PERCEIVED EFFECT AND RISK INVOLVEMENT OF CONDOM USE AMONG STUDENTS IN ADENIRAN OGUNSANYA COLLEGE OF EDUCATION, LAGOS STATE NIGERIA

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

The higher institution environment with its attendant relative lack of supervision provides a great privilege for youths who are in transition from adolescence to adulthood to examine the limits of their recently obtained  freedom through sexual exploitation Duncan et al, (2014).youths  (peers) in higher institution try to experiment about sex and a study by Reysoo (2016) observed that youths experienced strong pressure from their peers to acquire their sexual debut in order to be called men or women. Many of the tertiary students who are already coming from poor parental upbringing try to manipulate and influence their peers into sexual escapades and that early initiation of sexual escapedes increases the risk to get a sexually transmitted infection (Avery, 2010). Such experimentation mostly involves engagement in dangerous sexual activities with series of partners, inconsistent use of condoms and having sex under the manipulation of alcohol or drugs. Sexual activity among adolescent and young adult is not uncommon and has been reported to be quite high among students in tertiary institutions in Nigeria [Izekor S et al 2014]. HIV/AIDS and other sexually transmitted infections have remained a source of concern globally, especially to healthcare groups and organizations. There is high prevalence of sexually transmitted infections among the adolescents and young adults in Africa, mainly as a result of high risk behavior and neglect of established preventive measures. Approximately 3.3 million young people are living with HIV/AIDS in sub Saharan Africa, and 76% of those Detected in this group are women [AIDS epidemic update (2007)]. Africa accounted for higher than two thirds of people living with HIV/AIDS worldwide and 72% of new infections among adults and children. Africa also, contributed about 71% of the world’s AIDS-related deaths in 2011. Most transmission in Africa occurs in heterosexual relationships [UNICEF (2014)]. Nigeria is the most populous country in Africa and has the second highest number of people living with HIV/AIDS [Agboghoroma CO, Sagay SA, Ikechebelu JI 2013]. The current trend of HIV/AIDS and other sexually transmitted diseases (STDs) still shows a high prevalence in Nigeria despite concerted efforts towards its eradication Globally, an estimated 210 million women become pregnant each year, of which 80 million are unintended. In addition about 44 million women have induced abortions, of which 22 million are unsafe. Deaths from unsafe abortion account for 13% of maternal deaths worldwide [Sedgh G, Singh S, Shah IH, Ahman E, Henshaw SK, et al. 2012]. Of the 4 million abortions that occur in Africa annually, Nigeria accounts for about 760,000 cases [Olley BO, Rotimi OJ 2011]. It is estimated that there are about 25 abortions per 1000 women aged 15-44 years [Bankole A, Oye-Adeniran BA, Sigh S 2015]. Unsafe abortion causes over 36000 deaths annually in Nigeria, accounting for 30-40% of maternal deaths [Oladeinde BH et al 2011]. The free atmosphere on higher institution environments means that most students may be enjoying freedom from the watchful eyes of their parents for the first time in their lives. All these conditions exist within a overall atmosphere of poor condom use in the country entirely (Anarfi, 2000). This exposes most tertiary students to potentially negative outcomes of sexual activities, specifically unwanted pregnancy and infections and diseases through sex including Human Immuno deficiency Virus (HIV). Condoms offer protection against STIs transmitted via skin-to-skin contact or contact with mucosal surfaces, including genital herpes simplex virus, Human Papillomavirus (HPV), syphilis, and chancroidin those affected areas covered by the condom, Steiner, Warner, Stone, et al (2008). This further supports Hoffman et al (2011) study which shows that both laboratory and in-vitro-studies have established that polyurethane is impermeable to small viruses such as cytomegalovirus, herpes virus, hepatitis B virus and HIV. However, condom use is determined by some specific number of reasons, some of which are related to gender in more or less obvious ways. The need for consistent and correct use of condom, particularly among young adults, is increasing due to the rapid spread of the HIV. Also, condom is a veritable instrument in prevention of unwanted pregnancy and the unpleasant squeal of unsafe abortion and maternal death. Its dual function in prevention of sexually transmitted infections as well as contraception makes it very important, especially for the adolescents and young adults who are at high risk of STIs and unwanted pregnancy. The undergraduate students of higher institutions mostly fall into this age category. Studies on condom use in university populations are few, despite the vulnerability of students to unsafe sexual practices. Previous studies have shown a low prevalence of consistent condom use among undergraduate students [National Population Commission NPC 2009]. This study therefore examines the perceived effect and risk involvement of condom use among students in Adeniran Ogunsanya College of Education, Lagos State.

