Research Work

CHAPTER ONE

1.0 INTRODUCTION/ BACKGROUND OF THE STUDY
Sexually Transmitted Infections (STIs) also referred to as Sexually Transmitted Diseases (STD) and Venereal Diseases (VD) are illnesses that have a significant probability of transmission between humans by means of human sexual behaviour including vaginal intercourse, oral sex, and anal sex. Sexually Transmitted Infections (STIs) are infections passed on from one person to another through unprotected sex (sex without a condom) or sometimes through genital contact. (Davis & Weller 2007). Sexually Transmitted Infections (STIs) are infections contacted by intimate as well as sexual contact. Mostly, sexually transmitted infections are easily transmitted through the mucus membrane lining of the penis, vulva, rectum, urinary tract.
Sexually Transmitted Infections are infections which affect people of all races, ages, sex most especially the young people (18-25 years).
According to d World Health Organisation (WHO, 2005) estimates, 448 million new cases of curable sexually transmitted infections (syphilis, chanchroid) occur annually throughout the world in adults aged 15-49 years, this however excluding HIV and other sexually transmitted infections which continue to adversely affect the lives of individuals and communities worldwide making it rank in the top five diseases categories for which adults seek health care.
Sexually Transmitted Infections include HIV/AIDS, chanchroid, gonorrhoea, syphilis, chlamydia, candidiasis, herpes simplex, human papillovirus, viral hepatitis, trichomoniasis to mention a few (Kozier, O & Erb, C. 2005).
Etiology of a sexually transmitted infection may be bacterial, viral, protozoan, parasitic or fungal. The current increase in severity and incidence of sexually transmitted infections can be attributed to demographic, lifestyle, indulgence in high risk sexual behaviour and poor health habits such as failure to use condom, drug use and douching increases an individual’s risk of exposure (Crosby, RA & Diclemente RJ. 2004).
This study therefore is intended to know the opinion of students of college of education in Ilesha on the use of condom in preventing sexually transmitted infection.

1.1 STATEMENT OF THE PROBLEM
The researcher detected that the rapid rate of spread of sexually transmitted infections including HIV/AIDS among youths is unrecordably high, based on this, this study is designed to seek the opinion of students of college of education on condom use as a preventive measure against sexually transmitted infections.

1.2 OBJECTIVES OF THE STUDY
This study is set out to achieve the following objectives: 1. to assess the students’ knowledge about sexually transmitted infections 2. to determine the level of condom acceptability and usage among the students of Osun State College of Education, Ilesha. Osun state in southwest Nigeria. 3. to find out which gender of student agreed most to the use of condom as means of protecting and preventing themselves against STIs.

1.3 SIGNIFICANCE OF THE STUDY
Considering most importantly, the UNAIDS (2004) report that Ijesaland is having the highest HIV/AIDS incidence and prevalence rate in Osun State. This research is therefore paramount to enhance the scientific findings of the involvement of students of College of Education, Ilesha in sexual risk behaviour and also their views and opinion about condom use as a preventive opinion advocated.

1.4 RESEARCH QUESTIONS
Do the students have adequate knowledge about sexually transmitted infections?
Do students of Osun State College of Education accept the use of condom as a means of preventing or protecting themselves from being infected?
Does gender influences the use of condom as a preventive measure against sexually transmitted infections?
1.5 RESEARCH HYPOTHESES
There is no significant difference in the opinion of students of diverse subject orientation on the use of condom. There is no significant difference between students’ gender and their opinion about the use of condom. 1.6 SCOPE OF THE STUDY
This study focuses on students of College of Education in Osun State; south-western Nigeria.

1.7 LIMITATION OF THE STUDY
The study was limited by inadequate fund and time factor to carry out a more elaborate research work.

