Prevalence and Determinants of Risky Sexual Behaviour Among Secondary School Adolescents in Kaiama Community, Bayelsa State

Risky sexual behaviour among adolescents constitutes a major public health challenge due to its adverse effects on their reproductive and physical health. In a bid to understand this among secondary school adolescents in Bayelsa State, a descriptive cross-sectional study using a multi-stage sampling technique was conducted from January 2020 to March 2020, involving 293 secondary school adolescents. Data for socio-demographic characteristics and sexual behaviour were collected using a pre-tested self-administered questionnaire. Data was analyzed using IBM SPSS version 23.0. Descriptive statistics were summarized, and a chi-square test was used to examine the relationship between the participants' socio-demographic characteristics and sexual behaviour. The mean age of the participants was 15.17 ± 1.61 years. Sexual activity (59.4%) and risky sexual behaviour (51.2%; CI = 45.3 - 57.1%) were high among the participants. Among the sexually active participants, early sexual debut was 80.2%, multiple sexual partnership was 47.1%, non-use of condoms at last sexual intercourse was 52.3%, while having sex under the influence of alcohol and transactional sex were 52.9% and 30.5%, respectively. Thus, highlighting a high level of risky sexual behavior amongst the study participants.

Adolescent sexual behavior has remained an issue of public health concern due to the numerous risks associated with it in adolescence and later years [1-3]. Many of the social disorders and diseases of public health significance (such as teenage pregnancy, drug and alcohol misuse, and sexually transmitted infections) have their roots in human sexuality and its adverse outcomes [4]. The sexual and reproductive health needs of young people are a global burden requiring a renewed and ongoing focus, because of their lasting effects on the individual, family, society, and nations [2,5].

Adolescent sexual behaviour is a concept influenced by developmental processes across several domains and a transitional trend that is characterized by abstinence, preparation for sexual involvement, and sexual initiation [6,7]. Several factors have been shown to predict the sexual behaviour of adolescents, such as individual characteristics, family characteristics, and the influence of peers.8 Although this behaviour is normal and allows for a healthy exploration of sexuality, for most adolescents, it rather creates risks because of their cognitive immaturity, which predisposes them to poor sexual decision making and its adverse effects, such as sexually transmitted infections (STIs) including HIV, pelvic inflammatory disease, and several cancers [6,7,9].

Globally, the prevalence of adolescent risky sexual behaviour is increasing, especially in developing countries [10]. In Africa, a meta-analysis done on risky sexual behaviour among young people noted a prevalence ranging from 10.8% to 78.8% with an overall pooled prevalence of 42.8%. In Nigeria, a study done in the South-Eastern part of the country showed a prevalence of 24.1%, with early sexual debut, transactional sex, and intergenerational sex being the most prevalent risky sexual behaviours. In Bayelsa state, it was noted that early coitarche, transactional sex, and multiple sexual partnerships were highly prevalent amongst female undergraduate youths [11,12].

This study utilizes the social cognitive theory in providing a means of understanding, predicting, and changing human behaviour. According to this theory, the sexual behaviour of adolescents is an interplay of their personal competencies, efficacy to manage themselves, and the level of peer influence they encounter. This, in turn determines their ability to overcome or become involved in the practice of risky sexual activities. Personal (socio-demographic characteristics), behavioural (social interactions), and environmental (physical surroundings) factors are pivotal in the lives of adolescents, especially with regard to their sexual and reproductive health. This is due to the role they play in determining adolescents’ initiation and engagement in risky sexual behaviours [14,46]. Using the above triadic model in this study, the interaction between personal, environmental, and behavioural factors in shaping adolescent sexual behaviours will be the focus.

Figure 1: Predictors of Adolescent sexual behaviour.

The purpose of this study is, therefore, to determine the Prevalence and determinants of risky sexual behaviour among secondary school adolescents in Kaiama community in Bayelsa State.

Study Area

The study was carried out among secondary school adolescents in the Kaiama community of Bayelsa State. Kaiama is the area council headquarters of the Kolokuma-Opokuma local government area with a population of 77,292 [46]. The community has a peri-urban setting with a population of 8,764 as at the 1991 population census of Nigeria. The community had two Government secondary schools with a population of 550 and 472 students respectively, and three private secondary schools with a population of 450, 387, and 508 students respectively as of April 2019. 

