The Relationship between Contraceptive Use and Risky Sexual Behaviour among Secondary School Students in Nairobi City County, Kenya
Majiwa, Benson. O
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The effective use of contraceptives among adolescents remains a challenge for most developing countries. Therefore, adolescents, both unmarried and married, are faced with many risky sexual behaviors. Many teenagers are faced with the risk of sexually transmitted diseases including HIV/AIDS, unplanned pregnancies, and illegal abortions and even dropping out of school. This study evaluates the relationship between contraceptive use and risky sexual behavior among adolescent. This study sought to find out if accessibility of contraceptives contributes to risky sexual behavior and explore various risky sexual behaviors practiced by adolescent as well as their attitude towards contraceptives among secondary school students in Nairobi. Also, evaluate the role of counseling in intervening risky sexual behavior among secondary school students. The theory of reasoned action/theory of planned action is critical in predicting and understanding motivational influences on contraceptive use that is not under the individual's volitional control. This study used mixed methods design; descriptive survey and correlational research designs. The number of students both boys and girls in Nairobi County was used as the study population of 21,231 students. The sample population was 384 participants in twelve secondary schools in the Nairobi County selected through multi-stage sampling approach. Cluster sampling was used to select randomly three sub counties in Nairobi County. Stratified random sampling was used to select both public and private secondary schools, four schools from each sub county with two schools from each category of private and public giving a total of twelve schools. Simple random sampling was used to obtain a sample of 32 students from each school. Further, a quota sampling was used to create one focus group discussion (composing 8 to10 persons per group) in each school. The data was collected by administering questionnaires to participants in twelve secondary schools and interviews conducted on each FGD and 12 counselors. Split- half technique was used to determine reliability. To ensure validity, the instrument was given to experts on the topic of study at Kenyatta University. To ensure reliability of instruments, test re-test was adopted, and the reliability coefficient calculated using Pearson‘s product moment correlation. Qualitative data was transcribed, classified into various categories and reported according to emerging themes and sub themes for each of the objectives. Quantitative data was analyzed using descriptive statistics. Pearson‘s r was used to test the hypotheses and all of them were rejected. Qualitative data was analyzed using thematic analysis and presented through narrative, whereas quantitative data was coded and analyzed using SPSS 23.0. The results revealed that the probability of risky sexual behaviour reduces for those students who use contraceptives as compared to those who do not use contraceptives. It was observed that most of the students in Nairobi County had had sexual relationships without a condom or any other contraceptive. The findings revealed that education of the students forms a significant part of the current counseling program related to the use of contraceptives. The findings indicated that the use of contraceptives increases the prevalence of risky sexual behaviour among students. The study concluded that secondary school adolescents in Nairobi County believe that the use contraceptives can prevent risky sexual behaviors among adolescents. In addition, most of the students in Nairobi County engage in risky sexual behaviour at an early age and while still in school. It was further concluded that the school counselor play a vital role in advocating the use of contraceptives and positive behavioural change among the students.