners among young people is fairly a
common behaviour. Accordingly, a study among Mbarara University students (Uganda)
indicated that students who did not visit religious sites had higher number of lifetime sexual
partners compared to those who visit regularly (A. Agardh, et al, 2011).
In another study conducted among students of Ibadan University, about 12% female and
16% male respondents had more than three sexual partners (A. M. Sunmola, 2005). According to
NDHS (2013) about 1.9% of unmarried women who reported to have had more than two sexual
partners in the past 12 months while about 6.7% for men.
Studies from South East Nigeria have shown that the level of sexual activity among
young people in tertiary educational institutions is high, (Okafor II,et al 2005) and that](https://image.slidesharecdn.com/proposalonriskysexualbehaviouramongundergraduatestudentsinnigeriaupload-230617132311-3e8f0395/85/Proposal-on-Risky-Sexual-Behaviour-among-Undergraduate-Students-in-Nigeria-upload-docx-4-320.jpg)
Proposal on Risky Sexual Behaviour among Undergraduate Students in Nigeria upload.docx
- 1. DETERMINANTS OF RISKY SEXUAL BEHAVIOUR AND CONTRACEPTIVE USE AMONG UNMARRIED YOUTH (UNDERGRADUATE STUDENTS) IN OBAFEMI AWOLOWO UNIVERSITY ILE-IFE, OSUN STATE. A PROPOSAL BY: OYEKAN TOLULOPE JANET B.Sc (Hons.) Public Health
- 2. CHAPTER ONE 1.1 Background to the Study Youths are define as belonging to the age group of 15 to 24 years while the terminology “young people” covers the age of 10 to 24 years (www.un.org). According to UNESCO, “Youth is a period of transition from the dependence of childhood to adulthood’s independence and awareness of independence as members of a community” (www.unesco.org). According to Mulu et al (2014) reported that sexual behaviour is the core of sexuality matters among youths. Their modest or dynamic behaviour vulnerable youths to risky sexual behaviours. (Mulu et al. 2014). The youths are highly concerned with physical and sexual attractiveness with increased interest in the opposite sex, and are frequently changing relationships. Besides, they are risk takers who are more likely to make decisions about the future without adequately considering the consequences (J. Nicholson, 2012). Risky sexual behaviours encompass a variety of behaviours including premarital sex, multiple sexual partners, unprotected sex, alcohol/substances–induced sex and others (Bisexual, heterosexual), which may likely result in contracting HIV/AIDS, unwanted pregnancies and unsafe abortions (G.S. Charine; http://cdn.24.co.za/files/Cms). According to National Health Survey (2013), the Percentage of unmarried female in Nigeria between ages 15 to 19 is 70.4% and age 20 to 24 is 33.1% while for unmarried male their percentage is 98.7% for age 15 to19 while age 20 to 24 is 84.8%. (NDHS 2013).
- 3. According to NDHS (2013), age at first sexual intercourse for unmarried female age 15to 19 is 15.6% and for age between 20 to 24 is 18.7%. while for unmarried Male, Age at first sexual intercourse for age 15to 19 is 2.9% and for age 20 to 24 is 4.0%. (NDHS 2013). There have been rapid attitudes changing towards sex, and premarital sex has been accepted by many youths (Zhang K, et al 1999, Hershatter G, 1997). Youths’ risky sexual behaviours have been recognized as an important health, social and demographic concern in the developing world and are vulnerable to many health problems. Because they often have multiple sexual relationships and inconsistent use of condoms (Somba MJ, et al 2014, Ambaw F, et al 2010). Young men may have their first sexual experiences with prostitutes, while young females may have their first sexual experiences with older men, both of which increase the chance of getting sexually transmitted infections (STIs) including Human Immuno- deficiency Virus (HIV) (Somba MJ, et al 2014, Ambaw F, et al 2010). Also, substance abuse exposes the users to risky sexual behaviours such as having unprotected sex which can have economic, social, physical, psychological, and health problems (Ambaw F, et al 2010). Sexually transmitted diseases like HIV/AIDS and other reproductive health (RH) problems are the greatest threats to the well-being of youth (Shiferaw K, et al, 2014, Berhane F, et al 2005) Globally, one-third of the 340 million new STIs cases occur per year in people under 25 years of age. Each year, more than one in every 20 adolescents contracts a curable STI. Studies reported that more than half of all new HIV infections occur in people between the ages of
