Objective: The high prevalence of sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) among Nigerian young people has been linked to poor knowledge, attitudes and risk behaviour. This study evaluated the effectiveness of a sexuality education programme (SEP) in improving adolescents’ STI/HIV knowledge and attitudes and reducing risk behaviour. Design: A quasi-experimental pre–post study was conducted. The experimental group ( n = 189) and comparison group ( n = 195) comprised senior secondary school students. Data were collected via a validated self-report questionnaire. A paired t-test, an independent t-test and a one-way between-group analysis of covariance (ANCOVA) were used to analyse the data. Setting: Three hundred eighty-four young people aged 15–20 years at low and high risk for STI/HIV infection participated in the SEP in a school setting in Northeast Nigeria. Results: There were significant post-intervention improvements in students’ knowledge, attitudes and practices in the experimental group ( p < .001). A t-test showed that after the SEP, the mean scores of STI/HIV knowledge (11.25 ± 3.39 vs 8.23 ± 3.60) and attitudes (29.63 ± 6.21 vs 35.38 ± 7.86) were significantly higher in the experimental group than that in the control group. Similarly, the mean risk behaviour score (6.83 ± 2.10 vs 5.64 ± 2.27) was higher in the experimental group than that in the control group post-intervention. Conclusion: The school-based SEP increases STI/HIV knowledge, improves positive attitudes and reduces STI/HIV risk behaviour among school young people in Nigeria.
Introduction: Breast cancer (BC) is a major public health problem among women. However, BC screening uptake is abysmally low among Nigerian women. This study evaluated the association of BC fear and perceived self-efficacy with BC screening (clinical breast exam [CBE] and mammography) among middle-aged Nigerian women. Methods: A community-based cross-sectional study was conducted among middle-aged women in Enugu State, southeast Nigeria. The data were collected between September 2019 and February 2020. The BC screening uptake, fear, and self-efficacy were assessed using the validated Breast Cancer Screening Questionnaire (BCSQ), Champion Breast Cancer Fear Scale (CBCFS), and Champion’s Mammography Self-Efficacy Scale (CMSES). Data were analyzed using frequencies and percentages, chi-square test, and univariate analysis of variance. Bivariate and multivariable logistic regression models were used to examine independent associations between selected sociodemographic factors, cancer fear, perceived self-efficacy, and BC screening. Results: The mean age of the participants was 55.3 years (SD: 5.75). More than half of the women (51%) reported having a BC screening in the past 12 months. However, only 12.5% and 16.9% reported having a CBE or mammogram in the past 12 months. The prevalence of a high, moderate, and low level of fear was 68%, 22.3%, and 9.8%, respectively. The prevalence of a high, moderate, and low self-efficacy level was 50.6%, 37.5%, and 12.0%, respectively. The multivariable logistics regression analysis showed that women aged 50-59 years and 60-64 years were 3.5 times (adjusted odds ratio [AOR] = 3.50, 95% confidence interval [CI]: 2.07-5.89, P < .0001), and 5.92 times (AOR = 5.92 95% CI: 2.63-13.35, P < .0001), respectively, more likely to perform mammogram than those aged 40-49 years. Women with a high level of self-efficacy were 2.68 times (AOR = 2.68, 95% CI: 1.15-6.26, P < .0001) more likely to use mammographic screening than those with low self-efficacy. Although not statistically significant, women with a moderate level of BC fear were 0.56 times less likely to use mammogram than women with a low level of BC fear. Conclusion: A low proportion of women underwent CBE or mammography. Women had a high level of BC fear and a moderate level of self-efficacy for BC screening. The findings emphasize the need for health educational and psychosocial interventions that improve self-efficacy and promote regular BC screening among middle-aged women.
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