The association between alcohol consumption and high risk sexual behaviour in the South African adult population.

MMed, Epidemiology and Biostatistics,University of the Witwatersrand, 2009Background: South Africa is one of the countries with the highest Human Immunodeficiency Virus (HIV) prevalence in the world. The main mode of transmission in South Africa is via heterosexual intercourse. Thus there is the need to identify factors associated with HIV high risk sexual behaviour to inform future intervention programmes. Objective: To determine the association between alcohol consumption and high risk sexual behaviour in South African adults in 2006. Methods: Secondary data analysis of cross sectional study involving 1544 adult males and females, between 16-65 years interviewed in the Soul City National Survey. A multi-stage, stratified and clustered probability sampling technique was used. Univariate and multivariate analysis was done using student t test, chi square test and logistic regression models. Results: The prevalence of alcohol consumption in the week prior to the survey was 24.4% (95%CI: 22.2-26.6). The prevalence of heavy episodic drinking in last one month was 17.5% (95%CI: 15.5-19.4). There was an association between broad socioeconomic conditions and sexual behaviour particularly age, sex and race (P<0.05). The mean age at sexual debut was 17.13 (SD 2.61) years in the males and 17.91 (2.45 SD) years in females (P<0.001). Of the sexually active respondents, 12.7% and 4.2% of the men and women respectively had multiple partners currently (P<0.001). Generally consistent condom use was more in men although, only 10.3% of the men and 5.6% of the women used the condoms consistently with their casual partners (P=0.28). Multivariate regression showed that alcohol use predicted having multiple partners (AOR 2.37; 95%CI 1.19-4.69 and AOR 4.15; 95%CI 1.37-11.97) for moderate and problem drinkers respectively. Also, heavy episodic drinking predicted having multiple partners by three times (AOR 3.21; 95%CI 1.69-6.39). There was a significant dose response relationship for having multiple partners (P<0.05). As regards unprotected sexual intercourse, although not significant, female drinkers were found to be protected from inconsistent condom use with a casual partner. Male drinkers on the other hand, were found to be at a higher risk of having unprotected sex with casual partners. Perceptions of susceptibility to HIV (AOR 0.31; 95%CI 0.17-0.56), and alcohol related harm (AOR 0.17; 95%CI; 0.22-0.71) influenced consistent condom use with casual partners. Also regards gender differences, women who drank alcohol (AOR 9.68; 95%CI 1.31-17.45 vs. 1.17; 0.28-4.89) or were heavy episodic drinkers (AOR 4.45; 95%CI 1.46-3.55 vs. 2.43; 1.03-5.92) had a higher probability of having multiple partners than men. Conclusion: There is a strong association between risky alcohol use and high risk sexual behaviours. HIV prevention programmes need to address reduction in alcohol intake and changes in drinking pattern. Further research to disentangle the relationship between condom use and alcohol use is needed

Experience of gender-based violence to students in public and private secondary schools in Ilorin, Nigeria

Objective: To determine and compare prevalence of Gender based Violence (GBV) in public and private secondary schools students and to identify factors associated with experience of GBV by the students.Design: Comparative cross-sectional survey of using a 60 item self-administered questionnaire.Setting: Ten public and private secondary schools in Ilorin South Local Government area of Kwara State.Participants: 640 students, (320 each) from public and private schools.Main outcome variable: Prevalence and factors influencing experience of physical, sexual and psychological violenceResults: At least one form of GBV was experienced by 89.1% of public and 84.8% private schools students(p=0.32). Psychological violence was commonest type of GBV experienced (Public -72.5% vs. Private - 69.2%;p=0.37), while sexual violence was least (Public -41.4% vs. Private - 37.4%; p=0.3). Females were less likely toexperience physical violence (OR 0.3; 95% CI 0.2-0.4) and psychological violence (aOR 0.6; 95%CI 0.4-0.8). Studentswho were in a relationship and who had history of parental violence were more likely to experience sexual(aOR 1.7; 95%CI 1.2-2.4) and aOR 1.5; 95%CI 1.2-2.2) and psychological (aOR 1.3; 95%CI 1.1-1.5 and aOR 1.3;95%CI respectively) violence.Conclusions: GBV was a common experience of students in both groups of schools. Multi-disciplinary interventionsemphasising ending physical and psychological violence among private school students and sexual violence in public school are recommended. Interventions that involve the parents, school authorities and students on nonviolence conflict resolution are urgently required. Parents and students who perpetrate violence should be referred for counselling.Funding: Author fundedKeywords: Violence, Gender based violence, Violence exposure, Secondary School, Student