STATEMENT OF PROBLEM

Engaging in sexual activity provides opportunity for exposure to the potentially negative consequences of sexual intercourse, specifically unintended pregnancy and sexually transmitted infection (STI). Almost half of all higher institution students in the Nigeria have had sexual intercourse. While trends reveal a decline in risk-taking behavior since the early 2010’s, rates of sexual activity and condom use have been relatively stagnant for more than half a decade (CDC, 2010b; Mulye et al., 2009; Santelli, Orr, Lindberg, & Diaz, 2009). Condoms effectively reduce STI transmission. Findings of a meta-analysis of well-designed studies demonstrate that consistent condom use reduces the risk of HIV transmission by approximately 80%[ Weller S, Davis K 2014]. The effectiveness of condoms for prevention of non-viral STIs, especially gonorrhea and chlamydia, is well-documented. Consistent condom use was also associated with a decreased risk of syphilis acquisition [Koss CA, Dunne EF, Warner L. 2009], a 30% decrease in herpes simplex virus-2 acquisition [Martin ET, Krantz E, Gottlieb SL, et al. 2009], and a 70% decreased likelihood of acquiring human papillomavirus infection among women [Winer RL, Hughes JP, Feng Q, et al. 2015]. Therefore, the study tends to examine the perceived effect and risk involvement of condom use among students in Adeniran Ogunsanya College of Education, Lagos State.

AIMS OF THE STUDY

The major aim of the study is to examine the perceived effect and risk involvement of condom use among students in Adeniran Ogunsanya College of Education, Lagos State. Other specific objectives of the study include;

1. To examine level students involvement of condom use in Adeniran Ogunsanya College of Education, Lagos State.
2. To examine personal factors influencing condom use among students in Adeniran Ogunsanya College of Education, Lagos State.
3. To examine the effect of condom use on the students’ health in Adeniran Ogunsanya College of Education, Lagos State.
4. To examine the environmental factors influencing condom use among students in Adeniran Ogunsanya College of Education, Lagos State.
5. To examine the relationship between perceived effect of condom use and health of students in Adeniran Ogunsanya College of Education, Lagos State.
6. To examine the condom effectiveness for STI and pregnancy prevention .

RESEARCH QUESTIONS

1. What is the level students’ involvement of condom use in Adeniran Ogunsanya College of Education, Lagos State?
2. What is personal factors influencing condom use among students in Adeniran Ogunsanya College of Education, Lagos State?
3. What is the effect of condom use on the students’ health in Adeniran Ogunsanya College of Education, Lagos State?
4. What is the environmental factors influencing condom use among students in Adeniran Ogunsanya College of Education, Lagos State?
5. What is the relationship between perceived effect of condom use and health of students in Adeniran Ogunsanya College of Education, Lagos State?
6. What is the condom effectiveness for STI and pregnancy prevention?

RESEARCH HYPOTHESES

Hypothesis 1

There are is no significant effect of condom use on the health of students in Adeniran Ogunsanya College of Education, Lagos State.

There is a significant effect of condom use on the health of students in Adeniran Ogunsanya College of Education, Lagos State.

Hypothesis 2

H0: There is no significant relationship between perceived effect of condom use and students health in Adeniran Ogunsanya College of Education, Lagos State.

H1: There is a significant relationship between perceived effect of condom use and students health in Adeniran Ogunsanya College of Education, Lagos State.

SIGNIFICANCE OF THE STUDY

The study is considered to be innovative because it addresses the needs of tertiary students, who are underrepresented in the current literature and may be more strongly affected by the negative consequences of sexual activity, specifically STI and teen pregnancy, due to disparate access to healthcare. This study would also be of immense benefit to students and scholars who are interested in developing further studies on the subject matter.

SCOPE AND LIMITATION OF THE STUDY

The study is restricted to the perceived effect and risk involvement of condom use among students in Adeniran Ogunsanya College of Education, Lagos State.

LIMITATION OF THE STUDY

Financial constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview)

Time constraint: The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

OPERATIONAL DEFINITION OF TERMS

Personal factors: Personal is “of or peculiar to a certain person; individual” (Agnes, 2013). Personal factors are defined as personal characteristics such as age, gender, and race as well as the individual’s knowledge, level of self-esteem, perceived risk, personal standards, perceived self-efficacy, condom use barriers and condom use goals.

Perceived Risk: Theoretically, perception of risk, perceived threat, perceived susceptibility, and negative physical outcome expectations are overlapping constructs represented in commonly used behavioral theories (Bandura, 2014). Worry is identified to be a component of these theoretical constructs (Crosby et al., 2010). Worry is defined as “a state of mental distress or agitation due to concern about an impending or anticipated event, threat, or danger” (VandenBos, 2007, p. 1004), perceived risk is defined as frequency of expressed worry about the real or potential acquisition of HIV, STI, or unintended pregnancy as measured 10-item adapted from the Worry About Sexual Outcomes (WASO) scale (Sales et al., 2009).

Condom use barriers: Theoretically a barrier is consistent with the impediments outlined by SCT (Bandura, 2014), something which prevents behaving in a desired manner either real or imagined. Condom use barriers are defined as something real or imagined which prevents condom use as identified by three items on the Sexual Risk Behavior Beliefs and Self-efficacy (SRBBS) scales (Basen-Engquist et al., 2013), with higher scores reflecting increased barriers to condom use.

Condom use goals: Goals can be defined as “an end that one strives to attain” (Agnes, 2013, p. 607). Bandura (2014) says that theoretically defined, short term goals are synonymous with intentions for a given action. The intention to use condoms is a short-term goal for condom use in a specified manner with a specified person as measured by five items on the Intentions to Use Condoms scale (Delaney, Langille, Richardson, & Beazley, 2012). Higher summative scores reflect increasing goals for condom use.