Determinants of unsafe sex behaviour among the youth in relation to HIV/AIDS prevention in Lusaka Urban Basic Schools

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Sakuwaha, Adam C
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Objective : To determine the factors associated with unsafe sexual behaviour among the youth aged 13 to 19 years, in the prevention of HIV/AIDS in Lusaka Urban. Study Design: A cross section and comparative study design was carried out in 22 basic schools in Lusaka Urban among the youth attending grades 7,8 and 9. Setting: The study was carried out in Lusaka Urban, which has the highest HIV/AIDS prevalence rate of 22% in Zambia. Lusaka is the capital city of Zambia and has a population of 1, 084,703 with the youth below 19 years of more than 50%of the population The city of Lusaka is a trading centre for goods from the East and Southern African which is part of the sub-Sahara region that has the highest HIV/AIDS prevalence in the world. Subjects: The study focused on the youth who are the future leaders and yet affected by the great HIV/AIDS epidemic. A total sample size of 319 youth (160 males and 159 females) aged 13 to 19 years in Grades 7,8and 9 selected from a line list of 25093 youth by using EPI 6 statistical calculator the study sample was selected. The subject from different schools were proportionately and conveniently selected and involved in the study. Main outcome measures: In this study unsafe sexual behaviour was used as the main outcome. The youth that were sexually active at the time of conducting the research were assumed to be involved in unsafe sexual behaviour as well as the group of youth that did not use condoms during the last sexual intercourse. Results: Social demographic factors- More males than females require assistance on safer sex methods and that more males than females were involved in premarital sex (P=<0.001), the youth aged 15 years and above were significantly more involved in premarital sex than the youth below the age of 14 years (P=<0.001) Education- There was a significant increase on premarital sex as the youth progressed from 7 to grade 9(P=<0.001). Religion- The youths belonging to Catholic church were significantly more involved in premarital sex as compared to the youth from other churches (P=0.058). Residence-The youth residing in Lusaka central Kanyama and Munali constituencies were more involved in premarital sex than the youth from other constituencies of Lusaka urban (P=<0.001).Types of guardian-The youths kept by mothers only were found to be significantly more involved in premarital sex than the youth kept by both parents (P=<0.001). From the focus group discussion it was found that most parents did not discuss HIV/AIDS and safer sex with their children. Financial support- The youth that received adequate financial support were significantly more involved in premarital sex than the youth that did not receive enough financial support (P=0.05). Knowledge factors: Perceived risk- The youth who were at higher risk of contracting HIV AIDS were found to be more involved in premarital sex than the youth who did not know that they were at risk of contracting HIV/AIDS (P=0.005). Knowledge about HIV/AIDS- More condom users than non-users knew that HIV/AIDS could be cured (P=0.034). Safer sex- More males preferred masturbation than females (P=<0.001). Most male youths did not like condoms because they were big and described them as "eating a banana with its peel". Cultural factors- Significantly more users of sexual herbs were sexually active than non users (P=<0.001). Significantly more condom users than non-condom users were exposed to traditional initiation ceremonies (P=0.032). Source of information-The majority of the youth got information about safer sex from media as compared to health institutions. Conclusion: most factors under social demographic knowledge and culture were significantly associated with unsafe sexual behaviour among the youth. Recommendation: In accordance with the findings it is therefore recommended that Ministries of Education and Health should collaborate effectively and utilise the identified factors to mitigate the HIV/AIDS epidemic among the youth through education and material support. Lastly a countrywide study should be conducted to determine the sexual behaviour of the youth in schools and develop strategies to reduce HIV/AIDS epidemic in Zambia.
Youth -- Conduct of life , Youth -- Sexual behavior , Sexual behaviour surveys -- Lusaka