Journal of Behavioral Health

Original Research
www.scopemed.org
DOI: 10.5455/jbh.20140815092416

Sexual risk behaviors among

adolescents attending secondary schools
in a Southwestern State in Nigeria
Adeleye Abiodun Adeomi, Oluwatosin Adediran Adeoye,
Adefisoye Adewole, Oluwaseyi Israel, Abiola Temitayo-Oboh

Department of ABSTRACT
Community Medicine, Introduction: Several studies in Nigeria have reported high rates of risky sexual activities among adolescents.
Ladoke Akintola
This study, therefore, aimed to describe the sexual risk behaviors among adolescents attending secondary
University of Technology
Teaching Hospital,
schools in a Southwestern State in Nigeria. Materials and Methods: This was a descriptive cross-sectional
Ogbomoso, Oyo State, study, carried out among in-school adolescents in Osun State, Southwestern Nigeria. The multi-stage sampling
Nigeria technique was used to select the respondents, and data were collected with pre-tested, semi-structured
questionnaires which were self-administered and supervised by trained research assistants. A total of 815
Address for correspondence: questionnaires was administered, but only 786 (96.4%) were properly filled and analyzed using Statistical
Oluwatosin Adediran Package for Social Sciences version 16. Results: Many of the respondents (406, 51.7%) were early adolescents,
Adeoye, Department of
Community Medicine,
while the remaining 380 (48.3%) were late adolescents with a mean age of 14.2 ± 2.2 years. One hundred
Ladoke Akintola and eight (22.9%) were sexually exposed with a mean age of sexual debut of 12.7 ± 2.7 years. Of the 180
University of Technology that were sexually exposed, 134 (74.4%) had sex in the month preceding the study, 40 (22.2%) had paid for
(LAUTECH) Teaching or demanded for payment for sex before, and only 48 (26.7%) used condom for their last sexual intercourse.
Hospital, Ogbomoso,
Oyo State, Nigeria.
Only 2 (0.3%) respondents reported having had sexually transmitted infections (STI), but, 128 (16.3%) had had
Tel: +234803 3712940, symptoms suggestive of STI before. Conclusion: There was a high level of sexual risk behaviors among the
E-mail: tosinadeoye2002@ respondents with 22.9% of them being sexually exposed with a mean age at sexual debut of 12.7 ± 2.7 years.
yahoo.com Public health interventions to prevent human immunodeficiency virus/acquired immunodeficiency syndrome
should target adolescents in their early ages before they initiate sexual activity.
Received: March 24, 2014
Accepted: August 15, 2014
Published: August 25, 2014 KEY WORDS: Adolescents, in-school, sexual risk behavior, sexually transmitted infections

INTRODUCTION immunodeficiency syndrome (AIDS) among adolescents [11-14]

and so they are a high-risk group in HIV transmission.
One in three African adolescents lives in Nigeria, the most
populous country in Africa. About one-third of Nigeria’s total The Nigeria Demographic and Health Survey (NDHS) reported
population are young people between the ages of 10 and 24 [1], that among women who had sexual intercourse in the 12 months
and it is projected that by 2025, the number of Nigerian youth preceding the NDHS, the proportion who engaged in higher-
will exceed 57 million [2]. Nigeria’s birth rate for adolescents is risk sexual intercourse was the highest among those aged
one of the highest in the world, with an estimated adolescent 15-19 years. Younger women aged 15-24 years were twice as
population of 35 million adolescents by the year 2009 [3]. The likely as women aged 40-49 years to have had sexual intercourse
prevalence of sexually transmitted infections (STIs) including with two or more sexual partners in the 12 months preceding
human immunodeficiency virus (HIV), among adolescents in NDHS. Sixteen percent of young women and 6% of young men
Nigeria, is climbing rapidly [4,5]. aged 15-24 years initiated sexual activity before age 15 [15].

Research confirms that many young people participate in risky One of the consequences of the involvement of young persons
sexual activities including early debut in sexual activities, sex with in risky sexual activities is that this group is disproportionately
many partners, low and inconsistent use of condoms [6]. The affected by reproductive morbidity including STI/HIV,
adolescents in developing countries are also increasingly engaging unwanted pregnancies and their complications [6,16,17]. One
in sexual intercourse, especially high risk sexual intercourse [7-10], study found that the one-third of women obtaining abortions
and Nigeria is not an exception. Several studies in Nigeria were adolescents [13]. Hospital-based studies also showed
have reported high rates of risky sexual activities, unwanted that up to 80% of Nigerian patients with abortion-related
(unintended) pregnancy, abortion and STIs including HIV/acquired complications were adolescents [13].