1.8 OPERATIONAL DEFINITION OF TERMS
Opinion; beliefs or views about condom use
Condom; a thin rubber or plastic sheath usually worn on an erect penis or inserted into the vagina to provide a protective against body secretions
Prevention; actions taken to ensure that sexually transmitted infections do not occur
Sexually transmitted infections; such as gonorrhoea, syphilis, are infections contacted during sexual intercourse.
CHAPTER TWO
2.0 LITERATURE REVIEW
Sexually Transmitted Infections (STIs) also referred to as sexually transmitted diseases (STD) or venereal diseases (VD) are illnesses that have a significant probability of transmission between human by means of human sexual behaviour including vaginal intercourse, oral sex and anal sex. Sexually Transmitted Infections (STIs) according to Encyclopaedia (2004) are infections contacted by intimate as well as sexual contact. Mostly, sexually transmitted infections are easily transmitted through the mucus membrane lining of the penis, vulva, rectum, urinary tract.
Until 1990s, Sexually Transmitted Infections were commonly known as venereal diseases. Veneris is the latingenetive form of the name Venus, the Roman goddess of love (Berman, et al 2006). Sexually Transmitted infections are infections that usually can be transmitted from one person to another with heterosexual intercourse or intimate contact with the genitalia, mouth or rectum (Basavanthappa 2009).
Sexually transmitted infection is a broader term than sexually transmitted disease. An infection is colonization by a parasitic species, which may not cause any adverse effects. In a disease, the infection leads to impaired or abnormal function. In either case, the condition may not exhibit signs or symptoms. STD may refer only to infections that are causing diseases, or it may be used more loosely as a synonym for STI. Because most of the time people do not know that they are infected with an STI until they are tested or start showing symptoms of disease (Berman, et al 2006).
The term sexually transmissible disease is sometimes used since it is less restrictive in consideration of other factors or means of transmission. For instance, meningitis is transmissible by means of sexual contact, but is not labelled as a Sexually Transmitted Infections because sexual contact is not the primary vector for the pathogens that cause meningitis. This discrepancy is addressed by the probability of infection by means other than sexual contact.
According to Center for Disease Control and prevention (CDC), Sexually Transmitted Infection is an infection that has a negligible probability of transmission by means other than sexual contact, but has a realistic means of transmission by sexual contact (more sophisticated means- blood transfusions, sharing of hypodermic needles- are not taken into account). Thus, one may presume that, if a person is infected with an STI example; chlamydia, gonorrhoea, genital herpes, it was transmitted to him/her by means of sexual contact.
The diseases on this list are most commonly transmitted solely by sexual activity. Many infectious diseases, including the common cold, influenza, pneumonia and most others that are transmitted person-to-person can also be transmitted during sexual contact, if one person is infected, due to the close contact involved. However, even though these diseases may be transmitted during sex, they are not considered as STIs (Shukla 2004).
STI incidence rates remain high in most of the world, despite diagnostic and therapeutic advances that can rapidly render patients with many STIs non- infectious and cure most. In 1996, the World Health Organization (WHO) estimated that more than 1million people were being infected daily. About 60% of these infections occur in young people <25years of age and of these, 30% are < 20years. Between the ages of 14 and 19, STIs occur more frequently in girls than in boys by a ratio of nearly 2:1, this equalizes by age 20. An estimated 340 million new cases of syphilis, gonorrhoea, chlamydia and trichomoniasis occurred throughout the world in 1999.
Commonly reported prevalence of STIs among sexually active adolescents both with or without lower genital tract symptoms include chlamydia (10- 25%), gonorrhoea (3-18%), syphilis (0-3%), Trichomonas vaginalis (8-16%) and herpes simplex virus (2-12%). Among adolescent boys with no symptoms of urethritis, isolation rates include chlamydia (9-11%) and gonorrhoea (2-3%). (Shukla 2004).
According to WHO 2005 estimates, 448 million new cases of curable STIs (syphilis, gonorrhoea, chlamydia and trichomoniasis) occur annually throughout the world in adults aged 15-49 years this however does not include HIV and other STIs which continue to adversely affect the lives of individuals and their communities worldwide making it rank in the top five disease categories for which adults seek health care.
The higher prevalence of recent STI infection among young adults exists despite the fact that young adults report more consistent condom use than older adults. This paradoxical result arises because although condoms can be used for prevention of pregnancy and / or STIs including HIV/AIDS, young adults’ condom use is governed more by concerns about pregnancy than STI infection, such that when other forms of contraceptive are used, condom use is significantly less likely. Low levels of condom use for STI prevention may be due to misconceptions about STI prevalence, consequences and treatment or they may be due to a disregard of such knowledge as not personally relevant. 2.1 INFECTIONS AND TRANSMISSION
Sexually Transmitted Infections are infections that are spread primarily through person-to-person sexual contact. There are more than 30 different sexually transmissible bacteria, viruses and parasites. Several, in particular HIV and syphilis can also be transmitted from mother to child during pregnancy and childbirth and through blood products and tissue transfer (Davis, et al 2005).
STIs can be caused by bacteria, virus, parasites and fungi. Some of the most common infections are;
Common bacterial infections; * Neisseria gonorrhoea (causes gonorrhoea or gonococcal infections) * Chlamydia trachomatis (causes chlamydia infections). * Treponema pallidum (causes syphilis). * Haemophilus ducreyi (causes chanchroid).
Common viral infections; * Human Immunodeficiency Virus (causes AIDS)- venereal fluids, semen, breast milk and blood. * Herpes simplex virus type 2 (causes genital herpes) - skin and mucosal, transmissible with or without visible blisters. * Human papilloma virus (causes genital warts and certain subtypes lead to cervical cancer in women) - skin and mucosal contact. * Hepatitis B virus (causes hepatitis and chronic cases may lead to cancer of the liver) - saliva, venereal fluids. * Cytomegalovirus (causes inflammation in a number of organs including the brain, eye and the bowel) - saliva, blood, venereal fluids, organ transplant, urine, pregnancy, childbirth, breast milk).

Common parasitic infections; * Trichomonas vaginalis (causes vagina trichomoniasis) * Candida albicans (causes vulvovaginitis in women, inflammation of the glans penis and foreskin in men) * Sarcoptes scabiei (causes scabies).
Common fungal infections; * Yeast infection (causes candidiasis)
Many STIs are (more easily) transmitted through the mucous membrane of the penis, vulva, rectum, urinary tract and less often, the mouth, throat, respiratory tract and eyes. The visible membrane covering the head of the penis is a mucous membrane, though it produces no mucus (similar to the lips of the mouth). Mucous membrane differs from skin in that they allow certain pathogens into the body. The amount of contact with infective sources which causes infection varies with each pathogens but in all cases an infection may result from even light contact from fluid carriers like venereal fluids onto a mucous membrane; this is one reason that the probability of transmitting many infections is far higher from sex than by more causal means of transmission, such as non-sexual contact; touching, hugging, shaking hands- but it is not the only reason. Although, mucous membrane exists in the mouth as in the genitals, many STIs seem to be easier to transmit through oral sex than kissing (Lytle, et al 2003)
According to safe sex chart, many infections that are easily transmitted from the mouth to the genitals or from the genitals to the mouth are much harder to transmit from one mouth to another. Some infections labelled as STIs can be transmitted by direct skin contact- herpes simplex and HPV are both examples.

