MIGRANT FARM WORKERS IN SOUTHWESTERN ...

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Apr 2, 2003 - Slightly over half were from Nigeria, primarily from Kogi and Benue States in what is referred to as the middle belt of the country. Benue has the ...
MIGRANT FARM WORKERS IN SOUTHWESTERN NIGERIA: IMPLICATIONS FOR mv TRANSMISSION

ADEBOLA A. OYADOKE WILLIAM R. BRIEGER AZEEZ ADESOPE KABIRU K. SALAMI University of Ibadan, Nigeria

ABSTRACT Migration of labor is an international phenomenon, but is especially pronounced within the West African region. Such migration is also known to be associated with the spread of sexually transmitted infections and HIV. Farmers in southwestern Nigeria increasingly depend on migrant fann workers (MFWs) as the traditional source of farm labor, their children afe seeking further education and urban employment. This study documented a population of 482 MFWs within the Ibarapa Central Local Government Area of Oyo State, a number less than 1% of the total population, which is primarily Yoruba. A sample of 244 was interviewed. Three types ofMFWs were found: labor team leaders, their apprentices, and independent migrants. Slightly over half were from Nigeria, primarily from Kogi and Benue States in what is referred to as the middle belt of the country. Benue has the highest HIV prevalence in the country. Non-Nigerians came from neighboring Benin Republic and Togo. Their ages ranged from 14-46 years, with a mean of 31. Most were paid at the end of the harvest, though some received some cash and food from the farmers who hired them. The most commonly known STIs were AIDS (86%) and gonorrhea (76%). Fifty respondents (20.5%) reported symptoms of an STI in the past year, and few of these were the apprentices. While 199 (82%) had sex before, only 77 (39%) said they had sex in the past

Inn Quarterly of Community Health Education, Vol. 22(4) 247-266, 2003-2004

© 2004, Baywood Publishing Co., Inc.

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month. Most of these (61 %) had sex with their wives, and 13 (17%) had sex with multiple partners. Less than half (47%) who had sex with a non-marital partner used a condom. A positive association was found between condom use and the following: STI knowledge, perceived seriousness of STIs, favorable attitudes toward condoms, and self-efficacy perceptions for condom use.

INTRODUCTION

Population mobility in West Africa is among the most exteusive in sub-Saharan Africa according to Prothero [1], and the type of mobility in the region varies from temporary to permanent and internal to international. For example, more

than one

million citizens of landlocked Niger migrate annually across borders to costal cities as far as Abidjan [2]. Reasons for this mobility include familial (marriage, birth, and death ceremonies), religious (pilgrimage), economic (labor migration, trade, nomadism), and political (military, refugee resettlement) [1, 3]. Migrants are mostly young and economically active men (15-40 years) who occasionally are accompanied by wives or female partners [1,4]. Adolescents are a significant proportion of MFW populatious. The British Broadcasting Company (BBC) quoted Human Rights Watch as saying that Togolese boys often ended up as agricultural laborers in Nigeria because they could not pay their school fees at home [5]. Another BBC report described the experiences of one such boy who worked in the village of Awo outside Ibadan [6]. The boy told of 13-hour work days, minimal shelter, and inadequate food supplies. The team on which this boy worked consisted of four adolescents. The "boss" who brought them from Togo collected any money earned by the team, and after working for II months, he bought each boy a bicycle and told them to ride home to Togo. Migration for economic reasons has been linked to the spread of HIV and sexually transmitted infections (STIs) in a number of countries [7, 8]. Mobility itself has been identified as an independent risk factor for HIV infection [9]. Migration has been typically dominated by men who are mostly single and whose efforts to seek sexual gratification in their new environment contribute to disease

transmission [10-12]. According to Caldwell, Anarfi, and

Caldwel~

migration

to new places offers an uncontrolled opportunity to experience what otherwise

would have been controlled sexual practices [13]. A study in the United States found that 44% of male migrant farm workers reported sexual contact with commercial sex workers (CSWs), with married men reporting less condom use than single men [14]. Migration can expose the migrant worker to new diseases (15]. or conversely,

the migrant worker can bring health problems to the point of migration. The link between migration and STls and HIV has also been documented in several studies. Migrant laborers, such as truck drivers, itinerant traders, military personnel, and

CSWs, are regarded as a high-risk groups [16, 17]. A South African study reported

