Tobacco and Alcohol Use among a Sample of Men who have Sex with Men in Lagos state, Nigeria

Background: Research in other parts of the world has shows that men who have sex with men (MSM) may have higher rates of alcohol and tobacco use than the general population of men. Little is known about the pattern of tobacco and alcohol use among MSM in Nigeria. Aim: This study set out to assess the pattern of tobacco and alcohol use and to determine the factors associated with their use among a sample of MSM. Subjects and Methods: This cross-sectional descriptive study was carried out among 320 MSM. For the purpose of this study, we collaborated with an MSM-led registered Non-governmental organization (NGO) that works closely with the state and developmental partners to provide health programs exclusively for MSM in Lagos State. Data were collected using a pretested interviewer administered survey. MSM were recruited using a non-probability sampling technique (Snow ball sampling). Data analysis was carried out using Epi info version 3.5.3 and SPSS 17.0. Results: Up to 22.2% (71/320) were ever-smokers with 15.4% (49/320) remaining as current smokers. Among current smokers more than half of the men smoked daily and 36.7% (27/49) were heavy smokers (smoked more than 10 sticks per day). About one in three, 34.1% (109/320) currently drank alcohol with majority having their most recent drink less than a week before the study. Using the CAGE assessment for alcohol dependence, almost half of the current drinkers had a drinking problem. Respondents who used marijuana and those whose partners smoked were more likely to be current smokers. Current smokers, marijuana users and those whose partners consumed alcohol were more likely to have a drinking problem. Conclusion: Both tobacco and alcohol use is common among this sample of MSM. Efforts to address these issues should be given priority when planning health care programs targeted at MSM.Keywords: Men who have sex with men, Alcohol, Tobacc

The effects of educational curricula and training on LGBT specific health issues for healthcare students and professionals: a mixed-methods systematic review

Introduction: Poor access of lesbian, gay, bisexual and transgender (LGBT) people to healthcare providers with clinical and cultural competency contributes to health inequalities between heterosexual/cisgender and LGBT people. This systematic review assesses the effect of educational curricula and training for healthcare students and professionals on LGBT healthcare issues. Methods: Systematic review; the search terms, strategy and process as well as eligibility criteria were predefined and registered prospectively on PROSPERO. A systematic search of electronic databases was undertaken. Screening for eligible studies and data extraction were done in duplicate. All the eligible studies were assessed for risk of bias. The outcome of interest was a change in participants’ knowledge, attitude and or practice. Results: Out of 1171 papers identified, 16 publications reporting 15 studies were included in the review. Three were non-randomized controlled studies and 12 had a pre/post-design; two had qualitative components. Bias was reported in the selection of participants and confounding. Risk reported was moderate/mild. Most studies were from the USA, the topics revolved around key terms and terminology, stigma and discrimination, sexuality and sexual dysfunction, sexual history taking, LGBT-specific health and health disparities. Time allotted for training ranged from 1 to 42 hours, the involvement of LGBT people was minimal. The only intervention in sub-Saharan Africa focused exclusively on men who have sex with men. All the studies reported statistically significant improvement in knowledge, attitude and/or practice post-training. Two main themes were identified from the qualitative studies: the process of changing values and attitudes to be more LGBT inclusive, and the constraints to the application of new values in practice.Conclusions: Training of healthcare providers will provide information and improve skills of healthcare providers which may lead to improved quality of healthcare for LGBT people. This review reports short-term improvement in knowledge, attitudes and practice of healthcare students and professionals with regards to sexual and LGBT-specific healthcare. However, a unified conceptual model for training in-terms of duration, content and training methodology was lacking

Hidden healthcare populations: using intersectionality to theorise the experiences of LGBT+ people in Nigeria, Africa

Minority population groups are often excluded or marginalised within health systems and in health research and policy. This article argues that theories of intersectionality can help us to understand these issues and develops the concept of ‘hidden healthcare populations’ – using the case of people who identify as Lesbian, Gay, Bisexual, Transgender Plus (LGBT+) in Nigeria, in sub-Saharan Africa. The findings present original qualitative data from a seldom heard population group about instances of abuse, rejection and marginalisation by healthcare providers working in public and private healthcare facilities, and the attempts of LGBT+ people to resist and survive in that context. We extend theoretical understandings of intersectionality in global public health and explore how the concept relates to the social determinants of health. The article has significant implications for policy and healthcare education and responds to a call from the World Health Organisation to generate context-specific data to guide interventions targeted at minority population groups. Additionally, our discussion has wider significance because it highlights the Western-centric nature of much theory in health policy – and offers analysis and reinterpretation that incorporates queer, postcolonial, African perspectives

