PATTERNS, RISK FACTORS, PERPETRATORS AND CONSEQUENCES OF SEXUAL PRACTICES AMONG NIGERIAN TEENAGERS

Abstract

Background: Sexual practices among teenagers constitute a major public health concern globally, with Nigeria being no exception. Adolescence, defined by the World Health Organization as the period between 10 and 19 years, is marked by significant physical, emotional, and social changes that influence sexual attitudes and behaviours. In Nigeria, the South-South region has one of the highest prevalence rates of HIV/AIDS, sexually transmitted infections (STIs), teenage pregnancy, and sexual violence among young people. These challenges underscore the need for evidence-based interventions. This study aimed to assess the patterns, risk factors, perpetrators, and consequences of sexual practices among senior secondary school students in Akwa Ibom State, South-South Nigeria, to inform policymakers, healthcare providers, and other stakeholders promoting adolescent sexual health.

Methods: This was an analytical cross-sectional comparative study involving 740 public senior secondary school adolescents aged 14–19 years selected from four schools using a multistage sampling technique. Data were collected using an adapted, pre-tested, self-administered semi-structured questionnaire. Data analysis was conducted using the Statistical Package for Social Sciences (IBM SPSS Statistics) version 27. Logistic regression analysis was employed to identify factors associated with sexual practices among adolescents, with statistical significance set at p ≤ 0.05.

Results: The mean age of respondents in urban schools was 17.0 ± 1.52 years compared to 16.0 ± 1.19 years in rural schools (p < 0.001). A statistically significant association was observed in both settings between sexual practices and experiences such as breast caressing, unwelcomed kissing, and genital touching. In rural schools, 60.0% of respondents who experienced breast caressing reported increased sexual intercourse compared to 37.0% in urban schools (p < 0.007). Unwelcomed kissing was associated with sexual abuse in both urban (56.5%) and rural (54.9%) schools. Genital touching was significantly associated with sexual intercourse among urban respondents (χ² = 3.86, p = 0.005), with 52.8% of urban and 47.3% of rural respondents reporting sexual intercourse following exposure. Unwanted pregnancy was more prevalent in rural schools (32.5%) than urban schools (28.8%), although this difference was not statistically significant. Similarly, abortion following sexual abuse was higher among rural respondents (25.6%) compared to urban respondents (20.6%). Comparable proportions of respondents in both settings reported STIs as consequences of sexual abuse. Rural respondents experienced significantly higher overall consequences of sexual practices. Knowledge that sexual abuse could result in HIV infection was slightly higher among urban respondents (25.4%) than rural respondents (23.7%). Schoolmates were the most frequently reported perpetrators of sexual abuse, particularly in urban schools, while boyfriends or girlfriends were more commonly reported in rural schools. Adolescents engaging in sex for monetary gain had significantly higher odds of sexual practices in both rural (OR = 4.00; 95% CI: 2.549–6.275) and urban schools (OR = 2.00; 95% CI: 1.695–3.962). Peer pressure and poverty were also significant predictors of sexual practices across both settings.

Conclusion: Sexual practices among Nigerian teenagers remain a critical public health issue with profound physical, emotional, and social consequences. The findings reveal that adolescent sexual behaviour in Akwa Ibom State is influenced by a complex interaction of peer pressure, poverty, sex for money, sociocultural norms, and inadequate sexuality education. Early initiation of sexual activity and engagement in risky sexual behaviours are common, increasing the risk of unintended pregnancy, STIs, HIV infection, and psychological trauma. Perpetrators of sexual abuse include peers, intimate partners, and authority figures, emphasizing the need for comprehensive prevention strategies. Integrating comprehensive sexuality education into school curricula and community programs, expanding access to youth-friendly sexual and reproductive health services, addressing socioeconomic inequalities, and strengthening legal frameworks against sexual violence are essential for improving adolescent sexual health outcomes.