Relationship between Early Sexual Initiation and Reproductive Health among Undergraduates in Universities within Nairobi County
Abstract
Several studies in Sub-Saharan Africa have documented high and increasing premarital sexual activities among undergraduate students in universities. This exposes them to risks of unintended pregnancies, abortions, HIV and other sexually transmitted diseases. One of the SDGs is to reduce HIV/AIDs pandemic by the year 2030. In this context it is important to understand whether university students understand the consequences of engaging in premarital sex and the effects it has on their reproductive health. The main objective of this study was to determine the effects of premarital sexual behavior on the reproductive health of undergraduates in Nairobi County. Targeted universities were; Kenyatta, Moi, Mount Kenya, and Africa Nazarene University. Sample size was 324 students and included both male and female aged 18-24 years. The study adopted descriptive cross-sectional research design. Quantitatively, both open and closed ended questionnaires were used. FGDs and KIs were used for qualitative data. Stratified random technique was used to select the sample from the Universities Information management Unit. Statistical Package for Social Sciences (SPSS) version 20.0 was used to analyse data. Chi-Square tests was used to test for significance (P<0.05) and OR used to measure the exposure. Study found out that 63.6% of respondents had, and /or their partners contracted an STI following an unprotected sexual activity whereby only 63.5% were diagnosed by a healthcare provider. 66.7%) had several sexual partners ranging from 2-6 sexual partners. Mean SD age at sexual debut was at 15.9±2.67 years with a minimum and maximum age being 11 and 22 respectively. 115 of 169 female students had ever used a hormonal contraception with 62.6% having had exposure to emergency pills. Early sexual debut was a predictor to contracting STI at: OR=3.581, 95%CI (1.916-6.693), P<0.001. Respondents with one sexual exposure and with planned first sexual encounter were at lower risk OR=0.431, 95%CI (0.204-0.909), P=0.026 and OR 0.617(1.414-1.850), P=0.014 respectively. In conclusion, majority of respondents developed RH related complications following early sexual debt. Female youth are at a higher risk of developing STIs compared to their male counterparts. It is therefore recommended that institutional administrators, parents/guardians, the MOH, MOE and other key stakeholders provide access to condoms for students, provide reproductive health education and access to information, incorporate age appropriate sexuality education at primary school level and provide access to proper contraceptives in university infirmaries. The MOE and MOH must scale up the implementation of age-appropriate sexuality education framework as well as the ASRHR policy. Finally, it is imperative that the government increases the budgetary allocation for adolescent and youth programs to allow for efficient and effective implementation of youth programs.
Keywords: Sexual initiation, reproductive health, undergraduates, universities, Nairobi County
References
Adebayo, A.O. (1996). Some socio-economic and Environmental determinants of adolescent sexuality and interventions in the city of Nairobi. MA Thesis- PSRI- University of Nairobi.
Akvara, P.A, Nyovani J.M and Andrew H. (2003). Perception of risk of HIV/AIDS and Sexual behavior in Kenya. Journal of Biosocial Science 35 (3):385-411
Arjen, I and Fischbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice Hall.
Barbara S., Mensch Wesley, Clark, C., B. Lloyd and Annabel S. Erulkar. (2001). Premarital Sex, school-girls‟ pregnancy and school quality in rural Kenya. Studies in Family Planning 32(4): 285-301
Bauni, E.K and Jarabi, O.B. (2000). Family Planning and sexual behavior in the era of HIV/AIDS: The case of Nakuru District, Kenya. Studies in Family Planning 31(1): 69- 80.
Becker, M. H. (1974). The Health Belief Model and Personal Health Behavior. Health Education Monographs 44 (3): 236-473.
Bowden F J, Tabrizi SN, Garland SM, Fairley CK. (2010). Sexually transmitted infections: new diagnostic approaches and treatments. Medical Journal of Australia, 2002. 176(11): 551-557.
Bruce J. and Clark S. (2003). Including married adolescents in adolescent reproductive health and HIV/AIDS Policy‟ In UNFPA/WPIO/Population Council Technical consultation on married adolescents. Geneva. 9-12 Dec.
Carey, A.J. and Begley, K.W. (2010). Chlamydia trachomatis, a hidden epidemic: effects on Female reproduction and options for treatment. American Journal of Reproductive Immunology, 2010. 63(3): 576-586.
Chia SE, Ong CN, Chua LH, Ho LM, Tay SK (2000). Comparison of zinc concentrations in Blood and seminal plasma and the various sperm parameters between fertile and infertile men. Journal of Andrology 21(1): 53-57.
Delvaux T. and Nostlinger C. (2007). Reproductive choices for women and men living with HIV: Contraception, abortion and fertility.” Reproductive Health Matters, 2007. 15 (29 supplement): 46-66.
Fisher Jeffrey D, Stephen J.M. and William A. Fisher (1992). Impact of perceived social norms on adolescents‟ AIDS risk behavior and prevention. In Adolescents and AIDS.
FR Ochsendorf. (2008). sexually transmitted infections: impact on male fertility. Andrologia, 2008. 40(2): 72-75
H W G Baker, A Mijch, S Garland, S Crowe, D Edgar, G Clarke, P Foster, Blood J. (2003). Use of assisted reproductive technology to reduce the risk of transmission of HIV in discordant couples wishing to have their own.
children where the male partner is seropositive with an undetectable viral load. J Med Ethics 2003, 29: 315-320.
Katz, B., Fortenberry, D., and Orr, D. (1998). Factors affecting chlamydial persistence or recurrence one and three months after treatment. In Ninth International Symposium on Human Chlamydial Infections. 1998. Napa, CA: Berkeley University Press.
Mohammed Akibu, Fiseha Gebresillasie, Fitsum Zekarias, and Wintana Tsegaye (2017). Premarital Sexual Practice and its predictors among university students. The Pan African Medical Journal. 2017; 28 (1):1-11
National Centre in HIV Epidemiology and Clinical Research. (2009). HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia. Annual surveillance report, NCHECR, Editor 2009, The University of New South Wales: Sydney.
Pourhoseingholi MA, Vahedi M, Rahimzadeh M. (2013). Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench 2013; 6(1):14-17).
Ralph J. DiClemente (Ed). (1992). Sage Publications. Adolescents and AIDS: A Generation in Jeopardy.
V Akande, Turner C, Horner P, Horne A, Pacey A. (2010). Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for Practice. Human Fertility (Cambridge), 2010. 13(3): 115-125.
