Of Dutch courage and mobile chimneys: Pattern and predictors of alcohol and tobacco use among university students in Nigeria

Previous studies in Nigeria have associated alcohol and tobacco use among students with certain socioeconomic and educational achievement variables, albeit its determinants among university students remain largely unknown. This study examined current patterns and predictors of alcohol and tobacco use with a model involving socio-demographic factors among 708 undergraduate students. Participants included 280 males and 428 females; mean age was 21.4±4.4. The students were assessed with a questionnaire including living arrangement, satisfaction with course of study, current alcohol and tobacco use and parental educational levels. Overall, the prevalence of alcohol and tobacco use was 24.0% and 5.5% respectively. Inter-correlation of discrete variables with Cramer’s V showed: gender (φc =.23, p<.000); level of study (φc =.16 p<.01); father education φc =.11, p<.02); satisfaction with course of study (φc =.11, p<.01); having sex in the last three months (Cramer, =.26, p<.000) were associated with alcohol use. Gender  (φc =.20, p<.000); polygamous family structure (φc =-.074, p<.06); satisfaction with course of study (φc =.09 p<.04); having sex in the last three months (φ =.11, p<.005 and mothers higher education (φc =.12, p<.004) were associated with tobacco use. Binary logistic regression analysis revealed two variables: male gender (OR= 2.93; 95% CI = 1.95 – 4.42), level of study (OR= 0.82; 95% CI = 0.67-0.98), ethnicity (OR= 0.76; 95% CI = 0.62-0.92) satisfaction with course of study (OR= 0.65; 95% CI = 0.43-0.97), father education (OR= 1.5; 95% CI = 1.10.-2.06) and having sex 3 months prior survey (OR= 2.96; 95% CI = 1.93 – 4.54) significantly predicted alcohol use. Similarly male gender (OR= 7.71; 95% CI = 3.27 – 18.1), polygamous family structure (OR= 0.40; 95% CI = 0.97 – 0.92), satisfaction with course of study (OR= 0.54; 95% CI = 0.29 – 0.99) and increased mother education (OR= 3.33; 95% CI = 1.76 – 5.92) significantly predicted tobacco use. These data underscore the role of gender, sexual activity and mother’s educational level in drug use among Nigerian students. It also highlights the need for continuous drug education.Keywords: Alcohol use, tobacco use, university students, Nigeri

Psychopathology and coping in recently diagnosed HIV/AIDS patients- the role of gender

Background. Although there is growing literature on the psychological responses to and the psychopathology associated with HIV/AIDS, few investigations have focused on the role of gender. This study compared psychiatric morbidity, coping responses, and disability in male and female outpatients recently diagnosed with HIV/AIDS.Method. One hundred and forty-nine patients (44 male, 105 female) with HIV/AIDS (mean ± standard deviation (SD) months since diagnosis 5.8 ± 4.1) attending an infectious diseases clinic at Tygerberg Hospital, Cape Town, were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE, and the Sheehan Disability Scale. In addition, negative life events and risk behaviours were evaluated.Results. Fifty-six per cent of patients were diagnosed with a psychiatric disorder, most commonly major depression (34.9%), dysthymic disorder (21.5%), post-traumatic stress disorder (14.8%), and alcohol dependence (10.1 %). There were no significant gender differences in the prevalence of mood disorders in the sample. Men, however, were more likely than women to meet diagnostic criteria for alcohol abuse or dependence, and to engage in certain risky sexual behaviours. Women were more likely to suffer from post-traumatic stress disorder, and to use coping strategies of planning and religion to deal with the illness. There were no significant gender differences in disability.Conclusion. Psychiatric disorders are common in recently diagnosed HIV/AIDS patients in South Africa. Clinicians should be aware of the high prevalence of mood disorders in both men and women, and of gender-different responses such as increased alcohol and substance use and more risky sexual behaviour in men

The Role of Insecure and Fearful Attachment Styles in Sexual Risk Behaviours of HIV-Positive Women attending a Support Group in Ibadan, Nigeria.

