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Sexual coercion and violence among young women in Nigeria: A northern and southern comparison.

Abstract

Growing evidence shows that the experience of sexual coercion is fairly prevalent among young people and is associated with risky sexual behavior thereafter. This study compared patterns and correlates of sexual coercion among young people in northern and southern Nigeria. This cross-sectional comparative study investigated sexual coercion among 12,626 young women aged between 15 and 24 years. Respondents were all selected from all six geopolitical zones in Nigeria and divided into three northern and southern zones respectively. Relevant information was extracted from a nationally representative sample of young women from the NDHS survey data and analyzed using SPSS for windows Version 16. About 54% of respondents in spousal relationship in the northern part of Nigeria reported occasionally being physically forced to sex when not wanted compared to about 46% southern Nigeria. About, 74% of respondents in the south had been sexually coerced or forced by persons other than partner compared to 26% in the north. Majority of perpetuators were strangers (22.2%), and friends or acquaintances (20.3%). This study indicates that spousal sexual coercion was more common in northern Nigeria while sexual coercion occurring in non-spousal relationships was more prevalent in southern Nigeria. (Afr. J Reprod Health 2016; 20[4]: 37-43).

Keywords: Sexual Coercion, Young people, Nigeria

Resume

Les preuves croissantes montrent que l'experience de la coercition sexuelle est assez repandue parmi les jeunes et est associee a des comportements sexuels a risque par la suite. Cette etude a compare les tendances et les correlations de la coercition sexuelle chez les jeunes du nord et du sud du Nigeria. Cette etude transversale comparative a etudie la coercition sexuelle chez 12 626 jeunes femmes agees de 15 a 24 ans. Les interviewees ont toutes ete choisies parmi les six zones geopolitiques au Nigeria et divisees en trois zones du nord et du sud respectivement. Les donnees pertinentes ont ete extraites d'un echantillon national representatif de jeunes provenant des donnees de l'enquete ENDS et analysees a l'aide de SPSS pour les fenetres de la version 16. Environ 54% des interviewees en relation conjugale dans la partie nord du Nigeria ont signale avoir ete forcees physiquement de temps en temps a avoir des rapports sexuels quand elles ne voulaient pas compare'a environ 46% au sud du Nigeria. Environ 74% des interviewees dans le sud avaient ete contraintes sexuellement ou forces par des personnes autres que le partenaire, compare a 26% dans le nord. La majorite des auteurs etaient des etrangers (22,2%) et des clients amis ou des connaissances (20,3%). Cette etude indique que la coercition sexuelle conjugale etait plus frequente dans le nord du Nigeria alors que la coercition sexuelle qui ont lieu dans les relations non conjugales etait plus repandue dans le sud du Nigeria. (Afr. J Reprod Health 2016; 20[4]: 37-43).

Mots-cles: Coercition sexuelle, jeunes, Nigeria

Introduction

Sexual coercion has evolved to be a major public health challenge owing to its negative association with social and health outcomes. The concept of sexual coercion lies on the continuum from deception to obtain sex to sexually aggressive behavior, such as rape, sexual abuse and sexual assault (1). Heise defined sexual coercion as the act of forcing (or attempting to force) another individual through, verbal insistence, deception, cultural expectations or economic circumstance, violence and threats to engage in sexual behavior against his or her will (2). Struckman defines it as "the act of using pressure, alcohol or drugs, or force to have sexual contact with someone against his or her will; using tactics of post-refusal sexual persistence (3).

Growing evidence shows that sexual coercion is prevalent among young people (4-6). Experience of sexual coercion leads to a greater likelihood of risky sexual behavior, such as early sexual debut, multiple sexual partners, and inconsistent condom us. Reports in the scientific literature regarding the prevalence of sexual coercion vary greatly, ranging from as low as low of 5% to 20% among adolescents in northern Thailand (7,8), young people and adults in Australia (9) to as high as approximately 50% married and unmarried males and females ages 10-24 in Kenya (10), high school students in northeastern Nigeria (11).

Sexual coercion is associated with immediate and long-term consequences to women including injury, psychological distress and compromised sexual health. In addition sexual coercion increased risk of contracting HIV/AIDS and other sexually transmitted infections (STIs) among women experiencing sexual coercion (12).

However, evidence of increased rates of sexual risk behaviour (extramarital and multiple sex partnering, no or inconsistent condom use and forced unprotected sex) among male perpetrators of sexual coercion informed the need for this study. The study seeks to contribute to the global fight against the STI, HIV/AIDS epidemic by providing evidence base for raising awareness among young people's sexual and reproductive health needs with regard to unwanted pregnancy. It also seeks to communicate new knowledge to a broader audience including policymakers and healthcare providers.

