BackgroundYoung people are becoming increasingly exposed to the risk of HIV infection. According to the 2008 HIV/Syphilis sentinel survey in Nigeria, 3.3% of young people aged 15-19 years are infected. Primary prevention especially abstinence, remains one of the most realistic interventions for reducing further spread of the virus. However, the adoption of sexual abstinence as a prevention strategy among adolescents remains low and factors influencing its practice among urban young people in Nigeria are relatively unknown. The aim of the study was to document the sexual abstinence behaviour of in-school adolescents, the factors influencing or obstructing abstinence, and knowledge of HIV and AIDS in Ibadan, South-West Nigeria.MethodsThe study was a descriptive cross-sectional survey of students in Ibadan South-West Local Government Area. A total of 420 respondents (52% males and 48% females), selected through a multistage sampling technique, completed a semi-structured questionnaire. This was supplemented with eight focus group discussions (FGDs) which had an average of 9 respondents within the 10 and 19 years age group. The data from the FGDs were transcribed and summarized manually while the quantitative data was analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables and logistic regression analysis.ResultsTwelve percent of the entire sample had ever had sex. Overall, knowledge of HIV transmission and prevention was high and most respondents favoured the promotion of abstinence as an HIV prevention strategy. A smaller proportion of male respondents (79%) abstained compared with the females (98%). Major predictors of sexual abstinence were being a female, not having a boyfriend or girl friend, not using alcohol and having a positive attitude towards abstinence (P < 0.05).Sexual abstinence was also significantly associated with perceived self efficacy to refuse sex and negative perception of peers who engage in sexual behaviours (P < 0.05). Majority of the FGD discussants suggested the involvement of parents, media, schools, faith-based institutions and non governmental organizations in promoting the adoption of abstinence.ConclusionsThe sexual abstinence behaviour of young persons is influenced by multiple factors and should be considered in determining the effectiveness of interventions targeting this behaviour. Coherent sexuality education interventions to promote the adoption of abstinence among young people are urgently needed.

Patent Medicine Vendors (PMVs) can play a critical role in increasing access to emergency contraceptive pills (ECPs) in developing countries, but few studies have examined their knowledge and dispensing practices. Using cluster sampling, the authors selected and interviewed 97 PMVs (60.8 per cent female) in Oyo and Ogun States of Nigeria to assess their knowledge, dispensing practices, and referral for ECPs. About one-third (27.8 per cent) of respondents were not aware of ECPs, and only half knew that ECPs could prevent pregnancy. Forty per cent had ever dispensed ECPs. Reasons proffered by those who do not dispense ECPs included barriers from the State Ministry of Health, police, other regulatory agencies, and religious beliefs. Only 50.5 per cent have referral arrangements for clients. Strategies to increase access to ECPs through PMVs include training on counseling techniques and referral, effective government regulation, and community involvement. Where unsafe abortion is a major cause of maternal mortality, these strategies offer protection for many women in the future.

BackgroundReducing maternal mortality in Nigeria has received continuous attention both nationally and internationally.ObjectivesThis article highlights the outcome of an intervention which sought to address maternal mortality reduction through increasing contraceptive uptake in 10 rural local government areas (LGAs)in five Nigerian states.MethodThe community based distribution (CBD) approach was used in the implementation of a three year intervention that targeted 10 LGAs. Two hundred and fifty community members were trained as community based distribution agents (CBDA) to provide information on reproductive health, provide non-prescriptive family planning (FP) commodities, treat minor aliment and make referrals to primary health centres within the communities.ResultsFinal evaluation revealed an increase in the proportion of community members who had utilised FP commodities at all, from 28% at baseline to 49%, and an increase in the proportion of current contraceptive users from 16% at baseline to 37%. An average of 50% increase in clientele patronage was also observed in the 10 LGAs’ primary health care centres.Most (96%) of the interviewed CBDA agents reported that a drug-revolving system was in place to ensure that drugs and commodities were available. On-the-spot assessment of the service forms revealed that 86% of them had their activities regularly recorded in their worksheets. Some of the challenges faced by CBDA were discrimination and misconception of community members about family planning (38%), inadequate financial support (14%), and transportation problems (8%).ConclusionThis study has demonstrated that the CBD approach played a critical role in enhancing access to Reproductive Health and Family Planning information and services in the project communities.