THE USE CAMPAIGN AND ITS INFLUENCE IN THE SEXUAL LIFE OF STUDENTS OF UNIVERSITY OF NIGERIA, NSUKKA

EZEJI, EKWUEME EMEKA PG/MSC/08/47746

INSTITUTE OF DEVELOPMENT STUDIES (IDS), UNIVERSITY OF NIGERIA, ENUGU CAMPUS

DECEMBER, 2015

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THE CONDOM USE CAMPAIGN AND ITS INFLUENCE IN THE SEXUAL LIFE OF STUDENTS OF UNIVERSITY OF NIGERIA, NSUKKA

EZEJI, EMEKA EKWUEME PG/M.SC/O8/47746

A PROJECT SUBMITTED TO THE INSTITUTION FOR DEVELOPMENT STUDIES (IDS) UNIVERSITY OF NIGERIA, ENUGU CAMPUS. IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER OF SCIENCE M.SC IN DEVELOPMENT STUDIES

SUPERVISOR PROF. I.C NWIZUIGBO

DECEMBER, 2015

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CERTIFICATION

I, Ezeji Emeka Ekwueme (Msc) hereby certify that apart from references made to other person’s work which have been dearly acknowledged, the entire work is a product of my personal research and that this project, neither in whole nor in part has been presented for any degree anywhere.

------Ezeji, Emeka Ekwueme PG/M.Sc/08/47746

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APPROVAL PAGE

The study embodied in this work has been read and certified as an original work of Ezeji, Emeka Ekwueme with registration number (PG/M.Sc/08/47746). The work has been approved as meeting the requirements of the Institute of Development Studies University of Nigeria (UNN), Enugu Campus for the award of the Degree of Masters of Science (M.Sc) in development studies.

------Prof. Osita Ogbu. Ph.D Date Director, Institution for Development Studies (UNN) Enugu Campus

------External Examiner Date

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DEDICATION

To my wife Chinwe and Sons Favour, Chimdindu, Zokwasim and Kachimsiricho for their understanding and sacrifice.

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ACKNOWLEDGEMENTS

I am most thankful to Almighty God who inspired the beginning and successful completion of this work.

My profound gratitude goes to the Director and Staff of the Institute of Development studies, and to my Supervisor, Prof. I.C. Nwizugbo who in his constructive and shrewd intellectual criticism contributed immensely to the completion of this work.

I also extend my gratitude to my lovely wife – Chinwe and to my children for their support in one way or the other in making this work a success. May God bless and keep you all in Jesus Name.

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TABLE OF CONTENTS

Title Page ------i Certification ------ii Approval Page ------iii Dedication ------iv Acknowledgments ------v Abstract ------vi Table of Contents ------vii List of Tables ------viii

CHAPTER ONE: INTRODUCTION 1.1 Background of the Study ------1 1.2 Statement of Research Problem ------4 1.3 Aim and Objectives of the Study ------5 1.4 Research Question ------5 1.5 Research Hypothesis ------6 1.6 Significance of the Study------6 1.7 Scope and Limitations of the Study ------7

CHAPTER TWO: LITERATURE REVIEW 2.1 Overview of Condom use Campaign- What is Condom? - - - 10 2.2 History of Condom ------13 2.3 Why Condom Use ------16 2.4 Condom use and the Church ------18 2.5 HIV/AIDS and Condom use /Faith Based Organization (FBO) - - 21 2.6 Major and Minor Massage in Condom Campaign - - - - 22 2.7 Sexual Habits of Students ------25 2.8 Sexually Transmitted Diseases before 1960 - - - - - 26 2.9 Possible Misconception of Condom use - - - - - 28 2.10 General Assessment ------29

CHAPTER THREE: RESEARCH METHODOLOGY 3.1 Research Design------36

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3.2 Population of the Study ------37 3.3 Sample Size ------37 3.4 Sampling selection ------38 3.5 Methods of Data Collection ------39 3.6 Validity/ Reliability of instruments ------39

3.7 Methods of Data Analysis ------40

CHAPTER FOUR: DATA PRESENTATION AND INTERPRETATION 4.1 Introduction ------45

4.2 Presentation of Data ------45 4.2.0 Questionnaire Data Presentation ------45 4.2.1 Gender Structure ------45 4.2.2 Awareness of condom use ------46 4.2.3 Campaign on condom use ------51 4.2.4 Condom use and students sexuality ------52 4.3 Interpretation of Result ------55 4.3.2 Application principal component analysis on pattern of condom use campaign and sexual life - - - - - 56

CHAPTER FIVE: DISCUSSION OF FINDINGS 5.1 Introduction ------60 5.2 Findings from level of Awareness on Condom use in the Study Area (objective 1) ------60

5.3 Findings from Pattern of Condom use Campaign and Sexual Life of Students in the Study Area (objective 2 and 3) - - - 62

CHAPTER SIX: SUMMARY OF FINDINGS CONCLUSION AND RECOMMENDATIONS 6.1 Summary of Findings------64 6.2 Recommendation------65 6.3 Conclusion------66 Reference Appendix 8

LIST OF TABLES Table 4.1: Gender Structure ------45 Table 4.2: Age Structure of the Respondent - - - - - 46 Table 4.3: Awareness of condom use in the Study Area - - - 47 Table 4.4: Campaign on Condom Use ------50 Table 4.5 Condom use and students sexuality - - - - 52 Table 4.6 Analysis of variance (ANOVA) on Awareness of Condom Use - 55 Table 4.7 Communalities of Pattern of Condom use Campaign and sexual life 57 Table 5.8 Rotated Component Matrix of Discernible Pattern of Condom Use Campaign and Sexual Life - - - - - 58

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ABSTRACT

This study examined condom use campaign and its influence in the sexual life of students of University of Nigeria, Nsukka.The objectives of this study include the following: To determine the level of awareness in the use of condom among the students of University of Nigeria, Nsukka ,to analyze the trend of condom use campaign in Nigeria with particular reference to the students community of the university of Nigeria Nsukka and to determine the influence of condom use campaign on the sexual life of the students of University of Nigeria Nsukka.A total of 287 respondents were randomly selected within the two campuses and in various male and female hostels.Simple frequencies and tables were used to analyze date generated from the study. The analysis of variance (ANOVA) and principal component Analysis (PCA) was used to test the postulated hypotheses. The result of ANOVA recorded a P-value of 0.001 which showed significant difference on the perception of student on level of awareness of condom use campaign in the Campus. The PCA recorded total variance of 94.38120. This entailed significant pattern in condom use campaign and sexual life of students. Finding from the study ‘reveals that condom campaign is responsible for increase in sex habit of students as is the case of about 33% of students. This study established that condom use campaign and sexual innovation model is responsible for increase in sex habit and associated problems like have in 42% of sexual debut among students. The study also showed that 34% of students strongly agree that condom use campaign promotes sex addiction. However, the study upheld the fact that condom use have helped in saving life and controlled sexually transmitted diseases, there is therefore need to find a way to pass the message without causing more sexual habit problems. The study, therefore recommends, among others that emphasis must not only be on condom use. Abstinence should be emphasized as the best option, the government should re-orient our youth by putting together a Wholistic Programme that will focus more on protective behaviour other than condom use.

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CHAPTER ONE

INTRODUCTION

1.1 Background of the Study HIV/AIDS is one of the most widespread lethal diseases occurring in the world today (Scott,

2009). According to UNAIDS/WHO (2003) nearly 1 million Americans are infected with

HIV, most of them through sexual transmission, and an estimated 12 million cases of other sexually transmitted diseases (STDs) occurring each year in the , therefore effective strategies for preventing these diseases are critical. Sexually transmitted diseases, including HIV infection, are preventable. The connection between HIV infection and sexual risk behaviour in heterosexual relationships has been long established in sub-Saharan Africa.

An estimated 5 million new HIV/AIDS infections occurred in sub-Saharan Africa in 2003, most the result of heterosexual transmission.

Several factors such as community environment (Peltzer et al. 2009), poverty (SANAC

2010), home environment (Green et al. 2009), drug abuse (Harrison, 2009) and others have been identified as instigators of sexual risk behaviour and more recently, have been linked to the spread of HIV in South Africa. It has been argued that gender systems in sub-Saharan

Africa promote the spread of HIV through a variety of routes including inter alia: masculine identities that support dominance, sexual freedom, and sexual satisfaction (Schoepf, 1998); inequitable material resource allocation, meaning widespread female poverty and economic dependence upon men (Kaleeba et al, 1991); and a complex interplay between the norms and reality of partnership formation which implies both multiple sexual partners and barriers to condom use due to ideals of trust, honesty, and commitment within unions (Varga, 1997).

The effectiveness of responsible prevention strategies depends largely on the individual

(CDC, 1996). are a key component of comprehensive HIV prevention. Condoms are known to be effective in preventing HIV among both men and women (Davis& Weller, 11

1991). The usage of condom is one of those various ways of preventing the infection of

STD. Condoms are now widely used throughout the world. In Japan, 80% of sexually active people use condoms as their main method of contraception. However, it is hard to get an accurate picture of condom use, some teenagers and young adults might overestimate how often they use condoms during sex, a study found (MNT, 2009).Condoms, when used correctly and consistently, are highly effective in preventing HIV and other Sexually

Transmitted Infections (STIs). As STIs cause significant morbidity and mortality, preventing the spread of the infectious agent throughout a susceptible population is generally more cost effective than approaches involving early detection and treatment. In the absence of a vaccine, abstinence, mutual monogamy, and condoms are options for preventing genital

Human Papilloma Virus (HPV) infection.

In response to the recent congressional mandate to provide the public with more accurate information on the efficacy of condoms in preventing HPV-related infection, Condoms are highly effective in preventing and slowing the spread of HIV and some other sexually transmitted reproductive health problems (Cates, 2001). Research has identified condom use as a feasible means to control the spread, particularly in many parts of southern and eastern Africa where the AIDS epidemics have advanced (Laukamm-Josten et al.,

2000).A large body of scientific evidence shows that male latex condoms have an 80% or greater protective effect against the sexual transmission of HIV and other STIs (WHO,

2013). The strongest evidence of the role of male condoms in preventing disease transmission is for HIV. A meta-analysis of 25 studies of HIV-serodiscordant heterosexual couples provided a summary efficacy estimate of 87% (Manhart & Koutsky,

2002).However, due to the inclusion of inadequate measures of condom use and the lack of information on temporal sequence, it is not possible to use available data to draw definitive conclusions on the efficacy of condoms in the prevention of HPV-related conditions.

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Condoms are steadily increasing in acceptance within causal relationships, but have made little progression into longer-term, monogamous relationships (Scott, 2009). Condom use is particularly important for women in the protection of HIV/AIDS as other methods of prevention may be available to them. For men, condom use served the purpose of preventing both pregnancy and sexually transmitted infections (STIs) including HIV.

Condoms have therefore been promoted as a major public health strategy to combat unwanted pregnancies and the rising rates of STIs, including HIV/AIDS. To derive maximum benefit, condoms must be used correctly and consistently; however consistent use requires long-term commitment and a reliable distribution network that provides condoms even to the poorest groups (World Bank, 1997).

Condom use is one of the major forms of that reduces the likelihood of contracting sexually transmitted infections, including HIV/AIDS. It also reduces the risk of unwanted pregnancies and unsafe , and enhances adequate child spacing. Condom use is particularly important for women in the protection of HIV/AIDS as other methods of pregnancy prevention may be available to them (Akinyemi et al, 2010). When used correctly and consistently, condoms are a reliable method of preventing pregnancy, and have no medical side effects. According to World Health Organization (2005), the male condom is

98% effective, and the 94% effective when used according to instructions.

1.2 Statement of the Problem The United States of America, the United Kingdom, the Netherlands and other advanced democracies have led in the pursuit of Sexual Transmitted Diseases and HIV/AIDS prevention, control and the need for and youth awareness campaign. Also, leading developing nations are South Africa, Zimbabwe, Namibia, The Philippines and

Indonesia have led in championing policies to address prevention of the spread of HIV- related diseases. The need for countries to develop intensive HIV/AIDS response has

13 become of great importance. For emphasis, the Human Immuno-Deficiency Virus (HIV) is transmitted through blood and sexual fluids of an HIV infected person when sharing needles or syringes during drug usage, through infected blood transfusions, during unprotected sexual intercourse with someone who is not yet infected.