Sexual coercion is widely recognized as a global public health concern, with immediate and long-term consequences to women including injury, psychological distress and compromised sexual health. Although most available research has focused on physical abuse, rape and other forms of abuse, sexual coercion in Africa and other developing countries has received little attention (13). Hence his study draws on results from the NDHS 2008 nationally representative surveys (14), to examine coercive sexual experiences among young women aged 15-24 years in Nigeria.

Furthermore, this study builds on previous work by utilizing a large nationally representative Nigerian sample to investigate young women's self-reported experience of sexual coercion with a view to determining the prevalence and compare the correlates of sexual coercion among young people in northern and southern Nigeria.

Methods

This study utilized data from the NDHS 2008, and full details of the NDHS methodology, sampling procedure, and questionnaires are available in the report (14). In brief, the NDHS 2008 used two-stage stratified cluster sampling to select a representative sample of households. The primary objective was to provide national estimates with an acceptable level of precision for population characteristics such as population and health indicators at the national, zonal, and state levels. Data were collected by visiting households and conducting face-to-face interviews to obtain information on demographic characteristics, wealth, anthropometry, female genital cutting, HIV knowledge, and sexual behaviour. The sample design allowed for specific indicators, such as contraceptive use, to be calculated for each of the 6 zones and 37 states (36 states plus the Federal Capital Territory, Abuja) (14). The sampling frame used for the 2008 NDHS was the 2006 Population and Housing Census of the Federal Republic of Nigeria conducted in 2006, provided by the National Population Commission (NPC). Relevant variables were extracted and a cross-sectional comparative study carried out to investigate sexual coercion and violence experienced among young women in Nigeria. Information on 12,626 respondents who met the criteria for the study was extracted from a nationally representative sample of young women aged between 15 and 24 years, either married or never married who are sexually active in northern and southern Nigeria. Respondents were selected from all six geopolitical zones in Nigeria and classified into groups made up of three northern zones and three southern zones. Variables extracted include; Socio-demographic variables, (V013, V025, V106, V501, V130, V190) Variables on sexuality, sexual coercion and violence (V820, V830, V831, V850, D105H, D105I D108 D109, D125, D127, D128, D119X). The NDHS survey data was weighted using the WEIGHT command with the weight variable V005 (COMPUTE rweight = V005/1000000 then WEIGHT by rweight). Further analysis was done using SPSS for windows Version 16. This study is based on an analysis of existing survey data with all identifier information removed. The survey was approved by the Ethics Committee of the ICF Macro at Calverton in the USA and by the National Ethics Committee in the Ministry of Health in Nigeria. All study participants gave informed consent before participation and all information was collected confidentially.
Figure 1: Person who Forced Respondent to First Sexual Activity

Stranger                    22.2%
Own friend / acquaintance   20.3%
Current / former boyfriend  17.8%
Neighbor                     9.1%
Other relative               8.8%
Current husband / partner    6.6%
Others                       4.9%
Did not respond              2.6%
Teacher                      2.4%
Employer / someone at work   1.6%
Religious leader             0.9%
Former husband / partner     0.9%
In-law                       0.5%
Police / soldier             0.2%
Step father                  0.2%

Note: Table made from bar graph.


Results

A total of 12,626 respondents were young people aged between 15 and 24 years and met the criteria for the study. Approximately, the sample of young women were equally distributed in both Northern and southern part of Nigeria (50.4% and 49.6% respectively). Majority of respondents in both Northern and southern Nigeria where aged between 15-19 years. The mean age of respondents was 19-22 years [+ or -]2.80. Considering the type of residence, 64.1% of young people resided in rural areas in the north while 35.9 % of respondents lived in rural areas in the south.

Majority of respondents that were married resided in the north making up to 77.6% (n = 4119) of the entire study population. The socioeconomic class was depicted by the wealth index which shows that 71.8% of poorest respondents were from northern Nigeria while on the other hand 78.3% where among the richest and resided in southern Nigeria. Considering the level of education, 3,673 (94.4%) of young people in northern Nigeria had no education while 71.6% of the respond had secondary level of education as the highest level of education attained in the southern region of Nigeria.

Circumstances in which respondents in spousal relationship experienced been physically forced to sex when not wanted was almost equally distributed being 53.9% and 46.1% occurring in the northern and southern part of Nigeria respectively. Concerning respondents who have been sexually coerced or forced by anyone other than partner 65.6% of them reside in the south while 34.4% where in the northern part of Nigeria (Table 2). This relationship showed a statistically significant difference. (P < 0.0001) Overall, about 64.1% of respondents did not seek help following sexual coercion. A majority (62.1%) of respondents who did not seek help following sexual coercion or violence were from southern Nigeria compared to about 31.2% in the north. (p < 0.0001).