- 4. 15 and 24 years (Shiferaw K, et al, 2014, Fikre M, 2009). According to NDHS (2013), about 3.2% of unmarried women in the past 12 months reported to have STI while about 2.5% of unmarried men in the past 12 months reported to have STI. According to John Imaledo et al ( 2012), reported that more young people in higher institutions are getting sexually active and most lack the necessary reproductive health information to practice safe sexual practices.( John Abdulrahman Imaledo et al, 2012) Several research have confirmed the assertion that sex is a phenomenon currently ravaging higher institution in Nigeria as a lot of students are engaged in premarital and heterosexual relationships on campus [Magnus O.O,et al 2009]. In Nigeria, several studies across the regions have shown that sexual activity among youths is high and increasing. (NPC [Nigeria] and ORC Macro. NDHS 2008 and 2009, Bankole A et al. 2006. MOH (Nigeria). National HIV/AIDS Reproductive Health Survey 2005). Studies confirmed that having multiple sexual partners among young people is fairly a common behaviour. Accordingly, a study among Mbarara University students (Uganda) indicated that students who did not visit religious sites had higher number of lifetime sexual partners compared to those who visit regularly (A. Agardh, et al, 2011). In another study conducted among students of Ibadan University, about 12% female and 16% male respondents had more than three sexual partners (A. M. Sunmola, 2005). According to NDHS (2013) about 1.9% of unmarried women who reported to have had more than two sexual partners in the past 12 months while about 6.7% for men. Studies from South East Nigeria have shown that the level of sexual activity among young people in tertiary educational institutions is high, (Okafor II,et al 2005) and that
- 5. complicated illegally induced abortion for unwanted pregnancy has increased five-fold over the previous decades with significant abortion-related mortality.( Iyoke CA, et al 2010). Across the world, students in higher institutions of learning constitute an influential group of young people. Past evidence shows that the habits of students in tertiary institutions in Nigeria significantly influence other young people in their society who tend to take social cues from undergraduate students. Any pattern of reproductive health behavior among university students could therefore have a profound effect on young people in the society generally.(WHO: 351 fact sheet 2013, Abiodun OM, 2009, Ejembi CL,et al 2004, Imaledo JA, et al 2012) and have shown that some undergraduates resort to non pharmacological agents and off-label drug use for contraception. ( Imaledo JA, et al 2012, Ezebialu IU, et al 2013 ,Ibekwe PC,et al 2010.) 1.2 Statement of the Problem Higher institution student’s sexual behavior varies in terms of locality, civilization, urbanization and socio cultural context of the societies. Specifically, the University is located in areas where there is high flow of tourists and night clubs that will expose the students to be engaged in different sexual risk behaviours. Certain behaviors can place the university students at greater risk of HIV infection. As they are in the youth age category, they are exposed to many risky behaviors including sexual coercion, STI / HIV/AIDS, unwanted pregnancy and abortion like other youths. Groups of people who engage in these high-risk behaviors are considered vulnerable to HIV infection and need to be watched cautiously in order to control its epidemic (UNAIDS, WHO 2009) . According to NDHS (2013) about 18.0% of unmarried women age 15
- 6. to 19 who reported to have had sexual intercourse with partner who are 10 or more years older than them in the past 12 months. These risky behaviours may further be worsened by the fact that university students are too many in number, lack facilities for sexual and reproductive health services and live away from their parents and free from parental control. In addition, some are subjected to wide spread substance use and peer-pressure that aggravate the risky behaviours (Mitike G, et al 2002.) The University environment and its youths’ perception about contraceptives use and their sexual behaviour have shown to have a great impact on their frequency of contraceptive use during emergency. Their view that the social environment of the university and attainment of parental or guardian freedom of “do whatever you want” since there is no close monitoring of activities engage in by the youth, have given them the power to make decision and be engage in risky sexual behaviour that is detrimental to their reproductive health and life in general. The high-risk sexual behaviour are transactional sex, engagement with multiple partners, unprotected casual sex and gender- based violence and as such African institutions of higher learning have recently been described as “high-risk institutions” for the transmission of sex related infections (P.I. Okonkwo, A.O. Fatusi and A.L. IIika 2005). According to NDHS (2013) about 2.3% of unmarried men paid for sex in the past 12 months. There is high prevalence of risky sexual behaviour among University youths despite a high level of knowledge about reproductive health issues (Akande A. 1994, Arowoju AO, et al 2002). A lot of other problems result from risky sexual behavior such as withdrawal from school, grim future, prostitution, poverty, lack of contribution to economic build, infant mortality and even death.
