title: Impact of an intervention to improve treatment-seeking behavior and prevent sexually transmitted diseases among Nigerian youths.
abstract: BACKGROUND
  Interventions to treat STDs have been reported to reduce HIV incidence. Interventions to improve treatment-seeking for STDs may impact on the duration and prevalence of STDs. Nigeria has high rates of STDs and an increasing incidence of HIV.
  
  
  OBJECTIVE
  To evaluate the impact of an intervention on STD treatment-seeking behavior and STD prevalence among Nigerian youth.
  
  
  METHODS
  A randomized controlled trial in 12 schools in Edo State was conducted to evaluate an intervention to improve STD treatment-seeking and STD treatment provision. The intervention, based on formative research, consisted of community participation, peer education, public lectures, health clubs in the schools, and training of STD treatment providers, including those with no formal training. A questionnaire measured outcomes before and 10 months into the intervention. The effect of the intervention among four randomly selected intervention schools compared to eight randomly selected control schools was assessed using logistic regression with Huber's formula to account for school clusters.
  
  
  RESULTS
  One thousand eight hundred and ninety-six and 1858 youths 14-20 years of age were enrolled in the pre- and post-intervention surveys. Youths in the intervention schools, compared to control schools, reported statistically significant improvements in knowledge of STDs, condom use, partner awareness that the youth had an STD, and STD treatment-seeking behavior. Treatment by private physicians increased (OR=2.1, 95% CI=1.1-4.0), and treatment by patent medicine dealers or pharmacists decreased (OR=0.44, 95% CI=0.22-0.88). The reported prevalence of STD symptoms in the past 6 months was significantly reduced in the intervention compared to control schools (OR=0.68, 95% CI=0.48-0.95).
  
  
  CONCLUSIONS
  Significant improvements in treatment-seeking for STD symptoms can be effected among Nigerian youths. The prevalence of reported STD symptoms can be decreased by improving treatment-seeking for and awareness of STDs.
authors.affiliation: Women's Health and Action Research Centre, 4 Alofoje Street, Off Uwasota Street, Box 10231, Benin City, Edo State, Nigeria. wharc@hyperia.com
authors.forename: Friday E
authors.initials: FE
authors.lastname: Okonofua
authors.forename: Paul
authors.initials: P
authors.lastname: Coplan
authors.forename: Susan
authors.initials: S
authors.lastname: Collins
authors.forename: Frank
authors.initials: F
authors.lastname: Oronsaye
authors.forename: Dapo
authors.initials: D
authors.lastname: Ogunsakin
authors.forename: James T
authors.initials: JT
authors.lastname: Ogonor
authors.forename: Joan A
authors.initials: JA
authors.lastname: Kaufman
authors.forename: Kris
authors.initials: K
authors.lastname: Heggenhougen
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000600:supply & distribution*; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D016358:Contact Tracing; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D012306:Risk; D012736:Sex Education; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission