PREDICTORS OF SEXUAL VALUE SYSTEMS AMONG JIMMA UNIVERSITY STUDENTS, SOUTHWEST ETHIOPIA

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Boy/Girl Friend and Virginity Values, and Stigma Related to Condom Among Jimma University Students

BACKGROUND: Traditional views of sexual behaviors are frequently changing as the factors influencing them are changing. Therefore, assessing sexual practices that are not part of the tradition would be necessary. The objective of this study was to identify the types of sexual practices, their development pattern and how these development patterns expose students to sexually transmitted infections and unplanned pregnancy. METHODS: A cross-sectional survey was conducted on a sample of 1986 (1612 males, 365 females, and with 9 subjects’ gender not indicated) Jimma university students in August 2009 with their age ranging from 17-45 years (median = 20). Quantitative data was collected using a piloted, precoded questionnaire and qualitative data was collected from six focus group discussions. Logistic regression and descriptive statistics were computed and qualitative findings were triangulated with quantitative findings. P-value less than 0.05 was considered significant. RESULTS: Practice of penile to vaginal intercourse, masturbation, kissing, oral sex, and anal sex were reported by 567 (28.9%), 688 (36.7%), 840 (42.4%), 179 (9.2%) and 83 (4.3%) of the respondents, respectively. Respondents had two years (one year with and one year without condom) of sexual experience before marriage. Sixty percent of those who had sexual experience were exposed to sexually transmitted infections and 46.6% were exposed to both unplanned pregnancy and sexually transmitted infections. Forty seven percent of those who practiced oral sex and 29% of those who practiced anal sex did not consider their acts as sexual intercourse. Conclusions: University students are high risk groups that need more focused research and concerted health care. The term ‘sexual intercourse’ should be consciously defined for its future use in Ethiopia. Furthermore, Service providers and researchers should address all types of sexual practices

Sexual Practices and Their Development Pattern Among Jimma University Students

BACKGROUND: Traditional views of sexual behaviors are frequently changing as the factors influencing them are changing. Therefore, assessing sexual practices that are not part of the tradition would be necessary. The objective of this study was to identify the types of sexual practices, their development pattern and how these development patterns expose students to sexually transmitted infections and unplanned pregnancy. METHODS: A cross-sectional survey was conducted on a sample of 1986 (1612 males, 365 females, and with 9 subjects’ gender not indicated) Jimma university students in August 2009 with their age ranging from 17-45 years (median = 20). Quantitative data was collected using a piloted, precoded questionnaire and qualitative data was collected from six focus group discussions. Logistic regression and descriptive statistics were computed and qualitative findings were triangulated with quantitative findings. P-value less than 0.05 was considered significant. RESULTS: Practice of penile to vaginal intercourse, masturbation, kissing, oral sex, and anal sex were reported by 567 (28.9%), 688 (36.7%), 840 (42.4%), 179 (9.2%) and 83 (4.3%) of the respondents, respectively. Respondents had two years (one year with and one year without condom) of sexual experience before marriage. Sixty percent of those who had sexual experience were exposed to sexually transmitted infections and 46.6% were exposed to both unplanned pregnancy and sexually transmitted infections. Forty seven percent of those who practiced oral sex and 29% of those who practiced anal sex did not consider their acts as sexual intercourse. Conclusions: University students are high risk groups that need more focused research and concerted health care. The term ‘sexual intercourse’ should be consciously defined for its future use in Ethiopia. Furthermore, Service providers and researchers should address all types of sexual practices

Parents' Perception, Students' and Teachers' attitude towards School Sex Education

Background: Sex education is described as education about human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, contraception, family planning, body image, sexual orientation, sexual pleasure, values, decision making, communication, dating, relationships, sexually transmitted infections (STIs) and how to avoid them, and birth control methods. This study was conducted to explore perception of parents about school sex education and assess the attitude of teachers and students towards school sex education.Methods: A cross-sectional quantitative and qualitative study was conducted on randomly selected 386 students, total census of 94 teachers and 10 parents in Merawi Town from March 13-27, 2011. Data were collected using self-administered structured questionnaire and in-depth interview guideline. Multiple linear regression analysis was performed using total score to determine the effect of the independent variables on the outcome variable and thematic analysis was used to analyze the qualitative data.Results: All study participants have favourable attitude towards the importance of school sex education. They also agreed that the content of school sex education should include abstinence-only and abstinence-plus based on mental maturity of the students. That means at early age (Primary school) the content of school sex education should be abstinence-only and at later age (secondary school) the content of school sex education should be added abstinence-plus. The students and the teachers said that the minimum and maximum introduction time for school sex education is 5 year and 25 year with mean of 10.97(SD±4.3) and 12.36(SD±3.7) respectively. Teacher teaching experiences and field of studies have supportive idea about the starting of school sex education. Watching romantic movies, reading romantic materials and listening romantic radio programs appear to have a contribution on the predictor of students’ attitude towards the starting time of school sex education.Conclusion: All study participants have a need to start sex education at school. All study participants said that at early age (Primary school) the content of school sex education is abstinence-only and at later age (secondary school) is added abstinence-plus. School Sex education should be under considers the need of students, teachers and parents.Keywords: Sex education, Attitude, perceptionEthiop J Health Sci. Vol. 22, No. 2 July 201

Acceptability and feasibility of peer-administered group interpersonal therapy for depression for people living with HIV/AIDS—a pilot study in Northwest Ethiopia

Background Psychological treatments are widely tested and have been effective in treating depressive symptoms. However, implementation of psychological treatments in the real world and in diverse populations remains difficult due to several interacting barriers. In this study, we assessed the acceptability and feasibility of peer-administered group interpersonal therapy for depressive symptoms among people living with HIV/AIDS in Northwest Ethiopia. Method We conducted a single-arm, peer-administered, group interpersonal therapy intervention with eight weekly sessions from 15 August to 15 December 2019 among people living with HIV/AIDS in Northwest Ethiopia. Four interpersonal therapy groups were formed for the intervention with a total of 31 participants. Results Of the 31 recruited participants, 29 completed the intervention providing a retention rate of 93.5%. The process of the intervention and its outcomes were highly acceptable as most participants expressed success in resolving their psychosocial problems, adjusting to life changes and coping with stigma. The intervention was also reported to be feasible despite anticipated barriers such as access to transportation, perceived stigma and confidentiality concerns. The post-intervention assessment revealed significant reduction in depressive symptoms (mean difference (MD) = 9.92; t =  − 7.82; 95% CI, − 12.54, − 7.31; p < 0.001), improvement in perceived social support (MD = 0.79; t = 2.84; 95% CI, 0.22, 1.37; p = 0.009) and quality of life (MD = 0.39; t = 4.58; 95% CI, 0.21, 0.56; p < 0.001). Conclusion Group interpersonal therapy is feasible and acceptable, and people living with HIV/AIDS can benefit from group interpersonal therapy in managing depressive symptoms and in improving perceived social support and quality of life. Future studies should examine the effectiveness of group interpersonal therapy in this setting

Comorbidities between tuberculosis and common mental disorders: A scoping review of epidemiological patterns and person-centred care interventions from low-to-middle income and BRICS countries

Background : There is increasing evidence that the substantial global burden of disease for tuberculosis unfolds in concert with dimensions of common mental disorders. Person-centred care holds much promise to ameliorate these comorbidities in low-tomiddle income countries and emerging economies. Towards this end, this paper aimed to review 1) the nature and extent of tuberculosis and common mental disorder comorbidity and 2) person-centred tuberculosis care in low-to-middle income countries and emerging economies. Main text : A scoping review was conducted of English-language studies published from 2000-2019 in peer-reviewed and grey literature, using established guidelines, for each of the study objectives. Four broad tuberculosis/mental disorder comorbidities were described in the literature, namely alcohol use and tuberculosis, depression and tuberculosis, anxiety and tuberculosis, and general mental health and tuberculosis. Rates of comorbidity varied widely across countries for depression, anxiety, alcohol use and general mental health. Alcohol use and tuberculosis were significantly related, especially in the context of poverty. The initial tuberculosis diagnostic episode had substantial socio-psychological effects on service users. While men tended to report higher rates of alcohol use and treatment default, women in general had worse mental health outcomes. Older age and a history of mental illness were also associated with pronounced tuberculosis and mental disorder comorbidity. Person-centred tuberculosis care interventions were almost absent, with only one study from Nepal identified. Conclusions : There is an emerging body of evidence describing the nature and extent of tuberculosis and mental disorders comorbidity in low-to-middle income countries. Despite the potential of person-centred interventions, evidence is limited. This review highlights a pronounced need to address psychosocial comorbidities with TB in LMICs, where models of person-centred TB care in routine care platforms may yield promising outcomes

Burden and presentation of depression among newly diagnosed individuals with TB in primary care settings in Ethiopia