Study Population

Male and female adolescents in secondary schools residing in the Kaiama community, between the ages of 10 and 19 years. The study was conducted between January and March 2020.

Study Design

Analytical cross-sectional study.

Sample Size Determination

The sample size was calculated using the Cochran equation13 and a prevalence of 24.1% for adolescent risky sexual behaviour.14 Accordingly, the calculated sample size was 262. Adjusting for 10% attrition (for non-response and missing data): N = 262 + 26.2 = 289 participants.

Sampling Technique

Multi-stage sampling technique.

The students were initially grouped according to their schools to ensure adequate coverage and generalizability of the results to the entire adolescent student population in the community. The total number of participants to be drawn from each school and each class was then proportionately allocated as calculated below;

The student population from the schools was as follows: School 1, 550 students; School 2, 472 students, school 3; 450 students; School 4, 387 students; and School 5, 508 students, giving a total of 2,367 students.

Hence sample size for school 1 was = 550/2367 X 289 = 67 participants.

For school 2, 472/2367 x 289= 58 participants.

For school 3, 450/2367 x 289= 55 participants.

For school 4, 387/2367 x 289= 47 participants

For school 5, 508/2367 x 289= 62 participants.

Study Instrument

Collection of data for the study was done using a pre-tested self-administered questionnaire adapted from the youth risk behaviour surveillance survey (YRBSS). The questionnaire consisted of three parts; the socio-demographic characteristics, social behaviour and sexual behaviour of the study participants.

Data Analysis

Responses derived from all questionnaires were coded into quantitative data to enable parametric analysis. Data were entered into a Microsoft Excel spreadsheet and then transported into the Statistical Package for the Social Sciences (SPSS) version 23.

Descriptive statistics in the form of charts, frequency tables, and percentages were used in describing the characteristics of the participants (categorical variables) and their sexual behaviour, as well as in determining the prevalence of risky sexual behavior among the participants.

Chi-square test was used to determine the socio-demographic factors and social behaviours associated with risky sexual behaviour in the study participants.

Ethical Issues

Ethical approval was gotten from the Health Research Ethics Committee of the National Hospital, Abuja, and the Bayelsa State Ministry of Health.

A letter of permission to conduct the study was also gotten from the Bayelsa State Post-Primary Schools Board. Informed consent was obtained from each participant’s parent/guardian, and their welfare, rights, and confidentiality were guaranteed throughout the research. The study was carried out in line with the Good Clinical Practice Principles and in conformity with the Declaration of Helsinki.

Socio-demographic Characteristics of Study Participants

Of the 293 participants, 150 (51.2%) were females, while 143 (48.8%) were males. The mean age of the participants was 15.17 ± 1.61, with a median and modal age of 16 years. The age range of the participants was 11-18 years, with most of them 178 (60.8%) being in their mid-adolescent years (14-16 years). The majority of the respondents, 216 (73.7%), were Ijaws, while the remaining 77 (26.3%) were from other tribes such as Igbo, Yoruba, Hausa, Isoko, Urhobo, and Itsekiri. Christianity was the dominant religion reported by the participants. Over half of the participants, 172 (58.7%), reported that they resided with their parents. Also, S.S.1 had the highest number of respondents (N=71, 24.2%), while J.S.S.1 had the least (N = 25, 8.5%) with regard to their educational class as shown in Table 1.

Table 1: Socio-demographic characteristics of study participants.

(n = number of participants in the study population; N = number of observation)

More than half (N = 176, 60.1%) of the participants' parents were married. On the educational qualification of the participants’ parents, the most frequent educational qualification reported by the respondents was secondary level of education for both parents (fathers’ N = 123, 42.0%, and mothers’ N = 139, 67.6%). On the occupation of their parents, most of the participants had mothers who were civil servants (N = 127, 43.3%) while the majority of their fathers (N = 131, 44.8%) were traders, as shown in Table 2.

Table 2: Marital status, occupation, and educational level of participants' parents.