2.1.1 SYPHILIS
It is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum. The primary route of transmission is through sexual contact, it may also be transmitted from mother to foetus during pregnancy or at birth, resulting in congenital syphilis (Lytle, et al 2003)
Syphilis is believed to have infected 12million worldwide in 1999, with greater than 90% of cases in the developing world. After decreasing dramatically, since the widespread availability of penicillin in 1940s, rates of infection have increased since the turn of the millennium in many countries often in combination with human immunodeficiency virus (HIV).
The signs and symptoms of syphilis vary depending on which of the four stages it presents (primary, secondary, latent and tertiary).
Primary syphilis is typically acquired by direct sexual contact with the infectious lesions of another person. Approximately three to 90days after the initial exposure (average 21days) a skin lesion called chancre appears at the point of contact. This is classically single, firm, painless, non-itchy skin ulceration with a clean base and sharp borders between 0.3 and 3.0cm in size. The lesion, however may take on almost any form. In the classic form, it evolves from a macule to a papule and finally to an erosion or ulcer. Lesions may be painful or tender, and they may occur outside of the genitals. The most common location in women is the cervix (44%), the penis in the heterosexual men (99%), and anally and rectally relatively common in men who have sex with men (34%).Lymph node enlargement frequently (80%) occurs around the area of infection, occurring 7-10days after chancre formation. The lesion may persist for 3-6days without treatment (Davis, et al 2005)
Secondary syphilis occurs approximately 4-10 weeks after the primary infection. While secondary disease is known for the many different ways it can manifest, symptoms most commonly involve the skin, mucous membranes and lymph nodes. There may be a symmetrical, reddish-pink, non-itchy rash on the trunk and extremities including the palms and soles. The rash may become maculopapular or pustular. It may form flat, broad, whitish, wart-like lesions known as condylomalatum on mucous membrane. All these lesions harbour bacteria and are infectious. Other symptoms may include fever, sore throat, malaise, weight loss, hair loss and headache. Rare manifestations include hepatitis, kidney disease, arthritis, optic neuritis, uveitis and intestinal keratitis. The acute symptoms usually resolve after 3-6weeks, however, about 25% of people may present with a recurrence of secondary symptoms (Davis, et al 2005)
Latent syphilis is defined as having serologic proof of infection without symptoms of the infection. It is further described as either early (less than 1year after secondary syphilis) or late (more than 1year after secondary syphilis). Early latent syphilis may have a relapse of symptoms. Late latent syphilis is asymptomatic and not as contagious as early latent syphilis.
Tertiary syphilis may occur approximately 3-15years after the initial infection, and may be divided into three different forms; Gummatous syphilis (15%), Late neurosyphilis (6.5%) and cardiovascular syphilis (10%). Without treatment, a third of infected people develop tertiary infection. People with tertiary syphilis are not infectious.
Gummatous syphilis or late benign syphilis usually occurs 1- 46years after the initial infection, with an average of 15 years. This stage is characterized by the formation of chronic gummas which are soft, tumour-like balls of inflammation which may vary considerably in size (Davis, et al 2005)
Neurosyphilis refers to an infection involving the central nervous system. It may occur early, being either asymptomatic or in the form of syphilitic meningitis or late as meningovascular syphilis. Late neurosyphilis typically occurs 4- 25years after the initial infection.
Cardiovascular syphilis usually occurs 10- 30 years after the initial infection. The most common complication is syphilitic aortitis, which may result in aneurysm formation.
Syphilis is difficult to diagnose clinically early in its presentation. Confirmation is either via blood tests or direct visual inspection using microscopy. Blood tests are more commonly used, as they are easier to perform. Diagnostic tests are, however, unable to distinguish between the stages of the disease.
The first-choice treatment for uncomplicated syphilis remains a single dose of intramuscular penicillin G or a single dose of oral azithromycin. Doxycycline and Tetracycline are alternate choices; however due to the risk of birth defects, these are not recommended for pregnant women.
For neurosyphilis, due to the poor penetration of penicillin G into the central nervous system, those affected are recommended to be given large doses of intravenous penicillin for a minimum of 10days. If a person is allergic, ceftriaxone may be used or penicillin desensitization attempted.
As of 2012, there is no vaccine effective for prevention. Abstinence from intimate physical contact with an infected person is effective at reducing the transmission of syphilis as is the proper use of latex condoms (Warner, et al 2009).

