Adeniji, Oluwakemi Iyabo (PhD, MPH, MNSc, PGDE, BNSc)^1*, Adeniji Adetunji Oladeni (MBBS, FWACS, FMCOG, FICS, MD)²

¹Nurse/Midwife/Public Health Nurse Tutors’ Programme, University College Hospital (Affiliated to Department of Nursing, University of Ibadan, Ibadan, Oyo State, Nigeria)

²Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.

*Corresponding Author: Adeniji, Oluwakemi Iyabo (PhD, MPH, MNSc, PGDE, BNSc), ¹Nurse/Midwife/Public Health Nurse Tutors’ Programme, University College Hospital (Affiliated to Department of Nursing, University of Ibadan, Ibadan, Oyo State, Nigeria).

Abstract
The study investigated factors influencing sexually transmitted diseases (STDs) among selected secondary school students in Egbeda Local Government Area, Oyo State, Nigeria. A descriptive cross-sectional research design was adopted for this study. The study population were both male and female secondary school students. A sample size formula was used to arrive at 346 respondents, and simple random sampling was used for the selection. A structured questionnaire, which was divided into four sections, was used for the collection of data. The face and content validity of the instrument were ensured by experts. The data was analysed using the descriptive statistics. Findings from this study revealed a low level of knowledge (59.5%) on the transmission of the diseases, while 43.4% of the respondents strongly agreed that females are more vulnerable. Also, 46.8% strongly agreed that the factors influencing sexually transmitted diseases include inadequate knowledge on its causes and prevention. There is a need to give health education on sexuality and sex education as well as the associated health risks of STDs among secondary school students.

Keywords: Factors, Influencing, Sexually Transmitted Diseases, Secondary school students.

Introduction
Sexual intercourse, though pleasurable and enjoyable to the body, could lead to significant causes of morbidity among adolescents with multiple consequences if they engage in unprotected sex, and this could lead to sexually transmitted diseases (STDs) [3,17]. The STDs are a group of communicable diseases that are transmitted predominantly by sexual contact and caused by a wide range of bacterial, viral, protozoa and fungal agent, and ectoparasites [4]. Annually, an estimated 499 million cases of STDs (gonorrhoea, syphilis, chlamydia, trichomonas) are detected and 536 million people are estimated to be living with incurable herpes simplex virus type 2 (HSV-2) infection and HIV[16]. Out of these estimated cases of STDs, 75%-85% of it occur in developing countries [6]. An estimate 109.7% million people is living with STDs in Africa [6]. This has led to 17% economic losses on the continent. Generally, adolescents are at a higher risk of contracting STDs because of their unhealthy sexual behaviours and lifestyles [1]. Secondary school students, especially females, are particularly vulnerable to the acquisition of STDs because of biological, cognitive, and social factors. Studies have revealed that STDs in adolescents is associated with early age initiation of sexual activities, alcohol and drug use before sex, having multiple sexual partners and non-use of contraceptives [5]. The high level of unsafe sexual behaviour among secondary school students has led to high rate of STDs, unintended and unwanted pregnancies resulting to either illegal abortion among them [14].

Forty-two per cent (42%) of the sexually active secondary school students who are less than 17 years had experienced an abortion at one point or the other[13]. Among them, 19% had symptomatic candidiasis, 4% had trichomonas infections, and overall, 38% of adolescents reported having vaginal discharge. Nineteen per cent of boys and 9% girls in secondary schools claimed that they were infected with gonorrhoea and syphilis [13]. A pre-existing sexually transmitted diseases (STDs) increase the susceptibility to acquire Human Immunodeficiency Virus (HIV) infection [7]. The 2017 HIV sero-prevalence survey on sexual encounters among students revealed that 54% of girls were drugged, 41% were raped, 7.4% were forced and 14.2% were deceived into having sex [10]. However, several studies on vulnerability to sexually transmitted diseases have indicated that the most common reasons cited for having engaged in unwanted sex were being drunk and pressure from a sexual partner [9]. Also, a study in Ghana reported that 3.4% of male and 5.2% of female adolescents’ experiences STDs [6].

