HIV/STD Risk Behaviors Among In-School Adolescents in Post-conflict Liberia

Abstract

We conducted a randomized trial to address the health needs of in-school adolescents in Liberia, where we analyzed data from a behavioral survey administered to 820 students from 8 urban schools. Our findings suggest that adolescents are at significant risk for HIV and other sexually transmitted diseases (STDs): 36% of respondents were sexually experienced, 34% of those had first sex at ages 14 or younger, and 66% of first sexual encounters were unprotected while 16% were described as “forced.” Also, females were more likely to have older boyfriends (Pearson chi square = 19.2, p = 0.0001) and sex resulting into pregnancies (Pearson chi square = 11.5, p = 0.01), while males were more likely to have a greater number of sexual partners (Pearson chi square = 5.6, p = 0.05) in the previous 3 months. We recommend further research to explore challenges associated with implementing behavioral-driven studies in post-conflict environments.

Perceptions of the effects of armed conflict on maternal and reproductive health services and outcomes in Burundi and Northern Uganda: a qualitative study

“…In some refugee camps hosting Burundian refugees in Tanzania, Märta [ 47 ] reported a similar pattern, with the high prevalence associated with low education attainment, breakdown of the culture, poverty, and unstable family relations. In post-conflict Liberia, Kennedy et al [ 48 ] and Atwood et al [ 49 ] observed that in-school adolescent girls were not only vulnerable to unplanned pregnancies, but also HIV/AIDS and other STIs; high levels of sexual activity, early sexual debut, and unprotected and risky sexual practices including transactional sex. Within some post-conflict areas in Eastern Uganda, Muhwezi et al [ 50 ] have observed vulnerability to high-risk sexual behaviour among the population, including transactional sex, early and forced marriage, and sexual predation.…”

Experiences and acceptance of intimate partner violence: associations with sexually transmitted infection symptoms and ability to negotiate sexual safety among young Liberian women

“…Chronic exposure to sexual violence and lack of resources has led to transactional sex, with 30% of young women in a recent survey reporting trading sex for money, food, and shelter (Behrendt 2008). Conditions of poverty and political unrest additionally compromise women’s power within relationships and likely translate into reduced ability to engage in safe sexual practices (e.g., the ability to refuse sex and to negotiate condom use) (Kennedy et al 2004; Kennedy et al 2011) and increased acceptance of physical violence against women. Although work toward reducing sexual and gender-based violence in Liberia is underway, strategic planning tends to emphasise rape and sexual abuse of young children and girls and neglects to address the more widespread issue of intimate partner violence that is likely adversely affecting sexual health outcomes among Liberian women.…”

Risky sexual behaviors and substance use among youths in post-conflict Liberia

“…Males were also found to be more likely to have sex, have multiple sexual partners, and initiate sex early (Quiterio et al, 2013). Another study among youths in Liberia found 34% of their sample had their sexual debut at less than 15 years of age (defined as early sexual debut), and 21% of those who were sexually active had multiple sexual partners (Kennedy et al, 2012). Furthermore, 26% of sexually active youths had never used a condom, 11% had got pregnant or got someone pregnant one or more times, and 11% reported sexual assault (Kennedy et al, 2012).…”