2.1.2 GONORRHOEA
It is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoea that can affect both males and female. It most often affects the urethra, rectum or throat and cervix. In some cases, it causes no symptoms. The infection is transmitted from one person to another through vaginal, oral or anal sex. Men have a 20% risk of getting the infection from a single act of vaginal intercourse with an infected woman. Women have 60- 80% risk of getting the infection from a single act of vaginal intercourse with an infected man. A mother may transmit gonorrhoea to her newborn during childbirth; when affecting the infant’s eyes, it is referred to as Ophthalmia neonatorum.(Hoare 2010), It is the second most common bacterial sexually transmitted infections after chlamydia. According to the CDC, overall African Americans are most affected by gonorrhoea. Blacks accounted for 69% of all gonorrhoea cases in 2010.
Half of the women with gonorrhoea are asymptomatic while others have vaginal discharge, lower abdominal pain or pain with intercourse. The most common male symptoms are urethritis, associated with burning with urination and discharge from the penis. The incubation period is 2-14days with most of these symptoms occurring between 4-6 days after being infected. Rarely, gonorrhoea may cause skin lesions and joint infection after travelling through the blood stream. Very rarely, it may settle in the heart causing endocarditis or in the spinal column causing meningitis (both are more likely among individual with suppressed immune systems). Symptoms of rectal infection in both men and women may include discharge and anal itching, soreness, bleeding or painful bowel movements (Berman, et al 2006)
Traditionally, gonorrhoea was diagnosed with gram stain and culture; however, newer polymerase chain reaction (PCR) based testing methods are becoming more common. In those who fail initial treatment, culture should be done to determine sensitivity to antibiotics. All people who test positive for gonorrhoea should be tested for other STIs such as Syphilis, chlamydia, and HIV.
Gonorrhoea if left untreated, may last for weeks or months with higher risks of complications. As of 2010, injectable ceftriaxone appears to be one of the few effective antibiotics. As of 2011, there are reports of strain of gonorrhoea that show antibiotic resistance to multiple agents, specifically to both cefuxime and ceftriaxone.
While the only sure way of preventing gonorrhoea is abstaining from sexual intercourse, the risk of infection can be reduced significantly by using condoms correctly and by having a mutually monogamous relationship with an uninfected person.
One of the complications of gonorrhoea is systemic dissemination resulting in skin pustules or petechiae, septic arthritis, meningitis or endocarditis. This occurs in between 0.6 and 3.0% of women and 0.4 and 7.0% of men. In men, inflammation of the epididymis (epididymitis), prostate gland (prostatitis) and urethral stricture (urethritis) can result from untreated gonorrhoea. In women, the most common result of untreated gonorrhea is pelvic inflammatory disease. Other complications include septic abortion, chorioamnionitis during pregnancy, neonatal or adult blindness from conjunctivitis and infertility (Hoare 2010)

2.1.3 CHLAMYDIA
It is a sexually transmitted infection caused by bacteria chlamydia trachomatis. When transmitted through sexual contact, the bacteria can infect the urinary and reproductive organs. This infection is easily spread because it often causes no symptoms and may be unknowingly passed to sexual partner. About 75% of infections in women and 50% in men are without symptoms (Shukla 2004).
It is not easy to tell if one is infected with chlamydia since symptoms are not always apparent. But when they do occur, they are usually noticeable within 1-3weeks of contact and can include the following.
In women; * Abnormal vaginal discharge that may have odour. * Bleeding between periods. * Painful periods. * Abnormal pain with fever. * Pain when having sex. * Itching or burning in or around the vagina. * Pain when urinating.
Untreated chlamydia also can lead to pelvic inflammatory disease (PID) which can affect the vagina, cervix, uterus, fallopian tubes and ovaries. Also, scarring of the fallopian tubes which can lead to other serious health problems such as chronic pelvic pain, infertility or ectopic (tubal) pregnancy can occur.
In men; * Small amounts of clear or cloudy discharge from the tip of the penis. * Painful urination. * Burning and itching around the opening of the penis. * Pain and swelling around the testicles.
Untreated infections can lead to epididymitis, an inflammation of the coiled tubes in the back of the testicles; this can result in testicular swelling, pain and even infertility.
A swab is usually used to take sample from the urethra in men and from the cervix in women and then sent to the laboratory for analysis. Also, there are also other tests which check a urine sample for the presence of the bacteria (Shukla 2004)
Oral antibiotics usually azithromycin (Zithromax) or doxycyclines are prescribed. Treatment of partner is also recommended to prevent reinfection and further spread of the disease. After taking antibiotics, both partners should be re-tested to be sure if infection is cured, this is particularly important if one is unsure that one’s partner obtained treatment.

2.1.4 HEPATITIS
Is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ.
The signs and symptoms include
For acute stage;
Features are of non-specific flu-like symptoms, common to almost all acute viral infections and include malaise, fever, muscle and joint aches, nausea or vomiting, diarrhoea and headache. More specific symptoms include loss of appetite, dark urine, yellowing of the eyes and skin and abdominal discomfort. Acute viral hepatitis is more likely to be asymptomatic in younger people, symptomatic individuals may present after convalescent stage of 7-10 days with the total illness lasting 2-6 weeks.
For chronic stage;
It often leads to non-specific symptoms such as malaise, tiredness and weakness and often leads to no symptoms at all. Extensive damage and scarring of liver (i.e. cirrhosis) leads to weight loss, easy bruising and bleeding tendencies, peripheral edema (swelling of the legs) and accumulation of ascites (fluid in the abdominal cavity).
Eventually, cirrhosis may lead to various complications; oesophageal varices (enlarged veins in the walls of the oesophagus that can cause life-threatening bleeding), hepatic encephalopathy (confusion and coma) and hepato-renal syndrome (kidney dysfunction).
A physical examination may show; enlarged and tender liver, fluid in the abdomen and yellowing of the skin. Laboratory tests to diagnose and monitor the hepatitis include; abdominal ultrasound, autoimmune blood markers, hepatitis virus serology, liver function tests, and liver biopsy to check for liver damage (Sanders, et al 2002)
Complications include liver cancer, liver failure and permanent liver damage called cirrhosis.