Preparing medical students to recognize and respond to gender based violence in Nigeria

Background: Medical practitioners are ideally positioned to mitigate the impact of gender based violence (GBV) on the health of victims.  However, there is a lack of information on students’ ability and willingness to do so. Objective:  To identify factors which impact on students’ attainment of the knowledge and perceived ability to manage victims. Methods: A cross-sectional survey was conducted on 388 (91.5%) final year medical students from three medical schools in South West, Nigeria.   Results: Students were knowledgeable on sexual (63.7%) and physical (54.6%) forms of GBV and unfamiliar with other forms. The mean scores for knowledge (7.1 ± 2.5 out of 11); attitude (52.6 ± 10.3 out of 80); personal comfort (44.1 ± 10.0 out of 65) and skills (3.1 ± 2.6 out of 7) were calculated.  Younger respondents, females and married students reported less skill to manage victims.  The location of school, previous training and personal comfort remained significant determinants of students’ self reported skills on GBV. Respondents with prior training on GBV and comfortable with managing patients, were four times more likely to perceive they were more skilled than their peers [AOR = 4.33, 95% CI: 2.37 – 7.90 and AOR 3.53; 95% CI 2.16- 5.78 respectively]. Conclusion: Formalised skills training on GBV is a necessity, especially for young, female students and training cannot be left to serendipity. The medical curriculum should be reviewed.Keywords: Undergraduate medical curriculum, gender based violence, violence against women, medical student perceptions, teaching and training undergraduate

Development and structural validity of a Nigerian culture- and environment-friendly low back pain outcome measure: Ibadan Low Back Pain Disability Questionnaire

Background: Low Back Pain (LBP) is the leading cause of disability globally. Standardized outcome measures for measuring LBP disability exist but none was developed with consideration for the Nigerian culture and environment.Objective: This study was aimed to develop a Nigerian culture- and environment-friendly LBP scale, the Ibadan Low Back Pain Disability Questionnaire (ILBPDQ).Methods: Items on ILBPDQ were devised from literature review, interview of patients (231 consecutively-sampled patients with chronic non-specific LBP) and 12 professionals experienced in LBP management and were contentvalidated.The first draft of the questionnaire underwent pretesting twice among individuals with chronic non-specific LBP (n=35 and 114 respectively), factor analysis and experts’ reviews to produce the final version.Results: The final scale comprised 18 items with a two-factor structure (common Activity of Daily Living [ADL] and culture-specific ADL). It has eigen value ≥ 1 and explained 60% of variance. Items on ILBPDQ covered important constructs relevant to an average Nigerianpatient with LBP.Conclusion: A scale for assessing disability in LBP is made available for use in Nigeria and similar populations.Keywords: Low back pain, Outcome measure, Ibadan, Development, Structural validityFunding: None declare

Preparing medical students to recognize and respond to gender based violence in Nigeria

