SOCIO-DEMOGRAPHIC CORRELATES OF PERCEIVED SEXUAL BEHAVIOURS OF ADOLESCENTS IN IMO STATE, NIGERIA

ABSTRACT
This study was designed to determine the socio-demographic correlates of perceived sexual behaviours of adolescents in Imo State. The statement of problem is the increase in risky sexual behaviours of adolescents and inherent dangers of unplanned pregnancy, dropping out of school, unsafe abortion and sexually transmitted infections/HIV/AIDS. Furthermore, no empirical data was identified in Imo State hence the motivation to determine the socio-demographic variables that influence the level of sexual behaviours of adolescents in Imo State. The study was guided by 11 purposes, 11 research questions and 11 hypotheses. A cross sectional survey research design was used for the study. Sample size was 3360 (2.2%) adolescents drawn from a population of 153586 adolescents. A structured, validated and reliable questionnaire (r = 0.77) was used as the instrument for data collection. Data analysis was done using mean for research questions, ANOVA and Z-test statistics were used to test the hypotheses. The result showed that in Imo State Secondary Schools, the sexual behaviours of the older adolescents ( x = 2.60) were significantly higher than those of the younger adolescents ( x = 1.41), P < 0.05. The males had higher levels of sexual behaviours (x =1.53) than the females (x = 1.44), P < 0.05. There were significant differences among adolescents in classes JSS1 to SS3 in terms of their levels of sexual behaviours with SS3 ranking highest followed by SS2 and SS1. The rural adolescents’ level of sexual behaviour ( x = 1.51) was higher than that of the urban adolescents (x = 1.43). Furthermore, there were no significant differences among adolescents of different family sizes in terms of their levels of sexual behaviours, P > 0.05. There were significant differences among adolescents of different family structures, financial strengths, and religious beliefs, P < 0.05. Furthermore, there were significant differences among adolescents with various ages at first sexual intercourse in terms of their levels of sexual behaviours. Finally, there was a significant difference in the levels of sexual behaviours of the adolescents who used alcohol (x =2.60) and those who did not use alcohol (x =1.78) as well as adolescents who used illegal drugs ( x = 1.68) and those who did not use illegal drugs (x = 1.50). Based on the above findings, conclusions were drawn and recommendations made.


CHAPTER ONE 

INTRODUCTION

Background of the Study
Sexual behaviour is a form of physical intimacy that may be directed to reproduction (one possible goal of sexual intercourse), spiritual transcendence, and/or the enjoyment of any activity involving sexual gratification (Wikipedia, 2005). Behaviour refers to the actions or reactions of an object or organism usually in relation to the environment (Wikipaedia, 2006). It was further noted that behaviour can be conscious or unconscious, overt or covert, and voluntary or involuntary. Human behaviour is the most basic human action and can be common, unusual, acceptable and unacceptable.

Health South Australia (2009) stated various types of sexual behaviour as follows, abstinence, masturbation, coitus, anal sex, oral sex, prostitution, transvestism (use of clothing of opposite sex for sexual gratification) and transsexualism (a disorder of gender identity in which the individual wishes to be or feels that he or she is a member of the opposite sex). This study will concentrate on sexual behaviours that could result to sexually transmitted infections.
The term adolescence comes from the Latin verb adolescere, which means “to grow up” or “to grow to maturity. It means somewhat more than the physiological development implied by the original Latin verb (Dusek, 1977). Adolescence is the bridge between childhood and adulthood. Dusek further noted that it is the transition from childhood to adulthood, the stage in which the individual is required to adapt and adjust childhood behaviours to the adult forms that are considered acceptable in his or her culture.

Decey and Kenny (1994) in their explanation of adolescents are of the view that adolescents’ fall within the age range of 10 to 19 years. World Health Organization (WHO) (2003) defined adolescence both in terms of age (spanning the ages of 10 to 19 years) and in terms of phase of life by special attributes. These attributes include rapid physical growth and development, physiological, social and psychological maturity, but not all at the same time. According to WHO (2003), there is Sexual maturity and the onset of sexual activity, experimentation, development of adult mental process and adult identity as well as transition from total socio-economic dependence to relative independence. WHO/United Nations Fund for Population Activities (UNFPA)/United Nations Children’s Fund (UNICEF) (1989) are of the view that adolescence is the period between childhood and adulthood and includes those between 10 and 19 years.