The present study investigated the relationship between adult attachment style and unprotected sex among women living with HIV-positive in Ibadan. HIV-positive participants (N = 60) completed questionnaires assessing consistent condom use three months preceding study, multiple sexual partners, adult attachment, self-esteem, and depressive symptoms. Results revealed that insecure attachment styles (particularly negative attachment representations of self) and fearful attachment were associated with both number of none condom use in the past three months and having multiple sexual partners in the same period. Similarly negative self esteem and depressive symptoms were related to these high risk sexual practices. These relationships remained significant after controlling for self-esteem, and depressive symptoms. These results suggest the inclusion of relational factors such as attachment in HIV prevention

Abus sexuel sur enfant, usage nuisible de l'alcool et l' âge comme déterminants des comportements sexuels risqués chez les étudiants de première année dans une université nigériane

In Nigeria, freshmen constitute a risk group of adolescents and young adults capable of engaging in unsafe sexual practices. This study documents the associated factors to sexual risk behaviours practices of University of Ibadan, Nigeria freshmen. Eight hundred and forty one (841), freshmen who attended a routine orientation program were asked to respond to a questionnaire. Results showed that 30.8% were sexually active and 47% did not use condom in their last sexual episode. Associated with sexual risk behaviours include: being a male freshman, increasing age; lower tendency for violence; increase sexual compulsivity; alcohol abuse; history of rape and a history of Child Sexual Abuse (CSA). Three variables: alcohol abuse; history of CSA and increasing age remained significant in a multiple regression analysis. The paper presents the first evidence of vulnerability of freshmen to sexual risk practices in a Nigerian University.Abus sexuel sur enfant, usage nuisible de l'alcool et l' âge comme déterminants des comportements sexuels risqués chez les étudiants de première année dans une université nigériane. Au Nigéria les étudiants de première année constituent un groupe d'adolescents et de jeunes adultes capables de s'engager dans des pratiques sexuelles dangereuses. Cette étude documente les facteurs qui sont liés aux pratiques sexuelles risquées chez les étudiants de première année à l'université d' Ibadan. Huit cent quarante-et-un (841) étudiants de première année qui ont assisté à un programme d'orientation de routine ont été demandé de répondre à un questionnaire. Les résultats ont montré que 30,8% étaient sexuellement actifs et que 47% n'utilisaient pas des préservatifs pendant leur dernier épisode sexuel. Liés aux comportements sexuels risqués sont: le fait d' être en première année, l'augmentation de l' âge, une tendance réduite de la violence, une compulsivité sexuelle accrue; l'abus de l'alcool; les antécédents de viol et d'abus sexuel sur enfant (ASE). Trois variables: abus de l'alcool, les antécédents de l'ASE et l'âge croissant, sont restés significatifs dans une analyse de la regression multiple. L'article présente la première évidence de la vulnérabilité des étudiants de première année aux pratiques sexuelles risquées

Influence of gender and life orientation on depression and psychological functioning among persons living with diabetes

Depression and psychological functioning in persons living with diabetes is of great concern more especially because of the increased report on diabetes health complications which has rippling effect on survival among this population. Indeed, literature attest to socio-demographic factors as been relevant to report of psychological functioning and depression. However, little is known about the vital role of personal factors such as gender and life orientation dimensions impact on depression and psychological functioning among persons living with diabetes. Consequently, the current study explored the influence of gender and life orientation on depression and psychological functioning in persons living with diabetes. Participants were 125 [34.4% males and 65.6% females] persons living with diabetes who were purposively sampled from a teaching hospital, in Ibadan. The age of respondents ranged between 30 and 90 years, with a mean age of 62.71 and standard deviation of 9.64. The study utilized the cross-sectional survey design and gathered data through psychometrically sound scales. Results revealed that life orientation dimensions (optimism and pessimism) were significant joint predictors of psychological functioning (F (1, 124) = 6.882; p < .001; R2= .224) and depression (F (1, 124) = 3.374; p < .01; R2= .124) among persons living with diabetes. Also, it was observed that gender differences exist for depression (t (123) = 2.117; P<.05) but not for psychological functioning (t (123) = -0.819; P>.05). The practical implications of findings for psychological intervention and management of persons living with diabetes mellitus were discussed

Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa

This study examined the prevalence of and factors associated with post-traumatic stress disorder in recently diagnosed HIV/AIDS patients in South Africa. One hundred and forty-nine (44 male, 105 female) recently diagnosed HIV/AIDS patients (mean duration since diagnosis =5.8 months, SD =4.1) were evaluated. Subjects were assessed using the MINI International Neuropsychiatric Interview (MINI), the Carver Brief COPE coping scale and the Sheehan Disability Scale. In addition, previous exposures to trauma and past risk behaviours were assessed. Twenty-two patients (14.8%) met criteria for PTSD. Current psychiatric conditions more likely to be associated with PTSD included major depressive disorder (29% in PTSD patients versus 7% in non-PTSD patients, p=0.004), suicidality (54% versus 11%, p =0.001) and social anxiety disorder (40% versus 13%, P=0.04). Further patients with PTSD reported significantly more work impairment and demonstrated a trend towards higher usage of alcohol as a means of coping. Discriminant function analysis indicated that female gender and a history of sexual violation in the past year were significantly associated with a diagnosis of PTSD. Patients whose PTSD was a direct result of an HIV/AIDS diagnosis (8/22) did not differ from other patients with PTSD on demographic or clinical features. In the South African context, PTSD is not an uncommon disorder in patients with HIV/AIDS. In some cases, PTSD is secondary to the diagnosis of HPV/AIDS but in most cases it is seen after other traumas, with sexual violation and intimate partner violence in women being particularly important. © 2005 Taylor & Francis Group Ltd.Articl

Determinants of unprotected sex among HIV-positive patients in South Africa

This study examined the prevalence of unprotected sex, other sexual risk behaviours, and factors associated with unprotected sex among men and women recently diagnosed with HIV in South Africa. One hundred and forty-nine outpatients (44 males and 105 females) were assessed, of whom 101 were sexually active at least 6 months prior to study entry. Subjects were asked about sexual risk behaviours with reference to their most recent sexual encounter. Logistic regression analysis was employed to determine the predictors of condom use, with independent variables selected from five general categories: (1) sociodemographic characteristics; (2) situational characteristics regarding sexual intercourse (i.e. alcohol or drugs used before intercourse); (3) clinical diagnoses; (4) negative life events; and (5) coping styles. Fifty-five patients (19 males and 36 females), representing 54.4% of those sexually active in the 6 months preceding the study, had not used a condom during the most recent intercourse. Compared with those who used condoms, participants who did not significantly reported shorter duration of HIV infection (t = -2.7, p < 0.001), have a current partner (χ2 = 3.98, p = 0.005), and lack knowledge of their partner's HIV status (χ2 = 4.78, p = 0.004). Also they were significantly more likely to engage in denial (t = 3.2, p < 0.002) and to use substances (t = 1.98, p < 0.05) as a means of coping. Logistic regression showed that shorter duration of illness (odds ratio (OR) = 1.2, 95% confidence interval (CI) = 1.01-1.41) and coping styles characterized by denial (OR = 0.6, 95% CI = 0.45-0.96) were significantly associated with unprotected sex. These data suggest the need for interventions to further reduce sexual risk behaviours in HIV-positive patients in South Africa.Articl

Psychosocial factors predicting severity of depression among treatment-seeking HIV/AIDS patients: A multi-site Nigerian study

Background and Objectives: Depression as major psychological sequelea of the HIV/AIDS infection has continued to attract investigation. With few studies in Nigeria, it is unclear whether levels of perceived stigma, sexual risk behaviors, and anticipated discrimination are differentially associated with severity of depression.Materials and Methods: The present study using a multivariate design investigated the role of stigma, anticipated discrimination, self-esteem, HIV-related factors (e.g., drug use combination, knowledge of duration of HIV diagnosis) and socio demographic factors (e.g., multiple spouse, age, gender, and ethnicity) in depression among people living with HIV/AIDS (PLWHA) on follow-up management in three tertiary hospitals in Nigeria. Five hundred and two (187 [37.3%] males and 315 [62.7%] females) HIV/AIDS patients participated in the study. Results: Mean age and mean time in months since diagnosis were 36.73 ± 9.38 and 19.42 ± 23.12, respectively. Three variables: Ethnicity, anticipated discrimination, and HIV-related stigma were related to severity of depression at (P < 0.05). Multinomial logistic regression analyses showed that being from Yoruba (odds ratio [OR] = 0.25; 95% confidence interval [CI] = 0.145-0.441), or Igbo extraction (OR = 0.43; 95% CI = 0.214-0.873) reduces the risk of reporting severity of depression by 25% and 43%, respectively. Moreover, low perceived HIV-related stigma (OR = 0.59; 95% CI = 0.355-0.966) and low anticipated discrimination (OR = 0.54; 95% CI = 0.319-0.914) reduced the risk of reporting symptoms of severe depression by 59% and 54%, respectively.Conclusion: Intervention to reduce the severity of depression should consider cultural specificity in its design and also evolve educational programs that incorporate discrimination and stigma in managing depression among PLWHAs. Keywords: Anticipated discrimination, HIV/AIDS patients, severity of depression, stigm