Risk Factors of Sexually Transmitted Infections among Women of Child-Bearing Age in IDP camps in Abuja

Background: Sexually Transmitted Infections (STIs) are a major public health concern which is responsible for acute illness, infertility, long-term disability and death globally. The adverse effect is however profound in developing countries and among women when left untreated. In Nigeria, the Boko haram insurgence and other conflicts has given rise to internally displaced persons. The increased reports of STIs among internally displaced persons which women and children make up the largest population and the dearth of literature on epidemiological studies on STIs among internally displaced persons initiated the need for the study. Aim: This study seeks to determine the risk factors of Sexually Transmitted Infections (STIs) among internally displaced women of child bearing age in Internally Displaced Persons Camps in Abuja. Methodology: A community based retrospective case-control study design was used. Each consenting participant was screened to detect the presence of antibodies for Hepatitis B, C, HIV, and Syphilis using Rapid Diagnostic Tests. A self-administered structured questionnaire was used to assess risk factors among study participants after being validated and its reliability tested. Multistage sampling technique was used to select the study participants (n=362) and Cases and Controls were selected using set criteria. Results: Data was entered and analysed using SPSS version 21. Chi- square was used to determine the association between variables and STI morbidity within the risk factor of STIs among the study group. Thus, there is need for more comprehensive community based STI studies alongside implementation of risk targeted Public health intervention. STI morbidity. In addition, the results revealed that there is a significant relationship between use of sexual enhancers and STI morbidity. (X2=12.302, P=0.001 OR=0.362, CI=0.202 -0.648).


Introduction
Clinical Health Volume 17 September/October Issue, 2020      disease or outcome (controls), and look back retrospectively with the aid of a questionnaire to compare how frequently the exposure to a risk factor is present in each group so as to determine the relationship between risk factor and the disease. Thus, the study is designed to not only measure association but also calculate odds ratio which is a measure of association that quantifies the relationship between an exposure and two categories of health outcome.
Cases were defined as any internally displaced woman within the ages 15 Any internally displaced woman of child-bearing-age between the ages of 15-49 who has been resident in the IDP camp for at least 6months and above and not currently receiving treatment for any STI. In addition, to participate in the study the woman must give informed consent.
Women of child bearing age who are not internally displaced although resident in the camp. Women who are already on Antiretroviral Therapy (ART) and who do

Exclusion criteria
Clinical Health Volume 17 September/October Issue, 2020 8 not give their informed consent were excluded from this study.
Serologically, data was collected using the following instruments: alcohol swab, sterile specimen collection bottle, tourniquet, syringe and Rapid Test Kits for antibody test for Hepatitis B, C, HIV and Syphilis. Also, a self-administered questionnaire with four sections namely; socio-demographic characteristics, sexual behaviour, prior exposure to gender-based violence and IDPs mobility was used to collect information on risk factors exposure.
A written informed consent was obtained from each respondent before data was In the multistage sampling method used for this study, the following steps were carried out: ? Abuja Municipal Area Council was categorised into wards which were twelve in number namely; City centre, Garki, Kabusa, Wuse, Gwarimpa, Jiwa, Gui, Karshi, Orozo, Karu, Nyanya and Gwagwa. The number of IDP camps in each ward was then indicated (Appendix B).
? Wards which have IDP camps were then purposively selected for the study.
There were nine IDP camps in AMAC. The IDP camps were further classified (stratified) into types namely; integrated and non-integrated camps (Appendix C). There were two integrated camps and seven non-integrated camps.
? Using the list of IDP camps simple random sampling by balloting without

Sample size
Clinical Health Volume 17 September/October Issue, 2020 9 replacement was carried out proportionately for each type of camp. Using onethird proportion, one camp was selected from the integrated camps and two camps from the non-integrated camps. ?
The population of women of child-bearing age in each selected IDP camp was then established. The study sample was gotten using simple random sampling technique. In each of the IDP camps selected, displaced women of child -bearing age were classified as cases or non-cases with the aid of the case definition.
Controls were later selected from the non-cases and matched frequency-wise using adequate variables. Copies of the questionnaire were then administered to cases and controls to find out exposure variables. In

Influence of gender-based violence as a risk-factor for STI
Clinical Health Volume 17 September/October Issue, 2020 In Table 3, prior exposure to gender based violence by respondents was recorded.
It indicated that of the 309 respondents who had never been exposed to GBV,   With respects to behavioural factors, frequency of condom use which is a behavioural factor in this study was not statistically significant to STI. The study by 12 Park, Seo, Jeong, & Lee , was in concurrence with this study as it reported that there was no significant difference between STIs and behavioural factors or sexual practices.
When Prior exposure to gender based violence was examined as a risk factor for to gender-based violence was measured, reward for sex was a significant risk factor for STI. IDP mobility revealed that the nature of relationship IDPs had outside the camp was a major predictor of STI.
Furthermore, the logistic regression model revealed that the use of sexual performance enhancers such as Alcohol, herbs and drugs to be the most significant risk factor STI.
After the conclusion of this study, the researcher made the following recommendations: ? Further studies can be carried out to identify peculiar risk factors of STIs among male IDPs.

Recommendations
Clinical Health Volume 17 September/October Issue, 2020 ? Risk targeted public health intervention should be carried out systematically among IDPs so as to improve knowledge, awareness and prevention of STIs via mitigation of its risk factors.
? Sexual health programs should be implemented with the inclusion of gender sensitive and youth friendly centres within IDP camps so as to encourage health seeking behaviours.
? Routine screening should also be carried out among IDPs and treatment administered to confirmed cases of STI. Ukwajiunor Judith I. conceived the study, designed the instrument for data collection, performed data collection and manuscript drafting.
Abanobi O.C, supervised the study and also contributed in study design, face validity of instrument of data collection and in-depth manuscript review.
Ebirim C.I.C. performed the statistical analysis with interpretations and manuscript review.
Ibe S.N.O. was responsible for giving content validity to the instrument for data