BACKGROUND: Studies done in both developed and developing countries have reported the tendencies of adolescents to engage in risky behaviours. Such behaviours include indulging in early and unsafe sexual activities, having multiple sexual partners, alcohol and drug use and dropping out of school among others. PURPOSE: The main aim of the study was to develop intervention strategies for reducing sexual risk practices among adolescents in Ethiopia. METHODS: A mixed method approach using quantitative and qualitative approaches was employed in order to investigate the risks of sexual practices among urban and rural adolescents in the selected area. A cross-sectional survey was used to gather data quantitatively and focus group discussions were used for the qualitative part of data collection. A total of 449 students and 72 FGD participants were selected for quantitative and qualitative study respectively using systematic random sampling technique. Logistic regression was done to identify possible factors associated with knowledge on emergency contraceptive, condom utilisation, pre-marital sex practices and perception of risky sexual practices. RESULTS: One hundred and seventy (37.9%) respondents had experienced sexual intercourse at the time of the study. The higher proportion (42.6%) of those who had engaged in sexual relationships was from the rural school compared to 33.1% in the urban schools. The proportion of sexually active respondents was higher among males (44.8%) compared to (29%) females. Multiple partners were higher in rural adolescents (44.7%) compared to 31.8% among urban adolescents. Sexually Transmitted Diseases were reported by 28.6% of the sexually active adolescents and the prevalence was higher among males (73.5%) compared to 27% females. 87% of the sexually active adolescents rarely used a condom. CONCLUSION: The study identified a knowledge gap on ASRH which limited adolescents to access reproductive services. Social, cultural and economic factors contributed to adolescent engagement in risky sexual behaviours. Based on the major findings of this study, intervention strategies targeting behavioural, biomedical and structural interventions were proposed. / Health Studies / D. Litt. et Phil. (Health Studies)

No description available.

Today, 1.2 billion adolescents stand at the challenging crossroads between childhood and the adulthood. Driven by a combination of biological, psychological and social forces, adolescence is a period of “stress and storm” for many adolescents predisposing them to risky behaviours with long term consequences. Adolescence is not only a time of vulnerability; it is also an age of opportunity for investment in sustained health and wellbeing through education and preventive efforts to help them navigate risks and vulnerabilities. Evidence-based sexuality education programmes are a cornerstone in reducing adolescent sexual risk behaviours and promoting sexual health. A qualitative, grounded theory study was undertaken to explore and describe experiences of adolescents, teachers and perceptions of parents of school-based sexuality education (SBSE). An indepth literature review through concept analysis on the phenomenon was conducted to assist the researcher with theoretical sensitivity and theoretical saturation. In-depth Individual interviews and focus group interviews were conducted to generate data. Interviews were audio-taped and transcribed by the researcher verbatim. The direct quotes of participants were coded and arranged into meaning units for analysis. A constant comparison method of data analysis was applied by following a Strauss and Corbin (1998) analysis process of open, axial and selective coding to analyse textual qualitative data until themes, categories and sub-categories were identified and developed. Data analysis revealed that adolescents benefitted from SBSE but the implementation of programme was undermined by challenges at national, institutional, community, family and individual levels enshrined in the physical. There were also challenging contextual factors at various levels that influenced the benefits of the SBSE. It is recommended that there is need to review the teaching and learning resources and to fully integrate sexuality education into the formal curriculum. The ministry of education in Uganda should take a leadership role in fostering engagement and participation of major stakeholders, particularly teachers, parents and other community groups in delivering school-based sexuality education that addresses the needs of the schoolgoing children / Health Studies / D. Litt. et Phil. (Health Studies)

BACKGROUND: Studies done in both developed and developing countries have reported the tendencies of adolescents to engage in risky behaviours. Such behaviours include indulging in early and unsafe sexual activities, having multiple sexual partners, alcohol and drug use and dropping out of school among others. PURPOSE: The main aim of the study was to develop intervention strategies for reducing sexual risk practices among adolescents in Ethiopia. METHODS: A mixed method approach using quantitative and qualitative approaches was employed in order to investigate the risks of sexual practices among urban and rural adolescents in the selected area. A cross-sectional survey was used to gather data quantitatively and focus group discussions were used for the qualitative part of data collection. A total of 449 students and 72 FGD participants were selected for quantitative and qualitative study respectively using systematic random sampling technique. Logistic regression was done to identify possible factors associated with knowledge on emergency contraceptive, condom utilisation, pre-marital sex practices and perception of risky sexual practices. RESULTS: One hundred and seventy (37.9%) respondents had experienced sexual intercourse at the time of the study. The higher proportion (42.6%) of those who had engaged in sexual relationships was from the rural school compared to 33.1% in the urban schools. The proportion of sexually active respondents was higher among males (44.8%) compared to (29%) females. Multiple partners were higher in rural adolescents (44.7%) compared to 31.8% among urban adolescents. Sexually Transmitted Diseases were reported by 28.6% of the sexually active adolescents and the prevalence was higher among males (73.5%) compared to 27% females. 87% of the sexually active adolescents rarely used a condom. CONCLUSION: The study identified a knowledge gap on ASRH which limited adolescents to access reproductive services. Social, cultural and economic factors contributed to adolescent engagement in risky sexual behaviours. Based on the major findings of this study, intervention strategies targeting behavioural, biomedical and structural interventions were proposed. / Health Studies / D. Litt. et Phil. (Health Studies)

