Is Women's Tendency to Negotiate Safer Sex Another Opportunity for Intimate Partner Violence in Nigeria?

Husband's controlling and domineering attitudes have been shown to contribute to women's intimate partner violence experience in Nigeria. Some scholars have suggested that women's safer sex negotiation may create additional opportunity for incurring partner violence. The purpose of the current study was to test the possibility that married women's tendency to negotiate safer sex would contribute significant additional proportions of the variance in their experience of physical, sexual, and emotional violence. Using nationally representative data from a sample of married women in Nigeria (N = 19,360), three separate hierarchical regression analyses were performed to examine the contributions of husband's controlling and domineering attitudes and tendency to negotiate safer sex to the three types of violence experience. Regression analyses revealed that women whose husbands endorsed more controlling and domineering attitudes experienced more physical, sexual, and emotional violence. Furthermore, women with higher tendency to negotiate safer sex experienced more of all the forms of violence. After accounting for the influence of husband's controlling and domineering attitudes, regression analyses revealed that women's tendency to negotiate safer sex accounted for significant additional contributions of the variance in physical, sexual, and emotional violence experience. The additional contributions suggest that specific interventions may be needed for improving women's negotiation skills to reduce husband perpetrated violence risk.

Moderating Effect of Husband's Controlling Attitudes on the Relation Between Women's Household Decision-Making Autonomy and Intimate Partner Violence Experience in Nigeria.

Existing studies show a consensus on the importance of women's household decision-making autonomy. However, the studies also show mixed findings of the association between the variable and intimate partner violence (IPV). In this study, moderating effects of husband's controlling and domineering attitudes on the association between women's household decision-making autonomy and husband-perpetrated physical, sexual, and emotional violence were investigated. Data used in the study were drawn from an existing database of a 2013 cross-sectional Demographic and Health Survey (DHS) of nationally representative sample (N = 19,360) of Nigerian married women. Participants were interviewed on measures of women's autonomy, husband's attitudes, and husband-perpetrated violence. Results revealed that women who exercised high household decision-making autonomy significantly experienced more physical (b = .31, t = 11.78, p < .001), sexual (b = .05, t = 3.59, p < .01), and emotional (b = .17, t = 9.76, p < .001) violence if they reported relationship with husbands who endorsed high controlling and domineering attitudes. The results represent an extension over existing research and have implications on how husband's attitudes could improve women's autonomy and reduce their IPV experience in various intervention settings.

Mobile phone use for a social strategy to improve antiretroviral refill experience at a low-resource HIV clinic: patient responses from Nigeria.

In sub-Saharan African areas where antiretroviral (ARV) drugs are not available through community pharmacies, clinic-based pharmacies are often the primary source of ARV drug refills. Social pressure is mounting on treatment providers to adjust ARV refill services towards user-friendly approaches which prioritize patients' convenience and engage their resourcefulness. By this demand, patients may be signalling dissatisfaction with the current provider-led model of monthly visits to facility-based pharmacies for ARV refill. Mobile phones are increasingly popular in sub-Saharan Africa, and have been used to support ARV treatment goals in this setting. A patient-centred response to on-going social pressure requires treatment providers to view ARV refill activities through the eyes of patients who are negotiating the challenges of day-to-day life while contemplating their next refill appointment. Using focus groups of five categories of adult patients receiving combination ARV therapy, we conducted this cross-sectional qualitative study to provide insight into modifiable gaps between patients' expectations and experiences of the use of mobile phones in facility-based ARV refill service at a public HIV clinic in Nigeria. A notable finding was patients' preference for harnessing informal social support (through intermediaries with mobile phones) to maintain adherence to ARV refill appointments when they could not present in person. This evolving social support strategy also has the potential to enhance defaulter tracking. Our study findings may inform the development of ARV refill strategies and the design of future qualitative studies on client-provider communication by mobile phones in under-resourced HIV treatment programmes.

Predictors of condom use among sexually active persons involved in compulsory national service in Ibadan, Nigeria.

Migration is known to increase the risk of heterosexual transmission of human immunodeficiency virus (HIV) in sub-Saharan Africa, but little attention has been paid to fresh graduates of tertiary institutions who are on migration for compulsory national assignment in Nigeria. In July and August 2004, a survey was conducted on sexually active men (n = 344) and women (n = 373) to investigate determinants of condom use during national service. Sixty-eight percent of men and 41% of women reported condom use at last intercourse before the survey. For both men and women, condom use was common if they had one or more regular sex partners and if they were purchasing condoms. In addition, women's condom use was predicted by being single and having intention to use condoms in next intercourse. The findings further showed that there was high risk of HIV transmission in the sample population as consistent condom use was 15% for men and 4% for women. Twelve percent of men and 8% of women reported STI diagnoses in the last 12 months before the survey. Four percent of men and 2% of women reported they already had HIV diagnoses. Only 1% of men and 2% of women reported they would receive voluntary HIV test if offered free by the government. The study findings suggest the need to extend the existing condom social marketing services in the country to the youth on national service and promote condom education messages among them prior to commencing national service.

Reproductive knowledge, sexual behaviour and contraceptive use among adolescents in Niger State of Nigeria.

Eight hundred and ninety six adolescents aged 11-25 years were recruited into this study using a multi-stage random sampling method. Overall, about 33% of them had already had first sexual experience but more males than females reported having experienced first sexual encounter. Only 3.6% of the respondents were married. One half of the sexually experienced adolescents had more than one sexual partner at the time of the study. Majority of the respondents (91.9%) had heard about HIV/AIDS and at least a STD. A wide disparity was found in knowledge and use of the contraceptive methods studied, ranging from 41.9% to 63.8% for knowledge and from 0.7% to 12.5% for use. Knowledge and use of condom was highest. For prevention of HIV/AIDS, more males than females thought condom was useful. More Gwari and Hausa respondents claimed that they did not use any family planning method during their first sexual relationship than Yoruba and Igbo respondents. There is need for reproductive health programmes to intensify efforts towards improving adolescents' attitudes to risky sexual behaviours and motivate them to undertake behaviours that would limit such risks.

Reproductive, sexual and contraceptive behaviour of adolescents in Niger State, Nigeria.

This is a multi-stage random sampling study involving 896 male and female adolescents aged 11-25 years in Niger State of Nigeria. Thirty three per cent of them had already had first sexual experience. Only 3.6% were married. Most of the Gwari and Hausa respondents acknowledged that they married at an earlier age than the Yoruba respondents. One half of those who were sexually experienced had more than one sexual partner. Majority of the respondents were informed about HIV/AIDS and STDs. More Gwari and Hausa respondents felt that HIV infection could be prevented by not having multiple sexual partners than Yoruba and Igbo respondents. A wide disparity between contraceptive knowledge and use was found. Knowledge rate was between 41.9% and 63.8%, while use rate was between 0.7% and 12.5% for the contraceptive methods studied. Condom knowledge and use rate was highest. For prevention of HIV/AIDS, more males than females thought condom was useful. Most Gwari and Hausa respondents did not use any FP method during their first sexual relationships. It is imperative for reproductive health programmes to intensify efforts in improving adolescents' attitude towards sexual risk and motivate them to exhibit behaviours that limit it.