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that among 327 pregnant women attending rural prenatal clinics, 153 (47%) mentioned that their sexual partner was a migrant worker [18). Many migrant workers move to boom towns and tourist centers, which also attract CSWs to whom men, separated from their spouses or regular sexual partners, may tnrn and become infected with STIs or HIV [19, 20). While MFWs in southwestern Nigeria live among the local population, they are not active participants in local life. Ajuwon et al. studied sexual behavior in another Oyo State town similar to the study area. They reported that sexual networks among indigenous residents were primarily exclusive [21]. CSWs in that community were themselves from other tribes and countries, and reported that MFW s and long distance transporters were their most common customers. In

the health sphere it was found that MFWs were often ignored when it came to health programs. In particular, their coverage during onchocerciasis control activities (ivermectin distribution) was significantly lower than that of the indigenous population, and qualitative results confmned that MFWs felt neglected [22]. It is generally agreed that migrant workers around the world suffer discrimination and stigmatization in their host communities [23, 24). MFWs are a mainstay of agriculture in southwestern Nigeria. This study addressed two issues: first, the need to document the population and characteristics of this diverse group, and second, the nature of their sexual behavior as it might influence the spread of STls and HIV. METHODS This cross-sectional study examined MFWs in southwestern Nigeria on tw'Q

levels. The first consisted of a documentation of their presence, status, and movements. The second inquired into their sexual behaviors and their HIV and

STl knowledge. The study was based in the Ibarapa Central Local Govemment Area (LGA) of Oyo State. Ibarapa Central is one of 36 LGAs in Oyo State and has two major towns, Igbo-Ora (the LGA Headquarters) and Idere, and more than 200 scattered farm hamlets. Of the estimated population of 65,000, approximately 20% reside in the farm hamlets. The people ofIbarapa Central LGA are predominantly Yoruba. Other Nigerian ethnic groups resident in the area include nomadic Fulani herdsmen and agricultural Ohori living in rural settlements and Hausa and Igbo traders and craftsmen living in the towns. MFWs come from Nigerian ethnic groups such as Egede, !doma, Tiv, and Igala, as well as people from Togo and Benin RepUblic. MFWs usually live in work teams based in both towns and farm hamlets The general population has access to both public and private schools. There are over 30 primary schools, 10 secondary schools, and one government technical

college. The LGA has three general hospitals (one run by the State Government), five LGA health clinics, 60 patent medicine shops, and numerous indigenous and religious healers. Producing, processing, marketing, and transporting of

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agricultural products is the primary or secondary occupation of most residents. Transport along the unpaved roads and paths to the farm hamlets where MFW s work consists of pick-up trucks, lorries, and motorcycles, although many trek. Fanning and consequently the movement of the MFWs is based on the seasons, which include a dry period from October through March and a rainy season between April and September. Major crops include cassava, maize, melon seed, and vegetables. Ibarapa Central is part of a wide area that serves as the food basket for major cities such as Lagos and Ibadan. Farmers and MFWs are occupied with clearing and preparing the ground at the end of the dry season, begin planting as the rains start, carry out weeding throughout the rainy season, undertake a second planting in mid-rainy season, and begin harvesting as the rains end.

Although there are tractors for hire in the LOA, MFWs compete favorably in terms of cost and availability. Market days and weekends provide hamlet-based MFW s an opportunity to come to town. Traditional farming use to be a family affair. The need for MFWs has increased over the years as more local children seek education or learn trades that take them out of the area. MFW s are paid in cash and kind, with the latter in the form of foodstuffs, often sustaining them until cash can be paid after harvest After payment, MFWs may go home right before ChristmaslNew Year. Some MFWs use their gain to start small businesses at home, while others, especially those who lead worker teams, return on an annual basis.

The study population consisted of all male migrant farm workers (married or single) who were present in the LOA at the beginning of the planting season of 1999 and who had been doing this work for at least one year. There was no previous census of the MFW s for the area. Hence, it was necessary to visit all the wards in the two major towns (Idere and Igbo-Ora) and all 217 farm hamlets in the LOA. MFWs usually work in teams. Older, more experienced workers bring younger workers who are know as their "apprentices." The apprentice works under a master who pays him at the end of a season. After a few seasons, the apprentice

may become a team leader and bring his own group of young apprentices from home. Some older MFWs do bring wives and children and live semi-permanently in the area. Sampling was based on the fact that some more-experienced MFW s work on their own, while others are in teams. All independent MFW s living/working on their own and all team leaders were interviewed. In teams with less than four members excluding the leader, one apprentice was randomly chosen

for interview by balloting and in larger teams, two apprentices were randomly seJected. The study focused on two key sets of variables. Socio-demographic characteristics provided some context for understanding this previously undocu-

mented segment of the population. The second set of variables focused on sexual experience and behavioral antecedents in the form of cognitive factors. Sexual