Background: Medical practitioners are ideally positioned to mitigate the impact of gender based violence (GBV) on the health of victims. However, there is a lack of information on students\u2019 ability and willingness to do so. Objective: To identify factors which impact on students\u2019 attainment of the knowledge and perceived ability to manage victims. Methods: A cross-sectional survey was conducted on 388 (91.5%) final year medical students from three medical schools in South West, Nigeria. Results: Students were knowledgeable on sexual (63.7%) and physical (54.6%) forms of GBV and unfamiliar with other forms. The mean scores for knowledge (7.1 \ub1 2.5 out of 11); attitude (52.6 \ub1 10.3 out of 80); personal comfort (44.1 \ub1 10.0 out of 65) and skills (3.1 \ub1 2.6 out of 7) were calculated. Younger respondents, females and married students reported less skill to manage victims. The location of school, previous training and personal comfort remained significant determinants of students\u2019 self reported skills on GBV. Respondents with prior training on GBV and comfortable with managing patients, were four times more likely to perceive they were more skilled than their peers [AOR = 4.33, 95% CI: 2.37 \u2013 7.90 and AOR 3.53; 95% CI 2.16- 5.78 respectively]. Conclusion: Formalised skills training on GBV is a necessity, especially for young, female students and training cannot be left to serendipity. The medical curriculum should be reviewed. DOI: https://dx.doi.org/10.4314/ahs.v19i1.22 Cite as: Fawole OI, M. van Wyk J, Balogun BO, Akinsola OJ, A A. Preparing medical students to recognize and respond to gender based violence in Nigeria. Afri Health Sci. 2019;19(1). 1486-1498. https:// dx.doi. org/10.4314/ ahs. v19i1.2

Intimate partner abuse: wife beating among civil servants in Ibadan, Nigeria

Wife beating is one of the most common forms of violence against women by husbands or other intimate male partners. Although violence against women is pervasive, there are only few studies documenting the magnitude of the problem especially among the working class. The civil service comprises of persons from all socio-economic levels and different backgrounds. They act in advisory capacity and assist those responsible for making state policy. Thus, 431 civil servants of the Oyo State government service were interviewed using a 44-item self-administered questionnaire. Results revealed that prevalence of wife beating was 31.3%. Ninety one (42.5%) men had been perpetrators, while 44 (23.5%) women had been victims. Consuming alcohol and growing up in an environment where parents fight publicly were significantly associated (p < 0.05) with men beating their wives; while being young, unmarried and a parental background of fighting was significantly associated with women being beaten (p < 0.05). Female respondents justified reasons for various types of domestic violence, including beating, more than the males (p < 0.05). Younger respondents had significantly worse attitudes (p < 0.05), while married and educated respondents had better attitude (p < 0.05). “Not wanting the children to suffer” (60.7%) and “hoping that partner will change” (28.8%) were reasons given for remaining in abusive relationships. There is an urgent need for education of the women on their rights, sensitisation of the men on gender-based violence and punishment for perpetrators. Supportive care and counselling services should also be provided for victims of violence. African Journal of Reproductive Health Vol. 9(2) 2005: 54-6

Survey of Knowledge, Attitudes and Sexual Practices Relating to HIV Infection/AIDS among Nigerian Secondary School Students

The research was carried out to study the AIDS-related knowledge, attitudes and sexual behaviour of 540 students selected by the multistage sampling technique from four Nigerian secondary schools. Eighty-three per cent of the students knew AIDS was transmitted sexually, but the percentage of those aware of other modes of transmission' was much lower. Attitudes were poor, as 372 (82.7%) students would dislike having someone with AIDS near them. First sexual experience occurred at 15.8 years for males and 16.3 in females. Of the 450 students studied, 159 (35.3%) had experienced sexual intercourse before. Of the 120 students (26.7%) who became sexually active a month before the survey, 34 (28.3%) had multiple sexual partners. Constituent condom use was reported in only 22 (19.8%) of the sexually active students. The use of unreliable methods for the prevention of sexually transmitted diseases was common. There is an urgent need to intensify ongoing AIDS campaign especially school-based AIDS education programmes to secondary school students before their behaviour become fixed. (Afr J Reprod Health 1999; 3[2]: 15-24) Key Words: HIV, AIDS, students, knowledge, attitude, practic

Survivorship curves showing probabilities of developing pubic hair at different ages by selected characteristics of males.

Survivorship curves showing probabilities of developing pubic hair at different ages by selected characteristics of males.</p