The statement of the problem is that various condom mass media campaigns by the organizations and similar agencies on the campaign of condom use is not directly proportionate to its use or reduce the spread of STDs. Neglect and avoidance of condom use constitute a major challenge in the attempt to eradicate HIV-related diseases. Although, most

Nigerians have fairly widespread knowledge of the disease in addition to its condom preventive measure, nevertheless their use of condoms is comparably low, manifested through numerous patterns of unsafe sexual practices. It is important too, to note that unethical sexual behaviour is not only found among the uneducated class but also found among the educated class. Therefore, ethical condom use campaign has market advantage if it is strategically positioned.

However, this study seek to examine the condom use among students of the Nigerian tertiary institutions with particular reference to the University of Nigeria, Nsukka which is the major cause of the spread of HIV/AIDs diseases. In trying to look into sexual discrepancies and proffer a way forward towards a state of efficient public enlightenment among students, that enhances sustainable health and social value, this research work emanated.

1.3 Aim and Objectives of the Study The broad objective of the study is to investigate the influence of condom use campaign on the sexual life of the students of the University of Nigeria, Nsukka. Hence, the specific objectives of the study are to:

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i. Determine the level of awareness in use of condom use among the students of the

University of Nigeria, Nsukka;

ii. Analyze the trend of condom use campaign in the Nigeria with particular

reference to the students’ community of the University of Nigeria, Nsukka;

iii. Determine the influence of condom use campaign on the sexual life of the

students of the University of Nigeria, Nsukka.

1.4 Research Questions

The following questions will be addressed in this study, these include:

i. To what extent do the students of the University of Nigeria, Nsukka aware of condom use?

ii. What is the current trend of condom use campaign among the student of the University students?

iii. To what extent does condom use campaign influence the sexual life of the students of the University?

1.5 Research Hypotheses

For the stated objectives of the study to be achieved the following Null Hypotheses will be tested:

i. Ho: There is no significant difference in the perception of student on level of

awareness in the use of condom in the study area.

ii. H1: There is no significant pattern of condom use campaign and sexual

life of student in the study area.

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1.6 Significance of the Study

The significance and justification for this study among others are firstly, to engage student population of the University of Nigeria, Nsukka to be adequately informed of sex-related issues as a result of unethical sexual behaviour and unguided or unprotected sexuality. This will enhance the students’ understanding of sex and thereby increase their consciousness of danger associated with unethical sexual life.

The study will facilitate understanding of condom use and strict compliance to its proper and effective usage. The study will also the students of the University of Nigeria, Nsukka and other tertiary institution around the world in efficient evaluation of ready available alternative to casual and unethical sexual life in the study area. More so, provide useful guidance data to undertake assessment of social life vis a vis sexual partner and behaviour of the students of the Nigerian tertiary educational institutions and its impacting effects.

Besides, it is beneficial to the entire student’s populace as ethical social life is required of them at all time.

This study will assure commitment of the various organizations and stakeholders in health and educational sectors to general public enlightenment about the use of contraceptives so as to prevent sexual-related diseases and unwanted pregnancies. The study should stimulate national policies and programmes for the inclusion of sex education in the curriculum. It is therefore relevant for improved and ethical social life. It will further enhance research in development studies.

1.7 Scope and Limitations of the Study

Human sexuality is generally described as the sum total of manner through which people experience and articulate their sexual sensation. However, most of these studies have their focus on premarital sexual behaviour, knowledge and attitudes towards sex, high risk sexual

16 behaviour, and contraceptive usage with restricted attention on student’s sexual behaviours.

Recent developments in human sexual behaviour make it imperative for us to increase our knowledge base about diverse aspects of human sexuality. On this premise, this paper investigates the condom use campaign and its influence in the sexual life of students of university of Nigeria, Nsukka.

However, there are several limitations to the study are envisaged. These would be reported at the conclusion of this study.

REFERENCES

Akinyemi A. I., Aransiola J. O., Banjo O., Bamiwuye O., Fadeyibi O. and Adewuyi A. (2010): Influence of Independent and Proximate Variables on Condom Use in Selected States in Nigeria. African Journal of Reproductive Health December 2010; 14(4): 53

Cates W. Jr. (2001): The NIH Condom report: the glass is 90% full. Family Planning Perspectives33(5): 231-233.

Centre Disease Control & Prevention [CDC] (1996): Condoms and Their Use in Preventing HIV Infection and Other STDs (Online) available at http://www.hawaii.edu/hivandaids/Condoms%20and%20Their%20Use%20in%2 0Preventing%20HIV%20Infection%20and%20Other%20STDs.pdf. (Assessed on August 18, 2013).

Davis K. R. & Weller S. C. (1991): The effectiveness of condoms in reducing heterosexual transmission of HIV. Family Planning Perspective; 31: 272–279. 17

Derek, Llewellyn-Jones (1998): Everywoman, A Gynecological Guide for life (9th Edition). Penguin Books Australia Ltd.

Green C, Hearst T, Mah A, Herling-Ruark M 2009. A framework of sexual partnerships: Risks and implications for HIV prevention in Africa. Studies -in Family Planning, 40: 63-70.

Kaleeba, N., S. Ray, and B. Willmore. 1991. We miss you all: AIDS in the family. Harare, Zimbabwe: Women and AIDS Support Network.

Laukamm-Josten et al., (2000) in Sunmola A. M. (2005). Sexual practices, barriers to condom use and its consistent use among long distance truck drivers in Nigeria. AIDS Care, February 2005; 17(2): 208_/221

Manhart L.E. & Koutsky L. A. (2002): Do Condoms Prevent Genital HPV Infection, External Genital Warts, or Cervical Neoplasia? A Meta-Analysis. American Sexually Transmitted DiseasesAssociation.

MNT (2009): What Are Condoms? How to Use a Condom (Online) available at http://www.medicalnewstoday.com/articles/152833.php. (Assessed on August 18, 2013).

Peltzer K., Matseke G., Mzolo T., Majaja M. (2009): Determinants of knowledge of HIV status in South Africa: Results from a population-based HIV survey. BioMedicine Central Public Health, 9: 7-9.

SANAC (2010):National Strategic Plan 2007-2011: Mid Term Review 2010. Pretoria: SANAC. Schoepf, B.G. 1998. Inscribing the body politic: Women and AIDS in Africa. In M. Lock and P. Kaufert (Eds.) Pragmatic women and body politics. Cambridge: Cambridge University Press.

Scott S. (2009): "IV/AIDS: Understanding Socio-Cultural Factors and their Influence on Sexual Behaviour and Decision Making in Africa. Journal o/the Manitoba Anthropology Students ' Association. Volume 28, 2009 (Online) available at http://umanitoba.ca/publications/openjournal/index.php/mb- anthro/article/viewFile/27/7 (Assessed on November 13, 2013).

UNAIDS/WHO (2003): AIDS epidemic update 2003. Geneva: Joint United Nations Program on HIV/AIDS and World Health Organization.

Varga, C. 1997. Sexual decision-making and negotiation in the midst of AIDS: Youth in KwaZulu-Natal, South Africa. Health Transition Review 7(suppl. 3): 45-67.

WHO (2013): Condoms for HIV prevention (Online) available at http://www.who.int/hiv/topics/condoms/en/ (Assessed on November 12, 2013).

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CHAPTER TWO

LITERATURE REVIEW

2.1 Overview of Condom use Campaign – What is Condom

Condom is a barrier device commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases. Condoms are also used for collection of semen for use in treatment (Wikipedia, 2013).Condoms are a barrier method of contraception that, when used consistently and correctly, can prevent pregnancy by blocking the passage of semen into the vaginal canal. Condoms can also prevent the exchange of blood, semen, and vaginal secretions, which are the primary routes of STD transmission (Hatcher, et al, 1998). The male condom is a barrier method of contraception that is placed over the glands and shaft of the penis (The Body, 2002).

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Condoms manufactured from lambskin, also known as "natural skin," or "natural membrane," are made from the intestinal lining of lambs. Condoms are 98% effective in preventing pregnancy when used consistently and correctly. While these condoms can prevent pregnancy, they contain small pores that may permit passage of some STDs, including HIV, the hepatitis B virus, and the herpes simplex virus (The Body, 2002). Most male condoms are made from natural rubber latex. When used consistently and correctly and without slippage or breakage, male condoms cover the penis and will contain pre-ejaculate emissions as well as semen following ejaculation, thus protecting the female reproductive tract. Condoms also may prevent penile exposure to cervicovaginal secretions and tissues under similar conditions and use. Condom shape, thickness, and other specifications, including the latex formulation itself, have been engineered to produce a product that is placed easily (onto the penis), minimizes slippage and breakage during vaginal intercourse, and contains the collected fluids (National Institute of Allergy and Infectious Diseases, et al

2001).

For current condom use among the sexually active population, the significant variables were the number of AIDS campaigns, sex, age, marital status, perception of self-efficacy and risk perception. Intention to use condoms in the future also increased with increase in exposure to AIDS/HIV campaigns. The older age groups (30-39, 40+) were less likely to plan to use condoms in the future. Those not in marital unions were more likely to use condoms in the future. Self-efficacy, risk perception and PLWHA were other significant variables. As can be deduced from the four outcome variables of interest, exposure to the AIDS campaigns had significant positive effect on sexual behavioural changes, current condom use and intention to use condoms, and testing for HIV status (Odimgwe et al, 2003).

Involvement in sexual relationships, no doubt, has its consequences. The consequences may come in form of sexual health (enjoyment) or difficulties in diverse areas of human sexuality

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(Abiodun et al, 2013). Condom use both for family planning and for disease prevention is often thought to increase as contraceptive practice becomes more widespread. Condom use is strongly differentiated by parity. The method is rarely used by unmarried and even married couples because of the strong desire and social pressure to establish fertility as soon as possible within marriage. Because of this attitude to procreation in Nigeria, condoms are rarely used for long in most marriage. In fact there is inconsistent use of condom and a high discontinuation rate by married couples in Nigeria (Iyaji & Ogbuke, 2010).

An effective tool in HIV/AIDS prevention campaign is the condom. The condom, male or female is the only technology available to prevent the sexual transmission of HIV. When used consistently and correctly, condoms have been proven to be effective in the prevention of HIV, unwanted pregnancy and several sexually transmitted infections (Holmes et al,

2004). Knowledge and use of the male condom is not uncommon. However with well over

50% of all young people living with HIV worldwide being women, (UNAIDS, 2010) there is need for a female HIV prevention initiative (female condoms) to empower women to protect themselves from risk of HIV infection.

The Nigerian social marketing programme has grown in breadth and depth over the past twelve years, promoting delayed sexual activity among youth, reduction in the number of sexual partners, and condom use in non-marital and non-cohabitating sexual relationships

(including commercial sex).Despite these advances, a large portion of at risk Nigerians still do not use condoms. Akinyemi, (2012) opined that the campaign to increase condom use would benefit the general populace. However, factors that influence sexual behaviour and ultimately condom use include religion, economic status, pressure from partners and peers, and cultural norms; the relative importance of these factors, in determining behaviour is not known, nor is it clear which ones, if tackled by education and communication, would engender safer practices. Research could also inform marketing strategies that use multiple

21 means of reaching the same audience. Finally, the issue of embarrassment at the point of condom purchase must be addressed and other distribution options identified (PAS

International Seminar, 2004).

PAS International Seminar (2004) Dr. A. M. Sunmola of the University of Ibadan presented a paper on ‘New Priorities for Condom Research in the Second Decade of AIDS in Nigeria’.