2.1.5 CANDIDIASIS
It is a fungal infection of any of the candida species (all yeasts) of which Candida albicans which is the most common of the species, is the causative agent. It is also known as candidiasis, moniliasis or oidimycosis. The fungus is normally found in; the mucous membrane, rectum, vagina, male genitals, gastrointestinal tract, mouth, outer layer of the skin, nails, deep skin fold, urinary bladder.
Mode of spread is through contact with excretions from infected mouth, vagina, skin, and penis etc., sexual intercourse with an infected person.
Signs and symptoms include; * Itching and discomfort * Soreness * Irritation * Sexual dysfunction * Fatigue * Dysuria * Muscle pain * Dyspareunia * Intensive pruritus vulvae (most especially at night) * A whitish or whitish gray cheese-like discharge, often with a curd-like appearance. * Red patchy sores near the head of penis or on the foreskin * Burning sensation.
It is recommended that the infected person be diagnosed at first occurrence and this is done through microscopic examination or culturing
Candidiasis is commonly treated with antimycotics; other antifungal drugs commonly used include topical nystatin, fluconazole and topical ketoconazole. In severe infections, amphotencin B, caspofungin or variconazole may be used.

2.1.6 HUMAN IMMUNODEFICIENCY VIRUS (HIV/AIDS)
HIV is a lentivirus (a member of the retrovirus family) that causes AIDS, a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive (Douek, et al 2009)
HIV in humans is considered as pandemic by the World Health Organization (WHO). From its discovery in 1981 to 2006, AIDS killed more than 25million people. HIV infects 0.6% of the world’s population. In 2009, AIDS claimed an estimated 1.8million lives, down from a global peak of 2.1 million in 2004. Appropriately 260,000 children died of AIDS in 2009.
Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre- ejaculate or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unsafe sex, contaminated needles, breast milk and transmission from an infected mother to her baby at birth (prenatal transmission). Transmission of HIV risk increases substantially in the presence of genital ulcers, mucosal lacerations, concurrent sexually transmitted infection or a partner with a high viral load of HIV. The majority of HIV infections are acquired through unprotected sexual relations. Complacency about HIV plays a key role in HIV risk. Sexual transmission can occur when infected sexual secretions of one partner come into contact with the genital, oral or rectal mucus membrane of another (Weiss, 2005)
Unlike some other viruses, infection with HIV does not provide immunity against additional infections, in particular, in the case of more genetically distant viruses. HIV infects the vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages and dendrites’ cells. HIV infection leads to low levels of CD4+ T cells through three main mechanisms. First, direct viral killing of infected cells; second, increased rates of apoptosis in infected cells and third, killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell mediated immunity is lost and the body becomes progressively more susceptible to opportunistic infections (Cunningham 2010)
Most untreated people infected with HIV-1 eventually develop AIDS. These individuals mostly die from opportunistic infections or malignancies associated with the progressive failure of the immune system. HIV progress to AIDS at a variable rate affected by viral, host and environmental factors; most will progress to AIDS within 10years of HIV infection, some will have progressed much sooner and some will take much longer.
The stages of HIV infection are acute infection (also known as primary infection), latency and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, rash, lymphadenopathy (swollen lymph nodes), pharyngitis, myalgia (muscle pain), malaise and mouth and oesophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection is defined by low CD4+ T cell count (fewer than 200/microliter), various opportunistic infections, cancers and other conditions. A strong immune defence reduces the number of viral particles in the bloodstream, marking the start of secondary or chronic HIV infection. The secondary stage of HIV infection can vary between two weeks and 20 years. During this phase of infection, HIV is active within the lymph nodes which typically become persistently swollen, in response to large amounts of virus that become trapped in the follicular dendrites’ cells (FDC) network. The surrounding tissues that are rich in CD4+ T cells may also become infected, and viral particles accumulate both in infected cells and as free virus, individuals who are in this phase are still infectious (Cunningham, et al 2010)
Many HIV positive people are unaware that they are infected with the virus. For example, in 2001, less than 1% of the sexually active urban population in Africa has been tested and this proportion is even lower in rural populations (Tzeng 2005). HIV-1 testing is initially by an enzyme- linked immune-sorbent assay (ELISA) to detect antibodies to HIV-1. Specimens with a non-reactive result from the initial ELISA are considered HIV-negative unless new exposure to an infected partner or partner of unknown HIV status has occurred. Specimen with a reactive ELISA results are re-tested in duplicate, if the result of either duplicate test is reactive, the specimen is reported as repeatedly reactive and undergoes confirmatory testing with a more specific supplementary test (e.g. Western blot). Only specimens that are repeatedly reactive by Western blot are considered HIV- positive and indicative of HIV infection. Specimens that are repeatedly ELISA- reactive occasionally provide an indeterminate western blot result, which may be either an incomplete antibody response to HIV in an uninfected person. Testing post exposure is recommended initially and at six week, three months and six months.
There is currently no cure for HIV infection, treatment consists of highly active antiretroviral therapy or HAART. This has been highly beneficial to many HIV-infected individuals since its introduction in 1996, when the protease inhibitor-based HAART initially became available. Current HAART options are combinations consisting of at least three drugs belonging to at least two classes of antiretroviral agents. Typically, these classes are two nucleoside analogue reverse transcriptase inhibitors (NARTIs or NRTIs) plus either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor (NNRTI). HAART neither cures the patient nor uniformly removes all symptoms; high levels of HIV-1, often HAART- resistant, return if treatment is stopped. One study suggests the average life expectancy of an HIV infected individual is 32years from the time of infection if treatment is started when the CD4 count is 350/µl. In the absence of HAART, progression from HIV infection to AIDS has been observed to occur at a median of between 9-10years and the median survival time after developing AIDS is only 9.2months. Life expectancy is further enhanced if antiretroviral therapy is initiated before the CD4 count falls below 500/µl.
Without treatment, average survival time after infection with HIV is estimated to be 9-10years, depending on the HIV subtype, and the average survival rate after diagnosis of AIDS in resource-limited settings where treatment is not available ranges between 6 and 9months. HAART reduces the death rate by 80% and raises the life expectancy for a newly diagnosed HIV-infected person to 20-50years. As new treatments continue to be developed and because HIV continues to evolve resistance to treatments, estimates of survival time are likely to continue to change. Without antiretroviral therapy, death normally occurs within a year after the individual progresses to AIDS. The rate of clinical disease progression varies widely between individuals and has been shown to be affected by many factors such as host susceptibility and immune function and also the strain of virus involved (Douek, et al 2009)
Consistent condom use reduces the risk of heterosexual HIV transmission by approximately 80% over the long term. Where one partner of a couple is infected, consistent condom use results in rates of HIV infection for uninfected person of below 1% yearly (Crosby, et al 2004)
Depending on the STI, a person may still be able to spread the infections if no sign disease is present. For example, a person is much more likely to spread herpes infection when the blisters are present than when they are absent, however, a person can spread HIV infection at any time, even if he/she has not developed symptoms of AIDS. All sexual behaviors that involve contact with the bodily fluids of another person should be considered to contain some risk of transmission of STIs.
Although the likelihood of transmitting various diseases by various sexual activities varies a great deal, in general, all sexual activities between two people (or more) should be considered as being a two way route for the transmission of STIs i.e. “giving” or “receiving” are both risky although receiving carriers a higher risk (anodectal report)
Healthcare professionals suggest safer sex, such as the use of condom, as the most reliable way of decreasing the risk of contracting STIs during sexual activity, but safer sex by no means be considered as absolute safeguard. The transfer of and exposure to bodily fluids, such as blood transfusions and other blood products, sharing injection needles, needle-stick injuries (when medical staff are inadvertently jabbed or pricked with needles during medical procedures) and childbirth are other avenues of transmission (Olley, et al 2005).
Recent epidemiological studies have investigated the networks that are defined by sexual relationships between individuals, and discovered that properties of sexual networks are crucial to the spread of STIs. It is possible to be asymptomatic carrier of sexually transmitted infection.

