DOI 10.1515/ijamh-2013-0300 Int J Adolesc Med Health 2014; 26(2): 259–265 Charles I. Tobin-West*, Omosivie Maduka, Victor N. Onyekwere and Adedayo O. Tella Awareness, acceptability, and use of female condoms among university students in Nigeria: implications for STI/HIV prevention Abstract Background: Most university students in Nigeria are sexu- ally active and engage in high risk sexual behaviors. The aim of this study was to assess the acceptability and use of female condoms in the context of HIV prevention in order to provide basic information that can stimulate female condom programming to promote sexually transmitted infection and HIV prevention among youths in tertiary institutions. Materials and methods: A descriptive, cross-sectional study was carried out among 810 undergraduate students of the University of Port Harcourt from October to Novem- ber 2011, using a stratified sampling method and self- administered questionnaires. Results: Most of the students, 589 (72.7%) were sexually active; 352 (59.7%) reported having just one sexual partner, while 237 (40.3%) had multiple partners. The mean number of sexual partners in the past six months was 2.2± 0. Con- sistent condom use was reported among 388 (79.2%) stu- dents, 102 (20.8%) reported occasional usage, while 99 (16.8%) did not use condoms at all. Only 384 (65.2%) of the students had ever been screened for HIV. Although 723 (89.3%) were aware of female condoms, only 64(8.9%) had ever used one due to unavailability, high cost, and difficulty with its insertion. Nevertheless, 389 (53.8%) of the students expressed willingness to use them if offered, while 502 (69.4%) would recommend it to friends/peers. Conclusion: This study highlights significant challenges in the use of female condoms among university students. These include unavailability, high cost, and difficulty with insertion. Therefore, deliberate efforts using social mar- keting strategies, appropriate youth-friendly publicity, and peer education must be exerted to provide affordable female condoms and promote usage; such efforts should target vulnerable youths in Nigerian tertiary institutions. Keywords: female condoms; Nigeria; students. *Corresponding author: Dr. Charles I. Tobin-West, Department of Preventive and Social Medicine, College of Health Sciences, University of Port Harcourt, P. M. B. 5323, Port Harcourt, Nigeria, Phone: +234 803 317 0115, E-mail: drtobinwest@gmail.com Omosivie Maduka: Department of Preventive and Social Medicine, University of Port Harcourt, Rivers State College of Health Science Technology, Port Harcourt, Nigeria Victor N. Onyekwere and Adedayo O. Tella: Department of Community Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria Introduction HIV and AIDS have remained a threat to the global reali- zation of key developmental goals, including the Millen- nium Development Goals (MDGs). Despite the reported gradual decline in the epidemic, it has remained a cause of great concern for developing countries in sub-Saharan Africa, where two-thirds of all infected persons live and three quarters of global deaths occur (1, 2). Young people between the ages of 15 and 24 years are at the center of the epidemic, accounting for 40% of all new infections (1). In Nigeria, about 3.5 million people are living with the virus, with about 300,000 new infections occurring annually and young people contributing 60% of these new infections (3). Women are disproportionately affected by the epidemic, accounting for 31% of new infections, and such infection rates are two to three times as high as in men (3). Several factors, such as biological, socio-cultural and economic factors, account for women’s higher risk of infection. The female reproductive tract is more susceptible to HIV infec- tion than the male reproductive system, and young women are at the highest risk of the infection due to an immaturity of the reproductive tract (4, 5). Furthermore, sexual violence and coercion that occur in college settings, along with the unfavorable social norms that condone gender inequality, frequently play a significant role in the inability of women and girls to practice safer sex in developing countries like Nigeria (6). Most youths in Nigeria and elsewhere are sexu- ally active and engage in risky sexual behaviors, such as early sexual debut, unprotected sex, multiple sexual part- nerships, anal sex, and lopsided knowledge about sexually transmitted infections (STIs) (7, 8). In addition, they lack the confidence to negotiate sex or contraceptive use, while many do not perceive themselves as being at risk of contract- ing STIs, including HIV and AIDS (9, 10). Brought to you by | provisional account Unauthenticated Download Date | 3/8/16 3:50 PM