HIV/STIs health-seeking behaviour among in- and out-of-school urban male adolescents in the Bolgatanga Municipality of Upper East Region, Ghana

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The adolescent period is marked by the emergence of sexual behaviours that may lead to sexually transmitted infections (STIs), including HIV/AIDS and their attendant consequences. Studies conducted across the globe indicate that majority of young people are sexually experienced by the age of 20, and premarital sex is not uncommon among 15-19 year-olds. This partly explains why the control of sexually transmitted infections among adolescents has been recognized as a major concern globally, especially with the onset of the HIV/AIDS pandemic in the 1980s. Regrettably, little is documented on Male adolescents’ HIV/STIs health-seeking behaviour in Ghana to inform policy and programme decisions within specific socio-cultural context. The main objective of the study was to examine and compare the health-seeking behaviour for HIV/STIs among in- and out-of-school adolescents (16-20 years) in urban Bolgatanga Municipality with a view to improving Adolescent Reproductive Health (ARH). A descriptive current cross sectional study that sought to compare the HIV/STIs health-seeking behaviour among in-school and out-of-school urban male adolescents (16-20 years) was used. The study adopted a quantitative method of data collection, using a structured interviewer questionnaire. The study was conducted in three second cycle schools and among selected artisanal training workshops in Bolgatanga, the Upper East Regional capital. A sample of 205 (115 in-school and 90 out-of- school adolescents were selected using multi-stage sampling method. Survey data was entered using Epi Info 6, exported to Excel for cleaning and merging, and analyzed using the Statistical Package for the Social Sciences (SPSS - 11) and STATA 7. Chi-square p-values derived from bivariate cross analysis were used to compare selected exposure variables with the outcome variables. The results indicate that respondents have a high knowledge (100% for students versus 97% for apprentices) of HIV/AIDS, but knew little about other specific STIs. There was, however, no difference in ability to recognize correct symptoms of STIs between the two adolescent groups. In-school adolescents were less likely to have initiated sexual intercourse, compared with their out-of-school counterparts. Almost half (46%) of out-of-school adolescents were sexually active as compared with participants in school (22%). Generally, there was high use of condoms among sexually active adolescents in both groups [currently using condoms: in school 17/26 (65%), out of school 34/41 (83%)]. Majority of respondents in both groups also wanted to be screened and tested for HIV/STIs [in-school (97%), out of school (5 7%)]. Ever had sexual intercourse was strongly associated with having received screening and testing for HIV/AIDS/STIs among out-of-school respondents (p<0.0l), compared with students. There was no significant difference between in-school (3 6%) and out-of-school (33%), with regard to their risk perception for HIV/AIDS/STIs infection, in-school adolescents had better knowledge of the causes of STIs than their out-of-school counterparts. Out-of-school adolescents more frequently practiced risky sexual behaviours that could lead to acquisition of HIV/STIs than in-school adolescents (22.6% of sexually active students versus 46% of sexually active apprentices). More students were willing to undergo VCT (77%), compared with their out-of-school counterparts (57%). There is the need for comprehensive adolescent friendly services where counseling, education and treatment of STIs are provided in the Municipality, targeting especially the out of school youth. Schools could also be good entry points where health workers can make reproductive health services more accessible and friendly to students.
A Dissertation submitted to the School of Graduate Studies, Kwame Nkrumah University of Science And Technology, in partial fulfilment of the requirements for the degree of Master Of Science in Population and Reproductive Health