Stressing that behaviour change is the primary key to preventing HIV transmission, he agreed with Akinyemi’s assertion that condom use must be encouraged so long as heterosexual sex remains the primary mode of transmission in Nigeria. Risky behaviour at all levels of society takes many forms, including intergenerational sex, extramarital affairs, and non-monogamous relationships; increasing the risk are commercial sex workers and

‘bridge populations’-migrant workers, traders, military personnel and members of the Youth

Service Corps- who have the potential to transfer the virus across wide areas. It is essential, according to Sunmola, that condoms are used consistently and correctly since transmission often occurs among regular partners.

Sunmola also further stressed those condom-promotion strategies that have been effective elsewhere must be put to the test in Nigeria. He cited the case of Thailand, where the government mandated condom use by all commercial sex workers and used its authority to penalize brothel managers and proprietors who did not force compliance. Community-level studies of resistance to condom use would yield insights, he said, that could help shape campaigns that go beyond general exhortation and billboard advertising. He also recommended cognitive/behavioural studies that examine how Nigerians connect levels of risk with condom use.

2.2 History of Condom

Wikipedia (2013) “Condoms have been in use for about 400 years yet they have undergone very little technological improvement in the past 50 years,” Grand Challenges says. 22

Condoms or sheaths are the oldest form of barrier contraception used by the male. It has been suggested that the Ancient Egyptians were among the first to wear them and even dye these sheaths in various colours. The word condom first appeared in print in 1706 in a poem by Lord Belhaven, then in a book by Daniel Turner in 1717. Actually, the history of the condom may go back even further than four centuries.

It is really hard to pinpoint just when the first condom was used. Some researchers have suggested that the ancient Egyptians used condoms and even dyed them in various colours, but evidence for this is scarce. There are more solid reports of glans condoms, which covered only the head of the penis, being used amongst the upper classes of Asia before the

1400s. Such condoms were made of intestine, oiled paper, animal horn or tortoise shell. A female condom of a sort crops up in an ancient story about Minos, the king of Crete, who was supposedly cursed such that his semen was full of scorpions and snakes, which needless to say would complicate things a bit. The scorpion-laden emissions problem was solved by inserting a goat bladder into the of Minos’s sexual partners, according to the Greek writer Antoninus Liberalis.

The oldest condoms ever found were dug up in the cesspit- or big toilet - of Dudley Castle, an English ruin, in 1985. Made of fish and animal intestine, the condoms were most likely dropped into the cesspit sometime in the mid-17th century. The condoms were only able to survive thanks to the fetid, airless environment of the castle toilet, which prevented the growth of bacteria. Until the industrial production of rubber was perfected in the mid-19th century, most condoms were made from animal intestines. One recipe from that era, describes how to make a condom from the large intestine of a sheep: Soak it first in water, turn it on both sides, then repeat the operation in a weak ley (solution) of soda, which must be changed every four or five hours, for five or six successive times; then remove the mucous membrane with the nail; sulphur, wash in clean water, and then in soap and water;

23 rinse, inflate and dry. Next cut it to the required length and attach a piece of ribbon to the open end.

The history of condoms goes back at least several centuries and perhaps beyond. For most of their history, condoms have been used both as a method of , and as a protective measure against sexually transmitted diseases. Condoms have been made from a variety of materials; prior to the 19th century, chemically treated linen and animal tissue (intestine or bladder) are the best documented varieties. Rubber condoms gained popularity in the mid-

19th century, and in the early 20th century major advances were made in manufacturing techniques. Prior to the introduction of the combined oral contraceptive pill, condoms were the most popular birth control methods in the Western world. In the second half of the 20th century, the low cost of condoms contributed to their importance in family planning programs throughout the developing world. Condoms have also become increasingly important in efforts to fight the AIDS pandemic. The oldest condoms ever excavated were found in a cesspit located in the grounds of Dudley Castle and were made from animal membrane, the condoms dated back to as early as 1642

The rubber vulcanization process was invented by Charles Goodyear in 1839, and patented in 1844. The first rubber condom was produced in 1855, and by the late 1850s several major rubber companies were mass producing, among other items, rubber condoms. A main advantage of rubber condoms was their reusability, making them a more economical choice in the long term. Compared to the 19th century rubber condoms, however, skin condoms were initially cheaper and offered better sensitivity. For these reasons, skin condoms remained more popular than the rubber variety. However, by the end of the 19th century

"rubber" had become a euphemism for condoms in countries around the world. For many decades, rubber condoms were manufactured by wrapping strips of raw rubber around penis- shaped molds, then dipping the wrapped molds in a chemical solution to cure the rubber.

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The earliest rubber condoms covered only the glans of the penis; a doctor had to measure each man and order the correct size. Even with the medical fittings, however, glans condoms tended to fall off during use. Rubber manufacturers quickly discovered they could sell more devices by manufacturing full-length one-size-fits-all condoms to be sold in pharmacies

(Wikipedia, 2013).

2.3 Why Condom Use

According to WHO/UNESCO/UNAIDS/Education International (1998), an estimated 42 million people are infected with HIV or have AIDS worldwide. The children and young people who had become infected worldwide by 2002 were estimated at 2.9 million. It is noteworthy that this is the period when people are daring and adventurous. About 8,000 children and young people become infected with HIV each day – approximately six per minute. In many countries, over 50% of all infections are among 15 – 24 year-olds.HIV as a serious and deadly disease was strongly associated with condom use in both male and female models. In an attempt to eradicate HIV, there is a need to educate people, most especially the youths who are very sexually active (Odu & Akanle, 2008).

Studies have shown that casual heterosexual relationship is one of the major means of spreading HIV/AIDS following the decline in its transmission through blood products

(Uwalaka & Matsuo, 2002). The scourge of HIV/AIDS has been globally acknowledged as pandemic. Legitimate alarm has been, and is being sounded in various quarters about the grave situation that has claimed millions of lives and turned many more widows or orphans prematurely (Obadara, 2009).AIDS stand for Acquired Immune Deficiency Syndrome. It is a pattern of devastating infections caused by the Human. Immuno Deficiency Virus or HIV, which attacks and destroys certain white blood cells that are essential to the body’s immune system.

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Also, Sprecher (1990) studied the impact of the threat of HIV/AIDS on heterosexual dating relationships among adolescents and found that majority of the dating partners reported discussing HIV/AIDS in their relationship. The participants, however, reported only a small amount of change in their sexual behaviours as a result of the threat of HIV/AIDS, with females reporting that they engaged in more cautious behaviours than their males counterparts. A majority of the participants believed that they would stay with their partner if he or she became HIV-infected while they also believed that their partner would stay with them if they became HIV-infected.

Research is urgently needed to understand the gap between awareness of the value of condoms and their actual use (PAS International Seminar, 2004). Condom use may imply a physical vulnerability, a need to shield oneself against infections or alternatively to protect one’s spouse from impurities that may have infiltrated the body during extramarital relations

(Iyayi & Ogbuke, 2011).The condom is a reliable contraceptive. It is relatively inexpensive, light, compact and disposable, requires no medical examination, supervision or follow-up, has no side effects. It also offers physical post-coital evidence of effectiveness provides protection against venereal disease and permits the male to share actively in planning his family (Tatum & Tatum, 1981). The British Standard Institute allows an acceptable quality level of 0.05% for holes in condoms in continuous production (Mills, 1998).

AIDS could well become one of the worst health problems in the history of the world

(Bowen, 2005). Sexual exploitation by both the young and old has contributed to the scourge, which has reached crisis proportion. AIDS has become a disease of consequence since there is no cure yet; millions of lives are claimed despite all combined efforts of individuals, government and non-governmental organizations to find a solution to the diseases. Heterosexual intercourse is the leading means of transmitting human immunodeficiency virus (HIV) in Nigeria (Sunmola, 2001).

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Condom has globally become one of the most potent phenomena in reproductive health issues. Condom saves lives and prevent morbidity and for the married users, it enhances quality of life, allowing couples to choose when they wish to have children. And for the teenagers and other unmarried users, it provides protection against ,

HIV/AIDS and other sexually transmitted infections (STIs) (Olaitan, 2009).Concern about young people’s vulnerability to new HIV infections has led to a deluge of youth-oriented reproductive health programs focusing on protective behavior, especially condom promotion

(Brieger et al., 2001), as a means of stemming the tide of infection (Adedimeji e tal.,

Undated).

The truth about condoms is that they offer the best protection for the sexually active (CDC,

1998). In view of the spread of AIDS, condoms make sense (Dixit, 1993). As a preventive measure the condom appears to be very effective especially where religiously adhered to.

Rajanapitayakorn (1993) reports that a 100% condom use campaign in Bangkok, Thailand may have slowed the spread of the infection there.

2.4 Condom Use and the Church

“The church could take the lead and say this is a thing that could happen to anybody,” says

Simpson. “If it could happen to a priest, it could happen to anybody else.” To do so would be an opportunity for the church for the church to move beyond the obstructionism it has engaged in with regards to condom distribution to an actual position of advocacy, challenging stigma by refusing secrecy and even the tradition of principled duplicity within their own house. Acknowledging the truth about people’s lived sexuality—from the fact that people have sex outside marriage to the reality that clergy have sexual lives—could amount to a much more human understanding of sex than the pope has envisioned so far (Kathryn

Joyce, 2012)

27

Religious affiliation may have both positive and negative effects on the risk of HIV infection. For example, religious groups that oppose both premarital sex and condom use may motivate adolescents to delay sexual initiation and to not use condoms when they do initiate sex (Agha, S. et al, 2006).

In 2010, when Pope Benedict XVI opened the door to approve condom use to prevent the transmission of HIV, he opened it just a crack, in a statement so laden with conditions and insult that it was hard to tell whether this was the groundbreaking news many took it to be.

Benedict told German journalist Peter Seewald, in his bookLight of the World: The Pope, the

Church, and the Signs of the Times that condoms might be permissible in limited situations.

But the situations he had in mind were limited indeed: use by male sex workers, for whom trying to prevent HIV transmission could be “a first step in the direction of moralization, a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants.” Benedict went further to suggest that illicit sexual relations weren’t quite human, and that condom use was only an option for those so debased that protected sex could constitute “a first step in a movement toward a different way, a more human way, of living sexuality.”Benedict clarified further that condoms weren’t “really the way to deal with the evil of HIV infection. That can really lie only in a humanization of sexuality,” he said.

The Catholic Church is the largest private provider of care to HIV AIDS patients in the world. In relation to the sexual transmission of the disease, the Church holds that sexual- abstinence before marriage and monogamy inside marriage are a better means of limiting the spread of the epidemic than is the use of condoms. In 2010, Pope Benedict

XVI characterized condom use as not a "real or moral solution" to the spread of AIDS, but potentially a "first step" in the direction of moralization and responsibility, when used with

"the intention of reducing the risk of infection". Pope Benedict XVI has said it was

28 acceptable to use a prophylactic when the sole intention was to "reduce the risk of infection" from AIDS. Pope Benedict XVI has restated the Catholic Church’s believes that contraception interferes with the creation of life, but using a condom to preserve life and avoid death could be a responsible act – even outside marriage. In the face of this ingrained opposition to condoms, the pope’s statement not only wasn’t revolutionary, it was all but ignored. Local Catholic officials still fail to consistently support condom use as a means to protect against HIV transmission.

HIV & AIDS advocates have long maintained that the Catholic ban on condom use, though largely ignored in the West, has led to devastating results in developing countries dependent on humanitarian aid, which is often filtered through Catholic or other religious groups.

Because Catholic leadership discourages the use of condoms, or religious relief organizations block their distribution, hundreds of millions are left more exposed to disease.

The condom is widely accepted by medical and administrative authorities as the most reliable way to stop the spread of AIDS. The Catholic Church instead emphasizes "education towards sexual responsibility", focusing on partner fidelity rather than the use of condoms as the primary means of preventing the transmission of AIDS. The Church's position is that all responsible sex must occur within the framework of a faithful, monogamous relationship. In addition, various members of the Church hierarchy have pointed out that condoms have a non-zero risk of transmitting AIDS.