According to Wikipedia (2005), correlate is a causal, complementary, parallel, or reciprocal relationship, especially a structural, functional or quality correspondence between two comparable entities; for example, a correlation between drug abuse and crime. Wikipedia further noted that it is used to predict the value of one variable given the value of the other. Houghton (2007) stated that correlate is to put or bring into causal, complementary, parallel or reciprocal relation and further noted that in brief, it is to put in or have some relation or connection. Furthermore, correlate was defined as causal, complementary, parallel, or reciprocal relationship and was explained as being connected either logically or causally or by shared characteristics or either of two interrelated things, especially if one implies the other (Houghton, 1995; Webster, 2009 & Martin, 2009).

Flay (2002) stated that all behaviours, not just problem behaviours, are related to each other. They are correlated and they also cause each other. Brian, Flay, Dphil, FSBM, and FAAHB (2002) pointed out that the linkages between alcohol or drug use and both violence and sexual behaviour among adolescents were clear. The authors further noted that about a third of the youth that committed serious crimes consumed alcohol just before the offense. The authors further pointed out that more than 70 per cent of teen suicides involved frequent use of alcohol or drugs and nearly 40 per cent of drowning involved the use of alcohol. Studies have shown that alcohol and drug use were the best predictors of early sexual activity and were associated with more unplanned pregnancies, more sexually transmitted diseases, more HIV infections, and greater school dropout than any other factor (Code, 1992; HHS Youth & Alcohol, 1992; Reis & Roth, 1993; Eron, Gentry & Schlegel, 1994; Levine & Rosich, 1996; Healthy Youth, 2000; & Poulin & Graham, 2001).

Sharma (2003) reported that adolescents practice a wide variety of sexual behaviours. The commonest of them is masturbation. Mutual masturbation among same sex adolescents is also common. Other forms of sexual behaviour include necking and petting, which are physical contacts in an attempt to produce erotic arousals without sexual intercourse. Sometimes petting and necking can also lead to orgasm. Heterosexual intercourse, lesbianism and homosexual relations are some other forms of sexual behaviour practiced by some adolescents (Sharma, 2003). Sharma further noted that among the sexually active adolescents one may observe that many have single partners; others have multiple partners at a time. Many adolescents, according to Sharma, entered into a sporadic sexual activity and then kept away from sex while others indulged in sexual activities regularly. Sharma (2003) further stated that one can rightly say that information about safer-sex practice and its usage is far below optimum levels among sexually active adolescents.

Obiajuru (2000) observed that some adolescents were exposed to sexual risk behaviours like having casual sex with unknown partners, having multiple sex partners, anal sex, oral sex, non compliance to the use of condom during sexual intercourse, homosexuality and lesbianism. Among all these also are the watching of pornographic films, collecting money in exchange for sex and having group sex. Doedens (2000); FMOH (2001); Garofalo, Cameron, Wolf, kessel, and Durant (1998) & Sharma (2003) noted that there is alarming increase of exposure to risky sexual behaviours among the adolescents not considering the consequences like pregnancy, abortion, STIs including HIV/AIDS.

Infections transmitted from one person to another through sexual intercourse are referred to as sexually transmitted infections (STIs). Sexually transmitted infections constitute a serious and sometimes deadly group of infectious diseases especially Human Immune Virus /Acquired Immune Deficiency Syndrome (HIV/AIDS).

In an uninformed or a deviant in sexual behaviour, there are two undesirable consequences such as disease and/or pregnancy (Hanlon & Pickett, 1979). The authors further reported that the present epidemic of STIs among adolescents is of serious dimensions. Centers for Disease Control and Prevention (2002) stated that the number of conception in unmarried female adolescents is unknown. It is estimated that each year approximately 10 per cent of all adolescent girls become pregnant, the majority out of wedlock. The Center for Disease Control and Prevention further reported more than 300,000 teenage abortions in 1976 and about 600,000 pregnancies that were carried to term in the United States of America.