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experience was considered in two fonns: firs~ whether the MFW had ever had sex, and second, whether he had sex in the month prior to the survey, The former was a measure of sexual initiation, while the latter was a measure of current sexual activity. The cognitive factors or intermediate variable included attitudes toward safe sex, perceived self-efficacy for using condoms, perceived seriousness of STIs, perceived susceptibility to STIs, and knowledge of STI preventive measures. The independent variables included age, nationality, religion, educational level, and marital status. A questionnaire, which was pretested in a neighboring LOA, was the basic instrument used for data collection and was administered by two of the authors. Both an English and a Yoruba version were developed. MFWs from other parts of Nigeria preferred being interviewed in English, while those from Benin Republic and Togo preferred the Yoruba version. In fact, some of them nonnally spoke a dialect of Yo rub a known as Sabe. Since MFWs normally finish fann work late in the evenings, interviews were conducted either from 6:00 to 8:00 P.M. or from 5 :00 to 7 :00 A.M. Data were also collected on weekends from those who live in the towns. Each interview lasted between 45 to 50 minutes. The authors were responsible for editing, cleaning, entering, and analyzing the data. In addition to the normal issues of confidentiality, the authors had to meet with MFW leaders to allay any fears that they might have as "outsiders" in the community. It was fortunate that one of the authors had worked in the national guinea wonn eradication program and was known in the farm hamlets throughout the LOA.

RESULTS

The census found that MFW s lived in both towns and 67 of the farm hamlets. The resident popUlation ofMFWs was 482, or less than 1% ofthe LOA population. Of these, 366 (75.9%) were based in the hamlets, while 68 (14.1%) stayed in Igbo-Ora and 48 (10.0%) lived in Idere. Ultimately, 244 MFWs were interviewed, 180 from the farm hamlets and 64 from the two towns. The age of the 244 respondents ranged from 14 to 56 years, with a mean age of 31.3 years. The majority (75.0%) were between 20 and 39 years of age. More than half (59.8%) of the MFWs were from Nigeria, the largest number were from Kogi (47.3%) and Benue (40.4%) States, which are located in what is known as the "middle belt" of the country. Other states of origin included Cross River, Enugu, Ebonyi, and Imo in the east and Sokoto, Nassarawa, Kaduna, and Zamfara in the north. Among the non-Nigerians were 67 (27.5%) from Republic of Benin and 31 (12.7%) from Togo. About one-third (34.0%) of the MFWs had no formal education. The majority had some education: 36.1% had primary education, 18.8% attended secondary school, 9.0% had post-secondary education, while five (2.1 %) had non-fonnal

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education (Islamic school, home lessons). Most (63.9%) respondents were Christians, 34.0% were Muslims, while a few (2.1%) practiced indigenous religion. The MFWs had been doing farm work for an average of 12.2 years, with a range of 2 to 40 years. The three main groups of MFWs were represented as follows: 36.5% were independent fanners who were neither master nor apprentice; 33.2% were apprentices on a team; and 30.3% were masters or team leaders. Twenty-seven MFWs (11.1 %) had additional jobs ranging from being artisans (mechanics, tailors) to other forms of manual labor (digging gravel, processing food stuffs). Half of the respondents (50.4%) had their own farm plots ranging in size from a quarter to 21 acres, with an average of3.5 acres. Their work week ranged from three to seven days, but most (85.2%) worked six days a week. Overall, 154 (63.1 %) reported that they received money only at the end of the season. Some received cash immediately on completion of a job, while others were paid at intervals (e.g., weekly, monthly). Cash was reportedly received before the end of the season by 21.0% of apprentices, 37.8% of team masters, and 50.6% of independent workers. During the week prior to interview, 125 (51.2%) respondents reported receiving support in cash or kind for their work. Support in kind from the farm owner included meals (47.1%), food stuffs with which the MFWs could prepare their own meals (13.5%), and cigarettes (0.8%). Only 25 (10.2%) received any cash. Only 7.8% of apprentices received any cash compared to 25.6% of team leaders and 31.4% of independent workers (31.4%) (p < 0.015). The median value of the cash received was approximately US$3.00. Most of the respondents (57.0%) had been married, and 55.3% were currently married at the time of interview. These had between one and five wives, with an average of 1.3. Of the 135 currently married MFWs, 87 (64.4%) had at least one wife with them in !barapa Central LGA. Those who had ever married reported having between 0 to 15 children with a mean of3.3. Sixty-two MFW s had children with them in !barapa Central. The respondents had been coming to !barapa Central from between 2 and 20 years, and 45.5% had been coming for more than 5 years. Thirty-eight (15.6%) said they had never been home since they arrived, but 32 of these had arrived within the past five years. Among apprentices, 76.5% had been home since their first arrival compared to 93.2% of masters and 84.3% of independent workers.