Childhood sexual abuse (CSA) is one of the least studied HIV-related risk factors in Haiti although research in the United States and Europe has clearly established the link between childhood trauma and HIV risk behaviors. Understanding the role and impact of CSA on HIV-positive Haitian women is likely to strengthen future HIV prevention and treatment efforts aimed at this vulnerable group. The current study was a cross-sectional examination of baseline data collected during a randomized trial of a cognitive-behavioral stress management (CBSM) intervention in Haiti. The purpose of this study was to analyze the association between CSA and sexual risk behaviors, alcohol use, and social support in a group of Haitian women, ages 17-55 (n=229), who are HIV-positive alcohol users living in Haiti. The outcomes investigated were the respondents’ level of exposure to CSA and their current HIV-related risk factors. The Theory of Gender and Power provided the theoretical framework for variable selection and associative exploration. Statistical tests included descriptive analyses, chi-square tests, analysis of variance (ANOVA), and correlations. Results showed that women who were exposed to some level of sexual abuse during childhood had less favorable attitudes towards condom use than women who reported no exposure to sexual abuse during childhood [F(2, 217) = 5.10, p = .007]. There were no differences between exposure groups for the remaining sexual risk behaviors: multiple partners, knowledge of HIV, and sexual self-efficacy. Women who were exposed to CSA also reported higher levels of alcohol use than reported by the women in the non-exposure group. Finally, there were no differences between exposure groups for social support. Group differences in attitudes towards condom use and levels of alcohol use among HIV-positive Haitian women demonstrate that HIV-positive individuals have different past and present experiences that affect their current beliefs and behaviors. Examining women at the beginning of their diagnosis for childhood trauma and providing targeted interventions for coping with that trauma presents a valuable research opportunity. The findings of the current study suggest that more research is required to understand the association between CSA and HIV-related risk factors in this subset of the HIV-positive population.

PhD (Public Health) / Department of Public Health / The well-being of adolescents’ population is a major concern to policy makers, educators and researchers all over the world. Research has shown that adolescents engage in deviant and risky sexual behaviour, and such behaviour may have consequences for their present or future health. Likewise, it has been shown that adolescents are also known to conform to societal norms if they are given proper guidance. In the light of this, the present study proposed to explore and explain the influence of family dynamics in the occurrence of adolescents deviant and sexual risk behaviour. This study involved a sequential explorative, descriptive and analytic mixed method design, combining both qualitative and quantitative research approaches. The study was divided into three (3) phases. Phase 1 was purely qualitative in nature, where a total of 10 parents and 13 adolescents were engaged in an in-depth interview. Phase 2 was quantitative in nature, using a cross-sectional analytic design involving 388 adolescents, while Phase 3 was the development of a public health intervention to mitigate the influence of family dynamics on adolescent deviant and sexual risk behaviour. The qualitative data were analysed using thematic content analysis, while the quantitative data were analysed using the Statistical Package for Social Sciences (SPSS) version 22. The Chi-square test, Fisher’s exact test, multinomial and binary logistic regression were used to compare differences between the dependent and independent variables. The level of statistical difference was set at p<0.05. Couple conflicts was a common finding in the study. In addition, many families suffered severe financial constraints and some parents were disconnected from their children physically, emotionally and financially (particularly the fathers). Adolescents claim that the age difference between them and their parents remains a barrier to communication, in addition, some participants claimed that they received little or no sex education from their parents. The present study found a high level of recent physical violence (30%), alcohol (52.9%) and drug use (10%) among participants. The level of sexual activity in this study was high, with 60.1% of the participants being sexually active and 23.1% having been pregnant. In addition, only 35.6% using condoms regularly. There was gender difference among participants on the following variables: cigarette smoking, teenage pregnancy and having multiple sexual partners. Furthermore, participants differed significantly across age group on the following variables: cigarette smoking, sexual activity, having friends who are sexually active, reported pregnancy and currently having iii a relationship. However, ‘relationship with mother’ was the family dynamic variable that recorded a wider effect on deviant and sexual risk behaviour. Furthermore, age, duration of stay in the community, living with siblings, relationship with mother, having enough money at home, being supported emotionally at home and parental love for each other, were predictors of deviant and sexual risk behaviour in the present study. There was also low level of risk perception and low level of skill for self-protection among the participants. As part of the objectives of the present study, the study findings were used to develop an evidence-based public health programme targeted at vulnerable adolescents and adolescents at high risk for deviant and sexual risk behaviour. It is hoped that this programme will be able to empower parents and caregivers to apply better parenting practices to forestall undue exposure of adolescents to factors that contribute to deviant and sexual risk behaviour. The present study demonstrated that although adolescents have the propensity for deviant behaviours, many may transit to adulthood without much adverse sequelae even in the face of harsh family social and economic adversities. However, a proportion of the adolescent population in this community remains vulnerable due to the effects of family de-structuring, poverty and unemployment. / NRF

