Behavioural risk factors for sexually transmitted infections and health seeking behaviour of street youths in Ibadan, Nigeria

Children in street situations' access to healthcare: qualitative findings from the Street Child World Cup 2022

BACKGROUND

Children in street situations (those who live or work on the street) are known to face barriers in accessing healthcare.

METHODS

The study combined a remote survey with 33 adult non-governmental organisation (NGO) staff members, in-depth interviews with staff members of 11 NGOs and 4 formerly street-connected adult young leaders and a questionnaire with 30 street-connected children from 15 countries participating in the Street Child World Cup event in Qatar in 2022. Data were analysed using thematic analysis.

RESULTS

The participating children have strong connections with supportive organisations and do tend to seek adult assistance when they are ill or injured, refuting the assertion of adult participants and the literature that children in street situations only seek healthcare in emergencies. Some barriers that children in street situations face when seeking healthcare are likely shared by other disadvantaged groups, including the cost of care, long waiting times, the quality of public healthcare and discrimination based on socioeconomic status. Children in street situations may face further discrimination based on assumptions about their lives, their appearance or hygiene levels. Identity documents are highlighted in the literature as a major barrier but seemed less important to the participants. Both adult and child participants emphasised the need for an accompanying adult to find appropriate services and be treated.

CONCLUSIONS

This study highlights the important work of organisations supporting street-connected children to access healthcare both during and after their time working or living on the street. It concludes that while some of the barriers to accessing healthcare that children in street situations face are not specific to this group, the absence of an adult caregiver differentiates many street-connected children from other disadvantaged groups. This also signals differences among children in street situations, with those with connections to family or organisations having more support.

Health-seeking behaviours of young women with sexually transmitted infections: Analysis of the 2014 Ghana Demographic and Health Survey

BACKGROUND

Young people are at a disproportionately higher risk for sexually transmitted infections (STIs) due to biological factors, low awareness and limited access to sexual and reproductive health information and services. Untreated STIs can lead to major complications, including HIV, congenital infections, infertility, permanent disability and mortality. This study aimed to identify the salient factors associated with health-seeking behaviours of young women with a history of STIs in Ghana.

METHODS

We analysed data from the 2014 Ghana Demographic and Health Survey. In all, we analysed data from a weighted sample of 742 young women with a history of STIs. At the univariate level, frequencies and percentages were computed, while Chi-square analysis was computed at the bivariate level. Both crude and adjusted odds ratios were computed at the multivariable level using binary logistic regression.

RESULTS

The findings showed that the majority (72%) of the participants sought treatment for STIs. Among the participants who sought treatment for STIs (n = 532), 26% sought treatment at a public hospital/polyclinic, 34% sought treatment at a chemical/drug store and 10% self-medicated. Seeking treatment for STIs was significantly associated with older age (20-24yrs), and higher socioeconomic and educational status.

CONCLUSION

This study demonstrated that majority of the young women sought treatment for STIs. Seeking treatment for STIs was influenced by socio-demographic factors. These findings have implications for sexual and reproductive health policies and interventions in Ghana.

Street youths: reproductive health risk status, reproductive health challenges and barriers to health services utilization in a southwestern City, Nigeria

Background Information

According to the United Nations, about 150 million youth spent most of their time on the street, or better still, homeless. This is becoming a global phenomenon and majority of this vulnerable people live in large cities and urban areas of developing countries. Street youths are among the high risk, insecure and vulnerable groups who are often exposedto various forms of abuses and diseases, including reproductive health issues.

Methodology

A descriptive cross sectional study carried out among street youths in Ikorodu Local Government, Lagos State using a multi staged sampling technique. Frequency tables were drawn at the univariate level, chi squared was used to test for association between socio-demographic characteristics and sexual risk level. Data was analyzed using SPPSS version 22, p value was set at 0.05.

Results

Almost half 48(48.5%) of the respondents were between the age range 20-24years and two third 61(61.6%) of them were female and 27(27.3%) had up to senior secondary education attainments. Majority 73(73.7%) of them have been on the street for more than 3months and 32 (32.3%) professed that the reason they were on the street was to search for job while 25 (25.3%) because of family disharmony among parents. Eighty six (86.9%) of the respondents were sexually active, 31 (36.0%) of which have more than four sexual partners. Duration of stay on the street and their educational status were determinants of risky sexual behavior and polygamous setting was found to be statistically significant(p value =0.035) with reproductive health challenges.

Conclusion

There is high risk sexual practice among street youths in Ikorodu Local Government. Strategic interventions aimed at minimizing sexual risky behaviors among street youths should focus on reducing the duration of stay on the street as well as increasing access to contraception.

