Correlates of Substance Use, Risky Sexual Behaviour and Effectiveness of Awareness Campaigns against Alcohol and Drug Abuse among University Students in Coastal Region, Kenya

Abstract

Substance abuse amongst university students is a major public health concern because it predicts health-related problems later in life. The campus environment favours risky behaviours such as substance use and risky sexual behaviour among students. Effective response to the challenge of drug abuse as well as risky sexual behaviour and mitigation of their negative effects among young people relies mainly on accurate information on the extent of substances abuse and risky sexual behaviour among this group of individuals. The aim of this study was to determine prevalence and factors associated with substance use and risky sexual behavior as well as determine the effectiveness of alcohol and drug use awareness campaigns on behaviour change among public university students in the coastal region of Kenya. Mixed method design was used to carry out the study. A qualitative study was done through key informant interviews and focus group discussions while the quantitative study was a quasi-experimental study with both baseline and end-line surveys. The study revealed a high prevalence of substance use with alcohol being the most commonly used substance in both baseline and end-line surveys. Similarly, although the respondents were relatively young, they had significant risky sexual behavior exhibited by early sexual debut, multiple sexual partners, inconsistent condom use and tendency to engage in sex under the influence of drugs. Some of the factors associated with a history of having used alcohol were the male gender, the age of the student, not attending church/ mosque regularly, having schooled in a high school located in the urban area or residing in the urban area during high school life, religion, and the monthly allowance. The female gender, living in the parents/ relatives house as opposed to the university hostel, attending church/mosque regularly were protective factors against being sexually active. There was a positive relationship between substance use and risky sexual behavior among students. Students who engaged in alcohol abuse were more likely to have more than one sexual partner, have unprotected sex, get pregnant or impregnate others accidentally and engage in sex under the influence of drugs. Awareness campaigns against alcohol and drug abuse were not effective in dissuading first-year undergraduate students not to engage in substance use. Despite the intervention being in Technical University of Mombasa only, the prevalence of drug use increased notably in both universities. The prevalence increased from 38.9% to 48.9% in Pwani University and from 31.3% to 55.2% in the Technical University of Mombasa.There is a high prevalence of substance use and risky sexual behavior among first-year undergraduate students in the coastal region. Information awareness campaigns against alcohol and substance abuse alone are not effective in reducing uptake of substance use among university students. Therefore, there is a need to devise more effective strategies to prevent substance use among university students under control. Programs to prevent risky sexual behaviour should also be implemented.