Browsing by Author "Seme, Assefa"

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    Assessment of Alcohol Use and Risky Sexual Behaviors among Local Drink Sellers in Addis Ketema Sub-City, Addis Ababa
    (Addis Ababa University, 2011-05) Kedir, Ibrahim; Seme, Assefa
    AIDS continues to be a major global health priority. The number of people living with HIV is still growing worldwide reaching an estimated 33.3 million in 2009. Slightly more than half are women. Patterns of alcohol consumption prevail in countries with the most severe HIV epidemics. Hazardous alcohol use is often assumed mainly to affect men, but women are harmed in large numbers by alcohol use: either their own or that of their partner. Women are at risk of alcohol-related sexual risk behavior in several ways. Women who sell alcohol are at increased risk of drinking alcohol themselves, engaging in unprotected sex with their clients, and HIV infection. Objective The objective of this study was to assess the prevalence of alcohol use and its association with risky sexual behaviors among local drink sellers in Addis Ketema sub-city, Addis Ababa. Method A cross sectional study was conducted among 698 women engaged in selling local alcohol drinks in Addis Ketema sub-city Addis Ababa. The sample size was calculated using single population proportion formula and multistage cluster sampling technique was used. The data were collected through standardized questionnaire by trained data collectors. Respondents were assessed by socio demographic variables, type, amount and frequency of alcohol use and also risky sexual behaviors and bivariate and multivariate analysis were used to assess the association between these variables. Logistic regression was used to control confounding variables. Results The prevalence of alcohol use among local drink sellers was found to be 33.3%. About 72(41%) of the respondents drink alcohol on a daily basis, while 46(26.4%) drink alcohol twice a week and 56(32.2%) drink alcohol once a week or less and the type of alcoholic drink that majority 133(59.1%) of the study participants used was “Tela”. Five hundred sixty six (82.4%) of the respondents had initiated sexual intercourse, out of which 85(15%) had sex with non regular partner and 29.7% didn‟t use condom the last time they had sex with non regular partner. About 71(13.0%) of respondents reported that they had received gift or money in exchange for sex. Alcohol drinking was found to be associated with monthly personal income of 100 birr or more and being divorced. Having 3 or more drinks at one time was associated with having had sex with non regular partner and also with receiving gift or money in exchange for sex. Drinking alcohol daily and twice a week was also associated with receiving gift or money in exchange for sex. Considering types of alcoholic drink, drinking beer was found to be positively associated with having had sex with non regular partner. Condom use at last sex was higher among those who ever drink alcohol, had primary and above level of education and those who were never married. Conclusions HIV prevention programs for local drink sellers should recognize that alcohol use may be an important indicator of risk for HIV infection and AIDS through its association with risky sexual behaviors.
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    Assessment of knowledge and utilization of youth friendly health service among adolescents (15-19) in Addis Ababa
    (Addis Abeba Universty, 2016-06) Yohannes, Lelissie; Seme, Assefa
    Background: Several reproductive health challenges confront adolescents (10-19 years) globally and are more pervasive in developing countries where services and facilities are absent. An estimated 1.3 million adolescent girls and 780,000 adolescent boys are living with HIV worldwide, and 79 percent of new HIV infections among adolescents are in Sub-Saharan Africa. With 104 births per 1,000 women aged 15-19, Ethiopia’s high adolescent birth rate was likely associated with the low use of modern contraceptives. Regardless of the interventions put in place for adolescents as a response for reproductive health needs of adolescents in Ethiopia adolescent and youths are still facing reproductive health challenges; furthermore knowledge and utilization of the youth friendly reproductive health service in available places has not been assessed in an all inclusive manner. Objectives: To assess knowledge and utilization of youth friendly reproductive health service among adolescents in Addis Ababa. Method: A community based cross-sectional study was conducted in a randomly selected 5 sub cities in Addis Ababa. Data was collected from 755 adolescents aged 15-19 through structured questioner. Data was coded cleaned and entered using EPI data 3.1 and transported to STATA 12.1 for analysis. Descriptive analysis of respondents was done. A bivariate analysis was done identify factors associated with utilization of youth friendly reproductive health service and reproductive health knowledge those with a P<0.25 were moved to multivariate analysis to identify their significance with the dependent variables; those with P< 0.05 were taken as independent factors affecting utilization of YFRHS. Result: – Three hundred ninety eight (52%) of the adolescents had knowledge about reproductive health. Age (AOR = 2.19, 95% CI: 1.28-3.73), sex (AOR = 2.52, 95% CI: 1.62, 3.97) and radio as a means of communication (AOR = 2.64, 95% CI: 1.44, 4.81) were associated with reproductive health knowledge. Three hundred twenty four(42.9%) of the adolescents had ever used reproductive health services including counseling, IEC/BCC material, family planning, sexually transmitted infections treatment, abortion and post abortion care. Reproductive health services utilization was significantly associated with age (AOR = 1.99, 95% CI:1.3,3.05) , source of information being HEW (AOR = 1.7, 95% CI: 1.1, 2.69) and awareness IEC/BCC ii service(AOR=1.9 95%CI: 1.24,2.9). “Not needing the service”, lack of information about the service, inconvenient working hour of the facility and embarrassment to ask for the service were the main reasons mentioned for not using youth friendly reproductive health service. Conclusion and recommendation: Both reproductive health knowledge and services utilization is low amongst adolescents in Addis Ababa .Factors like age, sex, having access to radio were factors that determined reproductive health knowledge of adolescents while age, source of information about YFRHS being health extension worker and awareness of services like IEC/BCC and post abortion care as components were factors that determined utilization. A platform where adolescents could get quality information, concerning reproductive health should be created; in addition urban health extension program that is integrated in schools should be strengthened.
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    An Assessment of Premarital Sexual Practice and Factors Contributing to Premarital Sex among High School Adolescents in Nekemte Town, E/Wollega Zone, Oromia Regional State
    (Addis Abeba Universty, 2006-05) Wirtu, Dessalegn; Seme, Assefa
    Back ground. In the era of HIV/AIDS pandemic, understanding the nature of adolescents’ sexual behaviors is critical in developing an effective preventive strategy. Objectives The purpose of this study were to assess the prevalence of premarital sexual practice, factors contributing to premarital sex and condom utilization among high school adolescents. Methodology: A cross-sectional study (both quantitative and qualitative) was conducted on 722 adolescents using a pre tested questionnaires from January to April 2006, among 2 high schools. in Nekemte town, east Wollega zone, west oromia regional state. Result. Of 676, study population 21.4% (70.3% of males and 29, 7% of females).reported having practiced premarital sexual intercourse. The mean age at first sexual intercourse was 16.2+1.5 years and 15.18+1.7 years for males and females, respectively. From those sexually active adolescents 5.8% of males and 13.3% of females reported to having had sexual intercourse before the age of 14 years (10-14). However, 57.2% (69.5% of males and 56.6% of females) had their first sexual intercourse between the age of 15 and 17 years. The reasons cited for the initiation of the first sexual intercourse were fall in love (34.9%), had desire (29.5%), rape (2.7%), peer pressure (16.8%), to get money/gifts (7.4%) and were drunk (3.4%). In the past 12 months, 74.2% of the adolescents reported to ever use condom. But only about half (52.8 %) used condom consistently, while only one-third (33.3%) reported to having used condom the first time they had sexual intercourse. Moreover, in the past 12 months, 91(79.8%) reported one, 14(12.3%) two and 9(7.9%) three and more sexual partners. Conclusions and recommendations From this study, one can conclude that there is a high prevalence of premarital sexual practices among the adolescents. Moreover, adolescents are practicing risky sexual behaviors such as unprotected sex, multiple sexual partners, and sex at early age. Therefore, an integrated effort needs to be vii initiated to address such adolescents’ sexual and reproductive health problems through establishing and strengthening school anti AIDS clubs, providing inservice training for teachers on adolescent reproductive health and establishing youth centers.