- 7. The use of contraceptives among youths is significantly different from that of older married couples. It is influenced by educational, developmental, social and psychological factors. Youths’ Compliance to contraceptive use tends to be poor even when family planning services were available and were properly educated. Explanation given includes service design not attuned to their need, lack of guaranteed confidentiality, little psychological support, poor judgment and tendency to risk-taking (Arayo MO, et al 1998, Adinma JIB, et al 1994). According to NDHS (2013) about 61.8% of unmarried women and 53.6% for unmarried men age 15 to 24 who had more than two sexual partner in the past 12 months and reported using a condom at last intercourse. 1.3 Justification for the Study There has been increase concern on human sexuality, especially in respect to contraceptive and control of sexually transmitted infections among the youth. There is need to identify factors influence risky sexual behaviour and contraceptive use among unmarried youth. Nigeria had witness rapid expansion of University system in the past two decades, this have led to explosion of the proportion of undergraduates in the country therefore there is need for a recent study to show how it have affect trends and need to direct attention to the reproductive sexual behavior of youths in the Nigeria tertiary institutions in terms of both research and intervention. Current statistics on HIV/AIDS in Nigeria, provide evidence as to the relatively higher risk that youth (between age 19 -24) face in respect to HIV transmission. According to 2001 National Survey (MOH: HIV/AIDS: what it means for Nigeria. 2002.) recorded a minimal of 6% sero-prevalence level (6.1% for 15-19 and 6.0% for 20-24) as compared to all other age
- 8. categories none of which had a Sero-prevalence rate above 5.0%. Nigeria’s STI/HIV control estimated that more than 60% of new HIV infections occur among youth ages 15 to 24(Okonofua F.E, 1999). In a research conducted among rural female teens age 17 to 19, over 80% of them had experience sexual intercourse. At the time of the study, 16.5% had some STI (UNESCO 2000). According to NDHS (2013) about 3.2% of unmarried women and 1.8% for unmarried men age 15 to 24 reported to have had STI for the past 12 months. (NDHS 2013) 1.4. Research questions: a) Are unmarried youth knowledgeable about failed and attitudes toward risky sexual behavior? b) What are the factors associated with risky sexual behavior among unmarried youth? c) What are the factors that drive contraceptive preferences among unmarried youth? d) What is the relation between sexual behavior and contraceptive use? 1.5 General Objective To assess the pattern and identify factors influencing risky sexual behaviour and contraceptive use among unmarried youths in Ile Ife, Osun State, Nigeria. 1.5.2 Specific Objectives To ascertain the magnitude of risky behavior and its predisposing factors. To assess knowledge and factors associated with risky sexual behavior and pregnancy among unmarried youth. Factors that drive the trends in contraceptive preferences.
- 9. Determine the relationship between risky sexual behavior and contraceptive use among unmarried youths. 1.6 Expected Contribution to Knowledge Findings from this study will provide a more comprehensive understanding of youth sexual risky behaviors. This study will provide information on medical, socio-culture, individual, socio-demographical factors associated, with utilization of contraceptive use. The Information from the research might assist policy makers to develop effective and feasible intervention strategies targeting youth who are at increased risk for HIV/STI infection and unplanned pregnancy. The youths are the basis of the future and represent the hope for an HIV/AIDS free generation.