Person who forced respondent to first sexual activity were mostly strangers (23.1%), followed by current boyfriend (19.8%) and own friend or acquaintance (19.1%). (Figure 1).

Discussion

Non-consensual sexual experiences can be described in different forms and phases. These ranging from sexual abuses, threats and intimidations to unwanted touching of erotic parts of the body, attempted rape and even rape (15). Results of this study support exiting data which indicates that sexual coercion is a common occurrence among young people. It was revealed that even with under-reporting on such a sensitive issue as sexual coercion, perpetrators of forced sexual coercion at sexual debut where mostly respondents boyfriend and strangers. This finding is consistent with similar studies in Ibadan, Kenya and South Africa, which showed that the main perpetrators of the coercion were persons well known to the victims including neighbours, peers and boy/girlfriends (1,10,16). This invariably implies the need for multiple intervention programs including skill based training for young persons on relationship issue adolescent sexuality as well as media advocacy for the public.

With respect to intimate partner violence and sexual coercion it was revealed that one out of every two of married respondents often experienced sexual coercion in the northern region, in contrast to about two in five who often experienced this in the southern part of Nigeria. This finding appeared higher compared to studies conducted with Bangladeshi (46%) (17), Ethiopian (46%) (18), American (20%-46%) (19), and Australian women (21%) (20). This finding may likely be related to the cultural practice of early marriage which is more prevalent in the Northern part of Nigeria. We also found some evidence that most respondents in spousal relationship in Northern Nigeria did not seek any form of help haven experienced one form of nonconsensual sexual exposure or the other. Results also revealed that only a small percentage of the women who had experienced sexual coercion sought help, even though their experience may have occurred in spousal relationship. Observers have suggested a number of reasons why women who experience nonconsensual sexual victimization do not seek help. Most of the research in this area has focused on nonconsensual sexual experience in non-spousal relationships and has not specifically addressed other forms of sexual coercion. Yet it is likely that the reasons for failure to get help after sexual coercion are religious and cultural related especially relating to issues of early marriage. The role of religion and culture as it affects reproductive and sexual health right of women and adolescents remains controversial. These has evolved into a major public argument, causing researchers, women, and policy analysts to rethink and debate on effective intervention programs which take in to account the religious and cultural perspective (21,22).

With respect to the respondents' age at first coerced sexual activity, three out of every five respondents were aged between 15-19 years in the south compared to two in five in the North. About 66% of respondents in spousal relationship in the northern part of Nigeria reported occasionally being physically forced to sex when not wanted compared to 33.6% southern Nigeria. About, 65% of respondents in the north had been sexually coerced or forced by persons other than partner compared to 34.4% in the south. Majority of perpetuators were strangers (23.1%), followed by current boyfriend (19.8%) and own friend or acquaintance (19.1%). The study yielded considerable insight into the magnitude and patterns of sexual coercion experienced by among female in spousal and non-spousal relationships in Nigeria.

A legal framework which clearly delineates the implication of perpetuating various forms of sexual coercion should be legislated. Skill based training should be organized for young people. Sexuality education programs are needed to appraise and train on acquiring the require skills to deal with occurrences of coercion or unwanted sexual advances. Further research directed at more intricate influence of socio-cultural contexts that shape and support sexual coercion is needed. These include studies of Sexual values, attitudes, gender-based sexual roles, economic and cultural practices that give rise to sexual violence.

Acknowledgements

The authors are grateful to ICF macro (Calverton, USA) for providing the 2008 DHS data of Nigeria.

Reference

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(10.) Erulkar AS. The experience of sexual coercion among young people in Kenya. International family planning perspectives. 2004:182-9.

(11.) Ajuwon AJ, Olaleye A, Faromoju B, Ladipo O. Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria. BMC Public Health. 2006;6(1):310.

(12.) Monascha R, Mahyb M. 2. Young people: the centre of the HIV epidemic. 2006.

(13.) Folayan MO, Morolake Odetoyinbo AH, Brown B. Rape in Nigeria: a silent epidemic among adolescents with implications for HIV infection. Global health action. 2014;7.

(14.) Abuja N. National Population Commission and ICF Macro; 2009. National Population Commission (NPC)[Nigeria] and ICF Macro Nigeria Demographic and Health Survey. 2008.

(15.) Peterson ZD, Muehlenhard CL. Conceptualizing the "wantedness" of women's consensual and nonconsensual sexual experiences: Implications for how women label their experiences with rape. Journal of sex research. 2007;44(1):72-88.

(16.) Ajuwon A, Olley BO, Akin-Jimoh I, Akintola O. Experience of sexual coercion among adolescents in Ibadan, Nigeria. African Journal of Reproductive Health. 2001:120-31.

(17.) Naved RT. Sexual violence towards married women in Bangladesh. Archives of sexual behavior. 2013;42(4):595-602.

