FIELD REPORTS ON SEXUAL BEHAVIOUR OF PERI URBAN AND RURAL YOUTHS
AND UNIVERSAL ACCESS TO HIV/AIDS PREVENTION,TREATMENT, CARE AND SUPPORT.
Mr Sam Ajufoh
Action For Community Development
The purpose of this research paper is to share our findings from research and implementation of the programme Improving Reproductive Health in Nigeria.IRHIN project in partnership with the Society For Family Health (SFH) and USAID.
Interestingly over 70 percent of the people we reached out to were youths of reproductive age and our findings would no doubt shed more light and provide useful information that would help to redirect policy and also improve the development of of rural and peri urban youth focused instruction, education and communication (i.e.c) materials.
It will also expose the fears, myths, and misconceptions about sexual and reproductive health of peri urban and rural youths as we see again the need to ensure that rural and peri urban youths are properly educated about sexual and reproductive health, HIV/AIDS.
Myths and misconceptions about sexual and reproductive health by rural and peri urban youths,low level of knowledge about sexual and reproductive health , HIV/AIDS,Unwillingness on the side of the youths to discuss reproductive health and sex. Wrong societal perception on young women who are looking for ways to promote their reproductive health and be able to negotiate safe sex,.very low prevalence level of male and female condoms and other reproductive health products. Lack of skill and know how on reproductive health counseling on the side of health care providers.
Young Adults and Adolescents in Edo State
Statistics from the National Population Commission projected from the 2006 census, indicate that young adults aged 10-24 years, constitute 32.9% of the population of Edo
state. Thus, it is estimated that there are currently about 823,567 young adults in the state. Of these, 410,689 (16.4%) are males, while 412,878 (16.5%) are females, giving a
male: female ratio of nearly 1:1
With close to 90 percent of inhabitants of the state as Christians, marriage in adolescent is less common compared to the northern part of the country with predominantly Muslims. With the unfortunate rise in the cost of marriages orchestrated by
strange societal inclinations towards expensive high society weddings, And the usual norm of conducting traditional and christian wedding by would be couples,sexual experience among unmarried young men and women is becoming more prevalent. As a result of this fact youths especially those in rural communities are greatly exposed to risky sexual behaviours, unwanted pregnancies and sexually transmitted infections.
When we started our bi weekly peer education sessions over 80 percent of the young men who attended including those who were married had multiple sex partners. More than 90 percent of unmarried young girls from 21-24 who attended also had multiple sex partners. Although all the young married women who attended the sessions all professed to being faithful to their husbands, some of them said they were aware that their husbands had other sexual partners apart from them. In the course of our interactions and organizing more peer sessions, it was discovered that many of them were not officially married to their husbands but were live in lovers who started to have children in the process.
Among the semi literate and peri urban youths, HIV was not taken seriously. Many said disease nor dey kill African man. While others said that they only use condoms when they are having sex with a lady that is not their permanent girlfriend, but with their permanent girlfriend they do not.
When asked if they knew the girlfriends HIV status he was dumb founded. This was the state of the peri urban and rural youths in Evbuotubu when we started initially. Most of the people who had casual sex did not use condoms and even when they did, they lacked knowledge about the proper insertion of the condoms. And for all of them they saw the female condom for the first time when we showed it to them.
However after the first three months we began to experience some degree of behaviour change.
Here is an excerpt from our March 2010 report:
A man who attended one of our peer session told us that he has multiple sex partner since he was enlightened on female condom he has since been using it the found very pleasurable and that he usually fixed it for his partners.
A respondent at our peer session who told us that he has ten(10) girl-friends and prefer skin to skin(no form of protection) he was educated about HIV/AIDS, STIS. He was later taught how to insert the female condom using the female model and he was also taught how to correctly use the male condom to avoid. It getting burst. Since then he stuck to the female condom saying that it is very good and it is like skin to skin.