Seventh Day Adventists get their name from their observation of the Sabbath (the seventh day) as the Holy Day. Observation of the Ten Commandments, including the Sabbath, is the foundation of their church. Adventists take a special interest in health concerns. This includes having a healthy diet and avoidance of alcohol and tobacco. Many Seventh Day

Adventists are vegetarians. Adventists are expected to shun worldly amusements and are only permitted spiritually uplifting entertainment. Premarital sex is forbidden in the church.

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Those found guilty of premarital sex have their membership withdrawn from the church immediately. Anyone found pregnant outside of marriage is deregistered from the congregation. Those de-registered are not allowed to take part in any religious activities, including partaking of the Holy Communion.

2.5 HIV/AIDS and Condom/Faith Bases Organization (FBO)

Use of condoms or non-use of condoms has been of particular interest to public health researchers trying to describe the young people’s sexual behaviour. Condoms are of clinical interest because of their dual role in protecting against pregnancy while simultaneously reducing risk of transmission of sexually transmitted infections, including HIV (Marston,

2004). Abstinence, faithfulness and use of condom have been suggested as the main strategies to prevent the HIV/AIDS transmission; but successful prevention programmes need to contain a balanced response, it is in nobody’s interest to undermine the extremely valuable role that condoms have to play in HIV/AIDS prevention. It is naïve in the extreme to believe that entire populations of sexually active adults can abstain or be faithful. Condom use has to be promoted as the main method of prevention, to enable people to make a well informed choice and therefore protect their sexual health (Open Science Repository, 2013).

The Human Rights Watch (2004) emphasized that to promote the condom use as a way of limiting the HIV /AIDS through the campaign must be done in conjunction with local governmental leaders, non-governmental organizations, and private sectors. An educational program is necessary to make educated and non-educated people aware of the effectiveness of condoms, in spite of their usual social, religion and cultural predictions regarding condom. There are many evidences of effectiveness of condom use promotion’s intervention; Cambodia is one of the countries where condom use was promoted successfully (WHO, 2001).

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Religious values are seen as sources of moral interdiction for many individuals and helps in the formation of personal attitudes, values and decisions making. Religion is being explored in the campaign against STDs in Nigeria; recently, some governmental agencies have partnered with religious organizations and leaders in the campaign against premarital sex and the further spread of HIV and other STDs. While there is increasing rate of religious activities in Nigeria, it is not out of place to find some young individuals that would not be in support of religious doctrines especially the abstinence ideology (Titilayo, Agunbiade &

Okanlawon, 2009).

2.6 Major and Minor Message in Condom Campaign

SFH began the social marketing of condoms in Nigeria in 1985, and its efforts have progressed through four phases. The introductory phase coincided with a period of extreme sensitivity to the promotion of condoms. The initial aim of the social marketing campaign was to make Nigerians aware of the benefits of using condoms. The second phase was a radio, TV, and billboard message campaign that presented condoms as both a family planning tool and a means of preventing disease. In the third phase, SFH shifted its focus from condom sales and sales promotion to promoting healthy practices. It also altered its goals from expanding sales volume to changing the behaviour of vulnerable persons, especially the poor. This phase relied on behaviour-change communicators and the dissemination of behaviour-change models. The fourth phase, now under way, emphasizes community mobilization that combines community-level interventions with social marketing practices (PAS International Seminar, 2004).

The success of male condom social marketing in both family planning and HIV/AIDS prevention programmes has led to a natural progression to consider use of social marketing in creating interest and access to the female condom, a relatively new device that provides

31 additional protection against STDs and HIV/AIDS. The first large-scale social marketing launch of the female condom was the “care contraceptive sheath” in Zimbabwe in 1997.

Female condom social marketing has now been tested and expanded in at least eight additional countries (UNAIDS, 1999).

Researchers have examined effects of numerous public communication campaigns, beginning with the classic campaign to teach Cincinnati residents about the United Nations

(Star and Hughes, 1950).Several community studies of HIV prevention programs have shown that print media messages contribute to higher levels of condom use and bleach use to clean IV needles(MMWR, 1996; Santelli et al., 1995).A teenage-targeted HIV prevention program in the Seattle area utilized a media campaign and enhanced condom distribution

(Alstead et al., 1999).

Greater attention needs to be directed towards measures that will reduce the risk of HIV infection in Nigeria, and since 1984 several approaches have been used by various governmental and no-governmental agencies to protect the public from HIV/AIDS infection.

The major focus of the efforts to encourage condom use has been advocacy through radio and television broadcasts, as well as other popular media channels, and within counseling relationships. Rational and self-evident as these messages may be, most Nigerians are only aware of condom use as birth control and sexual diseases protective measures. These efforts have not produced significant practical use of condoms in sexual relationships (Sunmola,

2001).

The campaign against the spread of HIV/AIDS in Nigeria was intensified following the formation of the National Action Committee on AIDS (NACA) and the State Action

Committee on AIDS (SACA) for every State in the Federation in 2000. Most of the

Government sponsored advertisements on the radio, television, in newspapers and on

32 billboards on the prevention of HIV/AIDS emphasize the use of condoms for , yet the prevalence has not declined (Ibe & Ibe, 2003).

Condoms are a crucial component of worldwide campaigns to reverse the AIDS pandemic.

Nigeria’s social marketing of condoms was subjected to an intensive and often critical review. ‘Social marketing’ refers to the application of commercial techniques in the pursuit of public goals. It has been used to address such issues as energy conservation, smoking cessation, safe driving, family planning, and improved nutrition. The promotion of condom use provokes both negative and positive reactions from Nigerians. In his presentation on

‘Advancing Prevention of HIV through Social Marketing of Condoms: The Nigerian

Experience’, Mr. Zach Akinyemi of the Society for Family Health (SFH) emphasized that because sexual activity is the main mode of HIV transmission in Nigeria, the expanded and consistent use of condoms is key to halting spread of the disease.

A way of encouraging condoms use may be, according to Donald and Ferreros (1990), through social marketing which is a method of promoting awareness of supply and distribution that complements many health delivery systems. While condoms are becoming popular and social marketing is encouraging condoms use to prevent transmission, a new concern has emerged on how to sustain such efforts (Manuel 1993).

2.7 Sexual Habits of Students

Risky sexual behaviour involves unprotected intercourse (intercourse without barrier such as condoms), unprotected mouth to genital contact, early sexual activity (before age 14), multiple sex partners, high-risk partner (partner who has multiple sex partners or uses drugs) and prostitution (Oluwatosin & Adediwura, 2010). Varga (2000) reported that many African youths and adolescents are at increased risk of HIV infection and transmission due to risky sexual practice. She further stated that such behaviour patterns include early initiation of

33 intercourse, low contraceptive use rates, multiple sex partners and poor sexual negotiation skills.

As Olaitan (2009) rightly recommended that the universities in south west Nigeria should liaise with the federal ministry of health for intensive campaign against HIV/AIDS through posters, handbills, mass media, through which the students could be adequately reached.

Finally, universities authorities in south west Nigeria should place at strategic locations on their campuses, information about HIV/AIDS and the usefulness of condom to prevent against the deadly diseases.

In Nigeria, the student population is composed mainly of those in the age bracket of 20 -30 years. Those in this age bracket are more sexually active and are vulnerable to HIV/AIDS infection. Studies on young people’s reproductive health in Nigeria have shown a high prevalence of risky sexual behaviour and low use of contraceptives (Alubo, 2000).Nigerian campuses are full of activities that promote sexual promiscuity (Fawole A. O., Ogunkan

D.V, Adegoke G.S, 2011). This is why awareness programmes are often developed and intensified on Nigeria campuses. Several methods have been used to sensitize Nigerian students on the existence of HIV/AIDS scourge. In spite of various campaign about

HIV/AIDS there is a conception that the prevalence rate of the scourge is high among the students in tertiary institutions and this has attracted the research interest of scholars (Ibe,

2005). On the contrary, all the youths in tertiary institution had good knowledge of condom use whereas 39.1% of youths with secondary school education have poor knowledge of condom use (Oyebanji, 2011).

2.8 Sexually Transmitted Disease Before 1960

Sexually transmitted diseases (STDs) are viral and bacterial infections passed from one person to another through sexual contact (encyclopedia.com). Prior to the invention of

34 modern medicines, sexually transmitted diseases were generally incurable, and treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases was founded in 1746 at London Lock Hospital. Treatment was not always voluntary: in the second half of the 19th century, the Contagious Diseases Act was used to arrest suspected prostitutes. The first effective treatment for a sexually transmitted disease was salvarsan, a treatment for . With the discovery of antibiotics, a large number of sexually transmitted diseases became easily curable, and this, combined with effective public health campaigns against STDs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat (News Medical, 2013).

The first hospital for patients with sexually transmitted diseases was established in Finland in 1756. By the end of the nineteenth century, up to 44 percent of bed days in the hospitals was attributable to STDs. The first chair of dermatovenereology was established at the

University of Helsinki in 1874. Systematic data on the incidence of sexually transmitted diseases in Finland have been available since 1930, when and syphilis were the most common STDs. In 1935, 10398 new gonorrhea cases and 1775 syphilis cases were reported. During wartime in the 1940s, the number of persons with STDs doubled. After the introduction of penicillin in the 1940s, the incidence of gonorrhea decreased. In the 1950s,

4500 to 5000 cases were reported yearly. Penicillin became the primary treatment for syphilis. An obligatory effective serological screening program for all pregnant women contributed to the disappearance of congenital syphilis in the 1950s (Eija Undated)

Syphilis and gonorrhea were long thought to be one disease. Real progress in characterizing them did not occur until the early 20th century, when their different causative microorganisms were identified and reliable diagnostic tests were developed. Effective treatment in the form of sulfa drugs and penicillin was introduced in the 1930s and ’40s, and the eradication of such diseases seemed imminent. By the end of the 1950s, however, the

35 frequency index had begun to rise again; among the many reasons cited were the tapering off of active “anti-VD” campaigns, the causative microorganisms’ growing immunity to the antibiotics used in treatment, and a variety of sociological factors influencing sexual behaviour. The widespread acceptance of oral contraceptives and their sup plantation of other methods of birth control were possibly linked, for a variety of reasons, to the spread of sexually transmitted diseases. Not only had the lack of oral contraceptives tended to discourage sexual promiscuity but also the older methods of condom and diaphragm had provided some protection against disease. Only with the outbreak of the AIDS epidemic did a return to the condom and “safe sex” receive new encouragement (Encyclopedia

Britannica)

In the late 1950s, there were only five types of sexually transmitted diseases of which syphilis and gonorrhea figured prominently. A new type of STD appeared and in the 1980s, the Human Immunodeficiency Virus (HIV) infected 12 million worldwide and claimed

160,000 lives in the U.S. and 25 million in sub-Saharan Africa. Today, there are 25 types of

STDs (Test Country Articles, 2013).

2.9 Possible Misconception of Condom use Despite extensive efforts in promoting condom use, men still engage in risky sexual behaviors due to certain myths and misconceptions (Fiaveh, 2012). In Zimbabwe, one of the major barriers to condom use among men and women is the belief that condoms are not effective in preventing HIV (low condom efficacy scores). According to KAP 2003, only

60% and 55% of males and females respectively feel that condoms are effective against

HIV. These scores had dropped for men (63% to 60%) and remained about the same for women (54% to 55%) from the baseline KAP data in 2001. Some of the contributing factors to this include myths and misconceptions around condoms (condoms break, are not big enough, need two per sex act etc.), inadequate knowledge on correct use resulting in

36 condoms breakages. These myths and misconceptions have been associated with condoms since their introduction on the Zimbabwean market.

Evidence suggests that the consistent and proper use of condoms could reduce the risk of being infected with HIV (Bankole et al, 2009). However, the misconceptions are that condom use reduces pleasure, condom use leads to loss of erection sexual act with a condom is inferior, and condom use implies sexual promiscuity (Maharaj, 2005). Consistent with studies conducted elsewhere, the study findings confirmed that the psychosocial barriers are associated with non-condom use among sexually experienced respondents (Hounton, e tal,

2005). The psychosocial factors associated with non-condom use in this study were as follows: my religion prohibits condoms, condoms reduce sexual pleasure, condoms offer no protection, and feeling shy to buy a condom. The strongest psychosocial barrier to condom use, for both men and women was their concern regarding condoms' reduction of sexual pleasure. Generally, adolescents tend to believe that a condom reduces sexual pleasure and this belief discourages condom use. According to existing literature on sexuality, there are four basic reasons why an individual may want to have sex. The first is sex for pleasure; the second is sex for procreation; the third is sex for money/or gifts; and the fourth is sex for cultural rituals (UNAIDS/WHO, 2008).