2.2 STI SYNDROMES
Although many different pathogens cause STIs, some display similar or overlapping signs (what the individual or the health provider feels such as pain on examination). Some of the signs and symptoms are easily recognizable and consistent, giving what is known as syndrome that signals the presence of one or a number of pathogens (Warner, et al 2009).
For example, a discharge from the urethra in men can be caused by gonorrhea alone, chlamydia alone or both together.
The main syndromes of common STIs are; * Urethral discharge * Genital ulcers * Inguinal swelling (bubo, which is a swelling in the groin) * Scrotal swelling * Vaginal discharge * Lower abdominal pain * Neonatal eye infections (conjunctivitis of the newborn).

2.3 PREVENTION
Prevention is a key in addressing incurable Sexually Transmitted Infections such as HIV/AIDS and herpes.
The most effective way to prevent sexual transmission of STIs is to avoid contact of body fluids which can lead to transfer with an infected partner. Not all sexual activities involve contact; cybersex, phone sex or masturbation from a distance is methods of avoiding contact, although all these methods are not globally accepted.
Proper use of condoms reduces contact and risk.
Ideally, both partners should get tested for STIs before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else.

2.4 CONDOMS
A condom is a thin rubber or plastic sheath, specially made to cover, protect and prevent the contact of the mucosa linings and secretions between the male erect penis and the female vagina during the act of sexual intercourse. It could be male or female condom.
Condoms are available in different sizes; shapes and textures aimed at promoting pleasure and as well increase the preventive efficiency. Most often, some condoms are coated with spermicidal, which further enhances its contraceptive and preventive efficiency.
2.4.1 Male Condom
Condoms when correctly worn over an erect penis cover the skin mucous lining of the male organ and therefore forms a thin barrier layer between the secretions of the male penis and the vaginal mucous secretion of the female counterpart.
In view of this, condoms help prevent both the ejaculation of spermatozoa into the female vagina and as well inhibit the transmission of infectious microorganisms that are sexually transmitted from either of the partner to each other.
Novak (2009) gave the advantage of condom as being protective against sexually transmitted infections and pregnancy which makes it the most useful type of contraception in casual intercourse.
Adding further, AIDS MIRROR stated that condom provides an effective mechanical barrier against sexually transmitted pathogens including HIV/AIDS.
For the wearer, condoms provide a barrier that reduces the risk of infections acquired through penile exposure to infectious secretions or lesions of the cervix, vagina, vulva and anus.
Proper usage entails; * Not putting the condom on too tight at the end and leaving 1.5cm room at the tip for ejaculation. * Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not. * Avoiding condoms made of substances other than latex, polyisoprene or polyurethane that do not protect against STIs. * Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms as oil can eat holes into them. * Using flavoured condoms for oral sex only, as the sugar in the flavouring can lead to yeast infections if used to penetrate.
Not following the first four guidelines above perpetuates the common misconception that condoms are not tested or designed properly. 2.4.2 Female Condom
Also known as femidom was produced using a polyurethane plastic and first became available in 1992, is a device that is used during sexual intercourse as a barrier contraceptive and to reduce the risk of sexually transmitted infections (such as gonorrhoea, syphilis and HIV) and unintended pregnancy. It is worn internally by the female partner and physically blocks ejaculated semen from entering that person’s body. It can be used by the receptive partner during anal sex.
The female condom is a thin, soft, loose-fitting sheath with a flexible ring at each end. They typically come in various sizes. The inner ring at the close end of the sheath is used to insert the condom inside the vagina and to hold it in place during intercourse. The rolled outer ring at the open end of the sheath remains outside the vaginal and covers part of the external genitalia.
In order to prevent oneself and the partner from STIs, the old condom and its contents should be assumed to be infectious. Therefore, the old condom must be properly disposed of and a new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the effectiveness as a barrier.