Health Concerns MFW s were asked to list the most common health problems faced by farm workers. This was done in order to ascertain whether any would spontaneously mention ST!. Body pain (59.0%) topped the list, followed by malaria (48.8%), waist pain (44.3%), headache (44.3%), and backache (41.8%). Other conditions among the top 10 complaints included fever (40.6%), which was mentioned

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separately from malaria, respiratory complaints including cough and catarrh (25.4%), feeling cold (24.2%), stomach upset (22.1%), and chest pain (20.1%). Other concems mentioned by less than 10% but atleast 5% included guinea worro, piles. constipation, onchocerciasis, general weakness, dizziness, and cuts. No MFW mentioned an STI. Respondents explained that they commonly sought treatment for these problems by using herbs at home (48.4%) or going to a medicine shop (46.3%). Other sources were orthodox drugs kept at home (33.2%), private clinics (19.3%), government clinics (15.2%), and drug hawkers (10.6%). A few other options (4.9%) included traditional healers, visiting a nurse at his home, drinking fluids, resting, and praying.

Sexual Behavior

The majority ofrespondents (81.6%) said they had sex before. The age when they reportedly started sex ranged from 5 to 30 years with a mean of 17.7. Among the 199 who have had sex, only 77 (38.7%) said they had sex in the past month. The following sexual partners were mentioned: wife (61.0%), girlfriend (41.6%), casual partners (11.7%), and prostitutes (7.7%). Thirteen (16.9%) of these 77 MFWs had sex with at least two different partners during the previous month. Information about condom use was requested from those who had sex in the previous month. Among the 77, only 21 (27.3%) had used a condom at all in the past month. Only 8.5% of the 47 who had sex with their wives in the previous month had used a condom. Half(50.0%) of those 32 MFWs who had sex with their girlfriend used a condom at least once. Among the nine who had sex with casual partners, 44.4% used a condom at least once, while only two (33.3%) of the six who had sex with prostitutes had used a condom (Figure I). Respondents were asked about condom acquisition. Only 72 (29.5%) said they knew where condoms were sold in this area. Fewer still (I 5.6%) said they had ever bought a condom. Among the 206 who had never bought a condom, only 14.0% indicated that they were willing to buy one in the future. Those 72 who knew where to buy condoms listed chemist shop (79.2%), hospitals and clinics (36.1 %), and other places like shops (11.1 %), markets (11.1 %), drug hawkers (5.6%), and barbing salons (1.4%), as seen in Figure 2. The places of actual purchase for the 38 who had ever bought a condom included chemist shops (71.1 %), hospitals and clinics (15.8%), shops (5.3%), and markets (2.6%) (see Figure 2). Two did not know where the condom had been obtained because they sent someone to buy it for them. Most (73.7%) bought their condoms in packets containing four or more condoms, while the remainder bought

them singly. Less than half (42.1 %) said they could afford, at present day prices, to buy a condom every time they had sex. Only 66 (27.0%) were aware of significant others who used condoms, including friends (78.8%), brothers (34.8%),

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50r---------------~--------------_.

40

; 30

• Condom

~

!!I None

~ 20

10

o Girlfriend

Wife

Casual

Prostitute

Partner

Figure 1. Condom use in recent sexual encounters.

9U

80 70

..

~

~

~

"

0..

60 50 40 30 20 10 0 Chemist

Clinic

Shop

Market

Other

I_ Know Where (N=72)~Actuallly Bought (N=38) Figure 2. Knowledge of condom sources and actual place of purchase.