Many Nigerians cite diminished sexual satisfaction and the embarrassment of buying condoms in public as barriers to using them. Where gender relations are unequal, as is often the case in Nigeria, negotiations between sexual partners over condom use can be severely inhibited. Efforts to encourage consistent and correct condom use must therefore take these intersecting issues into consideration (PAS International Seminar, 2004).

2.10 General Assessment

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The effectiveness of preventing STDs over treatment may have influenced the preference for abstinence and contraception. However, the desire to attain absolute prevention has remained a mirage in many cultures as incidence and prevalence of STDs are found at variant degrees. Abstinence from premarital sex enjoys wide social approval in Nigeria; while contraceptives use among young people is largely socially restricted even among married people (Titilayo, Agunbiade & Okanlawon, 2009). Attitude towards contraceptive methods especially among youths is a principal determinant of general sexuality risk rate and fertility. Due to high proportion of early onset of sexual initiation among the youths

(Fadeyibi & Adewuyi, 2005).

In Nigeria, for example, UNFPA began collaboration in 2005 with the Federal Ministry of

Health to implement a UNFPA Female Condom Initiative. Over 30 registered national RH and HIV/AIDS NGOs were trained in FC counseling and distribution and linked to sustainable supplies of stock for their programmes. These NGOs are now distributing 76% of the FCs used in Nigeria. The social marketing organizations currently engaged in distributing most (about 80%) of all male condoms used in Nigeria are planning to launch marketing of FCs as well. These social marketing organizations (including Population

Services International, DKT International, and Marie Stopes International) play an important role across Africa. In 2006-07, UNFPA signed several collaborative Memoranda of

Understanding (MOUs) that allowed for delivery of UNFPA condoms to governments that distributed them through these organizations (GCM, 2009)

Even though, condoms recur in all genuine efforts towards AIDS prevention, some writers and researchers have raised issues with them (Slutkin 1993; Finger 1993). Shreedhar (1994) reports that Indian condom markets are awash with inferior condoms. These condoms are easily busted, not lubricated and easily fall to bits. The poor condom quality is attributed to two factors which are lack of consumer pressure and scarcity of reliable quality control.

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Inferior condoms may give rise to deep-seated resentment against their usage especially by first-timers. Condom of quality is important in view of the fact that it is one of the most effective means of AIDS prevention.

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WHO/UNESCO/UNAIDS/Education International (1998). WHO Information Series on School Health – Document 6. HIV/AIDS prevention as entry point for the development of health-promoting schools. Geneva: WHO.

Youssef H (1993): The history of the condom. Journal of the Royal Society of Medicine Volume 86 April 1993

CHAPTER THREE

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RESEARCH METHODOLOGY

In this chapter the research methodology used in the study is described. The study design and the population and sample are described. The instrument used to collect the data, including the methods implemented to maintain validity and reliability of the instrument are described. Qualitative, descriptive and cross-sectional approaches are mainly adopted.

3.1 Research Design

Research design can be thought of as the logic or master plan of a research that throws light on how the study is to be conducted. It shows how the entire major parts of the research study– the samples or groups, measures, treatments or programs, etc., work together in an attempt to address the research questions. Research design is similar to an architectural outline. The research design can be seen as actualization of logic in a set of procedures that optimizes the validity of data for a given research problem.

A quantitative approach was followed in the study. Burns and Grove (1997) define quantitative research as a formal, objective, systematic process to describe and test relationships and examine cause and effect interaction among variables. Surveys may be used for descriptive, explanatory and exploratory research. A descriptive survey design will be used. A survey is used to collect original data for describing a population too large to observe directly (Mouton, 1996). A survey obtains information from a sample of people by mean of self-report, which is the people respond to a series of questions posed by the investigator (Polit & Hungler, 1993). In this study the information will be collected through self-administered questionnaires distributed personally to the subjects.

A descriptive survey would be used because it provides an accurate portrayal or account of the characteristics, for example behaviour, opinion, abilities, beliefs and knowledge of a particular individual, situation or group.

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3.2 Population of the Study

According to Burns and Groove (1993), a population is defined as all elements (individual, objects and events) that meet the sample criteria for inclusion in a study. Population refers to the entire group of people, events, institutions, issues, countries that is the target or subject of investigation (Agbaje & Alarape, 2006). In this regard, the study population consists of all about students of the University of Nigeria, Nsukka. The total population of students in the University of Nigeria in both campuses amount to thirty one thousand five hundred and seventy-three (31,573) where male students amount to sixteen thousand seven hundred and thirty one (16,731) and female students population is fourteen eight hundred and forty-three 14,843 (UNN Registrar Office, 2014)

3.3 Sample Size

A convenient sample of 287 respondents was randomly selected from the study population.

Mouton (1996) defines a sample as elements selected with the intention of finding out something about the total population from which they are taken.

A convenient sample consists of subjects included in the study because they happen to be in the right place at the right time (Polit & Hungler, 1993). This sample include 287 (students) respondents in the study area.

3.4 Sampling Selection

The process of drawing up smaller subsets from a population is what is called sampling. In the social sciences, sampling has become the norm for at least four reasons:

§ Population is often too large for us to study.

§ Population is often unknown.

§ Cost of studying population may be too prohibitive.

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§ It is no longer necessary to study entire populations because we are now able to

drawn smaller samples from which inferences can be drawn valid for the population.

Sampling as a scientific procedure stands on two pillars. These are the principle of randomization, which enables us to draw samples representative of the population; and statistics, which enable us to make valid inferences about the sample and from the sample to its population (Agbaje & Alarape, 2006).

In Guilford and Fruchter (1973), sample size determinant ascribed to Taro Yamani is expressed in the formula stated as:

n = N / {1 + N (e2)}

Where: n = Desired Sample Size

N = Total Population

e = Accepted error limit (0.05 on the basis of 95% confidence level)

Therefore, n = 31,000 / (1 + 31,000 (0.052)

= 31,000 / (1 + 31,000 (0.0025)

= 31,000 / (1 + 124.00)

= 31,000 / 125

Therefore, Sample Size = 248 approximately 250 students.

Stratified sampling was applied in selecting our sample size for purpose of relevance of condom use among students. Stratification sampling is done according to considered sexual activity impact on the health and social life of the students. among student to ethical standards. It is considered that both research methods will be complementary and make for fuller evaluation of true state of ethical living and condom use campaign among the students.

3.5 Methods of Data Collection

46

The primary instrument through questionnaire administration to sample students’ opinion will be utilized. Primary data were collected through structured questionnaire. The questionnaire was structured into four broad sections A to D; Section A will address the students’ level of awareness of the Sexual transmitted related diseases; Section B, on impacts of unethical sexual behaviours on students’ health and social life, Section C on issues of sex education and condom use campaign and Section D on compliance level

3.6 Instrument Reliability and Validity

3.6.1 Instrument Reliability

Secondary data instrument are the Students information from the registry of the University and those from internet. It is will be asserted that the Reports are documents of the

University which are produced statistics and reference purposes.

Questionnaire instrument for primary data were used in the study. Questionnaires will be administered in all the departments that make up the University Community. The total of the even number questions and the total of the odd number questions were compared to determine a correlation.

3.6.2 Instrument Validity For Instrument validity, face-content validity, expert advice and best practice in health sector will be combined. In these regards, the views of experts and specialists in the University of

Nigeria Teaching Hospital (UNTH) will be sought on validity of questionnaire research instrument. Besides, past studies on related issue conducted will partly constitute bases for factor variables. The contents of questionnaires will be reviewed on several occasions by the

Supervisors of this work as the work progressed.

3.7 Method of Data Analysis

47

The study utilized Analysis of Variance (ANOVA) and Principal Component Analysis in the process of data analysis.

Analysis of Variance (ANOVA) is the statistical tool that was employed to test hypothesis one which state that; Ho: “there is no significant difference on the perception of students on the level of awareness in the use of condom in the study area”. ANOVA is a statistical technique utilized in partitioning of variations in an observed data into its various sources. It breaks down the total variations occurring in a dependent variable into various separate factors causing the variation. This technique does not stipulate any functional differences between the dependent and independent variables. The ANOVA procedure produces analysis of variance for a quantitative dependent variable by a single factor (independent) variable. Analysis of variance is used to test the hypothesis that several means are equal.

This technique is an extension of the two-sample t test.

In addition to determining that differences existing among the means, you may want to know which means differ. There are two types of test for comparing means: priori contrasts and post hoc tests. Contrasts are tests set up before running the equipment and post hoc tests are run after the experiment has been conducted. You can also test for trends across categories. Data factor variable values should be integers and the dependent variable should be quantitative (interval level of measurement). Assumptions: Each group is an independent random sample from a normal population. Analysis of variance is robust to departures from normality, although the data should be symmetric. The groups should come from populations with equal variances.

The equation for simple ANOVA is stated as follows:

SST (∑X2) − (∑X2)……………………………………….2

2 2 2 2 SSB = ∑(X1) + ∑(X2) + ∑(X3) + ∑(X4)

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N N N N

SSW = SST – SSB

Where;

SST = total sum of squares (perception of students on the level of awareness in the use of condom in different hostel studied).

SSB = Between sum of squares (level of awareness in the use of condom).

Degree of Freedom df (total)=Number of case in total N minus 1 (n – 1) df (between groups) = Number of groups K minus 1 (k –) df(within groups) sum of the number of cases within each group n minus 1(n –).

Mean Squares: MSB (mean squares for between groups) = SSB divided by df (between groups)

F = MSW (mean square for between groups) ------4 MSW (mean square for within groups)

Mean squares are calculated by dividing each sum of square by its degree of freedom. The F ratio for testing equality of group means is

F = Mean Square between Mean Square = BSSMWSSM

The significance level is obtained from the F distribution with numerator and denominator degrees of freedom.

While Principal component analysis (PCA) with varimax was applied to assess hypothesis number two which states that Ho: “there is no significant discernible pattern of condom use

49 campaign and sexual life of students in the study area”. Principal Component Analysis is a factor extraction method used to form uncorrelated linear combinations of the observed variables. The first component has maximum variance. Successive components explain progressively smaller portions of variance and are all uncorrelated with one another.

Principal components analysis is used to obtain the initial factor solution. It can be used when a correlation matrix is singular. Varimax rotation method is an orthogonal rotation method that minimizes the number of variables that have high loadings on each factor. This method simplifies the interpretations of the factors. PCA with Varimax rotation helped the study to determine percentage total variance explained, initial extraction and screen plot of discernible pattern of e-waste management variability in the study area. This was used to test hypothesis one.

The basic assumption of Principal Component Analysis (PCA) is expressed as follows. k

X= ∑ irfr + ei (i=1,2,…p).

r = 1 where: fr=the rth common PCA factor of condom use campaign and sexual life of students.

K is specified, ei = are residual representative source of variation affecting only the variant xi of sexual life of students.

P= random varieties of ei period of sexual life of students

Ei is the in dependence of one another and also the independence of the k varieties.

50

REFERENCES

Agbaje A. & Alarape A. I.(2006): Introductory Lectures on Research Methodology

Burns N.& Grove S. K (1997): The Practice of Nursing Research Conduct, Critique, & Utilization. W.B. Saunders and Co., Philadelphia.

Mouton (1996) in Burns N. & Grove S. K (1997): The Practice of Nursing Research Conduct, Critique, & Utilization. W.B. Saunders and Co., Philadelphia.

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CHAPTER FOUR

DATA PRESENTATION AND INTERPRETATION

4.1 Introduction to Types of Data Presented

Data presented are result of questionnaire administration on perception of student on condom use in University of Nigeria. The data were presented inform of tables, graphs and charts.