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    The association Between Substance Abuse and HIV infection among People Visiting HIV Testing and Counseling centers in Addis Ababa, Ethiopia
    (Addis Abeba Universty, 2002-06) Seme, Assefa; Haile, Damen(PhD)
    The magnitude of HIV/AIDS in Ethiopia is ever increasing. It is also believed that the use of substances is increasing in some major towns including Addis Ababa. However, data regarding the relation of substance abuse and HIV infection is lacking. A case-control study was carried out in Addis Ababa from December 2001 to February 2002 to explore the association between substance abuse and HIV infection and to determine the prevalence and the factors related to substance abuse among people visiting HIV testing and counseling centers. Among all visitors for HIV testing and counseling, 227 cases and 726 controls were identified. Cases and controls were compared by socio demographic, socio economic, exposure to substances and risky behaviors that predispose them to HIV infection. The prevalence of “hard’ drug use was found to be 1.2% with the rate being 3.2% in the cases and 0.54% in the controls. Alcohol drinking was found to be associated with serum HIV positivity after controlling for other confounding variables. While young age of 15 to 24 and being single were found to be associated with serum HIV positivity, having monthly family income was found to be protective against HIV infection. Being male and having sex with commercial sex workers were related to both alcohol drinking and khat chewing. From the study, we concluded high prevalence of alcohol and khat abuse among people visiting HIV counseling and testing centers. Alcohol was found to be a significant risk factor for HIV infection among people visiting HIV testing and counseling centers. The need of health education to bring behavioral changes and further study to identify the prevalence and role of substance in exposure to HIV infection in the community is recommended.
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    Association of Non breast feeding and breast cancer among patients on chemotherapy and radiotherapy at Tikur Anbessa Specialized Hospital: A case-control study
    (Addis Abeba University, 2015-06) Mengesha, Hanna; Seme, Assefa
    Background: Breast cancer is a major life-threatening public health problem of great concern, with more than one million cases occurringworldwide annually. In Ethiopia breast cancer is the second most often occurring cancer among women. Even though there were studies that were done on risk factors of breast cancer worldwide there are very few studies in developing country especially in Ethiopia. Clarifying the role of non- breastfeeding in developing breast cancer may be helpful to establish preventive and control program to reduce the occurrence of the disease and serve as a baseline for further studies. Objectives: To assess the association between non breastfeeding practices and breast cancer development among patients who are on chemotherapy or radiotherapy at TikurAnbessa Specialized Hospital. Methods: This is unmatched case-control study design that tried to assess the association between non breast feeding practice and breast cancer. The study wasdone at TikurAnbessa Specialized Hospital radiotherapy center which is located in Addis Ababa, Ethiopia. Eligible cases were female breast cancer positive patient (pathology proven) and the controls were female breast cancer negative patient who were diagnosed for other non-reproductive system cancer, both cases and controls were either on chemotherapy or radiotherapy treatment service at TikurAnbessa Specialized Hospital. Theratio was 1:1 with 217female breast cancer patients and 217 females without breast cancers. The analyses were performed with Statistical Package for Social Sciences (SPSS) version 20. Odds ratio and 95% confidence interval done to quantify association between an exposure and disease. Result: , the odds of cases to report positive family history for breast cancer is about 2.6 times higher than the odds of controls to report the same. [AOR = 2.7(95%CI, 1.53, 4.93)]. The odds of cases to report menopausal status for breast cancer is about 2.4 times higher than the odds of controls to menopausal status to breast cancer. [AOR=2.4 (95% CI(1.2,4.7)]. The odds of cases that breastfed for breast cancer is about 50% lower than the odds of controls to report the same. [AOR = 0.05(95%CI, 0.34, 0.87)] Conclusion: The study document show that family history of breast cancer, women who never breast fed, and women in menopausal status were associated with Breast cancer risk. An inverse association between breastfeeding and breast cancer was found in this study among women on chemotherapy and radiotherapy in TikurAnbessa Hospital.
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    Knowledge, Attitude and Practice on Emergency contraception among preparatory, and high school female students in Debrezeit town Oromia Regional state, Ethiopia
    (Addis Abeba Universty, 2010-06) Tilahun, Ephrem; Seme, Assefa
    Introduction: - Maternal mortality in Ethiopia is one of the highest in the world. Surveys conducted on issue related to abortion and unwanted pregnancy suggests that the magnitude of unwanted pregnancy and unsafe abortion are among the main cause of maternal mortality in Ethiopia. Emergency contraceptive can serve as back up method to reduce the occurrence of un wanted pregnancy and its out come following un protected sex. Objectives: -To assess level of awareness, attitude and utilization of emergency contraceptives and factor influencing knowledge, attitude and practice of emergency contraceptive among preparatory & high school female students. Methods: A cross-sectional survey was conducted during April 2009. There were a total of 3792 female students in one preparatory & two high schools of Debrezeit town. Three hundred eighty four of them were sampled for the study with response rate of 91.1% . Self administered questionnaire was used to collect data Result: The magnitude of unwanted pregnancy for those who practiced sex was 33.3%. Among all respondents 213(60.9%) had knowledge about emergency contraception; Correct timing of emergency contraception was reported by 149 (70%) and only 25 (7.1%) of them had ever used emergency contraception. Oral contraceptive pill was the most widely used 24(96%). About one third 111 (31.7%) had this information from School education. Two hundred (77.1%) of the respondents had good attitude towards the use of emergency contraception. Knowledge of emergency contraceptive was significantly higher of those in higher class OR =3.4(95% CI 1.58 -7.51). Conclusion: even though there is a favorable number of knowledge on ECs by respondents, utilization of emergency is un satisfactory. Hence Youth friendly service should be strengthened as they are considered a major contributor on practicing modern contraception including EC, also by considering the importance of prevention of STD and HIV/AIDS.
