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EFFECT OF CONDOM IN PREVENTING SEXUALLY TRANSMITTED DISEASES AMONG THE YOUTHS

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Worldwide, over a million people acquire a sexually transmitted infection (STI) daily. Every year, there is an estimated 357 million new infections with one of the four STIs globally: chlamydia (131 million), gonorrhea (78 million), syphilis (5.6 million) or trichomoniasis (143 million).The United Nations, defines youths as those persons aged between 15 and 24 years. Young persons (youths) are those in the transition period, from the dependent phase of childhood to the interdependence of adulthood. Sexually transmitted infections are common among young people, with approximately 20 million new cases of STIs being reported every year in the United States, of which the majority occur among people aged between 15 and 24 years.

Young people are at high risk of getting an STI for the following reasons: young women’s bodies are biologically more prone to sexually transmitted diseases (STDs), lack of access to healthcare, confidentiality concerns and multiple sexual partners, among others.( center of disease control 2018)The Nigerian National Demographic Health Survey (NDHS) in 2008 reported that 16% of young women and 6% of young men aged between 15 and 24 years had sexual debut before the age of 15 years. A survey in Nigeria on the prevalence and predictors of early sexual debut among adolescents reported that an average of 18.6% had sexual debut before their 15th birthday – 16.6% in boys and 20.2% in girls. Nigeria (2018) This is clearly one of the reasons for the high prevalence of STIs among young people.

Sexually transmitted infections can lead to severe complications beyond the immediate impact of infections. Some STIs, such as herpes and syphilis, can increase the risk of human immunodeficiency virus (HIV) acquisition threefold or more. Gonorrhea and Chlamydia are major causes of pelvic inflammatory disease (PID) and infertility in women. Data on the incidence and prevalence of STIs in Nigeria are limited because of the under-reporting of STIs, especially among young persons, which is attributable to inadequate diagnostic facilities and limited access to treatment facilities, asymptomatic episodes of the infections and the stigma associated with STI. Omobude(2009)

Young adults are also exposed to diverse sources of influence (multiple sexual partners, lack of condom use) transecting different levels of causation. The knowledge of the non-HIV causes of STDs is still lacking, and the risky behavior practiced by sexually active young adults is on the rise. Prevention of STIs includes counseling, behavioral interventions, comprehensive sexuality education, STI and HIV pre- and post-test counseling, condom promotion and interventions targeted at key populations. Who (2018)

 The prevention of STIs, especially in the regions where they are endemic, propelled mainly by heterosexual transmission, includes vaccination (for vaccine-preventable diseases) and practice of the ‘ABC’ approach (abstinence, be faithful to one partner and use of condom).

Consistent and correct use of latex condoms reduces the risk of sexually transmitted disease (STD) and human immunodeficiency virus (HIV) transmission. However, condom use cannot provide absolute protection against any STD. The most reliable ways to avoid transmission of STDs are to abstain from sexual activity, or to be in a long-term mutually monogamous relationship with an uninfected partner. However, many infected persons may be unaware of their infection because STDs often are asymptomatic and unrecognized.

Condom effectiveness for STD and HIV prevention has been demonstrated by both laboratory and epidemiologic studies. Evidence of condom effectiveness is also based on theoretical and empirical data regarding the transmission of different STDs, the physical properties of condoms, and the anatomic coverage or protection provided by condoms.

Laboratory studies have shown that latex condoms provide an effective barrier against even the smallest STD pathogens.

Epidemiologic studies that compare rates of HIV infection between condom users and nonusers who have HIV-infected sex partners demonstrate that consistent condom use is highly effective in preventing transmission of HIV. Similarly, epidemiologic studies have shown that condom use reduces the risk of many other STDs. However, the exact magnitude of protection has been difficult to quantify because of numerous methodological challenges inherent in studying private behaviors that cannot be directly observed or measured.

Theoretical and empirical basis for protection: Condoms can be expected to provide different levels of protection for various STDs, depending on differences in how the diseases or infections are transmitted. Condoms may not cover all infected areas or areas that could become infected. Thus, they are likely to provide greater protection against STDs that are transmitted only by genital fluids (STDs such as gonorrhea, Chlamydia, trichomoniasis, and HIV infection) than against infections that are transmitted primarily by skin-to-skin contact, which may or may not infect areas covered by a condom (STDs such as genital herpes, human papillomavirus [HPV] infection, syphilis, and cancroids).Carey(1999)

The World Health Organization (WHO) defines adolescents as people between 10 and 19 years of age. Individuals within this age range have passed through childhood but are not yet considered adults. Adolescence is an important transitional phase, during which humans experience rapid physical, mental, and social development. This stage of human development is also marked by increased experimentation, as adolescents are keen to try new things, often without thought for their consequences. This second decade of life is thus fraught with dangers, including threats to health.

Today, adolescents are recognized as a group with special health-related vulnerabilities. In addition to tobacco use, suicides, and road traffic accidents, sexual and reproductive behavior is one of the four crucial factors leading to illness, disability, and death in this age group. Many people have sexual intercourse for the first time in their teen years, yet numerous studies reveal that adolescents are poorly informed about and have negative attitudes towards sexually transmitted disease (STD) prevention. Lack of information and negative attitudes encourage sexual risk behavior, thus increasing individuals’ chances of acquiring STDs. In recent years, STDs have occurred mostly among young people, with the highest reported rates found among those aged 15-24 years. Approximately 60% of new cases of human immunodeficiency virus (HIV) and half of HIV-infected people were found in this age group.

