Academic journal article International Perspectives on Sexual and Reproductive Health

STI Treatment-Seeking Behaviors among Youth in Nigeria: Are There Gender Differences?

Academic journal article International Perspectives on Sexual and Reproductive Health

STI Treatment-Seeking Behaviors among Youth in Nigeria: Are There Gender Differences?

Article excerpt

CONTEXT: There is little research on STIs among young people in Nigeria. It is important to determine gender differences in health-seeking behaviors among youth with self-reported STI symptoms.

METHODS: Data from 538 males and females aged 15-24 with at least one STI symptom were drawn from the 2003 and 2005 National HIV/AIDS and Reproductive Health Surveys. Bivariate and multivariate analyses were conducted to determine gender differences among those who had sought treatment for their STI symptoms, and the factors related to seeking treatment from formal health care sources versus informal sources.

RESULTS: A greater proportion of males than of females had sought treatment for their STIs (64% vs. 48%). Among those who had sought treatment, 60% of females had gone to formal sources, most commonly a government clinic; 54% of males had sought care from informal sources, most commonly a traditional healer. Females had lower odds than males of having sought STI treatment (odds ratio, 0.6). Among both males and females, economic status was positively associated with seeking treatment from a formal source rather than an informal source (2.4-4.2); among females, 22-24-year-olds were more likely than those aged 15-18 to have sought treatment from a formal source (2.5).

CONCLUSION: Programs and policies that aim to increase treatment of STIs among young people in Nigeria need to target males and females differently.

International Perspectives on Sexual and Reproductive Health, 2010, 36(2):72-79.

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The World Health Organization (WHO) estimates that more than three million new curable STI infections occur annually among people aged 15-49 worldwide--70% of those among 15-24-year-olds. (1), (2) STIs can lead to major pregnancy complications, secondary infertility, and severe pain and discomfort. (3) In addition to being serious diseases in their own right, STIs can increase the risk of HIV acquisition and transmission by a factor of up to 10.

In Nigeria, research on STIs among young people is limited, although there is some evidence that STIs are indeed a common problem in this population. According to a study conducted in the country's rural southeast, the prevalence of STIs among adolescent females was as high as 17%. (4) When only sexually active women were considered, 17-19-year-olds had the highest prevalence of chlamydia (11%) and candidiasis (26%), and were also the age-group most likely to have had any STI (44%); women younger than 17 had the highest prevalence of trichomoniasis (11%), and nearly 20% also had symptomatic candidiasis. Another study conducted in urban Port-Harcourt confirmed the high rate of STIs among adolescents and reported an overall adolescent STI prevalence rate of 14%. (5)

On the basis of this evidence, the promotion of prompt and appropriate health-seeking behavior among Nigerian adolescents should be a public health priority; however, very little information exists about whether and where young people seek care for their STIs. Health-seeking behavior is a highly complex and poorly understood subject, particularly in developing countries, where competing systems of traditional, informal and Western medicine coexist. (6), (7) Evidence from some developing countries suggests that the majority of adolescents who have tested positive for STIs or reported STI symptoms first try to treat their infections themselves or seek treatment from nonprofessional providers (e.g., traditional healers, patent medicine sellers), and only turn to public health clinics or formal health care providers as a last resort. (8-11) For example, according to a study in Bangladesh, female adolescents with self-reported STIs preferred to seek treatment from a pharmacy, followed by a local healer. (12) And in Zambia, male and female adolescents went to clinics only after failing to get traditional medicine from a traditional or spiritual healer or other private practitioner, or if traditional treatments did not work. …

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