1. Increase number of peers attending peer session from 85 in December to 224 peers as at this month.
2. Increase in acceptance and use of female condom by peers, community members and PPMV stores in Evbuotubu community.(7 cartons was sold in January,10 cartons in February and 13 cartons in March making Thirty (30) cartons of female condom since January 2010.
3.Expansion of fp products and methods in the community by incorporating other FP products in to the IRHIN project through the sales to PPMV and clinics in the community. See break down below.
Another key observation we got from the field was when we mobilized private patent medicine vendors for a training we organized in March 2010 in from okhokhugbo community ( a rural community after Evbuotubu.
1.The first glaring observation was the fact that the more we moved into the interior the fewer Private patent medicine vendors (chemists) we saw. There were even some that did not stock male condom. When we asked why, they claimed it was a temporal stock-out and that they would re stock when next they visit town.
The fact that people in rural communities need to travel several kilometers to get access to PPMVs (chemists) and condoms further exposes them to risky sexual behaviours. As far as rural youths are concerned we have not realized the theme for the World AIDS day for 2010 which was Universal Access to prevention treatment care and support. For them it is highly recommended that they theme for 2010 should continue to run along side future themes until it is realized in all the rural communities in Nigeria and indeed the world.
Also, many communities are still faced with cultural limitations to access which hinders women from accessing the necessary products that would empower them to negotiate for safe sex. In most communities(both urban and rural) women who patronize PPMVs to buy male or female condoms are stigmatized and seen as ashewo (prostitutes). This situation coupled with the absence of youth friendly sexual and reproductive health centres has increased the level of risky sexual behaviours among youths in both urban, per urban and rural communities. Young married women due to their poor financial status, also find it difficult to negotiate for safe sex even when they know that their husbands have multiple sex partners.
Although we recorded a lot of cases of women who were able to use the female condom with their husbands, we however observed that the success was due to curiosity and where it was clear that the woman was aware that her husband had other sex partners and as such wanted to protect herself from sexually transmitted infections,The women who succeeded were mostly women who had economic power.
Thus we see that poverty is another factor that exposes young people to unsafe sex.
Some Myths and misconceptions:1. That salt water can prevent pregnancy, That eritromycin and ampiclox prevents pregnancy. Some said they drink Krest bitter lemon immediately after sex. Some said that the ring (charm) they put on helps them to prevent pregnancy.
These were from direct interview from people in Evbuotubu community. A peri urban community in Benin City. If people in Benin City hold this views about sex,one can only imagine how it would look like in rural communities.
Approach/Sources of Data and information
Baseline surveys, direct administering of interviews and questionnaires to discover myths and misconceptions,special behaviour change communication peer education sessions,Inter personal communication sessions, mapping of the communities,assessment of male and female condoms , and other reproductive health products prevalence level , current sexual behaviours among rural and peri urban youths ,Project Monthly reports,
Problem solving techniques/skills deployed and success stories recorded.
Breaking the silence/communication barriers. Our Strategy and success stories, Winning the support of community heads, and gate keepers, communicating effectively to the youths . Developing and building the capacity of health care providers for more effective work. In the implementation of Improving Reproductive Health in Nigeria (IRHIN) Project.From October 2009- october 2010.
We can achieve the right sexual behavioural for rural and peri urban youths with consistent and competent peer education and training of PPMVs and health care providers in the community to be more youth friendly and sensitive, strong committed and highly knowledgeable leadership and team that is on ground to provide regular psycho social support and encouragement. Need for greater commitment on the side of government to promote the sexual health of youths especially rural and peri urban youths. By ensuring that their sexual and reproductive health needs are catered for in government health centres and also by establishing youth friendly sexual and reproductive health centres. There is also the need for government, community leaders, parents and NGOs to work to win the friendship and trust of youths in order to break the silence. For the friendly and down to earth approach which we employed greatly contributed towards the successes we recorded.
In my final words I would like to say that for us to increase our chances of victory in the fight against HIV and all other STIs,the change from risky sexual behaviour to the right behaviour by urban, peri urban and rural youths is imperative and possible.
Thank you very much.