To protect adolescents from these diseases, there is a need to educate them on STD prevention by providing them with relevant information and equipping them with the life skills that will enable them to put knowledge into practice. STD-prevention education programmes implemented by governments and international organizations in developing and developed countries have had positive impacts on adolescents. How to make these programmes meet the needs of different groups of adolescents is a challenge facing authorities and programmers.

1.2 STATEMENT OF PROBLEM

The statement of the problem revolves around the need for sexually transmitted disease (STD) prevention programs to address the differences between boys and girls in their risk of contracting STDs and their specific needs regarding prevention. Despite this recognized need, current STD prevention education programs targeted at adolescents often fail to adequately consider these sex differences. One possible explanation for this gap is the lack of clarity on how to effectively incorporate sex differences into program development. While it is understood that addressing these differences is important, there remains uncertainty about the most effective approaches to do so. Moreover, existing research on adolescents' knowledge, attitudes, and practices related to STD prevention has primarily focused on exploring individual factors influencing STD risk, with limited attention to how sex differences manifest across all three domains. Understanding how adolescent boys and girls differ in their knowledge, attitudes, and behaviors regarding STD prevention within the same study setting is essential for developing targeted and effective interventions. By addressing this gap in research, we can gain insights into the specific needs and challenges faced by boys and girls in preventing STDs and inform the development of more comprehensive and gender-responsive prevention programs.

1.3 OBJECTIVES OF THE STUDY

The main objective of the study is to determine the effects of condoms in preventing sexually transmitted diseases among youths. Specific objectives include:

1. To assess the effectiveness of condom usage in reducing the incidence of sexually transmitted diseases (STDs) among youths.

2. To examine the knowledge, attitudes, and practices of youths regarding condom use and STD prevention.

3. To identify socio-demographic factors influencing the consistent use of condoms among youths in preventing STDs.

1.4 RESEARCH QUESTIONS

1. How does consistent condom usage correlate with the prevalence of STDs among youths?

2. What are the perceptions and attitudes of youths towards condom use for STD prevention?

3. What socio-demographic factors (such as age, gender, education level) are associated with the consistent use of condoms among youths? 

1.5 RESEARCH HYPOTHESES

Hypothesis i

H0: There is no significant relationship between consistent condom usage and the incidence of STDs among youths.

H1: Consistent condom usage is associated with a lower incidence of STDs among youths.

Hypothesis ii

H0: There is no significant difference in attitudes towards condom use for STD prevention among youths.

H1: Positive attitudes towards condom use are associated with higher rates of condom usage among youths.

Hypothesis iii

H0: Socio-demographic factors have no influence on the consistent use of condoms among youths.

H1: Socio-demographic factors such as age, gender, and education level significantly influence the consistent use of condoms among youths.

1.6 SIGNIFICANCE OF THE STUDY

The significance of this study lay in its providing information regarding perceptions and factors potentially influencing the recent increase in STD incidence among Nigerian young adults. This study could help government and educational institutions understand young adults’ perception of sexual and reproductive health issues. As a result, the information could help officials construct effective holistic prevention and intervention approaches that are appropriate for the particular culture, community, and age group regarding STDs among young adults in Akwa Ibom State.

STDs are preventable when individuals take protective measures. In addition, the health risks associated with STDs must be widely known, access to treatment centers must be provided, and stigmatization of patients must be eliminated through confidentiality protocols that safeguard privacy. Researchers have shown that the various health risks associated with STDs include infertility, infection of newborns, cervical cancer, and HIV/AIDS, among others.

1.7 SCOPE OF THE STUDY

The scope of this study aims to investigate the effectiveness of condom usage in preventing sexually transmitted diseases (STDs) among youths aged 18-25. It will examine the correlation between consistent condom use and the incidence rates of STDs within this demographic. Factors such as knowledge, attitudes, and access to condoms will also be explored. The study will be conducted through surveys, interviews, and analysis of existing data sources.

1.8 LIMITATIONS OF THE STUDY

Limitations of a study on the effectiveness of condoms in preventing sexually transmitted diseases among youths may include sample bias, as participants might not accurately represent the entire youth population. Additionally, self-reporting of condom usage and STD status could introduce recall and social desirability biases. The study's duration and follow-up period might not capture long-term trends or behaviors accurately. Finally, external factors like access to healthcare and education could influence outcomes but may not be adequately accounted for.

1.9 DEFINITIONS OF TERMS

1. Condom: A thin sheath typically made of latex, polyurethane, or lambskin, worn over the penis during sexual intercourse to prevent the exchange of bodily fluids and reduce the risk of sexually transmitted infections (STIs) and unintended pregnancy.

2. Sexually Transmitted Diseases (STDs): Infections spread through sexual contact, including vaginal, anal, or oral sex, caused by bacteria, viruses, or parasites. Common STDs include Chlamydia, gonorrhea, syphilis, HIV/AIDS, herpes, and HPV.

3. Prevention: Actions taken to avoid or reduce the likelihood of a particular outcome, such as the transmission of STDs. Prevention strategies may include education, behavioral changes, condom use, vaccination, and regular testing.

4. Youths: Typically defined as individuals in the adolescent or young adult stage of life, generally ranging from ages 10 to 24. Youths may face unique challenges related to sexual health, including peer pressure, lack of knowledge, and limited access to resources. 

5. Risk Reduction: Strategies aimed at minimizing the likelihood of negative outcomes, such as contracting an STD, by implementing protective measures, such as condom use, practicing abstinence, engaging in monogamous relationships, and seeking regular STI testing.

6. Safe Sex: Sexual behaviors and practices that reduce the risk of transmitting STDs and unintended pregnancy. Safe sex practices may include the consistent and correct use of condoms, open communication with sexual partners, mutual testing for STIs, and limiting the number of sexual partners.

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