4.2 Data Presentation

4.2.0 Questionnaire Data Presentation

Questionnaire was used to examine the perception of student on condom use in University of

Nigeria. This enabled the study to formulate policy on condom use peculiar to the study area

4.2.1 Gender Structure

The demographic characteristics of the residents examined include the gender, age structure and literacy status of the respondents (table 6.1, 6.2 and 6.3).

Table 4.1: Gender Structure S/N Study Locations Female % Male % Male Female

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1 Mary Slesor hostel 29 10.1 21 7.32

2 Okpara Hostel 23 8.01 16 5.57

3 Bellow Hostel 24 8.36 21 7.32

4 Keneth Dike Hostel 25 8.7 19 6.62

5 Lady Ibiam Hostel 34 11.85 21 7.32

6 Ojukwu Hostel 30 10.45 24 8.36

(Source: Author’s Fieldwork, 2015)

The result in table 6.2 shows the number of female and male in various locations of the study area. Among the 287 students actually studied, 165 (57.49) are female and 122

(47.51%) are male.

Table 4.2: Age Structure of the Respondent

Options on Age Range S/N Study 15-19 20-24 25-29 30-34 35-39 40-44 Locations

1 Mary Slesor 10 6 10 3 5 9 hostel 2 Okpara Hostel 1 3 11 4 8 2 3 Bellow Hostel 3 3 8 10 12 9

4 Keneth Dike 15 5 9 8 9 9 Hostel 5 Lady Ibiam 1 12 13 16 6 7 Hostel 6 Ojukwu 3 13 12 5 9 9 Hostel (Source: Author’s Fieldwork, 2015)

The outcome in table 6.2 shows the age structure of the students studied. The greater proportions of the students are within age ranging from 20 to 44 years. This implies that the population is sexual active students.

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4.2.2 Awareness of Condom Use

The data of the awareness on condom use in the study area were presented in table 4.3.

These set of data was utilized to establish objective number 1 of the study. This objective

was set to examine level of awareness on condom use in University of Nigeria.

Table 4.3: Awareness of Condom Use in the Study Area

Awareness of University of Nigeria Students Condom Use

Mary Okpara Bellow Keneth Lady Ojukwu Total % Slesor Hostel Hostel Dike Ibiam Hostel hostel Hostel Hostel How do you hear about condom use Radio advert 5 15 27 17 40 28 132 33.5% Television Advert 4 17 17 41 18 41 138 35% Hospital 10 5 8 6 10 12 51 12.9% Peer group 1 2 0 9 20 21 53 13.4% Others specify 0 0 3 1 7 9 20 5%

Total 20 39 55 74 95 111 394

How often do you use Condom Very often 10 5 8 6 12 12 53 13.4% Often 1 2 0 9 19 21 52 13.1% Not often 5 15 27 17 38 27 129 32.7% Not at all 4 17 17 41 18 42 139 35.2%

Others specify 0 0 3 1 8 9 21 5.3% Total 20 39 55 74 95 111 394 Why do people use condom Avoid pregnancy 5 15 27 17 38 27 129 32.7%

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Avoid STD 4 17 17 41 18 42 139 35.2% Avoid HIV 10 5 8 6 12 12 53 13.4% I don’t know 0 0 3 1 8 9 21 5.3% Others specify 1 2 0 9 19 21 52 13.1% Total 20 39 55 74 95 111 394 Type of condom Latex condom 10 23 17 41 18 42 151 38.3%

Specialty condom 5 6 27 17 38 27 120 30.4% Non-latex condom 4 8 8 6 12 12 50 12.6% Invertible condom 1 2 0 9 19 21 52 13.1% Others specify 0 0 3 1 8 9 21 5.3%

Total 20 39 55 74 95 111 394

Brand of condom Rough riders 5 15 27 17 40 28 132 38.4% Gold cycle 4 17 17 41 18 41 138 40.2% 1 2 0 9 20 21 53 15.4% Female condom 0 0 3 1 7 9 20 5.8% Total 10 34 47 68 85 99 343 Why student don’t like condom Sex less 4 5 8 6 12 11 46 21.1% pleasurable We are not 10 6 10 3 5 9 43 19.7% infected It is not 100% 1 3 11 4 8 2 29 13.3% save My friends don’t 3 3 8 10 12 9 45 20.6% use it Others specify 15 5 9 8 9 9 55 25.2% Total 33 22 46 31 46 40 218 Why some student still don’t use condom Ashamed to buy 15 40 5 15 27 28 130 39.5%

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Superstition 17 18 4 17 17 41 114 34.6%

Not enough 5 10 10 2 0 12 39 11.8% awareness Stigma with 2 20 1 0 3 21 49 14.8% condom Others specify 0 7 0 1 4 9 21 6.3% No opinion 0 2 1 2 5 8 18 5.4% Total 39 97 25 37 12 119 329 (Source: Author’s Fieldwork, 2015)

The outcome of table 4.3 shows that the awareness of condom use is very high among

students of the study area. While about 35% of student received awareness through TV. 33%

listened to radio. However, this did not increase condom use amongst students. 35% of

students don’t use condoms atall. While a very low 13% use condom often. The study

further shows that 33% and 35% of students use condoms to avoid pregnancy and sexually

transmitted infections (Diseases).

The knowledge of the types and brands of condoms in circulation and available is quite

appreciable.

About 40% of students are ashamed to buy condom while 34% will not use condom because

of superstitious belief.

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Table 4.4: Campaign on condom use

Campaign on University of Nigeria Students condom use

Mary Okpara Bellow Keneth Lady Ojukwu Total % Slesor Hostel Hostel Dike Ibiam Hostel hostel Hostel Hostel Type of condom use campaign

Electronic media 4 17 17 41 18 42 139 35.2% Print media 5 15 27 17 38 27 124 31.4% Seminar/workshop 10 5 8 6 12 12 53 13.4%

Social network 1 2 0 9 19 21 52 13.1% Others specify 0 0 3 1 8 9 21 5.3% Total 20 39 55 74 95 111 394 Frequency of condom use campaign Very often 5 18 14 39 19 40 135 36.1% Often 4 14 28 18 37 29 130 34.8% Not often 10 5 8 6 12 12 53 14.2% Not at all 1 2 2 10 19 21 55 14.7% Total 20 39 52 73 87 102 373

Period of

Campaign October rush 10 5 8 6 12 12 53 13.4%

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Valentine period 1 2 0 9 19 21 52 13.1% Rainy season 5 15 27 17 38 27 129 32.7% Festival season 4 17 17 41 18 42 139 35.2% After semester exam 0 0 3 1 8 9 21 5.3% Others specify 0 0 0 0 0 0 0 0% Total 20 39 55 74 95 111 394 Other save method Abstinence 5 12 10 12 4 17 60 18.5% Contraceptive 2 21 1 19 5 15 63 19.4% Faithfull to one 15 27 5 38 10 5 100 30.8% partner Traditional method 17 42 4 18 1 2 84 25.9% Others specify 0 9 0 8 0 0 17 5.2% Total 39 111 20 95 20 39 324 Do students need condom use campaign Strongly agree 4 17 17 41 18 42 139 35.2% Agree 5 15 27 17 38 27 54 13.7% Disagree 10 5 8 6 12 12 53 13.4% Strongly disagree 1 2 0 9 19 21 51 12.9% No opinion 0 0 3 1 8 9 21 5.3% Total 20 39 55 74 95 111 394 Others source of clarify matter on condom use campaign Internets 5 15 27 17 38 27 129 32.7% Get back to 4 17 17 41 18 42 139 35.2% campaign sources Ask peer 10 5 8 6 12 12 53 13.4% Read books 0 0 3 1 8 9 21 5.3% Others specify 1 2 0 9 19 21 52 13.1% Total 20 39 55 74 95 111 394 (Source: Author’s Fieldwork, 2015)

4.2.3 Campaign on condom use

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The data of condom use campaign in the study area were presented in table 4.4. These set of

data was utilized to establish objective number 2 of the study. This objective was designed

to examine level of condom use campaign in the study area

The outcome of table 4.4 shows that most organization doing condom use campaigns use the

electronic and print media. This is so because 35% and 31% of students in the study area

depended on the electronic and print media respectively.

The frequency of the dependent of both campaigns and student turned out very high,

especially during the raining and festival seasons 32% and 35% respectively. However, a slit

prominence occurs during the October rush (opening of new academic year). And the

valentine season.

The study further shows, 35% of students believes that these should be more condom use

campaign and more interaction with service providers.

4.2.4 Condom use and students sexuality

The data of condom use and students sexuality in the study area were presented in table 4.5.

These set of data was utilized to establish objective number 3 of the study. This particular

objective was structured to examine condom use and students sexuality attitudes in the study

area.

Table 4.5: Condom use and Students Sexuality

Condom use and students sexuality University of Nigeria Students

Mary Okpara Bellow Keneth Lady Ojukwu Total % Slesor Hostel Hostel Dike Ibiam Hostel hostel Hostel Hostel Awareness of Condom use increases sex

59 frequency of student

Strongly agree 0 0 3 1 8 9 21 10% Agree 10 14 21 18 37 33 133 34% Disagree 5 18 13 39 19 37 131 33% Strongly disagree 1 2 10 10 19 21 63 18% No opinion 4 5 8 6 12 11 46 12% Total 20 39 55 74 95 111 394 Without condom sex is with fear Strongly agree 12 22 17 15 19 12 97 22% Agree 10 5 8 6 12 27 68 15% Disagree 5 15 27 17 38 21 121 27% Strongly disagree 4 17 17 41 18 42 139 31% No opinion 0 0 3 1 8 9 21 4% Total 31 59 72 80 95 111 448 Condom use increase sexual promiscuity Strongly agree 1 2 0 9 19 21 52 13% Agree 5 15 27 17 38 27 129 33% Disagree 10 5 8 6 12 12 53 13% Strongly disagree 4 17 17 41 18 42 139 35% No opinion 0 0 3 1 8 9 21 5% Total 20 39 55 74 95 111 394 Condom use increases homosexuality Strongly agree 5 15 27 17 38 27 124 33% Agree 1 2 0 9 19 21 43 12% Disagree 10 5 8 6 12 12 53 14% Strongly disagree 4 17 17 41 18 42 139 37% No opinion 0 0 0 0 0 0 0 0 Total 20 39 52 73 87 102 373 Condom use campaign reduces HIV & AIDS Strongly agree 12 22 17 15 19 12 97 30% Agree 10 5 8 6 12 27 68 21% Disagree 10 14 21 18 37 33 133 42% Strongly disagree 0 0 3 1 8 9 21 7% Total 32 41 49 76 81 81 319 Condom use campaign made it difficult for students to abstain from sex Strongly agree 10 5 8 6 12 12 53 13% Agree 1 2 0 9 19 21 52 13% Disagree 5 15 27 17 38 27 124 31% Strongly disagree 4 17 17 41 18 42 39 35%

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No opinion 0 0 3 1 8 9 21 5% Total 20 39 55 74 95 111 394 Condom use campaign promotes sex addiction Strongly agree 5 15 27 17 40 28 124 34% Agree 4 17 17 41 18 41 138 35% Disagree 10 5 8 6 10 12 51 13% Strongly disagree 1 2 0 9 20 21 52 13% No opinion 0 0 3 1 7 9 21 5% Total 20 39 55 74 95 111 394 Condom use campaign made sex less attractive Strongly agree 10 5 8 6 12 12 53 13% Agree 1 2 0 9 19 21 21 5% Disagree 5 15 27 17 38 27 128 31% Strongly disagree 4 17 17 41 18 42 139 35% No opinion 0 0 3 1 8 9 21 5% Total 20 39 55 74 95 111 394 Condom use campaign increase multiple sex partners Strongly agree 4 5 8 6 12 11 46 12% Agree 10 14 21 18 37 33 133 34% Disagree 5 18 13 39 19 37 131 33% Strongly disagree 1 2 10 10 19 21 63 16% No opinion 0 0 3 1 8 9 21 5% Total 20 39 55 74 95 111 394 Condom use made students lose virginity Strongly agree 4 17 17 41 18 42 139 52% Agree 5 15 27 17 38 27 129 33% Disagree 10 5 8 6 12 12 59 15% Strongly disagree 1 2 0 9 19 21 52 13% No opinion 0 0 3 1 8 9 21 5% Total 20 39 55 74 95 111 394 (Source: Author’s Fieldwork, 2015)

The outcome of table 4.5, shows that 34% students agreed that awareness of condom use

increase sex frequency among students. We must however not ignore the 33% that disagree.

