ABSTRACT
The study was conducted to explore drug abuse among youth in respect to their association on risky sexual related behavior. The study was conducted among 4th year university students in Nigeria where drug abuse is reported to be a serious concern, prevalent on many campuses and ingrained on university campuses worldwide. The general objective was to determine the association between drug abuse and STI risky sexual related behaviors among students in selected Nigerian Universities. The study adopted an exploratory cross sectional study design where data collection was done by both qualitative and quantitative methods. The data was collected by use of Semi Structured Questionnaires (SSQ), Focus Group Discussions (FGDs) and Key Informant Interviews (KII). The data were analyzed to determine relationships among self-reported drug abuse, Human Immunodeficiency Virus (HIV), Sexual Transmitted Infections (STI), risky sexual related behaviors. Further multivatiate and bivariate analysis was done to establish association between dependent and independent variables. The youth sampled were 2880 consisting of 54.1% male and 45.9% female, the mean age was 24 years with a range of 21–32 years. The reduced risk of drug abuse was significantly associated with accommodation in hostels compared to rented apartment. The respondents who had both parents were less likely to abuse substance by 0.67 times compared to those having only a father or none of the parents having an increased risk of drug abuse by 1.92 and 1.39 times respectively compared to those who had the mother as the parent. The female respondents were less likely to abuse substances by 0.77 times. The increased number of occupants in the house significantly decreased risk of drug abuse by 0.70 times. The respondents who received information from peers/friends, media and others abused substances by 1.38, 1.40 and 4.40 times respectively while receipt of information from church was less likely to contribute to drug abuse. The respondents who reported not having visualized posters on STI/HIV, abused substances by 1.43 times more than those who had. The respondents who were involved in receptive vaginal intercourse were significantly more likely to abuse substances (AOR 2.10; 95% CI 1.53 – 2.88; P < 0.001) but insignificant association between those who had none penetrative sex P > 0.05. With lecturers as the reference group, students who abused substances were significantly likely to have sex with a fellow student or others (strangers) P > 0.05 and P = 0.017 respectively. The prevalence of condom use among the university students was approximately 82%. The respondents who reported condoms safety from pregnancy were significantly less likely to abuse substances than those who did not P < 0.001. The students who reported that partner never trusted them were significantly less likely to abuse substances P <0.001. The respondents who reported untrustworthy among partners were significantly less likely to abuse substances P < 0.001. The respondents who consumed over 3 beers over the weekend were significantly P < 0.001 likely to report drug abuse compared to those who consumed1-2 drinks. This study noted that majority of respondents were aged between 21 – 32 years with the overall rates of sexual experience consistent among genders in all the universities and rented private accommodation though some resided in the university halls. At Nigeria University (KU) and Narok a small proportion resided in accredited hostel. There was a decrease in alcohol consumption among respondents and drinking rates were high in dormitories and residence halls with a consumption of 3-6 drinks over the weekend. The respondents who had both parents alive were less likely to abuse substance with a high prevalence of perceived risks motivated by drug abuse and alcohol with receptive vaginal sex being preferred though there was easy availability of condoms and availability of information. All the universities had HIV preventive activities but the HIV Policy document was available at JKUAT and KU unlike Rivers state university, Narok and Uniport Colleges.
University students should be targeted as high risk groups in the transition of STI and drug abuse through funding policies, frameworks and university administrators, staff and students. The university administration, parents and residential owners need to create intervention bonds against drug abuse and risky sexual behaviours. Availability of intervention information should be enhanced through a longitudinal study on condom use to establish the factors contributing to drug abuse and HIV /STI.
CHAPTER ONE:
1.0 INTRODUCTION
1.1 Background information
Education is touted as pivotal to the achievement of several of the millennium Development Goals (MDGs), which includes reduction in STI infections. The Association of African Universities (AAU) revealed that, education sector is a country’s learner’s strongest weapon to equip them with informed choices (AAU, 2007).
Information indicates that a significant number of the new HIV infections occur among the youth who are significantly involved in drug abuse as well as risky sexual behavior (UNAIDS, 2007). It is estimated that 70% of new HIV cases and 83% of AIDS deaths occur in Africa (UNICEF, 2010). In the Sub-Saharan Africa (SSA), youth aged 15-24 years account for 45% of new HIV infections and sexual contact account for 80-90% of all infections (UNODC, 2007; UNAIDS, 2008).
The student relationships on drug abuse and STI at Universities influence interactions (AAU, 2007) and this threatens the educational systems.
The higher education institutions are potential breeding ground for drug abuse and STI due to the close proximity of a large number of youth at their peak years of sexual activity and experimentation devoid of supervision (Saint et al., 2004). In a study in South Africa (S.A) the STI prevalence was of 8.2% among 4th year students (Rispel et al., 2006). The drug abuse and STI is a challenge to the youth who are the foundation of a society and define the pace of nation’s development. It is thus important to understand the risky sexual behavior forces that interlink and influence universities’ education in Nigeria, hence this study. This need to be explored as unavailability of condoms, cultural and social norms is associated with STI risks among the youth.