Slap, Lot, Huang, Daniyam, Zink, and Succop (2003) observed that family polygamy and lower educational level of parents were associated with increased sexual activity among adolescents. The proportions of students reporting sexual activity were 42.3 per cent in students from polygamous families and 27.5 per cent in students from monogamous families (Slap et al., 2003). United Nations programme on Acquired Immune Deficiency Syndrome (UNAIDS) and WHO (2000) reported that Nigeria’s birth rate for adolescents is one of the highest in the world and the prevalence among female adolescents in Nigeria of STIs including HIV, is climbing rapidly.

Nigerian Demographic and Health Survey (NDHS) (1990) reported that the median age at first sexual intercourse was 16.6years while about one third of the women had their first sexual intercourse at the age of 15years. In an effort to reduce its high maternal and infant mortality and higher rate of sexually transmitted infections and dropout from school, Nigeria developed a National Reproductive Health Policy in 2000 that focuses on preventing risky sexual behaviours during adolescence.

The programme, according to UNAIDS and WHO (2000), has been hampered by outdated and incomplete information on the sexual knowledge, attitudes and behaviours of the adolescents in Nigeria. The importance of clarifying needs before intervening is highlighted by the recent evaluation of sex education intervention in Nigeria and Ghana (Brieger, Delano, Lane, Oladepo & Oyediran, 2001). The evaluation showed that the programme was effective for young people in school but not for young people out of school because of differences in sexual experience and knowledge. Sexual activity was less common among female than male students, less common among female students attending female only boarding schools than other schools, 7.7 per cent versus 24.3 per cent and less common among students living in urban than in rural locations. Allan Guttmacher Institute (2001) and Kirby (2001) reported that the sexual health needs of young people in Nigeria are high, as evidenced by the prevalence of pregnancy and sexually transmitted diseases including HIV/AIDS.

Temin, Okonofua, Omorodion, Renne, Coplan, Heggenhougen et al. (1999) observed that students noted that having multiple partners and engaging in unprotected sex with unknown partners were high risk behaviours but did not acknowledge the potential health risks of sexual intercourse with a regular known partner. Temin et al. further observed that the adolescents’ perception of risk does not necessarily translate into safe behaviour. Regardless about risks, students described attitudes that discourage safe sexual behaviour and there was also low utilization of reproductive health services (Temin et al., 1999).

From the above background, it becomes obvious that some adolescents take for granted their high-risk sexual behaviours in relation to high prevalence of STIs. The trend and consequences of adolescents’ exposure to sexual risk behaviours have raised crisis among the adolescents. Efforts being made to curb the sexual revolution and these risky sexual behaviours seem to yield little positive result. It is on the basis of the above that this research work has been designed to find out the socio-demographic correlates of sexual behaviours of the adolescents in Imo State.

Statement of the Problem
The ideal sexual behaviour of the adolescents should be sexual abstinence, safe sex practice, and avoidance of illegal drugs and alcohol which influence sexual behaviours, but this appears not to be the practice. There is rising incidence of exposure to sexual risk behaviours by the adolescents within the age range of 10-19 years (Doedens 2000, Sharma 2003, Temin et al; 1999).

Watney (1987) stated that adolescents’ sexual activities were clearly not and never had been without risks. There are inherent dangers of unplanned pregnancy, dropping out of school, unsafe abortion and sexually transmitted infections/HIV/AIDS which are the major implications of sexual risk behaviours considering the grave consequences (Hadey, 1997; Nicholl, Catchpole, Cliff, Hughes, Simms & Thomas, 1999). In view of the fact that the number of cases of STIs/HIV/AIDS have been on the increase all over the world due to increased sexual activities among the adolescents (Getcell, Pippin & Varnes, 1991); and Nigerian government is also interested in controlling STIs/HIV/AIDS among adolescents through the control of their sexual behaviours, Nigeria hence formulated the National Reproductive Health Policy and Strategies to achieve quality reproductive and sexual health for all Nigerians (FMOH, 2001). Unfortunately, despite all these ongoing efforts, some adolescents still practice risky sexual behaviours as they in the last decade (1980-89) have developed a widely held sense that they are entitled to have sex (Williams, 1989).