The worry here is that 31% of students are not afraid of having sex without condom.

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Condom use campaign can give rise to sexual promiscuity as 33% of students agreed.

However, the number of students who disagreed is very high about 35%.

The study further shows that 37% of students strongly disagreed that condom use encourages more homosexual activities while 34% student opined that condom use campaign promotes sex addiction, they also don’t think it will affect abstinence. More student are now attracted to have sex since they started access condom use campaign, they also agree that there is increase in sexual activities among multiple partners and lose of virginity.

4.2 Interpretation of Result 4.3.1 Analysis of variance (ANOVA) on Awareness of Condom Use

The ANOVA result in table 4.6 was obtained for hypothesis 1 which states “there is no significant difference on the perception of students on the level of awareness in the use of condom in the study area”. The ANOVA was carried out with data in table 4.3 of this study.

Table 4.6 Analysis of variance (ANOVA) on Awareness of Condom Use Mode Sum of l Squares df Mean Square F Sig. 1 Regression 225.084 5 45.017 2.486 .001(a) Residual 507.034 28 18.108 Total 732.118 33 (Source: Author’s SPSS ANOVA, 2015)

The result of the ANOVA can be rewritten as follows:

Sum of Sqaure = 225.084

Degree of Freedom = 5

Mean Square = 45.017

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F. value = 2.486

Signiicant Value of f Statistics = 0.001

P. value = 0.001

The P of 0.001 is less than critical value of 0.01. This P value of 0.001 shows statistical significance within the components of study. The implication is that there is significant difference on the mean score of perception of students on the level of awareness in the use of condom in the study area (p = 0.001).

Resolution Considering the P value of 0.001, which is les than critical value of 0.01, hypothesis 2, which state “there is no significant difference on the perception of students on the level of awareness in the use of condom in the study area” is rejected. As a result, the alternate hypothesis which state H1 “there is significant difference on the perception of students on the level of awareness in the use of condom in the study area” is accepted.

4.2.1 Application of Principal Component Analysis on Pattern of Condom use Campaign and Sexual Life The Principal Component Analysis (PCA) in Appendix 2 was conducted for hypothesis number 2 which state “HO: there is no significant discernible pattern of condom use campaign and sexual life of students in the study area”. The PCA used opinion data on condom use campaign and sexual life in the study area (see data in table 4.4 and 4.5). The result of PCA includes communalities, total variance explained, and Eigen value screen plot and rotated component matrix. The detail result is shown in appendix 2 section of this work.

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Total cumulative percentage variance for pattern of condom use campaign and sexual life in the study is 94.381%. The explained variance indicates 94.381% significant in pattern of condom use campaign and sexual life Therefore, the complexity of data set on pattern of condom use campaign and sexual life information loss is 5.619 (ie 100- 94.381%).

The total variance explained of 94.381% entailed significant discernible pattern of condom use campaign and sexual life.

The pattern of condom use campaign and sexual life is also validated with the extraction communality. The extraction communality of discernible pattern of condom use campaign and sexual life is presented in table 4.7 of the study.

Table 4.7: Communalities of Pattern of Condom use Campaign and Sexual Life Raw Rescaled Initial Extraction Initial Extraction Condom Use 20.999 13.092 1.000 .623 Type Sex Frequency 95.131 92.422 1.000 .972 Promiscuity 93.513 88.784 1.000 .949 Homosexuality 189.430 185.085 1.000 .977 Sex Abstain 131.702 120.170 1.000 .912 Sex Addicted 165.431 161.100 1.000 .974 Sex Less 20.999 13.092 1.000 .623 Attractive Multiple Sex 95.131 92.422 1.000 .972 Lose Virginity 93.513 88.784 1.000 .949 Extraction Method: Principal Component Analysis. (Source: SPSS, PCA 2015) The result of communality in table 6.7 shows the variables that are accountable for the variance of pattern of condom use campaign and sexual life of the students in the study area.

Initial communalities are estimate of variance in each variable accountable for pattern of condom use campaign and sexual life. The PCA initial extraction is 1 in all cases. Hence,

64 extraction communality estimates of variance in each pattern of condom use campaign and sexual life of students are analyzed in table 6.7.

The communality of pattern of condom use campaign and sexual life of students with extraction value of 0.5 and above indicates high value significant component score. All the 9 variables analyzed in table 6.7; recorded a range of 0.6 to 0.9 extraction values. The implication is that there is significant discernible pattern of condom use campaign and sexual life of students in the study area.

The result of varimax rotated component matrix of pattern of condom use campaign and sexual life of students is also shown in table 6.8. The table highlights the relevant condom use campaign and sexual life variables that are accountable for 94.381% total variance explained which was stated earlier in this work.

Table 5.8: Rotated Component Matrix of Discernible Pattern of Condom Use Campaign and Sexual Life Variables Components 1 2 3 Condom Use .786 .039 -.067 Type Sex Frequency .887 .133 .409 Sex .226 .920 .230 Promiscuity Homosexuality .345 .198 .905 Sex Abstain -.097 .943 .120 Sex Addicted -.187 .545 .801 Less Attractive .786 .039 -.067 Multiple Sex .887 .133 .409 Lose Virginity .226 .920 .230 Extraction Method: Principal Component Analysis.

Rotation Method: Varimax with Kaiser Normalization.

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(Source: Author’s SPSS PCA, 2015)

The varimax rotation reduced the 9 pattern of condom use campaign and sexual life of students used in the analysis to 3 components which includes components 1, 2 and 3.

The relevant pattern of condom use campaign and sexual life variables in component 1 are condom use type with 0.786, sex frequency with 0.887, less attractive with 0.786 and multiple sex partners with 0.887.

The significant pattern of condom use campaign and sexual life variable in component 2 are sex promiscuity with 0.920, sex abstain with 0.943, loss of virginity with 0.920

The relevant pattern of condom use campaign and sexual life variables in component 3 are

Homosexuality with 0.905 and sex addicted with 0.801

Hence, these high loading relevant patterns of condom use campaign and sexual life variables in component 1, 2 and 3 are known as derived parameter. The components of the derived parameter are related, consequently named condom use campaign and sexuality innovation model. This study established that condom use campaign and sexuality innovation model is responsible for increasing sex habit and associated problems in the study area.

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CHAPTER FIVE

DISCUSSION OF FINDINGS

5.1 Introduction The study examines the level of awareness on condom use, pattern of condom use campaign and sexual life of students of university of Nigeria. The study was carried out with survey data on level of awareness on condom use, pattern of condom use campaign and sexual life of students in the study area. The discussion of findings is based strictly on comparing the results of the study with the related literature raised in the study.

5.2 Findings from Level of Awareness on Condom use in the Study Area (Objective 1)

The findings of the study emphasized that there is significant difference on the perception of students on the level of awareness in the use of condom in the study area (p = 0.001). The study observed that level of awareness on condom use difference from issues raised on source of information on condom use, reason for condom use, type of condom use and why some students dislike condom use. The detail is contained in table 6.3 of this study. This is related to the study of Akinyemi (2012) who opined that increase in campaign of condom use would benefit the general populace. In agreement with Akinyemi, most students are up taking various forms of campaign especially the electronic and print media and majority of student will consider going back to several providers or the internet to know more about condom use.

The study also agrees with the (PAS interaction seminar, 2014) assertion that the most students are ashamed to or feel embarrassed at the point of buying condom.

While Olaitan, 2009 work supports the high acceptance of why condom use which ranges from avoiding pregnancy and sexually transmitted and allowed reproducing couples the choice to embrace quality life. As our study shows opinions. Brieger et al, 2001 supports

67 that, in the light of very high new HIV infections rate the reproductive health programme should focus more on protective behavioural life style by re-orienting the youth. There are changeable behavioural life styles like changing from being sex addict, unfaithful to abstinence and being faithful to yourself and partner. More so, up taking the condom use consistency and correcting re-orienting also incline change in values and up holding good moral principles.

Furthermore, Fawole A.O Ogunkan D.V, Adegoke G.S, 2011 agrees with our study that according to them, Nigeria campuses are full of activities that promote sexual promiscuity.

We are therefore not surprise that according to our study there is an increase of homosexual activities on campuses. The question then is how can condom campaign reduce the new incidence of homosexual activities and inflation of STIs and HIV on our campuses?

Oyebaji, 2011 opines that the promiscuity among youth don’t first start in the tertiary institution but from the secondary and possibly primary schools. Further looks at the very low condom use awareness in secondary and primary as the root cause. This work is however silent on this and suggests a research in this area and hopeful finding a way to reach out to this under age student without doing a condom use campaign.

This study disagree with Bankole et al, 2009 that said consistence and proper use of condoms could reduce the risk of being infected with HIV. Most student will rather insist that condom campaign has increased sex addiction among the study area.

Agumbiade and Okanlawon, 2009 agree with our study when they opined that abstinence from premarital sex enjoys wide social appeal in Nigeria. In our study most students disagreed strongly that condom campaign will stop them from abstaining or delaying sexual debt.

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5.3 Findings from Pattern of Condom use Campaign and Sexual Life of Students in the Study Area (Objective 2 and 3)

The findings of the study emphasized that there is significant discernible pattern of condom use campaign and sexual life of students in the study area (total variance explained of

94.381%). The communality extraction values for pattern of condom use campaign and sexual life of student ranges from 0.6 to 0.9; the derived parameter accountable for pattern of condom use campaign and sexual life of student is known as condom use campaign and sexuality innovation model. Its components include: condom use campaign type, sex frequency, sex promiscuity, homosexuality, sex abstinence, sex addiction, sex less attractive, multiple sex and lose virginity. The detail is contained in table 4.4 and 4.5 of this study. This is related to the study of Santelli el tal (1995) that which agrees that most condom campaign messages have been done through the electronic and print media as also agreed to by

MMWR (1996). It is also support the high acceptability of the media and the frequency.

While condom use campaign frequent is upheld by both researches, Donalch and Ferreros

(1990) insist on the social marketing method which has gain more popularity. The period best for this campaign is however not emphasized. This work therefore, have discovered that most students think the raining and festival season are prime periods while the October rush

(when fresh men join the community) should not be neglected. The sexual habit of students according to Oluwatosin and Adediwura (2010) are very risky as they involve themselves in earlier sex debt and unprotected most of the time. This agrees with our study to a very large extent. Our study shows that there is an increase of multiple sex partners because of condom use campaign . Varga (2000) also agrees with this study that risky sexual life is on the increase and opined that the poor sexual negotiation skills should be stepped up.

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Ibe and Ibe (2003) noted that inspite of the high emphasis on condom use for safe sex, the prevalence (HIV) has not declined. This agrees with Varga (2000) who had insisted on enhanced sexual negotiation

CHAPTER SIX

SUMMARY, RECOMMENDATION AND CONCLUSION

6.1 Summary

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The objectives of this study were as follows: To determine the level of awareness of condom use among the students of the University of Nigeria, Nsukka. To analyze the trend of condom use campaign in the Nigeria with particular reference to the students community of the university of Nigeria, Nsukka and to determine the influence of condom use campaign on the sexual life of the students of the University of Nigeria, Nsukka Students of both campuses were sampled from different hostels comprising of 165 (57.49) females and

122(47.51%) males totaling 287 students in all. Their opinions were sought and received through the administration, collection, collation and analyses of questionnaires.

The chapter one of this study provided the explanatory notes. Chapter two followed with the theoretical and empirical literature. The over view of condom use campaign; what is condom; the history of condom and why condom use. Moreso, condom use and the church;

HIV/AIDS. HIV/AIDS and condom use/faith based organization (FBO) were reviewed alongside major and minor messages in condom campaign and the sexual habit of students.

