1.1 Introduction
Sexually transmitted diseases (STDs) pose a significant public health challenge, particularly among youths who are at a higher risk due to various behavioral, social, and biological factors. Compliance with preventive measures, such as condom use, regular screening, and education on safe sexual practices, is crucial in mitigating the spread of STDs. According to CDC (2021), research indicates that enhancing youths' knowledge about STDs and preventive measures significantly improves compliance (CDC, 2021). Moreover, interventions that involve peer education and support have shown positive outcomes in promoting safe sexual behaviors (DiClemente et al., 2016). Accessibility to healthcare services, including affordable and confidential STD testing and treatment is also a critical determinant of compliance (Cohen et al., 2015).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
In the early 20th century, the recognition of STDs as a significant public health issue led to the establishment of the first STD prevention programs. However, these early efforts were often hampered by social stigma and a lack of comprehensive sexual education. It wasn't until the sexual revolution of the 1960s and 1970s that a more open discourse around sexual health began to emerge, paving the way for better awareness and educational efforts aimed at preventing STDs among young people (Brandt, 1985). Sexually transmitted diseases (STDs) remain a significant public health issue globally, with youths being disproportionately affected.
According to the World Health Organization (WHO), more than one million STDs are acquired every day worldwide, and a significant proportion of these infections occur among individuals aged 15-24 years (WHO, 2021). The high prevalence of STDs in this age group underscores the urgent need to understand and address the factors influencing their compliance with preventive measures.
Several studies have highlighted that youths are particularly vulnerable to STDs due to a combination of behavioral, social, and biological factors. Behaviors such as having multiple sexual partners, inconsistent condom use, and substance abuse increase the risk of STD transmission among this group (Kann et al., 2018). Social factors, including peer pressure, stigma associated with seeking STD-related services, and inadequate sexual health education, further exacerbate the risk (Sales et al., 2016).
Biologically, adolescents and young adults are more susceptible to STDs due to the anatomical and physiological characteristics of their reproductive systems. For example, the cervix of teenage girls and young women is not fully matured, making it more prone to infections (Hatcher et al., 2018). Additionally, hormonal changes during adolescence can influence the susceptibility and transmission dynamics of STDs.
Despite the availability of effective preventive measures, including condoms, vaccines, and regular screening, compliance among youths remains suboptimal. Barriers to compliance include lack of awareness, misconceptions about STD risks and prevention, limited access to healthcare services, and socio-cultural factors such as norms and beliefs about sexuality and health (Staras et al., 2015). Furthermore, the stigma and discrimination associated with STDs can deter youths from seeking information and services, thus hindering preventive efforts (Fortenberry et al., 2010).
Many of these diseases may have arisen in the content of modern social trends, perhaps the most frightened is the HIV and many disease unknown before the last eight decades of the twentieth century. This currently incurable virus has already infected more than 50% of the ordinary young adults population imparts of the Sub-Sahara Africa and is rapidly spreading. However, syphilis is potentially one of the most controllable disease (STIs) this unlike tuberculosis which is transmitted mostly by sexual intercourse. Even under these conditions, HIV is not nearly as transferable as some other STI e.g. hepatitis or gonorrhea. It is the cofactors of other STIs this largely explain the infectively and prevalence of HIV. The world bank estimated that STIs often easily treated, but if untreated principally, it affect the most economically productive section of the society young adult was the most effectives of the medical intervention. Anti-microbial treatment of some STIs is becoming problematic, some stain of gonorrhea are now resistant to all anti-biotic generally available in our countries.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to explore the factors influencing compliance with preventive measures of sexually transmitted diseases among youths.
1.3 Statement of Problems
Investigation revealed that the many youths lack adequate knowledge about STDs, their transmission, and preventive measures. Misconceptions and insufficient sexual education contribute to low compliance with preventive behaviors (Sales et al., 2016). A common belief among youths is that they are not at risk of contracting STDs, leading to complacency in adopting preventive measures. This perceived invulnerability often stems from a lack of personal experience or exposure to comprehensive sexual health education (Fortenberry et al., 2010).