There is need therefore; to identify the socio-demographic correlates of perceived sexual behaviours of the adolescents in order to formulate strategies to tackle the problem from the root. However, data on socio-demographic variables influencing the sexual behaviours of the adolescents exist in different parts of the world and few are available in other geopolitical areas of Nigeria (Temin et al., 1999; Anochie & Ikpeme, 2001; Ajuwon et al., 2001; Ibe & Ikechebelu, 2002 & Ibe & Agu 2006 ). Unfortunately, no empirical data has been identified in Imo state which has a different socio-economic and cultural background with HIV/AIDS prevalence of 3.05 per cent (Obiajuru & Ogbulie, 2007), hence the researcher was motivated to identify the socio-demographic correlates of sexual behaviours of the adolescents in Imo State. The problem of this study therefore, is the increase in the risky sexual behaviours; birth rate; STIs/HIV/AIDS among the adolescents and lack of empirical data on socio-demographic correlates of perceived sexual behaviours of adolescents in Imo State.

Purpose of the Study.
This study was designed to determine the socio-demographic correlates of perceived sexual behaviours of adolescents in Imo State secondary schools.

This study was guided by the following specific purposes, namely, to determine the levels of perceived

1.     sexual behaviours of the older and younger adolescents in Imo State secondary schools.

2.     sexual behaviours of male and female adolescents in Imo State secondary schools.

3.     sexual behaviours of adolescents in classes JSSI to SS3 in Imo State secondary schools.


4.     sexual behaviours of the urban and rural adolescents in Imo State secondary schools.

5.     sexual behaviours of adolescents with different family sizes in Imo State secondary schools.

6.     sexual behaviours of adolescents with different family structures in Imo State secondary schools.

7.     sexual behaviours of adolescents with various ages at first sexual intercourse in Imo State secondary schools.

8.     sexual behaviours of adolescents with different financial strengths in Imo State secondary schools.

9.     sexual behaviours of adolescents with different religious belief in Imo State secondary schools.

10.   sexual behaviours of adolescents who use alcohol and those who do not use alcohol in Imo State secondary schools.

11.    sexual behaviours of adolescents who use illegal drugs and those who do not use illegal drugs in Imo State secondary schools.

Significance of the Study
The general benefit of this research is that the adolescents and the general public would be aware of the socio-demographic variables that influence their sexual behaviours as well as high risk sexual behaviours which predispose them to contacting sexually transmitted infections including HIV/AIDS, unplanned pregnancy, dropout from school, and unsafe abortion. Specifically, identifying the level of sexual behaviours of older (15-19 years) and younger (10-14 years) adolescents in Imo State secondary schools establishes the group that is more vulnerable to risky sexual behaviour that requires emphasis during intervention.

Identifying the levels of sexual behaviour of male and female adolescents in Imo State secondary schools shows the sex that is significantly involved that will become a focus point during preventive and control measures. The levels of sexual behaviour of Imo State secondary school adolescents in various classes JSS1-SS3 indicate those who are sexually active and inactive. This calls for more attention towards those who are sexually active during intervention through sex education and introduction to protective measures. The level of sexual involvement of the urban and rural adolescents establishes the area that is more involved which is informative in regards to sex education and other strategies required to control unhealthy sexual behaviours.

Different family sizes, family structures and financial strengths independently could actively or inactively influence the sexual behaviours of the adolescents in Imo State. The understanding of the levels of influence consequently establishes those at risk that would become target for preventive and control measures. Furthermore, any age at first sexual intercourse that was more involved in sexual behaviour should be addressed during intervention through sex education.

The religious group or groups that are more involved in sexual behaviours would require special attention by sex education providers as well as introduction to protective measures. The study would establish the impact of the use of alcohol and illegal drugs on sexual behaviours of adolescents in Imo State. Furthermore, these would show the profile of those at grave risk that would become the target for prevention and control programmes.

The theoretical significance of the study is that the theoretical frame work for understanding health behaviours including sexual behaviours promotes safe sex, medical compliance and screening. The theory explains the perceived susceptibility and severity of the sexual behaviours of the adolescents.