Don't Know 1

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co-workers (25.8%), their team master (18.2%), a prostitute (4.5%), a neighbor (4.5%), and another apprentice (1.5%). MFW s were asked whether they had discussed condom use with a partner. Only 42 said they had ever done this, or 21.1% of the J99 who ever had sex. Furthermore, among those 77 who bad sex in the past month, 36.4% said they had ever discussed condoms with the partner. Among the 42 respondents who had ever discussed condoms with a partner 83.3% indicated that they raised the issue of condoms themselves, while 16.7% said the partner raised the issue. Ultimately, only 21 (27.3%) ofthose who has sex in the past month used a condom at least once.

STI Knowledge and Perceptions

When asked to mention STIs they knew, respondents mentioned gonorrhea (86.1 %) and AIDS (76.2%). Other STls (6.9%) included syphilis, lice, and herpes. A cultural condition knowu as magun was stated by 11.5%. Magun is the result ofa deadly curse on an adulterous couple. Ten (4.1 %) mentioned other conditions including stomach ache, hernia, and cholera. Twenty-six (10.6%) people could not name an STl. Fifty respondents reported that they had suffered from symptoms that they perceived were from an STI in the past year. This comprises 20.5% of the sample and 25.1 % of those who bad sex before. Among those who were sexually active in the previous month, 21.3% of 4 7 who had sex with their wife reported STI-like symptoms compared top 40.0% of 30 who did not have sex with wives. The symptoms they mentioned included a burning sensation when passing urine (90.0%), discharge from the penis (72.0%), severe itching (26.0%), swollen penis (12.0%), stomach upset (10.0%), ulcer/sore on the penis (10.0%), passing blood from the penis (4.0%), weight loss (2.0%), and general pains (2.0%). The mean age of those reporting STI symptoms was 33.7 years compared to 30.7 for those who did not (p < 0.035). Only 9.9% of apprentices reported STI symptoms compared to 24.3 % oftearn leaders and 27.0% ofindependent workers (p < 0.014). Various forms of treatment were reported for these signs and symptoms, with herbs at home (50.0%) being the most common. Others included private clinics (28.0%), chemist shop (22.0%), governmeut clinic (18.0%), drugs kept at home (14.0%), traditional healer (12.0%), and putting kerosene on their pubic hair (4.0%) as seen in Figure 3. Altogether, 44.0% attended any orthodox clinic. Concerning AIDS, nearly one-third of respondents (32.4%) did not know a way to prevent it, and one did not respond when asked. Those who had correct ideas mentioned having sex with one faithful partuer (49.2%), using a condom when having sex (20.1 %), never sharing a razor blade with an infected person (8.2%), not having sex with a prostitute (4.5%), not sharing needles with an infected person (3.3%), avoiding blood transfusion from an unknowu source (1.2%), and stetilizing barbing instruments (0.4%). Thirty-uine people (16.0%) gave other

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Kerosene , . . Trad. Healer

Home Drug

I

Govt. Clinic

I I I I

Chemist

I

Priv. Clinic

I

I

Herbs

i ,

0

5

10

15

20

25

NUmber

30:

I,

Figure 3. Sources of treatment for perceived STI symptoms.

ideas that offered no protection such as not sharing clothing, food, cooking utensils, or bathing sponge with an infected person. Other non-protective ideas included using antibiotics, not having sex in the sun, withdrawing the penis

before ejaculation, and use of local herbs. Two suggested avoiding stepping on the urine of an AIDS patient Most respondents (72.5%) stated that gonorrhea was curable, while only five (2.0%) said that AIDS could be cured. A knowledge score about S11 was constructed. Up to 3 points were awarded for each correctly mentioned S11. A maximum of 5 points was given for correct signs and symptoms ofS11. Knowing the correct answer to whether there was a cure for gonorrhea, a cure for AIDS, and what would happen to an AIDS patient attained 1 point each. FinaJly, up to 6 points could be obtained for mentioning correct ways to prevent AIDS. This produced a 17-point knowledge scale. The actual scores ranged from 0 to 13 points with a mean value of 5.9.

When asked about perceived susceptibility to STIs (AIDS and gonorrhea), 36 MFWs (14.7%) thought it was very likely or somewhat likely that they would have gonorrhea in the coming year. In response to the question of why this ntight happen 25 (69.4%) said, "I may get it from the girlfriend or lady with whom I have sex." Five (13.9%) actuaJly thought they might get it from their wives. One each said that, "I have done nothing to protect myself," "I might step on the urine of a person infected with gonorrhea," and "I pray that God wiJI protect me." Three did not have an explanation. The 29 (11.9%) MFWs who thought it was very likely or somewhat likely that they would have AIDS in the coming year gave similar reasons as were given for gonorrhea. Eighteen (62.1%) blamed girlfriends and eight (27.6%) blamed

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wives. One said he could get AIDS from houseflies, and two thought they could get it from the barbing salon. One simply said, "] have never been infected." Those 73 who were definite about not being susceptible to gonorrhea explained

that "] have sex with my wife only" (89.0%). Four (5.5%) said it was because they use a condom when having sex. The remaining six offered reasons that were not protective: "1 will use a drug to prevent gonorrhea." "I

will use antibiotics."

