Impact of Peer Education on Sexual Health Knowledge among Adolescents and Young Persons in Two North Western States of Nigeria

"The use of peer-to-peer education should be encouraged and consistently adopted to improve knowledge of pertinent health issues among young people."

Peer education is an approach to health promotion in which community members are supported to promote health-enhancing change among their peers. Nigeria's Society for Family Health implemented a peer education intervention (MTV Shuga Naija Peer Education Project) among young people aged 15-24 years in Kaduna and Kano states, Nigeria. This study was conducted to assess the effectiveness of the intervention in addressing sexual and reproductive health (SRH)-related knowledge and concerns among young participants.

The pre-intervention stage involved the recruitment and training of 54 young people (27 in each state) who were found to be knowledgeable about SRH issues and have influence among their peers. Conducted over a period of 3 days, the training curriculum for these peer educators covered topics on values clarifications, self-awareness, gender-based violence (GBV), safe sex practices, gender equality, and stigma prevention.

The trained peer educators were subsequently deployed to mapped communities in Kaduna and Kano states, where they facilitated the intervention among the study participants. Peer education sessions were held in selected communities among peers mobilised with the support of schoolteachers for the sessions held among the in-school participants, while community stakeholders were actively involved in the mobilisation of the out-of-school peers. A complete peer education session cycle lasts a period of 5 days, where a maximum of 12 adolescents and young people (referred to as peers) are exposed to 5 episodes of the SHR-themed, youth-oriented television drama series MTV Shuga Naija (see one epidode, below). The inherent SRH messages in the TV series form the discussion points for the peer education sessions.

A pre- and post-test study was conducted among the 8,930 young people aged 15-24 years who participated in the intervention. A baseline pre-test was conducted before the education programme, and it was followed up with a post-test at the end of the 5-day-long peer education sessions.

In terms of changes in knowledge, the study found, for example, that 6,099 (68.3%) of the respondents correctly stated that condoms prevent pregnancy during the pre-test, compared to 6,429 (72.0%) during the post test. Lower abdominal pain was correctly indicated as a symptom of sexually transmitted infection (STI) by 6,282 (70.3%) and 6,984 (78.2%) of the respondents at pre-test and post-test, respectively.

More males (58.5%) had good knowledge about condom use compared to females (51.9%), while more females (79.6%) compared to males (74.7%) opined that going for HIV test with their sexual partner is important to them during the pre-test. However, no significant difference was observed on knowledge of condom use and opinion on going for HIV testing with their sexual partner among either gender at post-test.

With regard to attitudes, there were observable positive changes in views and opinions of the respondents on STIs and HIV, HIV anti-stigma, and the use of condoms. For example, there was a more than 5% increase in respondents' belief that condoms, injectables, intrauterine devices (IUDs), pills, and cycle beads - except for implants (only about 2.5% increase) - are contraceptive methods that should be widely accessible to young people.

There was no marked difference in the perceived belief that condom use reduces sexual satisfaction among the respondents after exposure to peer sessions. This finding suggests that peer education alone might not be effective in changing some myths about SRH issues.

In conclusion, this study found that "Significant positive changes in knowledge, views and opinions regarding STIs and HIV, HIV anti-stigma and the use of condoms were observed following exposure to the peer sessions of the MTV Shuga peer education intervention. Sustained exposure and access to informative and enlightening peer education sessions over time have the potential to comprehensively improve SRH knowledge, influence positive opinion change and in turn adoption of positive behaviours among young people."