2.5 ABSTINENCE
Wikipedia, the Internet Encyclopaedia (March 2004) defined sexual abstinence as a practice of voluntarily refraining from sexual intercourse and other sexual activity and this is another means of preventing sexually transmitted infections including HIV/AIDS.
Also, it can be defined as the state of not having sexual relationship or never having had sex. The concept of sexual abstinence is as old as human history. In western societies and many African countries, abstinence in relationships has been idealized more consistently for women than for men.
Anthropologists and social historians have noted that being “chaste” is a fundamental concept of many cultures, which means sexually abstinence for unmarried persons as evidenced by virginity.
In the moral or socio -cultural perspective, abstinence is often viewed as an admirable act of self-control over the natural desire to have sex. Furthermore, it was noted that the display of strength of character allows the abstainer to feel superior to those not able to control their “base urges”.
2.6 CONCEPTUAL FRAMEWORK
There is an assumption that individual characteristics that affect sexual and health care behaviour in general; age, sex, ethnicity, marital status, religion, socio-economic status also affect behaviour subsequent to an STI infection.
Younger people engage in riskier sexual behaviour than those who are older, they accumulate partners more rapidly and they tend to choose riskier partners. Consequently, they are more likely to be exposed to the risk of acquiring STIs. We expect that infected young men are more likely than their older counterparts to continue to engage in behaviour that exposes their partners and themselves to infection.
Marital status is a reliable predictor of both sexual and health care behaviour. Single people engage in riskier sexual behaviour than those who are married perhaps because norms regarding sexual exclusivity are stronger for marriage than for other types of relationships. On the other hand, because perceived risk is generally lower in monogamous relationships, married people are less likely than single counterparts to use condoms. This may or may not be the case following an STI, married men maybe more likely to realize that condoms decrease the likelihood of infection and may use condoms at a higher rate to avoid infecting their spouse.
In general, as socio-economic status increases, so does the likelihood of having multiple partners and engaging in a variety of sexual behaviours with those partners. However, increasing socio-economic status may change once the individual has become infected. Higher socio-economic status is generally associated with a greater sense of self-efficacy and an STI may help an individual to realize the costs and consequences of risky sexual practices resulting in greater behaviour modification.
Two additional variables are included, as indicators of a propensity for risk taking; age at initiation of sexual activity, which is related to subsequent sexual behaviour and contraceptive use.

CHAPTER THREE

3.1 RESEARCH METHODOLOGY
This chapter presents with research design, research setting, target population, sample size and sampling technique instrument for data collection, validity/reliability of the instrument, method for data collection, method of data analysis and ethical consideration.

3.2 RESEARCH DESIGN
This research project employed is a descriptive design. The study aimed at describing the opinion on the use of condom in preventing Sexually Transmitted Infections including HIV/AIDS among students of Osun State College of Education, Ilesha.

3.3 RESEARCH SETTING
This research study was carried out in a college which was established in 1977, actually in the old Oyo state, then as the Oyo State College of Education. It was the only College of Education in the old Oyo state, hence, the oldest tertiary institution in the present in Ilesha Osun State Nigeria.

3.4 TARGET POPULATION
The target subjects are the students in College of Education, Ilesa. The population is heterogeneous and they are mainly youths. The population used for this project was is 80.
3.5 SAMPLE SIZE/ SAMPLING TECHNIQUE
Eighty (80) students constituted the subject of the study and was selected through convenient sampling technique whereby subjects were selected based on their availability at the site of data collection.

3.6 INSTRUMENT FOR DATA COLLECTION
A self-developed questionnaire was used to collect information from the subjects. The questionnaire was carefully designed and structured, ensuring simplicity, validity and reliability. The questionnaire was structured into 3 sections.
Section A which contained the bio-data questions such as sex, age religion, and marital status.
Section B contained questions to assess respondent’s knowledge of STIs including HIV/AIDS.
Section C contained questions on problems confronted by them as regarding the use of condom in preventing STIs including HIV/AIDS.

3.7 VALIDITY/ RELIABILITY OF INISTRUMENT
The validity of the instrument was ensured through face and content validity technique. The questions were reviewed and scrutinized by the supervisor and all corrections, authenticity and accuracy was made

3.8 METHOD OF DATA COLLECTION
A self-developed questionnaire was used to collect data. Test items were based on the knowledge about STIs and HIV/AIDS it also addressed problems confronted by them in accepting the use of condoms in preventing STIs. The researcher and research assistant distributed the questionnaire to the respondents and all were retrieved.

