HEALTHCARE SEEKING BEHAVIOUR AMONG YOUTH WITH SEXUALLY TRANSMITTED INFECTIONS IN NIGERIA

Abstract

In Nigeria and other developing countries, STls and their sequelae are ranked among the top five reasons for adults to seek health care. Despite these, there has been a disproportionate neglect on STis as most research focus is on HIV/AIDS. Also, more is yet to be explored on behaviour of youth towards seeking care especially on problems like STis that are often stigmatized. This study aimed to assess the healthcare seeking behaviour and associated factors among youth with STI in Nigeria. Data from 10,091 respondents aged 15-24 years were extracted from the 2012 National HIV/AIDS and Reproductive Health Survey (NARHS) consisting of 648 who self reported having at least one STI symptoms and 347 who had sought advice or treatment for their STis. The NARHS was a household survey with a cross-sectional design conducted in all the 36 states of Nigeria and the Federal Capital Territory (FCT). Variables on socio-demographics, lifestyle, sexual behaviour, condom use, media exposure, STI knowledge, self reported STI and health seeking behaviour of youths aged 15-24 years were extracted from the survey data. Associations between variables were tested using chi square tests and multiple logistic regression to determine factors associated with STis and healthcare seeking behaviour among youth with STis. Level of significance for all tests was at 5%. Overall mean age of the respondents was 19.1 years (SD=2. 7). A larger percentage were females (55.3%). Prevalence of at least one symptom of STI was 6.4%. By gender, 8.1 % females and 4.3% males were found. Overall knowledge of STI symptoms was low. For the reported STI symptoms, prevalence of genital itching was highest (4.3%), followed by genital discharge (3.3%), genital rash (1.7%) and genital sore/ulcer (1.3%). Variables which remained significantly associated with self reported STI in multiple logistic regression included being female (OR=2.65, 95% CI=2.01-3.50); Christianity (OR= 1.43, 9 5% CI=1.03- 1.96); North Central zone (OR=4.38, 95% Cl:a= 2.72-7.05); more than one sexual partnership (OR=1.76, 95% CI=1.31- 2.37); condom use at last sexual act (OR=0.69, CI=0.50-0.94); high STI knowledge (OR=0.69, 95% C.I= 0.53- 0.89). More than half (5 3.5%) of youth who self reported STI symptoms sought STI treatment, females (54.1 %) and males (52. 3%). Most reported source of seeking STI treatment was government clinic/hospital (17.l %) from which greater percentage of females (18.9%) than males ( 13.0%) sought STI treatment. Variables which remained significantly associated with seeking STI treatment in multiple logistic regression included having secondary school education or higher (OR=2.41. 95% CI=1.05-5.51); high STI knowledge (OR=4.41, 95% CI=2.44-7.96); alcohol use (OR=2.23, 95% C.I= 1.25-4. 33). STI prevalence and health care seeking for STI symptoms was higher in females than males. While more males had sought treatment from traditional healers, females preferred government hospitals/clinics. STI control programs should be improved generally among young people in Nigeria and should be targeted differently to males and females for optimum effectiveness.