A longitudinal mixed-method investigation of sexual development amongst a school-aged sample of adolescents in Ibadan, Oyo state, Nigeria.

Background: Around 1.2 billion people, or 1 in 6 of the world’s population, are adolescents aged 10 to 19. Evidence has shown that in most countries of the world children are attaining puberty and biological maturity at an earlier age. This trend may perhaps be due to improved nutrition though other factors may also be at play. In every population, adolescents are amongst the most sexually active of groups and may become involved in regular unhealthy and risky sexual practices that further threaten future reproductive health. STIs (including HIV) and unintended pregnancy among adolescents remain both a risk and public health burden, in spite of long-term efforts at prevention. Aim: This study aims to critically investigate the understanding and experience of sexual development of a school-aged sample of adolescents in Ibadan, Oyo State, Nigeria by means of a longitudinal mixed-methods approach. Methods: An adapted version of the WHO ‘Asking young people about sexual and reproductive behaviours’ survey was administered at baseline and 6 months (n=121). Hierarchical Cluster Analysis of baseline results was used in order to determine a sampling matrix for the qualitative phase of this study. The emergent clusters differed on the basis of whether participants were home or peer oriented in their outlook. Semistructured interviews (n=10) were undertaken with a mixture of peer-oriented and home-oriented young people. Result/findings: Statistically significant differences were determined between baseline and 6 months in terms of whether members of the sample had ‘ever had a boy/girlfriend’ (χ² = 20.407, P ≤ 0.000), ‘ever had sex before’ (χ² = 5.493, P ≤ 0.019), as well as changes in attitudinal orientations towards sex before marriage (U = 2268.00, P≤0.017). Thematic analysis of qualitative data revealed a complex interplay of factors mediating adolescent sexual choices including informational, family, peer, cultural and social structural factors. Conclusion: This study provides some evidence in support of the role of social structures in determining adolescent sexual choices: adolescent development is a reality, but not one that can be understood solely in terms of agency or culture. It can, therefore, be argued that society and government have a role to play in supporting young people in 4 | P a g e making responsible sexual choices. Improving adolescent sexual and reproductive health remains a public health priority both locally, nationally and internationally