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    Sexual and reproductive health needs and preferences of people living with HIV/AIDS in Southern Nations Nationalities and Peoples Region
    (Addis Ababa University, 2007) Debeko, Kekebo; Seme, Assefa
    Background: Sexual and Reproductive needs and preferences of HIV positive individuals are changing due to the development of antiretroviral therapy (ART) as effective for HIV infection. Due to improvements of symptoms and the change in quality of life PLWHA regain their normal activities and new challenges and new opportunities are arising. Objective: The aim of this study is to assess sexual & reproductive needs and preferences of PLWHA receiving antiretroviral therapy in five Hospitals of Southern Nations Nationalities & peoples Region (SNNPR). Methods: A cross sectional survey on 461 Patients receiving ART in five hospitals of SNNPR, was carried out from February to March 2007. The data on sexual and reproductive needs and preferences, and other variables were collected using structured and pre-tested questionnaire. A Quantitative method is supplemented by Qualitative (in-depth interview). Result: Two hundred twenty three (49.1%) of HIV positive individuals were found to have sexual practice with regular partner, 191(42.1%) were abstained, 24(5.3 %) had sexual practice with no or inconsistent condom use and 16(3.5%) with multiple sexual partners. One hundred fifty four (33.9%) of the respondents expressed their desire for children. One hundred sixty nine (70.4%) of the study population had ever used at least one method of contraception during the study time, while 33(53.4%) wanted to use at least one method in the future. Condom and injectable are the most commonly used method of contraception in the past and preferred method to be used in the future. Generally, HIV positive individuals who had sexual risk were those non married & had sexual partner (adjusted OR: 6.99, 95% CI: 2.34-20.9) and reported alcohol use (Adjusted OR: 6.07, 95% CI: 1.87-19.7). Respondents in the age group 15-34 were more likely to desire children (adjusted OR: 1.91, 95% CI:1.13-3.24) than other age group. Followers of orthodox Christianity were less likely to desire children than other Christians (adjusted OR: 0.54, 95% CI = 0.33-0.91). Being married (adjusted OR: 1.78, 95% CI: 1.05-3.14), those who had risky sexual behavior (OR=1.73, 95% CI=1.02-2.95) and those who reported no currently alive children adjusted (OR: 4.41, 95% CI: 1.46-13.36) were more likely to desire children. vi Conclusion: Sexual & reproductive health needs and preferences of PLWHA are not affected by their HIV status. Risky sexual practice was not uncommon, high number of them expressed a wish for children and wants to use family planning. To address such issues proper promotion & counseling of subjects is important. Moreover, National and the International stakeholders should be coordinated for intervention.
