Substance use and sexual behaviour among female students in Nigerian universities

Substance use continues to constitute social and health problems, more so among adolescents and young adults. One consequence is risky sexual behavior, a major problem in sub-Saharan Africa already facing the synergistic problems of poverty and HIV/AIDS. This study of female students aged ≥ 18 years in two universities in Nigeria uses a multi-stage stratified random sampling method, and each subject that gave consent to the study was administered with a structured questionnaire by trained interviewers; 2,408 female students were studied (1,854 from the University of Ibadan and 554 from the Bayero University, Kano). The mean age of the respondents was 21.6 (SD = 2.9), and about two-thirds (65.7%) were aged between 20-24, with 2,204 (91.5%) being single and 4.3% married. In all, 23.4% of the subjects used one form of substance. Alcoholic drinks of palm wine, alcoholic wine, and beer were the most common of substances used (22.7%), followed by tobacco (2%) and cannabis (1%). Substance use was significantly associated with religious affiliation of the students (p < 0.001), as the prevalence of substance use was least among Muslim students (11.7%) and highest among those who professed traditional religion (39.4%). Alcohol use was also positively associated with sexual activity (p < 0.001). Among the 547 students who used alcohol, 147 (26.9%) had sex in the 4 weeks prior to the survey, while among the 1,861 non-users, only 8.9% did so. The practice of unprotected sex was found not to be associated with substance use: a slightly lower proportion (29.5% vs. 36.6%) of substance users engaged in unprotected sex in their last encounter compared to non-users. There is need to scale up public health education on the dangers of substance use and its associated sexual risk behavior.