A few studies have previously attempted to explore the factors influencing the incidences of STDs among adolescents. Gwon and Lee (2016) reported that female adolescents were significantly more likely to contract sexually transmitted diseases (STDs) than male adolescents. The authors also reported that the adolescents who had initiated intercourse at age 13 or younger were significantly more likely to have had an STD than those who had begun intercourse at the age of 14 or older. Sexually transmitted disease (STDs) has a profound impact on sexual and reproductive health worldwide[13]. More than 1 million sexually transmitted diseases (STDs) are acquired everyday [15]. In 2020, WHO estimated 374 million new infections with one of four sexually transmitted disease (STD): chlamydia (129 million), gonorrhoea (82 million), syphilis (7.1 million) and trichomoniasis (156 million). More than 490 million people were estimated to be living with genital HSV (herpes) infection in 2016, and an estimated 300 million women have Human Papilloma Virus (HPV) the primary cause of cervical cancer [14]. An estimated 296 million people are living with chronic hepatitis B globally. Both HPV and hepatitis B infections are preventable with vaccination. This study specifically examined the knowledge, perception, and factors influencing sexually transmitted diseases among selected secondary school students in Egbeda Local Government Area, Oyo State, Nigeria.

Methodology
The study design used for this study was the descriptive research design to assess factors influencing sexually transmitted diseases among secondary school students in Oyo State, Nigeria. The study location was Egbeda Local Government Area (LGA) in Ibadan, Oyo State, which is located to the East and Northeast of Ibadan. The LGA has a land mass of about 410 sq. km, with its head quarter at Egbeda and divided into 11 wards. Five out of the twenty-one secondary schools within the LGA were selected using the simple random sampling and the Leslie Kish formula was used to calculate the sample size to derive 346 students. A structured and tested instrument by experts was used to collect data. Data obtained was collated, coded and analyzed using the descriptive statistics such as frequency table and percentage.

Results
The socio-demographic data (Table 1) of the respondents revealed that majority (82.7%) of the respondents were between the ages of 14- 17 years; 44.8% in the senior secondary class 1; 58.7% are Christians and 59.5% are females.

Table 1: Socio-demographic characteristics of the respondents

Also, the study revealed that STDs can be contracted from the toilet (39%) and 59.5% of the respondents called it ‘Toilet disease’. Majority (72.3%) of the respondents do not know the causes of STDs and 68.8% tagged it as a disease of the social and rich people. (Table 2).

Table 2: Knowledge on sexually transmitted diseases

Table 3 revealed that 43.3% of the respondents strongly agreed that female students are more likely to contract STDs than their male counterparts. Also, 43.6% strongly disagreed that having more than one sexual partner does not predispose someone to contract STDs.

Table 3: Perception on on sexually transmitted diseases

Furthermore, the study revealed inadequate knowledge (47.0%) on causes and prevention of STDs, absence of sex education in the secondary school curriculum (74.2%) and non-existence of youth friendly clinic (46.2%) as influencing factors on STDS among secondary school students (Table 4).

Table 4: Factors influencing sexually transmitted diseases.

Discussion
The study revealed that there was dearth in knowledge on transmission as well as causes and prevention of STDs among selected secondary school students in Egbeda Local Government Area, Oyo State, Nigeria. This was contrary to the study on awareness and knowledge of STDs among secondary school students in Ado Ekiti, Southwestern Nigeria by & Adegun (2015) which revealed that 75% of the respondents knew the mode of transmission. In another study on the causes and preventive practices of STDs [12], less than half of the respondents (34%) knew about the causes and prevention of STDs. Nzoputam et al., (2022), in a study on knowledge, prevalence, and factors on STDs among female students, ascertained a higher prevalence (27.7%) among female students.

Conclusion
The conclusion of the study is that secondary school student should be given health education on sexuality and sex education to improve their knowledge on transmission, causes and prevention of STDs.

Recommendations
1. Ministry of education should initiate sex education programs in secondary schools.
2. Sex education should be included in the school curriculum.
3. Establishment of youth friendly clinics at the Local Government Areas.

Contributions To Knowledge
The findings from this study stressed the importance of health education on sex education and sexuality. Data from this study also authenticate the need for a youth friendly clinic at the grassroots.

References

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