Social Behaviour of Study Participants

With regards to their social behaviour, almost half of the participants reported that their friends were sexually active (N = 126, 43.0%) and that they were under pressure from friends to indulge in sex (N=141, 48.1%). Of those who reported use of recreational drugs, 18.4% used it regularly, 58.7% used it sometimes, while 22.9% rarely used it. Among the smokers, 40.6% used cigarettes, while 59.4% used marijuana. About one third of the respondents reported that they drank alcohol (33.8%), of which 40.4% of them were regular drinkers, 26.3% drank only when with friends, 17.2% drank only at parties, 14.1% drank only to enable them get high, and 2.1% rarely drank alcohol, as shown in Table 3.

Table 3: Participants reported social behaviour.

Almost half of the participants (N=147) reported having a high religious inclination. However, only 32.5% of the respondents reported that they attended religious activities frequently. Also, more than half of the participants reported that their interest in school activities was average, while 70.3% of the respondents (N=206) described their physical surroundings as peaceful, as shown in Table 4.

Table 4: Participants reported social behaviour continued.

Participants Reported Sexual Behaviour

In tables 5 and 6 are the items used in assessing the sexual behaviour of the participants. The items in table 5 were used in computing the domain rating for the sexual behaviour of the participants as shown in figure 1 on page 2. More than half of the participants (59.4%) were sexually experienced. Majority of which (80.2%) experienced early sexual debut. The mean age at sexual debut among the participants was 14.14 ± 1.99 as shown in Table 5.

Table 5: Participants reported sexual behaviour.

Mean age at sexual debut 14.14 ± 1.99, *Age range at sexual debut: 10 – 17 years

More than one-third of the sexually experienced participants (35.6%) believed that it was good for adolescents to engage in sexual activity. One-third of them (33.3%) also reportedly engaged in anal sex, while 26.4% of them were bisexual, as shown in Table 6.

Table 6: Participants reported sexual behaviour continued.

Prevalence of Risky Sexual Behaviour in the Study

Among the participants, a high prevalence of sexual behaviour that put them at risk of sexual and reproductive health issues was noted. The prevalence of risky sexual behaviour among the study participants was 51.2% (95% confidence limit 45.3-57.1).

Figure 2: Pie chart showing participants reported sexual behaviour.

Socio-Demographic Characteristics and Participants' Sexual Behaviour

Socio-demographic characteristics were noted to predict the sexual behaviour of the participants in this study, as depicted in Tables 7 and 8. A significant association was found between gender and sexual behaviour (p=0.002) as well as class and sexual behaviour (p=0.001), as shown in Table 7.

Table 7: Participants' Socio-demographic Characteristics and their Sexual Behaviour.

A = Igbo, Yoruba, Hausa, Isoko, Urobho, Itsekiri. b = Islam, none, others

A significant association was found between the marital status of the participants' parents and the sexual behaviour of the participants (p=0.0014). Also, the educational qualification of the participants' fathers had a significant association with their sexual behaviour (p = 0.0139).

Table 8: Socio-demographic characteristics of participants and their sexual behaviour continued.

Others: None, primary, secondary.

On assessing the social behaviour of the participants, with regards to their sexual behaviour, a significant association was noted between participants sexual behaviour and the following characteristics; having friends that engage in sex (p=0.004), experience of peer pressure (p=0.0217), receipt of regular stipends from parents (p=0.04), use of recreational drugs (p=0.000), smoking (p=0.00) and alcohol ingestion (p=0.000) as shown in Table 9.

Table 9: Participants reported sexual behaviour and their social interactions.

A significant association was also found between the sexual behaviour of the participants and their religious inclination (p = 0.00), frequency with religious activities (p = 0.00), interest in school activities (p = 0.00), where they spend their spare time (p = 0.002), if they watched pornography (p = 0.00) and the nature of their physical environment (p = 0.00). This is as shown in Table 10.

Table 10: Participants reported sexual behaviour and their social interactions continued.

The findings showed that the participants were almost evenly distributed, with 51.2

Acknowledgment

There was no conflict of interest among the authors. The researchers appreciated the statistician, participants, research assistance and researchers for the time.

Conflict of Interest

The Researchers declare that there was no conflict of interest.