Harris substance abuse in liberia

LIBERIASubstance Abuse at the Secondary School Level

Introduction/History Founded in 1847, the Republic of Liberia

is a nation located on the western coast of Africa and is bordered by Sierra Leone, Guinea and Cote D’Ivoire

In 1989 Liberia entered a period of Civil War which continued through 2003

The nation is currently working to rebuild the republic to her former status but faces obstacles often seen in many post-conflict states…

2011 survey estimates population around 3.7

million inhabitants

Civil War: 1989-2003

Casualties

Displacement

Psychological Distress

University of Liberia begins research exploring current social

climate

Present Research Aims Determine rate of Substance Abuse (SA) among

Monrovian secondary schools(Study 1)Gauge level of use across economic and social

strataInform future researchDirect future SA intervention programs

Study Concurrence of SA with High Risk Behaviors in secondary school level (Study 2)Gain data on population and prevalence of High Risk

BehaviorsInform future researchDesign targeted

Methods/Demographics

Cross Sectional Design Study population pooled from first 16

secondary schools in Monrovia to respond.○ First 50 randomly drawn students from each

school were included (two schools drew an additional name) N=802

Mixed gender population from grades 7-12○ Mean Age: 19 ±3○ Age Range: 12-36

Substance Use Behaviors of Secondary School Students in Post-conflict Liberia:

A Pilot Study

Significant Findings Alcohol

51% of population has consumed alcohol

Average age of first use 16 ± 3 yrs

Within drinking pop. 78% reported starting before age 18

1/3 reported drinking at least once a week

Alcohol Significant Findings

< 18 (%) 19 + (%) Χ² p Value

Never consumed alcohol 55.5* 44.1* 9.973 .002

Consumed alcohol 44.5* 55.9* - - - - - -

Use Alcohol-Occasionally 78.8 58.1 11.709 .001

Use Alcohol-Once a week 21.3 40.9 - - - - - -

Does Not Drink Alone 80.7 68.5 5.662 .017

Sometimes Drinks Alone 19.3 31.5 - - - - - -

Male (%) Female (%) Χ² p Value

Never consumed alcohol 41.6 56.1 15.767 <.001

Consumed alcohol 58.4 43.9 - - - - - -

* Total population percentage

Cigarettes and Marijuana

Low Usage Rates6.8% of population has ever tried cigarettes9.7% of population has ever used marijuana

Gender and Age Males are more likely to try bothThose over 19 are more likely to have used

both

A Survey on High Risk Behaviors Amongst High School Students Living in Liberia

Examines SA and Sexuality in previously used study population

Significant Findings 80% of population reported having sex

Of those active, 96% report having sex at least once a month

21% reported never using a condom

60% of the population perceived personal risk of contracting HIV as low.

Sexual Activity Significant Findings< 18 (%) 19 + (%) Χ² p Value

Not had Sex 32.5 6.7 86.108 <.001

Has Had Sex 67.5 93.3 - - - - - -

Not had Sex for Money 90.5 84.6 4.321 .038

Has Had Sex for Money 9.5 15.4 - - - - - -

Male (%) Female (%) Χ² p Value

Not had Sex 14.2 21.4 6.667 .010

Has had Sex 85.8 78.6 - - - - - -

Sex Occasionally 5.4 97.8 3.935 .047

Sex at Least Once a Month 94.6 2.2 - - -

Has not had alcohol (%)

Has had alcohol (%)

Χ² p Value

Not Had Sex 25.3 9.8 31.540 <.001

Has Had Sex 74.7 90.2 - - - - - -

Had Sex

Not Had S

ex

Sex At L

east O

nce a

Month

Sex O

ccasio

nally

Not had S

ex fo

r Money

Sex fo

r Money

0

10

20

30

40

50

60

70

80

90

100

Significant Sexual Activity Findings

Under 1819 or olderMaleFemales

Χ²=16.827 p<.001

78%

17%

5%

Number of Sex Partners:Female

Less than 3 Between 3 and 6 7 or more

65%

23%

13%

Number of Sex Partners:Male

Less than 3 Between 3 and 6 7 or more

Discussion

Lack of infrastructure Alcohol use at higher rates than other

African nations Substance abuse as self-medication in

dealing with distressCounseling services availability

Rate of early sex higher than other African nations

Study Limitations

Cross Sectional Design

Social Desirability Bias

Survey Device Terminology

Looking to the Future Alcohol Intoxication VS Sexual Activity

Data Creating counseling services and SA

rehabilitation options Research with supports aimed at

gauging intervention effectiveness Initiate “safer sex” public health initiative

aimed at vulnerable populations

Upcoming Research Collaboration

In fall of 2011 residents students working with Massachusetts General hospital will be travelling to Liberia to conduct research

Topics will include:

Childhood trauma

Adult trauma

Violence towards women

This research will continue the collaborative efforts between the University of Liberia and Massachusetts General Hospital to gain data

on the state of mental health in this post-conflict society.

Sources Harris, B.L., Levey, E.J., Borba, C.P.C.,Gray, D.A., Carney, J.R., &

Henderson, D.C., Substance use behaviors of secondary schoolstudents in post-conflict liberia: A pilot study, International Journal

of Culture and Mental Health, 2011 Harris, B.L., Quietero, N.M., Borba, C.P.C., Gray, D.B., & Henderson, D.C.,

A survey on high-risk behaviors amongst high school students living in liberia. Under Preparation