It was also important to review the sexual transmitted diseases before 1960 then the possible misconceptions and the general assessment of condom use.

Chapter three of the study discussed the research methodology. This include, research design, population of study, sample and validation instruments, methods of data collection and data analysis. The chapter four articulated the findings of this study while chapter five discussed the finding as generated by the study.

The following therefore, can be deduced from the findings of this study.

1. Despite the fact that condom use campaign have helped in saving life and reduced

sexually transmitted diseases. It has also created some problems in the sexuality of

students.

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2. Despite condom use campaign, new sexually transmitted infections have been

recorded.

3. There is a high increase of sex frequency amongst students.

4. Despite the condom use campaign, a huge number of students still are not afraid to

have sex without condom.

5. Significant number of students agreed that there is a rise in sexual promiscuity.

6. There is a very high increase in the homosexuality amongst students.

7. Absence is on the decline due to condom use campaign amongst students leading to a

high number of students losing their virginity.

8. Multiple sex partners rose astronomically because of frequent condom use campaign

amongst students.

9. A new approach is therefore necessary which this study now identify, condom use

campaign and sexuality innovation model.

6.2 Recommendation Based on the findings of this study, the following recommendations are therefore suggested.

1. There is a need for an upscale approach that should encourage condom use without

giving the wrong message to students.

2. The church and other Faith Based Organization (FBO), Non-governmental

Organization, NGOs and Civil Society Organization CSOs should work with the

government and especially line Ministries to develop a more acceptable message on

condom use.

3. The government and school authorities should ensure that condom campaign carry a

cavet. Service provides should add caution to their messages like smokers are liable

to die young.

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4. Emphasis must not be only on condom use. Absence should be more emphasized as

the best option for protection.

5. The government should re-orient our youths by putting together, a wholistic

reproductive programme which will focus more on other health protective

behaviours other than condom use.

6.3 Conclusion

This study established that condom use campaign has both positive and negative effects.

However, the negative effect of increase in the sexual habit of student is very clear.

We therefore pray that it is important and almost imperative that urgent study and implementation of the above recommendation of this research be done.

Our expectation are that our students will up take recommendation and down scale on their negative sexual life.

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APPENDIX I

QUESTIONNAIRES Institute of Development Studies University of Nigeria Enugu Campus Dear Respondents, I am a Master candidate of the above mentioned department researching on the topic “Condom use campaign and its influence in the sexual life of students of the University of Nigeria Nsukka”.

The questionnaire is designed to generate information and data that would be relevant to the study.

Your responses would be treated in strict confidence and you are not expected to disclose your identity.

Thanks for your anticipated kind co-operation.

Yours sincerely,

Ven. Emeka Ezeji E.

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SECTION A- DEMOGRAPHIC CHARACTERISTICS 1. Gender a) Male [ ] b) Female [ ] 2. Age range a) 17 – 21 [ ] b) 22-27 [ ] c) 28-33 [ ] d)34-39[ ] e) 40 -44[ ] f) 45 & above[ ] 3. Year of study (a) 100 levels[ ] b) 200 levels [ ] c) 300 levels [ ] d) 400 levels and above [ ] 4. Are you sexually active a) Yes [ ] b)No[ ]

SECTION B: AWARENESS OF THE USE OF CONDOM 5. Have you heard about condom? a) Yes [ ] b) No [ ] c) I don’t know [ ] 6. How did you know about condom (a) Radio advert [ ] b) Television advert [ ] c) Hospital [ ] d) Through peer [ ] e) other specify ……………………………. 7. Have you ever used condom? (a) Yes [ ] b) No [ ] c) Can’t Remember [ ] 8. How often do you use condom? (a) Very often [ ] b)Often[ ] c)Not often[ ]d)Not at all [ ] 9. Why do people use condom? a. Avoid pregnancy[ ] b. Avoid Sexually Transmitted Infection STI[ ]

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c. I don’t know[ ] d. Others specify………………………………………………………… 10. Is condom 100% save? a. Yes[ ] b. No [ ] c. I don’t know[ ] 11. What are the types of condom you know? a. Latex condoms[ ] b. Specialty condoms[ ] c. Non- latex condoms[ ] d. Insertable (female) condoms[ ] e. I don’t know[ ]

12. What are the brand of condom you know? a. Rough rider condom [ ] b. Gold circle condom[ ] c. Durex condom [ ] d. Female condom[ ] e. Others specify…………………………………………………………. 13. Why do you think some students don’t like condom? a. Sex is less pleasurable [ ] b. We are not infected [ ] c. It is not 100% save[ ] d. To emulate others[ ] e. Others specify…………………………………………………………… 14. Why is it that some students inspite of the awareness of condom use still don’t assess condom a. They are ashamed to buy it [ ] b. Superstition associated with condom[ ] c. Not enough awareness[ ] d. Stigma associated with condom[ ] e. Others specify………………………………………………………….

SECTION C: CAMPAIGN ON CONDOM USE IN THE UNIVERSITY 15. Has there been condom use campaign in the university community? a. Yes[ ]

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b. No[ ] c. I don’t know [ ] 16. What type of condom use campaign is common in the university community? a. Electronic media[ ] b. Print media[ ] c. Seminars/ workshop[ ] d. Social networks[ ] e. Others specify………………………………………………………. 17. During Condon use campaign, was condoms shared to students a. Yes [ ] b. No [ ] c. I don’t know [ ] 18. How often do condom use campaigns happen in the university community? a. Very often [ ] b. Often [ ] c. Not often [ ] d. Not at all [ ] 19. What period does this campaigns mostly take place? a. October Rush[ ] b. Before February14 [ ] c. Rainy season[ ] d. Festive seasons[ ] e. Others specify…………………………………………………… 20. What are other safety measure discussed other than condom use a. Abstinence[ ] b. Contraceptive pills[ ] c. Faithfull to one partner[ ] d. Traditional methods [ ] e. Others specify …………………………………………………….. 21. Do you think students need condom use campaign in the University Community? a. Strongly Agree [ ] b. Agree [ ] c. Disagree [ ] d. Strongly Disagree[ ]

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e. No opinion [ ] 22. After condom use campaign, if you are confused how else do you get more information a. Internet [ ] b. Get back to campaign sources[ ] c. Ask my peer [ ] d. Read up books[ ] e. Others specify………………………………………………………

SECTION D: CONDOM USE CAMPAIGN AND STUDENTS SEXUALITY 23. Now that you know about condoms use, the number of sex times students have sex has increased. a. Strongly disagree [ ] b. Agree [ ] c. Disagree [ ] d. Strongly disagree[ ] e. No opinion [ ] 24. Before the condom use campaign, has been sex with a lot of fear a. Strongly agree [ ] b. Agree[ ] c. Disagree[ ] d. Strongly disagree[ ] e. No opinion [ ] 25. Condom use campaign has increased the sexual promiscuity in the University community a. Strongly agree[ ] b. Agree [ ] c. Disagree [ ] d. Strongly disagree [ ] e. No opinion [ ] 26. Condom use campaign has increased the activities of homosexuals a. Strongly agree [ ]

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b. Agree [ ] c. Disagree [ ] d. Strongly disagree [ ] e. No opinion[ ] 27. Condom use campaign has reduced the rate of HIV/AIDs new infection in the university community a. Strongly agree [ ] b. Agree [ ] c. Disagree [ ] d. Strongly disagree [ ] e. No opinion [ ] 28. Condom use campaign has made it increase difficult for students to Abstain from sex a. Strongly agree [ ] b. Agree [ ] c. Disagree [ ] d. Strongly disagree [ ] e. No opinion[ ] 29. Condom use campaign promotes sex addiction a. Strongly agree [ ] b. Agree [ ] c. Disagree[ ] d. Strongly disagree [ ] e. No opinion [ ] 30. Condom use campaign has made sex less attractive a. Strongly agree [ ] b. Agree [ ] c. Disagree [ ] d. Strongly disagree [ ] e. No opinion [ ] 31. Condom use campaign has increased the chances of multiple sex partners among students in the university community. a. Strongly agree [ ] b. Agree [ ]

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c. Disagree [ ] d. Strongly disagree [ ] e. No opinion [ ] 32. Condom use campaign made many students (male & female) lose their virginity a. Strongly agree [ ] b. Agree[ ] c. Disagree[ ] d. Strongly disagree [ ] e. No opinion[ ]

APPENDIX 2 STATISTICS Variables Entered/Removed (b)

Mode Variables Variables l Entered Removed Method 1 VAR0000 6, VAR0000 3, VAR0000 . Enter 2, VAR0000 5, VAR0000 4(a) a All requested variables entered. b Dependent Variable: VAR00001

ANOVA (b)

Mode Sum of Mean l Squares df Square F Sig. 1 Regressio 225.084 5 45.017 2.486 .001(a) n 86

Residual 507.034 28 18.108 Total 732.118 33 a Predictors: (Constant), VAR00006, VAR00003, VAR00002, VAR00005,

VAR00004 b Dependent Variable: VAR00001

Communalities

Raw Rescaled Initial Extraction Initial Extraction CondomUseTy 20.999 13.092 1.000 .623 pe SexFrequency 95.131 92.422 1.000 .972 Promiscuity 93.513 88.784 1.000 .949 Homosexuality 189.430 185.085 1.000 .977 Abstain 131.702 120.170 1.000 .912 Addicted 165.431 161.100 1.000 .974 LessAttractive 20.999 13.092 1.000 .623 MultipleSex 95.131 92.422 1.000 .972 LoseVirginity 93.513 88.784 1.000 .949 Extraction Method: Principal Component Analysis.

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Extraction Sums of Squared Rotation Sums of Squared Component Initial Eigen values(a) Loadings Loadings

% of % of Cumulative Varian Cumulati % of Cumulati Total Variance % Total ce ve % Total Variance ve %

Raw 1 529.719 58.478 58.478 529.719 58.478 58.478 214.713 23.703 23.703 2 211.400 23.337 81.815 211.400 23.337 81.815 335.224 37.007 60.710 3 113.832 12.566 94.381 113.832 12.566 94.381 305.014 33.672 94.381 4 22.348 2.467 96.848 5 18.844 2.080 98.929 6 9.705 1.071 100.000 7 8.43E-014 9.30E-015 100.000 8 1.32E-014 1.45E-015 100.000 9 -1.09E-014 -1.20E-015 100.000 Rescaled 1 529.719 58.478 58.478 4.272 47.468 47.468 3.074 34.150 34.150 2 211.400 23.337 81.815 2.368 26.313 73.781 2.955 32.828 66.979 3 113.832 12.566 94.381 1.312 14.576 88.358 1.924 21.379 88.358 4 22.348 2.467 96.848 5 18.844 2.080 98.929 6 9.705 1.071 100.000 7 8.43E-014 9.30E-015 100.000 8 1.32E-014 1.45E-015 100.000 9 -1.09E-014 -1.20E-015 100.000

Total Variance Explained

Extraction Method: Principal Component Analysis.

88 a When analyzing a covariance matrix, the initial Eigen values are the same across the raw and rescaled solution.

Rotated Component Matrix(a)

Raw Rescaled Component 1 2 3 1 2 3 CondomUseType - 3.601 .178 -.306 .786 .039 .067 SexFrequency 8.649 1.295 3.993 .887 .133 .409 Promiscuity 2.188 8.892 2.221 .226 .920 .230 Homosexuality 4.753 2.732 12.451 .345 .198 .905 Abstain - - 10.818 1.378 .943 .120 1.114 .097 Addicted - - 7.013 10.302 .545 .801 2.403 .187 LessAttractive - 3.601 .178 -.306 .786 .039 .067 MultipleSex 8.649 1.295 3.993 .887 .133 .409 LoseVirginity 2.188 8.892 2.221 .226 .920 .230

Extraction Method: Principal Component Analysis.

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Rotation Method: Varimax with Kaiser Normalization. a Rotation converged in 5 iterations.

90