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 Adeomi, et al.: Sexual risk behaviors among adolescents

It is estimated that 2 million adolescents (aged 10-19 years) participants themselves were given consent forms to fill, after
were living with HIV, in addition to the 2.5 million children they were properly informed about the study and all it entails.
under age 15 years living with the virus in 2009 [18]. Although All information gathered was kept confidential, just as the
these young people living with HIV/AIDS could be found in students were re-assured at the beginning of the study. All the
countries on all continents, most of them lived in sub-Saharan participants were identified using only serial numbers.
Africa [19]. An estimated 1.5 million of the 2 million adolescents
living with HIV were in sub-Saharan Africa. The highest RESULTS
numbers of adolescent boys and girls living with HIV are found
in South Africa and Nigeria. This study, therefore, aimed to Many of the respondents (406, 51.7%) were early adolescents,
update knowledge on the sexual risk behaviors among in-school while the remaining 380 (48.3%) were late adolescents with a
adolescents in a Southwestern State in Nigeria. mean age of 14.2 ± 2.2 years. The respondents were mainly
Christians (494, 62.8%), senior secondary school students
MATERIALS AND METHODS (442, 56.2%), and of the Yoruba ethnic group (778, 99.0%).
Other sociodemographic characteristics are as shown in Table 1.
This was a descriptive cross-sectional study, carried out
among in-school adolescents in Osun State, Southwestern Table 2 shows the sexual risk behaviors among the respondents.
Nigeria. Osun State has three senatorial districts namely Osun One hundred and eight (22.9%) were sexually exposed with
Central, Osun West, and Osun East, each comprising 10 local a mean age of sexual debut of 12.7 ± 2.7 years. Of the 180
government areas (LGAs) (making 30 LGAs) and one area that were sexually exposed, 134 (74.4%) had sex in the month
office, located in Osun East senatorial district. The 30 LGAs preceding the study, 40 (22.2%) had paid for or demanded for
are grouped into 18 rural and 12 urban LGAs. In the rural areas, payment for sex before, and only 48 (26.7%) used condom
majority of the inhabitants are farmers while in the urban areas,
for their last sexual intercourse. Among those who had sex
they are mostly traders, artisans, cloth dyers, and civil servants,
in the month preceding the study, 50 (37.3%) had more than
hence having differing socio-economic status.
one sexual partner with a mean number of sexual partners of
1.2 ± 1.3 partners. Other risky behaviors among the respondents
The multi-stage sampling technique was used to select the
include taking alcoholic beverages (170, 21.6%), smoking of
respondents. At the first stage, two out of the three senatorial
districts in Osun State were selected by simple random sampling
technique, while two LGAs were selected from each of the Table 1: Sociodemographic characteristics of respondents
selected senatorial district at stage 2. A total of eight schools was Variable Frequency Percentage
randomly selected from the selected LGAs at the third stage, Age group (in years)
and stratified random sampling technique was used to select 10‑14 (early adolescence) 406 51.7
15‑19 (late adolescence) 380 48.3
students from the eight schools at the fourth stage.
Mean age 14.2±2.2
Gender
Data were collected with pre-tested, semi-structured Male 388 49.4
questionnaires (i.e. having both closed and open-ended Female 398 50.6
questions) which were self-administered by the students in Religion
Christianity 494 62.8
designated classes and supervised by trained research assistants.
Islam 286 36.4
The questionnaire was designed to seek information about Traditionalist 6 0.8
the adolescents’ socio-demographic characteristics and their Tribe
indulgence in risky behaviors. A total of 815 questionnaires Yoruba 778 99.0
was administered, but only 786 (96.4%) were properly filled Others 8 1.0
Class
and analyzed.
Junior secondary 344 43.8
Senior secondary 442 56.2
The questionnaires were manually sorted out, entered into a Residence
computer, and the data were analyzed using Statistical Package Urban 390 49.6
for Social Sciences version 16 (IBM Corporation). Frequency Rural 396 50.4
Father’s occupation
distribution tables and/or charts were generated from variables Unemployed 76 9.7
while cross-tabulation and test statistics were done where Unskilled 72 9.2
applicable. The Chi-square test was used to compare rates, Semi‑skilled 318 40.5
ratios, and proportions. Level of significance was set with P Skilled 320 40.7
≤ 0.05. Mother’s occupation
Unemployed 46 5.9
Unskilled 28 3.6
Ethical clearance for the study was obtained from the Ethical Semi‑skilled 506 64.4
Review Committee of Ladoke Akintola University of Technology Skilled 206 26.2
Teaching Hospital, Osogbo. The Parent Teachers Association Family setting
and Principals of selected schools were properly informed, Monogamous 406 51.7
Polygamous 380 48.3
and their informed consent was obtained, while the study

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Adeomi, et al.: Sexual risk behaviors among adolescents