Instrument validity: HIV and other sexually transmitted infections in homeless people

ABSTRACT Objectives: to validate, through the Item Response Theory, an instrument on vulnerability to HIV and other sexually transmitted infections in homeless people. Methods: a cross-sectional study carried out between February and May 2018 with 100 homeless people in a municipality in northeastern Brazil. A sociodemographic questionnaire was applied, and another with items referring to behaviors vulnerable to HIV and sexually transmitted infections (STIs). Subsequently, it was assessed through the Item Response Theory. Results: the items previous diagnosis of STIs (F=0.473), partner with STI symptoms (F=0.518), drug use (F=0.509), sex for money (F=0.552), STI symptoms (F=0.448), number of sexual partners (F=0.616), sharps sharing (F=0.398) and being a victim of sexual violence (F=0.347) were validated. Conclusions: the instrument proved to be validated, being able to identify vulnerability to HIV and other sexually transmitted infections in homeless people.

An assessment of nursing mothers' and young people's access to proprietary and patent medicine vendors' services in rural communities of south-eastern Nigeria: implication for review of national drug policy

Background

Patent and proprietary medicine vendors (PPMVs) form part of the informal healthcare system and are the first point of call for 75% of Nigerians who live in rural and underserved areas where there is limited access to healthcare services. This group of healthcare providers are located close to communities and are easily accessible to the people. This study seeks to determine how PPMVs influence access to medicines among nursing mothers and young people and how this progresses South Eastern Nigeria towards universal health coverage.

Methods

A cross-sectional descriptive study was conducted using a purposive sampling technique. Two slightly different pre-tested and validated 5-point Likert scale questionnaires were used to survey the nursing mothers and young people (18–20 years old). The questionnaire for nursing mothers assessed the perception regarding PPMV services and community access to medicines used for the treatment of childhood infections. The questionnaire for young people assessed the services rendered by the PPMVs including family planning, and major enablers/barriers towards to access to medicine.

Results

A total of 159 nursing mothers and 148 youths participated in the study. Up to 60% of both population had a minimum of secondary school qualification. About 90% of the nursing mothers were married and 88% were nursing babies from 1 to 12 months. Results show that the PPMVs were the first point of call for healthcare needs among the respondents and they are easily accessible and sell affordable medicines. The nursing mothers frequently treat their children’s cough with antibiotics with a mean rating (MNR) of 4.7 out of 5 points and most source these antibiotics from PPMV shops. Up to 90% of the nursing mothers reported that the children got well after the treatment. The drugs mostly purchased by the youths from the PPMVs included antimalarials (95%), analgesics (87.7%) and antibiotics (81.3%). Only 25.5% of the respondents purchased family planning commodities. Most of the respondents sought health care from PPMVs with a MNR of 3.4. Patronage of PPMVs for and usage of family planning products by the respondents had MNRs ranging from 1.4 to 1.8.

Conclusion

PPMVs are bridging the gap in healthcare delivery in the rural and underserved areas. Training of this group of practitioners and appropriate monitoring will go a long way in ensuring that the services they render are efficient, effective and improve the health indices in a low-income setting.

Exploring barriers to sexual transmitted infections (STIs) and HIV testing among young black sub-Sahara African (BSSA) communities in diaspora, UK

Purpose

Sexual transmitted infections (STIs) are associated with high stigma leading to poor sexual health-seeking behaviour and mental health problems. Although human immunodeficiency virus (HIV) prevention has generally been successful in many communities across the world, statistics for young people have remained relatively low, especially among most affected communities such as the black sub-Sahara African (BSSA) communities. This paper aims to explore the barriers to STIs and HIV testing among young BSSA communities living in the UK.

Design/methodology/approach

The research study used an explorative qualitative approach. The study included 6 focus groups comprising 10 people each (N = 60), and 12 one-to-one follow-up interviews were held with the research participants. Two one-to-one follow-up interviews were held from each focus group (N = 12).

Findings

The study found that perceived risk taking, perceived HIV test embarrassment, sexual health professionals’ attitudes, perceived HIV as death sentence, limited educational awareness and general HIV stigma prevented research participants from testing and impacted on their mental health well-being.

Originality/value

There is a need to increase sexual health and mental health education awareness among young BSSA communities. More importantly culturally sensitive interventions to reduce the impact of HIV stigma need to be rolled out in different diverse communities. This study is the first of its kind to look at the barriers affecting young BSSA communities in accessing sexual health testing services in the UK.