patterns of sexuality and correlates of high-risk behaviour among urban youth in addis ababa ...

142 Pages·2005·1.26 MB·English

by  Yordanos M. Tiruneh

BEYOND KNOWLEDGE: PATTERNS OF SEXUALITY AND
CORRELATES OF HIGH-RISK BEHAVIOUR AMONG
URBAN YOUTH IN ADDIS ABABA, ETHIOPIA

YORDANOS MEQUANINT TIRUNEH

March 2004

DEPARTMENT OF INTERNATIONAL COMMUNITY HEALTH
UNIVERSITY OF OSLO
BEYOND KNOWLEDGE: PATTERNS OF SEXUALITY
AND CORRELATES OF HIGH-RISK BEHAVIOUR
AMONG URBAN YOUTH IN ADDIS ABABA, ETHIOPIA

YORDANOS MEQUANINT TIRUNEH

THESIS PRESENTED TO THE DEPARTMENT OF
INTERNATIONAL COMMUNITY HEALTH, FACULTY OF
MEDICINE, UNIVERSITY OF OSLO

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR
THE DEGREE OF MASTER OF PHILOSOPHY IN
INTERNATIONAL COMMUNITY HEALTH

MARCH 2004
OSLO, NORWAY
UNIVERSITY OF OSLO

Beyond Knowledge: Patterns of Sexuality and Correlates of High Risk
Behaviour among Urban Youth in Addis Ababa, Ethiopia

By

Yordanos Mequanint Tiruneh

International Community Health
Faculty of Medicine, University of Oslo

Approved by the Examining Board

____________________ _______________
Chairman, Department

_______________________ ________________
Advisor

________________________ ________________
Examiner

________________________ ________________
Examiner
TABLE OF CONTENTS

Page

Table of Contents i
Acknowledgments iii
List of Tables iv
List of Figures v
List of Appendices vi
List of Abbreviations vii
Glossary viii
Abstract x
I. Background 1
II. Literature Review 5
2.1 Young People 5
2.2 Magnitude of HIV/AIDS on Young People 5
2.3 Youth Sexuality 6
2.4 Correlates of High Risk Sexual Behavior 9
2.4.1 Knowledge and Beliefs 10

2.4.2 Perceptions of Personal Risk 11

2.4.3 Psychological/Psychosocial Factors 12

2.4.4 Substance Use and Deviance/ Delinquency 12

2.4.5 Peer Influence 13

2.4.6 Inter-personal Communication skills 14

2.4.7 Family Situation 14

2.4.8 Neighborhood Situation 16

2.4.9 Lack of Access to Services 17

2.4.10 Social-cultural Factors 17

2.4.11 Poverty 19
i
III. Objectives of the Study 21

IV. Research Methodology 22
4.1 Study design 22
4.2 Study area 22
4.3 Study population 23
4.4 Sample Size Determination 23
4.5 Sampling procedure 25
4.6 Data collection and Management 26
4.7 Data Processing and Analysis 28
4.8 Ethical considerations 28
4.9 Operational definition 29
V. Results 30
5.1 Quantitative Data 30
5.1.1. Socio-Demographic Variables 30
5.1.2. Immediate Environment 33
5.1.3 Peer Situations 33
5.1.4 Social Behaviors 35
5.1.5 Family Situations 39
5.1.6 Sexual Behavior 41
5.1.7 Knowledge about and Attitude towards HIV/AIDS 45

5.2 Qualitative Data 58
5.2.1 People Living with HIV/AIDS 58
5.2.2 Street Youth 62
5.2.3 Commercial Sex Workers 65
5.2.4 Out-of-School Youth 69
5.2.5 In- School Youth 73
VI. Discussion 77
VII. Conclusions 92
VIII. Recommendations 94
IX. References 96