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    Sexual Initiation and Contraceptive Use among Female Youths in Ambo Town
    (Addis Abeba Universty, 2013-07) Tsegaye, Digafe; Seme, Assefa
    Background: Early sexual debut may be linked to reproductive health problems later in life. In addition, both the timing of first sex and contraceptive use are affected by a variety of factors and this makes the consequences of youth sexuality much more serious. It is important to understand what influences youths‟ sexual initiation, the need to use contraceptive methods and the consequences of these behaviours. These may affect the design and implementation of effective early pregnancy and disease prevention strategies. Objectives: The aim of this study was to determine the age at first sexual intercourse, contraceptive use and related factors among female youths in Ambo town. Methods: A cross-sectional community-based study was conducted in Ambo town of West Shoa Zone, Oromia Regional State between January and February, 2013. Two kebeles out of three were randomly selected. Multistage cluster sampling technique was used to draw sample size of 675. Then, households were selected by systematic sampling technique. Structured and pretested questionnaire and semi structured FGD guide was employed to collect data. Descriptive statistics such as frequencies, percentages and graphs were used. To determine the association between dependent and independent variables, odds ratio with 95% confidence interval was computed. Logistic regression was also employed to assess possible factors. Result: Overall, nearly half, 48.7% of the surveyed participants have ever had sex. The median age at first sex being 17 years while; the mean ± SD age was 16.7±2.1.Multivariate analysis showed that age group of 20-24[AOR= 7.35, (95%CI 4.80, 11.26)], those who attend, at least secondary education [AOR = 3.09 (95%CI;1.44, 6.66)], those who encouraged by their friends to have boyfriend [AOR = 2.09 (95% CI; (1.42, 3.06), ever drank alcohol [AOR = 5.76 (95 % CI; 3.57, 9.31), and ever watched pornographic materials[AOR =1.78(95%CI; 1.19, 2.66)]were more likely to initiate sex. Knowledge of at least one contraceptive method was 95.4% and overall contraceptive current use was 37.3%. Multivariate analysis shows that age group of 20-24 [AOR= 3.22, (95%CI 2.08, 4.98)] and youths with partners who have discussed about the method [AOR= 2.15 (95%CI, 1.38, 3.34)] were more likely to use contraceptives. Currently unmarried [AOR= 0.17 (95%CI, (0.09, 0.31)] was less likely to use contraception compared to currently married. As the qualitative data suggested, the perceived age at sexual debut among young girls is very early. Conclusion and Recommendation: Substantial amount of female youths had started sexualactivity that might expose them to different reproductive health problems. Thus, early sexual initiation coupled with very low contraceptive use among youth females is a potential risk of the development of sexual and reproductive health problems. Therefore, in view of our finding, an active effort to promote sexuality education and contraceptive use should be intensified among female youths in the town, particularly young women, in making informed decisions about sexual intercourse and contraceptive uses.
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    Utilization of Long Acting and Permanent Contraceptive Methods and Associated Factors Among Married Women of Reproductive age in Bishoftu Town, Oromia Regional State, Ethiopia
    (Addis Abeba Universty, 2017-06) Bekele, Abebe; Seme, Assefa
    Background: The benefit of contraceptive methods has become an important factor in the life of reproductive age of women. Specially, the utilization of Long Acting and Permanent contraceptive Methods (LAPMs) is most effective methods of contraceptive available and are very safe and suitable; do not need daily initiation on the part of the users, and no need of frequent visit to service providers and hence, saves time and money for individual and the government. Objectives: To assess utilization of long acting and permanent contraceptive methods and associated factors among married women of reproductive age in Bishoftu town Methods: Community based cross-sectional study was conducted from September, 2016 among married women of reproductive age in Bishoftu town. Study Kebeles selected by lottery method. Systematic sampling used to select study households while all eligible women in the selected households recruited for the study. The minimum sample size required for the study was 419. A pre-test and structured questionnaire used to collect data from each respondent. The data field edited and entered in to EPI-Info 7 version and cleaned then exported to SPSS version 16 for analyses. Descriptive statistics such as frequency tables and percentages used to describe the study participants. In a bivariate analysis Odds Ratio (OR) and 95% Confidence Intervals calculated to see the magnitude and significance of the association between independent and the dependent variables, respectively. Multiple logistic regression analysis was conducted to determine the independent predictors of LAPMs utilization in the study area. Result: Utilization of LAPMs was 35.7%, the most common is Implant 101(25.5%), and followed by Intra Uterine Contraceptive Device (IUCD) 37(9.4%) and the least was female sterilization 3(0.8%). The result of multivariate analysis revealed that, the significant association of education of respondent on utilization of LAPMs [AOR 2.76, 95% CI (1.16, 6.55)], attitude of husband on LAPMs [AOR 2.97, 95%CI (1.58, 5.59)], discussion with service providers on use of LAPMs [AOR 5.68, 95%CI (2.06, 15.68)], and married women those who need any more additional children was found to be associated [AOR 2.01, 95%CI (1.19, 3.40)]. Conclusion: Utilization of LAPMs among contraceptive methods users in a town was 35.7% and higher than the LAPMs use rate reported other studies and Ethiopia Demographic and Health Survey (EDHS) 2014, but still lead by short acting methods that was inject-able followed by Implant and the least female sterilization.