The health workers, policy makers, international, governmental and Non-governmental agencies operating in the state would be aware of the predictors of perceived sexual behaviours of adolescents in the state that predispose them to unplanned pregnancy, unsafe abortion, dropout from school and sexually transmitted infections; and consequently, establish operational profile of persons at grave risk that would become specific targets for prevention and control programmes. Also this study could provide useful information to other researchers who may wish to carry out more researches in the area.

Scope of the Study
The main purpose of this study was to determine the socio-demographic correlates of perceived sexual behaviours of adolescents in Imo State secondary schools. The population of the study was limited to government owned secondary school adolescents within the age range of 10 to 19 years in Imo State. The secondary schools have a population of 153,586 adolescents.

The dependent variables of the study are the sexual behaviours of the adolescents’ defined in terms of multiple and casual sex partners, frequency of Sexual intercourse, non use of condoms, masturbation, heterosexual and homosexual relationships, lesbianism, prostitution, anal sex, oral sex and safe sex practice e.g. abstinence, single sex partner and use of condom.

The independent variables of the study are the socio-demographic values which are gender, location, age, level of education (class level), family size, family structure e.g. polygamy, monogamy and single parenthood, financial strength, use of alcohol, use of illegal drugs, religion, and various ages at first sexual intercourse.


Research Questions
The main research question for this study reads thus: What are the variables that influence the levels of sexual behaviours of the adolescents in Imo State?

Specifically the following research questions guided the study:

1.                 What are the levels of perceived sexual behaviours of older and younger adolescents in Imo State secondary schools?

2.                 What are the levels of perceived sexual behaviours of male and female adolescents in Imo State secondary schools?

3.                 What are the levels of perceived sexual behaviours of adolescents in classes JSS1 to SS3 in Imo State secondary schools?

4.                 What are the levels of perceived sexual behaviours of urban and rural adolescents in Imo State secondary schools?

5.                 What are the levels of perceived sexual behaviours of adolescents of different family sizes in Imo State secondary schools?

6.                 What are the levels of sexual behaviours of adolescents of different family structures in Imo State secondary schools?


7.                 What are the levels of perceived sexual behaviours of adolescents with various ages at first sexual intercourse in Imo State secondary schools?

8.                 What are the levels of perceived sexual behaviours of adolescents with different financial strengths in Imo State secondary schools?

9.                 What are the levels of perceived sexual behaviours of adolescents of different religious beliefs in Imo State secondary schools?

10.             What are the levels of perceived sexual behaviours of adolescents who use alcohol and those who do not use alcohol in Imo State secondary schools?

11.             What are the levels of perceived sexual behaviours of adolescents who use illegal drugs and those who do not use illegal drugs in Imo State secondary schools?

Hypotheses
The following hypotheses were formulated and would be tested at an alpha level of 0.05 significance.
1.                 There is no significant difference in the levels of perceived sexual behaviours of older and younger adolescents in Imo State secondary schools.


2.                 There is no significant difference in the levels of perceived sexual behaviours of male and female adolescents in Imo State secondary schools.

3.                 There are no significant differences among adolescents in classes JSS1 to SS3 in Imo State secondary schools in terms of their perceived levels of sexual behaviours.

4.                 There is no significant difference in the levels of perceived sexual behaviours of urban and rural adolescents in Imo State secondary schools.

5.                 There are no significant differences among adolescents of different family sizes in Imo State secondary schools in terms of their perceived levels of sexual behaviours.

6.                 There are no significant differences among adolescents of different family structures in Imo State secondary schools in terms of their perceived levels of sexual behaviours.

7.                 There are no significant differences among adolescents with different ages at first sexual intercourse in Imo State secondary schools in terms of their perceived levels of sexual behaviours.

8.                 There are no significant differences among adolescents with different financial strengths in Imo State secondary schools in terms of their perceived levels of sexual behaviours.

9.                 There are no significant differences among adolescents of different religious beliefs in Imo State secondary schools in terms of their perceived levels of sexual behaviours.

10.             There is no significant difference in the levels of perceived sexual behaviours of the adolescents in Imo State secondary schools who use alcohol and those who do not use alcohol.

11.             There is no significant difference in the levels of perceived sexual behaviours of the adolescents in Imo State secondary schools who use illegal drugs and those who do not use illegal drugs.

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