(18.) Takele A, Setegn T. Sexual Coercion and Associated Factors among Female Students of Madawalabu University, Southeast Ethiopia. Advances in Public Health. 2014;2014.

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(21.) Fontes LA, Plummer C. Cultural issues in disclosures of child sexual abuse. Journal of child sexual abuse. 2010;19(5):491-518.

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Victor A. Aduayi (1), Olufunso S. Aduayi (2) and Olayinka A. Olasode (3)

Department of Epidemiology and Community Health, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria (1); Department of Radiology, College of Medicine Ekiti State University, Nigeria (2); Department of Dermatology and Venerology, Obafemi Awolowo University, Ile-Ife, Nigeria (3)

(*) For Correspondence: E-mail: victoraduayi@yahoo.com; Phone: +2348037115415
Table 1: Background Characteristics of Young People in Northern and
Southern Nigeria.

Variable                      Zone
                     North          South          Total
                     n = 6362       n= 6264        n=12,626
                     Frequency (%)  Frequency (%)  Frequency (100.00%)

Age (years)
15-19                3193 (49.2)    3300 (50.8)    6493
20-24                3169 (51.7)    2964 (48.3)    6133

Residence
Urban                1621 (35.8)    2909 (64.2)    4530
Rural                4741 (58.6)    3355 (41.4)    8096

Wealth index                                       2288
Poorer               1643 (71.8)     645 (28.2)    2477
Middle               1226 (49.5)    1251 (50.5)    2869
Richer                971 (33.8)    1898 (66.2)    2801
Richest               608 (21.7)    2193 (78.3)
Education Level
No education         3252 (94.4)     194 (5.6)     3446
Primary              1053 (57.0)     793 (43.0)    1846
Secondary            1873 (28.4)    4724 (71.6)    6597
Higher                184 (25.0)     553 (75.0)     737
Marital status
Never married        2103 (30.3)    4837 (69.7)    6940
Married              4119 (77.6)    1189 (22.4)    5308
Living together        23 (10.7)     191 (89.3)     214
Widowed                22 (78.6)       6 (21.4)      28
Divorced               63 (86.3)      10 (13.7)      73
Not living together    31 (50.0)      31 (50.0)      62

Variable             Statistical test




Age (years)          [chi square] = 7.86
15-19                df = 1
20-24                P = 0.005

Residence            [chi square] = 603.10
Urban                df = 1
Rural                P = 0.0001

Wealth index         [chi square] = 2852.45
Poorer               df = 4
Middle               P = 0.0001
Richer
Richest
Education Level      [chi square] = 4166.65
No education         df = 3
Primary              P = 0.0001
Secondary
Higher
Marital status       [chi square] = 2873.34
Never married        df = 5
Married              P = 0.0001
Living together
Widowed
Divorced
Not living together

[chi square] = Pearson Chi-square, *statistically significant at p
value < 0.05, **statistically significant at p value < 0.001

Table 2: Patterns and Associated Risk of Sexual Coercion among
Respondents Spousal and Non-Spousal Relationships by Zone.

                                       Zone
Variable                        North        South        Total

Spouse ever physically
forced sex when not wanted
No                              3338 (74.5)  1144 (25.5)  4482 (100)
Yes                               76 (53.9)    65 (46.1)   141 (100)
Total                           3414 (73.8)  1209 (26.2)  4623 (100)
Anyone other than partner ever
forced respondent to have sex
No                              4327 (54.0)  3690 (46.0)  8017 (100.0)
Yes                               34 (25.8)    98 (74.2)   132 (100.0)
Refused to answer                 17 (63.0)    10 (37.0)    27 (100.0)
Total                           4378 (53.5)  3798 (46.5)  8176 (100.0)
Sought help following sexual
coercion
Help Sought                      238 (31.2)   524 (68.8)   762 (100.0)
No help sought                   516 (37.9)   847 (62.1)  1363 (100.0)
Total                            754 (35.5)  1371 (64.5)  2125 (100.0)


Variable                        Statistical Indices

Spouse ever physically
forced sex when not wanted
No                              [chi square] = 29.96
Yes                             df = 1,
Total                           p = 0.0001
Anyone other than partner ever
forced respondent to have sex
No
Yes                             [chi square] = 42.52
Refused to answer               df 2
Total                           p = 0.0001
Sought help following sexual
coercion
Help Sought                     [chi square] = 9.37 df = 1,
No help sought                  0.002
Total
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Title Annotation:ORIGINAL RESEARCH ARTICLE
Author:Aduayi, Victor A.; Aduayi, Olufunso S.; Olasode, Olayinka A.
Publication:African Journal of Reproductive Health
Article Type:Report
Geographic Code:6NIGR
Date:Dec 1, 2016
Words:3561
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