cigarettes or Indian hemp (8, 1.0%), and attending night parties smelling discharge from the penis/vagina, itching of or sores on
(96, 12.2%). After bivariate analysis, age, gender, smoking, and the genital organs and painful urination), 128 (16.3%) had had
attendance of night parties were significantly associated with such symptoms before [Table 4].
their sexual exposure [Table 3].
DISCUSSION
Only 2 (0.3%) respondents reported having had STI, but when
asked about symptoms suggestive of STI (like abnormal or bad A little more than 20% of the respondents had had sexual
intercourse before. This is similar to findings by Fatusi and
Table 2: Sexual risk behaviors among the respondents Blum, who reported that 19.8% of the adolescents who were
Variable Frequency Percentage randomly selected from the 36 States in Nigeria had initiated
Ever had sexual intercourse sexual intercourse [20], Asekun-Olarinmoye et al, in Osun State,
Yes 180 22.9 Nigeria reported that 27.6% of the in-school adolescents studied
No 606 77.1 were sexually exposed [21] and Moharson-Bello et al. who
Mean age at first sex 12.7±2.7 years reported 28.3% in a study carried out in Ibadan, Nigeria [16].
Had sex in the last 1 month (n=180)
Yes 134 74.4
The prevalence in this study is higher than the 13.0% reported
No 46 25.6 among adolescents in Northeastern Nigeria [22] and South
Number of sex partners in the last Africa [23]. Higher prevalence rates were, however, reported by
1 month (n=134) Slap et al. who reported 34% in Plateau State [5], Owolabi et al.
1 84 62.7 who reported 63% in Osun State [24] and Olugbenga-Bello et al.
>1 50 37.3
who reported 31.5% also in Osun State, Nigeria [17]. This
Mean number of sex partners in the last 1 month 1.2±1.3 partners
Ever had paid sex (n=180) variation in the proportion of adolescents who have been
Yes 40 22.22 involved in sexual intercourse agrees with the findings in a
No 140 77.8 review of studies on the sexual behavior of school students in
Used condom for the last sex (n=180) sub-Saharan Africa with Nigeria inclusive, the prevalence of first
Yes 48 26.7 sex was reported to vary from 3% to 93% [25]. This variation may
No 132 73.3
Other risky behaviors (multiple responses)
be due to the different values attached to the issue of adolescent
Take alcoholic beverages 170 21.6 sexuality by different cultures and people.
Have a smoking habit 8 1.0
Attend night parties 96 12.2 Of those that had sexual intercourse in the month preceding the
Had sex after a night party before (n=96) study, nearly two-fifths had sexual intercourse with more than
Yes 28 29.2
No 68 70.8
one sexual partner, and more than 1 in 5 of those sexually exposed
had paid someone or demanded payment for sex within the same
time period. A fifth of the respondents took alcoholic beverages,
Table 3: Factors affecting sexual exposure among respondents more than 1 in 10 attended night parties, and 1% had a smoking
Variable Ever had sexual χ2 P value habit. Of those who attended night parties, 3 out of 10 of them
intercourse (%) had sexual intercourse after such parties. This pattern of high-risk
Yes No sexual behavior has been well-established by previous studies,
Age group (in years) though the findings vary from place to place [5,12,14-16,20-27].
10‑14 70 (17.2) 336 (82.8) 15.23 <0.0001 Olugbenga-Bello et al. in Osun State [17] found that 14.6% of
15‑19 110 (28.9) 270 (71.1) the secondary school students surveyed had more than one sexual
Gender partner, and 3.3% had visited commercial sex workers before.
Male 122 (31.4) 266 (68.6) 31.67 <0.0001
Female 58 (14.6) 340 (85.4)
Asekun-Olarinmoye et al. [21] in Osun State found that, of the
Class sexually active students that were surveyed, 48.4% had multiple
Junior secondary 74 (21.5) 270 (78.5) 0.67 0.414 sexual partners, and 37.9% patronized commercial sex workers
Senior secondary 106 (24.0) 336 (76.0) [21]. Aderibigbe and Araoye [26] also worked among secondary
Family setting school students in Ilorin, Kwara State and found that 24.2% of
Monogamous 86 (21.2) 320 (78.8) 1.41 0.236
the respondents had received gifts in exchange for sex, while 45%
Polygamous 94 (24.7) 286 (75.3)
Residence 3.69 0.055 had more than one sexual partner. This high levels of risky sexual
Urban 78 (20.0) 312 (80.0) behavior have made adolescents and young people particularly
Rural 102 (25.8) 294 (74.2)
Take alcoholic beverages Table 4: STIs among the respondents
Yes 40 (23.5) 130 (76.5) 0.05 0.826
No 140 (22.7) 476 (77.3) Variable Frequency Percentage
Have smoking habit Ever had STI
Yes 6 (75.0) 2 (25.0) 12.43 *0.002 Yes 2 0.3
No 174 (22.4) 604 (77.6) No 784 99.7
Attends night parties Ever had symptoms suggestive of STI
Yes 46 (47.9) 50 (52.1) 38.76 <0.0001 Yes 128 16.3
No 134 (19.4) 556 (80.6) No 658 83.7
*Fisher’s exact test used STI: Sexually transmitted infections

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 Adeomi, et al.: Sexual risk behaviors among adolescents

vulnerable to and at risk of STI and HIV infections, and hence, they initiate sexual activity. There is also a need to explore
the reason why evidenced-based interventions should be directed evidenced-based interventions that work among adolescents
at this age group. and to direct them at this age group. Governmental, non-
governmental organizations, and other stakeholders and
Despite this high level of risky sexual behavior among the policy makers in adolescent reproductive health should work
adolescents, it is something of concern that just about a quarter toward designing comprehensive education programs to reach
used condom for the last sexual experience. This rather poor secondary schools across the country.
preventive culture among adolescents has been reported by
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