Knowledge and utilization of sexual and reproductive health services among young males in a slum area in Nigeria: A cross-sectional study

Background: Globally, young people are faced with sexual and reproductive health challenges such as unintended pregnancies, sexually transmitted infections and unsafe abortions which result from limited knowledge of sexual and reproductive health and poor utilization of the available services. The purpose of this study was to assess the sexual and reproductive health knowledge, pattern of service utilization, and the associated factors among young males in slum communities of Mushin Local Government Area (L.G.A), Lagos State, Nigeria. Methods: The study was conducted among young males, 15–24 years in Mushin Local Government Area, Lagos State, Nigeria. Data was collected using a pre-tested structured questionnaire that consisted of three domains with 57 questions, and was interviewer-administered. Multi-stage sampling technique was used to select 422 participants. Descriptive statistics, bivariate analysis, and binary logistic regression were carried out using SPSS version 20. Results: The mean age of the respondents was 21.01 years ± 2.00, and 73.06% of the respondents had good knowledge of sexual and reproductive health. 52.85% of the respondents had poor knowledge regarding the likely occurrence of pregnancy at mid-menstrual cycle. Nearly two-third (64%) of the respondents have ever visited a health facility for sexual and reproductive health service. Ethnicity(AOR = 2.73), access to the internet(AOR = 1.77) and having ever had sex(AOR = 1.96) were significantly associated with the utilization of the services. Conclusion: Good knowledge of sexual and reproductive health was observed among the respondents, although misconceptions still exist. Service utilization, however, remains low due to some individual and socio-cultural factors. It is therefore important to increase awareness of Sexual and Reproductive Health, and make the services available and affordable to young people for increased uptake

Utilization of insecticide treated nets (ITNs) among male students of a tertiary institution in Lagos State, Nigeria

Background: Malaria is an eminently preventable, treatable and curable disease. Proven effective options to reduce morbidity and mortality include early diagnosis, combined with prompt effective therapy and malaria prevention through reduction of human-vector contact, emphasizing the use of insecticide-treated nets (ITNs). The aim of this study was to determine the knowledge, attitude and utilization of malaria preventive methods among the students residing in Mariere Hostel of the University of Lagos, Akoka. Materials and Methods: The study design was a cross-sectional descriptive study. Simple random sampling method was used to select the respondents. Pre-tested, structured, open and close-ended self administered questionnaires were used for data collection. Data analysis was done using Epi info version 3.5.1 statistical software package. The study was carried out in February 2012. Results: A total of 221 out of the administered 250 questionnaires were retrieved and analyzed giving a response rate of 88.4%. All the respondents were males with a mean age of 20 ± 2.8 years. The mean knowledge score (%) of the respondents was 76.5 ± 3.19. Although, 91.0% of the respondents recommended the use of ITNs to all students, only 31.6% use ITNs. The major reason given for non-usage of ITNs being that it is uncomfortable (45.3%). There was no statistically significant relationship between socio-demographic characteristics and utilization of ITN. Conclusion: This study has demonstrated high level of knowledge of malaria and positive attitude towards malaria prevention but poor malaria prevention practice as evidenced by poor usage of insecticide-treated nets. There is therefore need for more enlightenment campaigns to improve and sustain the knowledge and attitude towards malaria prevention as well as improve utilization of ITNs

Predictors of tuberculosis knowledge, attitudes and practices in urban slums in Nigeria: a cross-sectional study

Introduction: Nigeria is among six countries responsible for the majority of tuberculosis (TB) cases in the world. The Nigerian government has emphasized community-based case finding to increase detection of TB. This process requires efforts to improve knowledge, attitudes and practices (KAP) of TB, particularly in the poorest of communities. This study presents data from a KAP survey administered in two underserved Nigerian communities. Methods: a structured survey was administered by trained interviewers among adult residents in two slum communities in Lagos, Nigeria. Participants were selected through multistage random sampling. KAP scores were computed and the predictors of higher scores were assessed. Results: a total of 504 respondents were surveyed. The mean KAP scores were relatively low: 9.8 ± 7.1 for knowledge (out of a maximum 34), 5.3 ± 3.4 for attitude (maximum = 10), and 5.2 ± 1.5 for practice (maximum = 7). The predictors of good knowledge were increasing age, post secondary education and professional occupation. The predictors of positive attitude were post secondary education and good TB knowledge. Good knowledge was a predictor of good practice. Conclusion: our findings underscore the need to improve the education about TB in underserved communities. Improving KAP scores will ultimately lead to higher rates of TB detection and treatment