BACKGROUND: Understanding co-morbidity of depression and tuberculosis (TB) has been limited by challenges in measurement of depression due to overlapping symptoms, use of small hospital samples and uncontrolled analysis. This study was conducted to better understand the burden and presentation of depression, and associated factors in people with TB in primary care settings in Ethiopia. METHODS: We conducted a cross-sectional survey among 657 people newly diagnosed with TB. Symptoms of depression were measured using the Patient Health Questionnaire (PHQ-9). TB symptoms and other factors were captured using standardised questionnaires. The factor structure of PHQ-9 was examined. Multivariable analysis was carried out to estimate prevalence ratios. RESULTS: The prevalence of probable depression was 54.0%. The PHQ-9 had one factor structure (alpha = 0.81). Little interest or pleasure in doing things (73.0%) was the commonest depressive symptom. Older age (Adjusted Prevalence ratio (APR) = 1.19; 95%CI = 1.06, 1.33), female sex (APR = 1.23; 95%CI = 1.18, 1.27), night sweating (APR = 1.25; 95%CI = 1.16, 1.35), pain (APR = 1.69; 95%CI = 1.24, 2.29), being underweight (APR = 1.10; 95%CI = 1.07, 1.13), duration of illness (APR = 1.35; 95%CI = 1.22, 1.50), level of education (APR = 0.93; 95%CI = 0.90, 0.95), and social support (APR = 0.89; 95%CI = 0.85, 0.93) were independently associated with probable depression. CONCLUSIONS: Depression appears highly prevalent in people with TB and PHQ-9 seems to be a useful instrument to detect depression in the context of TB. The frequency of depressive symptoms would suggest that the occurrence of the symptoms in people with TB is in the usual manifestation of the disorder. Prospective studies are needed to understand the longitudinal relationship between TB and depression

Incidence of depression in people with newly diagnosed tuberculosis in Ethiopia:a cohort study

BackgroundCross-sectional studies show that the prevalence of comorbid depression in people with tuberculosis (TB) is high. The hypothesis that TB may lead to depression has not been well studied. Our objectives were to determine the incidence and predictors of probable depression in a prospective cohort of people with TB in primary care settings in Ethiopia.MethodsWe assessed 648 people with newly diagnosed TB for probable depression using Patient Health Questionnaire, nine-item (PHQ-9) at the time of starting their anti-TB medication. We defined PHQ-9 scores 10 and above as probable depression. Participants without baseline probable depression were assessed at 2 and 6 months to measure incidence of depression. Incidence rates per 1000-person months were calculated. Predictors of incident depression were identified using Poisson regression.ResultsTwo hundred and ninety-nine (46.1%) of the participants did not have probable depression at baseline. Twenty-two (7.4%) and 26 (8.7%) developed depression at 2 and 6 months of follow up. The incidence rate of depression between baseline and 2 months was 73.6 (95% CI 42.8–104.3) and between baseline and 6 months was 24.2 (95% CI 14.9–33.5) per 1000 person-months respectively. Female sex (adjusted β = 0.22; 95% CI 0.16–0.27) was a risk factor and perceived social support (adjusted β = −0.14; 95% CI −0.24 to −0.03) was a protective factor for depression onset.ConclusionThere was high incidence of probable depression in people undergoing treatment for newly diagnosed TB. The persistence and incidence of depression beyond 6 months need to be studied. TB treatment guidelines should have mental health component

Depression among patients with tuberculosis:Determinants, course and impact on pathways to care and treatment outcomes in a primary care setting in southern Ethiopia - A study protocol

INTRODUCTION: Depression is commonly comorbid with chronic physical illnesses and is associated with a range of adverse clinical outcomes. Currently, the literature on the role of depression in determining the course and outcome of tuberculosis (TB) is very limited. AIM: Our aim is to examine the relationship between depression and TB among people newly diagnosed and accessing care for TB in a rural Ethiopian setting. Our objectives are to investigate: the prevalence and determinants of probable depression, the role of depression in influencing pathways to treatment of TB, the incidence of depression during treatment, the impact of anti-TB treatment on the prognosis of depression and the impact of depression on the outcomes of TB treatment. METHODS AND ANALYSIS: We will use a prospective cohort design. 703 newly diagnosed cases of TB (469 without depression and 234 with depression) will be consecutively recruited from primary care health centres. Data collection will take place at baseline, 2 and 6 months after treatment initiation. The primary exposure variable is probable depression measured using the Patient Health Questionnaire-9. Outcome variables include: pathways to treatment, classical outcomes for anti-TB treatment quality of life and disability. Descriptive statistics, logistic regression and multilevel mixed-effect analysis will be used to test the study hypotheses. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Institutional Review Board (IRB) of the College of Health Sciences, Addis Ababa University. Findings will be disseminated through scientific publications, conference presentations, community meetings and policy briefs. ANTICIPATED IMPACT: Findings will contribute to a sparse evidence base on comorbidity of depression and TB. We hope the dissemination of findings will raise awareness of comorbidity among clinicians and service providers, and contribute to ongoing debates regarding the delivery of mental healthcare in primary care in Ethiopia