This quantitative descriptive cross sectional study explored factors influencing sexual risk behaviours among youths in senior secondary schools in Ethiopia. Data were collected using structured questionnaires. Religious attachment, living with friends, living alone, parental control, level of parental education, peer pressure and number of friends who had experienced sex were some of the factors noted to influence youths to engage in sexual risk behaviours. The findings of this study have implications for both practice and policy development. They will enable healthcare workers to identify youths at risk of engaging in sexual risk behaviours and subsequently motivate them using health promotion strategies to engage in safe sexual practices. Adopting such an approach will prevent or at least minimise risk of youths being infected with sexually transmitted diseases, such as HIV/AIDS. / Health Studies / M.A. (Health Studies)

No description available.

Bakgrund: Tonårsperioden är en avgörande tid för unga. Ungdomars utsatthet för våld utgör en väsentlig folkhälsofråga globalt och nationellt. Vid mötet med ungdomar kan barnmorskor på ungdomsmottagningar ta upp ämnen som relationer, livsstil och sexuellt beteende. Västra Götalandsregionen har utvecklat SEXIT, en metod som kan bidra till att identifiera ungdomars sexuella risker och våldsutsatthet.   Motiv: Ungdomars sexuella och reproduktiva hälsa och rättigheter behöver förbättras. Genom att kartlägga ungdomars självrapporterade sexuella beteende och erfarenheter av våldsutsatthet kan en bättre uppfattning om vilka risker som de utsätter sig eller andra för nås.    Syfte: Att via SEXIT kartlägga ungdomars sexuella beteende och deras utsatthet för våld samt att utforska eventuella skillnader mellan ålder och kön.   Metod: Stickprovsundersökning med 284 ungdomar vid en ungdomsmottagning i Norrland under 2022, som besvarat SEXIT enkäten som innehöll bakgrundsfrågor, våldsutsatthet och sexuella riskbeteenden. 96 sorterades bort, 188 deskriptiva statistiska analyser utfördes i statistikprogrammet Jamovi 2.4.8.0., med uppdelning i ungdomar och unga vuxna samt jämförelser mellan våldsutsatthet, sexuellt risktagande, ålder och kön.   Resultat: En hög andel ungdomar och unga vuxna rapporterade utsatthet för fysiskt, psykiskt och sexuellt våld. Fler kvinnor uppger att de blev pressade till sex (kvinnor 22%, män 3%). Mer än en tredjedel (34%) av kvinnor rapporterade utsatthet för psykiskt våld och motsvarande siffra för män är 38%. Unga vuxna män angav att de oftare har blivit utsatt för fysiskt våld jämfört med unga vuxna kvinnor (p=0.018). Mer än hälften av kvinnor (60%), rapporterade att de hade utsatts för oönskade handlingar mot sin vilja. 15% använde sex som en strategi för att hantera känslomässiga svårigheter eller en form av självskada.  Konklusion: En betydande andel ungdomar rapporterade att de utsatts för psykiskt, fysiskt och sexuellt våld, och de tar stora sexuella risker. Tillgängliga ungdomsmottagningar är väsentligt för deras hälsa. / Background: Adolescence is a crucial period for youth. Youth exposure to violence is a public health issue globally and nationally. Midwives at youth clinics adress topics such as relationships, lifestyle and sexual behaviour. Västra Götaland Region has developed SEXIT, method to identify youth’s sexual risks and experiences of violence.  Motive: Adolescents' sexual and reproductive health needs to be improved and their rights strengthened. By mapping young people's sexual behavior and experiences of violence, we can see what risks they expose themselves to or expose others to.  Aim: to map adolescens´ sexual behavior and their exposure to violence through SEXIT and to explore potential differenses between age and gender.  Method: Survey with 284 youths at a youth clinic in Norrland during 2022, responding to the SEXIT questionnaire containing background questions,exposure to violence, and sexual risk behaviors. 96 were excluded, and 188 analyses were conducted using the statsistical software Jamovi 2.4.8.0, categorized by youths and young adults, including comparisions between exposure to violence, sexual risk-taking, age and gender.   Results: A high proportion of adolescents and young adults reported exposure to physical, psychological and sexual violence. More women state that they are pressured into sex (women 22%, men 3%). Over a third(34%) of women report exposure to psychological violence, corresponting to men who report 38%. Young adult men indicated that they have often been exposed to physical violence compared to young adult women (p=0.018)  More than half of women reported experiencing unwanted actions against their will. 15% used sex as a strategy to cope with emotional difficulties or as a form of self-harm.   Conclusion: A significant proportion of youths report exposure to psychological, physical and sexual violence, and they take substantial sexual risks. Accessible youth clinics are crucial for their health.