Association between substance abuse and HIV/STI risky sexual related behaviors among students in selected Public Universities, Kenya.

Abstract

The study was conducted to explore substance abuse among youth in respect to their association on risky sexual related behavior. The study was conducted among 4 th year university students in Kenya where substance abuse is reported to be a serious concern, prevalent on many campuses and ingrained on university campuses worldwide. The general objective was to determine the association between substance abuse and HIV/ STI risky sexual related behaviors among students in selected Kenyan Public Universities. The study adopted an exploratory cross sectional study design where data collection was done by both qualitative and quantitative methods. The data was collected by use of Semi Structured Questionnaires (SSQ), Focus Group Discussions (FGDs) and Key Informant Interviews (KII). The data were analyzed to determine relationships among self-reported substance abuse, Human Immunodeficiency Virus (HIV), Sexual Transmitted Infections (STI), risky sexual related behaviors. Further multivatiate and bivariate analysis was done to establish association between dependent and independent variables. The youth sampled were 2880 consisting of 54.1% male and 45.9% female, the mean age was 24 years with a range of 21–32 years. The reduced risk of substance abuse was significantly associated with accommodation in hostels compared to rented apartment. The respondents who had both parents were less likely to abuse substance by 0.67 times compared to those having only a father or none of the parents having an increased risk of substance abuse by 1.92 and 1.39 times respectively compared to those who had the mother as the parent. The female respondents were less likely to abuse substances by 0.77 times. The increased number of occupants in the house significantly decreased risk of substance abuse by 0.70 times. The respondents who received information from peers/friends, media and others abused substances by 1.38, 1.40 and 4.40 times respectively while receipt of information fromchurch was less likely to contribute to substance abuse. The respondents who reported not having visualized posters on STI/HIV, abused substances by 1.43 times more than those who had. The respondents who were involved in receptive vaginal intercourse were significantly more likely to abuse substances (AOR 2.10; 95% CI 1.53 – 2.88; P < 0.001) but insignificant association between those who had none penetrative sex P > 0.05. With lecturers as the reference group, students who abused substances were significantly likely to have sex with a fellow student or others (strangers) P > 0.05 and P = 0.017 respectively. The prevalence of condom use among the university students was approximately 82%. The respondents who reported condoms safety from pregnancy were significantly less likely to abuse substances than those who did not P < 0.001. The students who reported that partner never trusted them were significantly less likely to abuse substances P <0.001. The respondents who reported untrustworthy among partners were significantly less likely to abuse substances P < 0.001. The respondents who consumed over 3 beers over the weekend were significantly P < 0.001 likely to report substance abuse compared to those who consumed1-2 drinks. This study noted that majority of respondents were aged between 21 – 32 years with the overall rates of sexual experience consistent among genders xxi in all the universities and rented private accommodation though some resided in the university halls. At Kenyatta University (KU) and Narok a small proportion resided in accredited hostel. There was a decrease in alcohol consumption among respondents and drinking rates were high in dormitories and residence halls with a consumption of 3-6 drinks over the weekend. The respondents who had both parents alive were less likely to abuse substance with a high prevalence of perceived risks motivated by substance abuse and alcohol with receptive vaginal sex being preferred though there was easy availability of condoms and availability of information. All the universities had HIV preventive activities but the HIV Policy document was available at JKUAT and KU unlike Maseno university, Narok and Kimathi Colleges. University students should be targeted as high risk groups in the transition of HIV/STI and substance abuse through funding policies, frameworks and university administrators, staff and students. The university administration, parents and residential owners need to create intervention bonds against substance abuse and risky sexual behaviours. Availability of intervention information should be enhanced through a longitudinal study on condom use to establish the factors contributing to substance abuse and HIV /STI.