Additionally, the stigma associated with STDs and concerns about confidentiality can deter youths from seeking information, testing, and treatment. Fear of judgment and discrimination from peers, family, and healthcare providers remains a significant barrier (Staras et al., 2015). Furthermore, peer pressure and the desire for social acceptance can negatively impact youths' compliance with preventive measures. Social norms and behaviors within peer groups can discourage safe sexual practices, such as condom use or seeking STD testing (DiClemente et al., 2016). Hence, it is against this backdrop that this study aims to explore the factors influencing compliance with preventive measures of sexually transmitted diseases among youths.
1.4 Aim and Objectives of Study
The aim of the study is to explore the factors influencing compliance with preventive measures of sexually transmitted diseases among youths in Calabar South Local Government Area. In achieving this aim, the following specific objectives were laid out as follows:
- To assess the level of knowledge and awareness about STDs and their prevention among youths and how this influences their compliance with preventive measures;
- To examine the impact of stigma and confidentiality concerns on youths’ willingness to seek information, testing, and treatment for STDs;
- To investigate the role of social and peer influences on youths’ behaviors and decisions related to the prevention of STDs;
- To evaluate the availability, accessibility, and utilization of healthcare services for STD prevention among youths, including barriers to access;
- To explore the attitudes and beliefs of youths regarding sexually transmitted diseases and preventive measures; and
- To provide recommendations for targeted interventions to improve compliance with preventive measures and reduce the incidence of STDs among youths.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Are there the factor pre-disposing youths sexually transmitted infection?
- Are youths aware about STI history before having sex and to consider getting tested?
- Does abstinence from sex help youths to prevent sexually transmitted disease?
- Does the use of anti-biotic help in the treatment of sexually transmitted disease?
- Does sex education and voluntary counselling of the youths aid in the prevention of sexually transmitted disease (STD)?
- What is the level of knowledge and awareness about STDs and their prevention among youths and how this influences their compliance with preventive measures?
- What is the impact of stigma and confidentiality concerns on youths’ willingness to seek information, testing, and treatment for STDs?
- What is the role of social and peer influences on youths’ behaviors and decisions related to the prevention of STDs?
- What are the attitudes and beliefs of youths regarding sexually transmitted diseases and preventive measures?
- What are the availability, accessibility, and utilization of healthcare services for STD prevention among youths, including barriers to access?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: Youths with higher levels of knowledge and awareness about STDs and their prevention do not comply with preventive measures.
- H1: Youths with higher levels of knowledge and awareness about STDs and their prevention are more likely to comply with preventive measures.
Hypothesis Two
- H0: Higher socioeconomic status is negatively associated with greater compliance with preventive measures for STDs among youths.
- H1: Higher socioeconomic status is positively associated with greater compliance with preventive measures for STDs among youths.
1.7 Significance of Study
The findings from this study will enhance the effectiveness of health education programs by identifying gaps in knowledge and misconceptions about STDs and their prevention. By addressing these gaps, educators can develop more targeted and impactful curricula that resonate with youths, leading to better-informed decisions regarding their sexual health.
Additionally, the study sheds light on the psychological and social dynamics that affect youths' health behaviors. Understanding how attitudes, beliefs, and perceived risks influence compliance can help public health professionals design interventions that foster positive attitudes and beliefs, thereby encouraging safer sexual practices.
Ultimately, the study aims to contribute to a reduction in STD prevalence among youths by providing evidence-based recommendations for interventions. These recommendations can help in the development of comprehensive public health strategies that are tailored to the unique needs and challenges faced by youths, leading to improved health outcomes and well-being for this demographic.
1.8 Scope of Study
The scope of the research is focused on the Factors Influencing Compliance with Preventive Measures of Sexually Transmitted Diseases Among Youths in Calabar South Local Government Area of Cross River State.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
STD: STD is an acronym for sexually transmitted disease, Venereal Disease (VD) is an illness that has a significant probability of transmission between humans or animals by means of sexual contact including oral sex or it is a disease that is passed from one person to another during sexual activity.
HIV: The Human Immuno Deficiency Virus. It is the virus which causes (AIDS) and the disease can be transmitted to others.
Syphilis: This is a disease that gets worse over a period of time, spreading from the sexual organs to the skin, bores muscles and brain.
Anti-Biotic: A substance, for example Penicillin that can destroy or prevent growth of other bacteria and cure infections.
Gonorrhea: This is a disease caught by having sex with an infected person. An STD that affect the uncoils membrane particularly in the urinary tract and genital area. It can make urination painful and cause pus-liked discharge through the urinary tract.