"] pray, and God will answer me." "] have never been infected." Among the 83 who said they were not at all likely to become infected with HIV/AIDS, 88.0% said it was because they only had sex with their wives. Six (7.2%) said they use condoms for protection. Two said they do not use other people's blades to barb their hair, while one said he would try to avoid blood transfusions. The remainder said: "God will fight the disease for me." "I will not eat or play with an AIDS victim." "I will not step on an AIDS patient's urine." A score for perceived susceptibility to STIs was constructed from questions about whether one felt he was likely to get gonorrhea and HIVI AIDS. Responses to the two questions were scored from I to 4 points, that is from not at all serious to very serious. The overall score ranged from 2 to 8 points, and had a moderate mean score of3.8 points. Gonorrhea was perceived as very serious by 59.8% and AIDS by 75.0%. When asked why the particular disease was serious, many respondents talked about the discomfort of the symptoms; e.g., the painful urination of gonorrhea, weight loss associated with AIDS, and death. Death was associated with gonorrhea by 7.4%, and with AIDS by 36.9%. In addition, concerns about infertility and impotence arising from damage to the reproductive organs was mentioned by 18.3% who considered gonorrhea serious. Six said it could prevent a person from working. A score of perceived seriousness was also constructed and combined the perceptions about gonorrhea and AIDS. The score also ranged from 2 to 8, with a fairly high mean of 6.9 points. Perceived seriousness and susceptibility scores

are contrasted in Figure 4. Eleven 5-point Likert-type opinion statements were constructed to elicit MFWs opinions on condom use. These addressed issues such as perceived comfort and enjoyment using condoms, opinions about condom negotiation and the women who raise the issue, and ideas about the safety and efficacy of condoms.

The scores could range from II to 55 points, and the mean was slightly above the midpoint at 35.5 points. Factors Associated with Sexual Behavior

The mean age of the 45 who never had sex was 24.4 years (s.d. = 5.97), compared to 32.9 years (s.d. = 8.78) for the 199 who had been sexually initiated (p < 0.000001). Similarly, among the 81 apprentices, only 56.8% had sex before compared with 93.2% of 74 masters and 94.0% of 89 independent MFWs (p < 0.00001).

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140 120 100 .c 80 E 60 z" 40 20 0

. ~

2

3

4

5

6

7

8

Score

I ~ Seriousness • Susceptibility

Figure 4. Sources of perceived susceptibility and seriousness of STls.

More specific analysis looked at the characteristics of those 199 who had sex in the month prior to the survey (Table 1). A significantly greater proportion of Nigerians (72.6%) who had been sexually initiated had sex in the month prior to the survey than non-Nigerians (45.1%). No other demographic factor was associated with recent sexual activity. Table 2 examines the history of perceived STI symptoms and MFW characteristics. Only one factor was positively associated with history of STI symptoms and that was whether the MFW had ever bought a condom. Although the reported prevalence of STI symptoms was higher in educated respondents, the difference was not significant.

Table 3 presents the characteristics of MFWs who had sex in the past month and compared this with reported condom use. Those who used condoms were

significantly more likely to be unmarried, have completed secondary school, and know someone else (like a brother, friend, co-worker) who also used condoms. Finally, condom use was compared with cognitive factors. In addition to STI knowledge. favorable attitudes toward condoms, and perceptions of susceptibility and severity as described above, those who had sex recently were asked about their self-efficacy perceptions concerning condom use with current partners. Five 4-point items were used to determine whether a person was very confident, confident, uncertain, or not at all confident concerning putting on a condom, buying a condom, asking for advice about condoms, asking his partner about using condoms, and refusing sex if the partner did not want to

use a condom. The scores ranged from 5 to 20 points with a mid-level mean of 12.8 points.

HIV AND MIGRANT FARM WORKERS IN SOUTHWESTERN NIGERIA I 259 Table 1. M FW Characteristics and Recent Sexual Experience Percent who

Characteristic

Number

had recent sex

·x2 and p value

Age group