Many youth abuse substances for experimentation that compromise their judgment and increase their engagement in risky sex. This research anticipated university student’s drug abuse would be associated to risky sexual behaviors, as measured by lower levels of condom use. The youth are left to find their own way in a difficult and ever changing society on sexual behaviors matters.
According to the South Africa review, the HIV prevalence rate among youth aged 15–24 years and 20–24 years was 10.3% and 15.2% respectively (UNAIDS 2010). The National AIDs and STI Control Program (NASCOP) revealed 2.2 million Nigerians to be infected with HIV/AIDS and over 60% of new infections occur among people aged 15-35 years that represent 38% of the Nigeria’s population (NASCOP, 2005). The students at the
+universities are within 19–24 years and majority have first unplanned sexual experience due to misinformation at the universities (Pettiforet al., 2009).
The majority of university research focuses on risky sexual practices ignoring drug abuse that remains a major problem. Many students use tobacco, alcohol, khat (miraa), chang'aa (illicit liquor), marijuana (bhangi), mnazi (traditional brew), glue, heroin and ’brown sugar’, to maintain their social identities and shape risky sexual behaviors. There is demand coordination from the universities to mainstream the formulation of policies, plans, programs and activities which effectively address the epidemic concerns. The HIV/AIDS Control Unit is one of the major interventions to the pandemic.
The universities are not fully committed in drug abuse and STI response. The S.A Universities have been proactive in the first nationwide survey of HIV/AIDS in universities which determined an HIV prevalence of 3.4% (HEAIDS Report, 2010).
The study addressed various theories and models as a prerequisite for formulating a practical and workable framework. The unique perspective of this study focused on areas that are often neglected in HIV research, such as Institutional settings in which sexual partnerships and socio networks. The study established the association between drug abuse and STI risky sexual related behaviors. The investigation considered the weaknesses and strengths of the common models and theories that are used in the formulation of policies, strategies, elicit the gaps. This was very instrumental in the design and development of drug abuse and STI prevention frameworks in the Nigeria government sector through ACU, NACADA, Ministry of Higher Education and other ministries.
1.2 Statement of the problem
There is dearth of information in the magnitude of the drug abuse and HIV/AIDS in the universities due to inadequate mainstreaming activities (UON HIV/AIDS Policy, 2003). There is turmoil as youth matures, engages with peers and the influence of their family diminishes as they relate to increasing prevalence of drug abuse.
There has been weaker collaborative links between University authorities and the Nigerian Government. Little is known about STI status on African universities and there is an HIV conspiracy of silence at universities as students conduct themselves as if the disease did not exist.
There is a belief that university students are not a high risk population hence the need of the study at JKUAT, KU, Rivers state, Narok and Uniport. There is a complex relationship between higher education level, drug abuse and STI risks that require to be explored further by use of relevant theoretical models.
The limited published data has led to youth being sidelined by drug abuse and STI prevention efforts. More focus is needed to generate data through relevant forums such as ACU and government Ministries. The Nigerian youth grow up in a society where opportunity has been eroded by institutional collapse with insufficient data from which recommendations can be developed. The few interventions are based on generic models of ‘youth sexual behavior’ and do not take into account the many ways that university students’ experiences are different from those of other youth.
1.3 Justification
Nigerians below 30 years constitute 75% of the population, forming the largest human resource for national development. The universities are the centers of academic excellence and cream of skilled manpower yet threatened by increase of drug abuse and HIV risks (UON HIV/AIDs policy, 2003). The selected universities JKUAT, KU, Rivers state, Narok and Uniport can offer a catalytic role by providing technical support to halt the spread.
The unlimited freedom, curiosity, experimentation on substances and their invulnerability of STI perceptions make the study to rise to the occasion by “challenging the challenger” (drug abuse and STI). In Nigeria, there are limited qualitative researches done using theoretical models. There are few studies that produce insufficient, un-published and delinked data. The findings from this study suggest practical, interventions and innovative strategies to policy makers.
1.4 Research Questions
1. What is the prevalence and types of drug abuse among students in selected Nigerian Universities?
2. What are the STI risky sexual behaviors among students in selected Nigerian Universities in 2024?
3. What is the association between drug abuse and STI risky sexual behaviors among students in selected Nigerian Universities ?
1.5 Objectives
1.5.1 General objective
To assess drug abuse and STI risky sexual related behaviors among students in selected Nigerian Universities.
1.5.2 Specific objectives
1. To determine the prevalence and types of drug abuse among students in selected Nigerian Universities in 2024.
2. To establish STI risky sexual behaviors among students in selected Nigerian Universities in 2024.
3. To determine the association between drug abuse and STI risky sexual behaviors among students in selected Nigerian Universities in 2024.
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