ii
Acknowledgements
I am deeply indebted to the institutions and people who in their various capacities contribute to
the successful completion of this study. I would like to thank the Christian Michelsen Institute
(CMI), Norway and the Department of Sociology and Social Anthropology at the Addis Ababa
University (AAU), Ethiopia for the financial support offered for this research. I am also
grateful for the grant obtained from GLOBINF and Helle’s Legat for the successful completion
of my study.
I am greatly indebted to my primary advisor Prof. Johanne Sundby, whose dedication and
insightful advice has inspired me through out my study. It was a great pleasure to work with
her. Special thank you goes to my local advisor Prof. Yemane Berhane, who despite his
extremely tight schedule afforded me every available opportunity to benefit from his
supervision. I sincerely appreciate his resourceful, unreserved support and exemplary work
ethics. My deepest gratitude goes to my advisor Dr. Alula Pankhurst who has always
wholeheartedly given me a constructive advice and encouragement.
I thank Lord the creator who has blessed the path I walked. My heart-felt thanks goes to my
parents whose tremendous love, encouragement and unwavering support led me to success
through out my work. My sincere gratitude goes to my family members, for their constant
support and confidence in me.
I owe a special thanks to my dear friends and colleagues, who contributed to this work by
giving me feedback and advice in all the phases of my research. I was fortunate in receiving
substantial comments and help with training, editing, and references. I appreciate your loyal
support and assistance. I wish to recognize the support, which I received from the department
of International Community Health at the University of Oslo during my studies. The staff and
faculty members were unfailingly supportive.
Last but not least, I owe an enormous debt of gratitude to all of the young people who
participated in my study and shared their personal experiences with me. Thanks are also in
order for all the incumbents at the different administrative offices in Addis Ababa. Many
people helped me to realize the goal of this research; I wish to express my thanks to all of
them.
iii
List of Tables
Page
Table 1: Socio Demographic Characteristics of Urban Youth in Addis Ababa.…… 32
Table 2: Peer Norms and Peer Involvement of Urban Youth in Addis Ababa …….. 34
Table 3: Social Behavior of Urban Youth in Addis Ababa … ………………….…. 36
Table 4: Substance Uses of Urban Youth in Addis Ababa …… ……….………….. 38
Table 5: Parental Monitoring and Attachment to Family of Urban Youth in
Addis Ababa………………………………………………………………… 40
Table 6: Sexual Behavior of Young People in Urban Addis Ababa. ………………. 44
Table 7: Attitudes of Urban Youth towards HIV and HIV Testing ……….……….. 48
Table 8: Sexual Behavior of Young People by Variables Related to the Self
System…………………………………………………………………...... 50
Table 9: Sexual Behavior of Young People by Some Selected Variables
Related to the Family System ….……………………………………….... 53
Table 10: Sexual Behavior of Young People by Some Selected Variables
Related to Extra-familial System………………………………………… 55
Table 11: HIV/AIDS Risk Perception of Youth by Some Selected Variables……... 57

iv
List of Figures

Page

Figure 1: Conceptual Framework ………………………………………….. 20
Figure 2: Schematic Presentation of the Procedure Used to Select
Study Participants (Study Architecture)………………………………….. 24
Figure 3: Percent Distribution of Condom Use Trend by Urban
Youth in Addis Ababa …………………………………………………… 42
Figure 4: Knowledge about HIV/AIDS…………………………………….. 45
Figure 5: Perceived Chances of Contracting HIV………………………….. 46
v
List of Appendices
Appendix A: Case Studies
Appendix B: Questionnaire
vi
LIST OF ABBREVIATIONS
AIDS: Acquired Immune-Deficiency Syndrome.
CSA: Central Statistics Authority
FGD: Focus Group Discussion
HIV: Human Immuno-deficiency Virus
MOH: Ministry of Health
NAC: National AIDS Council
NGO: Non-Governmental Organization
PLWHA: People Leaving With HIV/AIDS
STI: Sexually Transmitted Infection
STD: Sexually Transmitted Disease
UNFPA: United Nations Population Fund
UNAIDS: United Nations Program on AIDS
UNICEF: United Nation Children Fund
WHO: World Health Organization
AA: Addis Ababa
OSY: Out -of -School Youth
ISY: In- School Youth
CSW: Commercial Sex Worker
IEC: Information, Education, and Communication
FHI: Family Health International
DHS: Demographic and Health Survey
vii