3.9 METHOD OF DATA ANALYSIS
The collected data was analyzed using t- test and analysis of variance. Statistical Package for Social Scientists Version 17.0 was used to facilitate the analysis.

3.10 ETHICAL CONSIDERATION
The value belief and privacy of the respondents were duly observed. Due dialogue was made with the authority of the college to enable the researcher collect relevant data from the target population through study sample.
An official permission letter was written to appropriate authorities. A full explanation of the procedure was given to the subjects and participants were allowed to participate voluntarily by gaining their consent. Confidentiality and anonymity was maintained for proper safeguard of the subjects and all acts that could lead to any form of injury (physical or mental) were avoided.

CHAPTER FOUR
This chapter discusses the analysis of result of information collected through 80 questionnaires. These are represented in tables, percentages, charts and graphs. 4.0 DATA ANALYSIS
SECTION A
TABLE 4.0.1: PERCENTAGE DISTRIBUTION OF RESPONDENTS SOCIO DEMOGRAPHIC STATUS SOCIODEMOGRAPHIC DATA | DISTRIBUTION OF RESPONDENTS | SEX | FREQUENCY | PERCENTAGES (%) | MALEFEMALE | 4436 | 5545 | TOTAL | 80 | 100 | AGE | | | LESS THAN 18 YEARS18-30 YEARS31-40 YEARSABOVE 40 YEARS | 1069NIL1 | 12.586.2501.25 | TOTAL | 80 | 100 | MARITAL STATUS | | | SINGLEMARRIEDDIVORCED | 755NIL | 93.756.250 | TOTAL | 80 | 100 | LEVEL OF RESPONDENTS | | | 100200300 | 57221 | 71.2527.51.25 | TOTAL | 80 | 100 | DEPARTMENTS | | | ACCT AND SOSPES/YORENG.POL SCI. | 18113618 | 22.513.754518.75 | TOTAL | 80 | 100 |

Table 4.0.1 summarizes the socio demographic status of the respondents.
Majority of the respondents are males (55%) while 45% are females, sixty nine (86.25%)are of the age category of 18-30 years while one (1.25%) fall in the extreme category of above 40 which shows that majority of the respondents are young undergraduates (18-30 years).
The marital profile indicates that majority of the respondents seventy five (93.75%) are single while a few five (6.25%) are married.
The educational status of the respondents used from the table above, it is revealed that 71.25% of the respondents are in 100 level, 27.5% of the respondents are in 200 level while 1.25% of the respondents are in 300 level. TABLE 4.0.2; Knowledge of HIV/AIDS among respondents | Distribution of Respondents | Definition of sexually transmitted infections | Frequency | Percentage% | It is a common disease that can be cured | 3 | 3.75 | Is an infection that can be contacted during sexual intercourse | 65 | 81.25 | Is a fungal infection that affects both man and plants | 4 | 5 | I don’t know | 8 | 10 | Total | 80 | 100 |

Majority of the respondents 65 (81.25%) gave the correct response of HIV/AIDS as an infection that can be contacted during sexual intercourse.
Expectedly, few but significant respondents gave wrong responses in that 15 respondents (18.75%) did not know the clear definitions of HIV/AIDS.

TABLE 4.0.3; knowledge about transmission of STIs including HIV/AIDS Knowledge about transmission of STIs including HIV/AIDS | Distribution of respondents | | Yes | No | Total | | Frequency | % | Frequency | % | Frequency | % | Sexually transmitted infections can be contacted through other means than sexual intercourse | 21 | 26.25 | 59 | 73.75 | 80 | 100 | Sexually transmitted infections including HIV/AIDS can be contacted at first sexual intercourse | 55 | 68.75 | 25 | 31.25 | 80 | 100 | Sexually transmitted infections can only be contacted if one has sexual intercourse with infected multiple partners | 26 | 32.5 | 54 | 67.5 | 80 | 100 |
Table 4.0.3 shows that, majority of the respondents fifty nine (73.75%) agreed that sexually transmitted infections cannot be contacted through other means than sexual intercourse, fifty five (68.75%) respondents agreed that sexually transmitted infections can be contacted at first sexual intercourse while few 25 (31.25%) respondents disagreed.
Fifty four (67.5%) of the respondents said that STIs can be contacted if an individual has intercourse with infected multiple partners while twenty six (32.5%) respondents said no.

TABLE 4.0.4; USE OF CONDOM AND EXPERIENCE OF CONDOM USE VARIABLES | FREQUENCY | PERCENTAGES (%) | DID YOU USE CONDOM DURING YOUR FIRST SEXUAL INTERCOURSE | | | YES | 59 | 73.75 | NO | 10 | 12.5 | CANT REMEMBER | 11 | 13.75 | TOTAL | 80 | 100 | I DON’T KNOW HOW TO PUT CONDOM CORRECTLY BEFORE HAVING SEXUAL INTERCOURSE | | | AGREE | 15 | 18.75 | STRONGLY AGREE | 13 | 16.25 | DISAGREE | 21 | 26.25 | STRONGLY DISAGREE | 31 | 38.75 | TOTAL | 80 | 100 |

Fifty nine (73.75%) respondents used condom during their first sexual intercourse while ten respondents (12.5%) did not use condom and 11 respondents (13.75%) couldn’t remember if they used or not.
31 respondents (38.75%) strongly disagrees that they don’t know how to put condom on before having sexual intercourse.
21 respondents (26.25%) disagrees that they don’t know how to put on condom before having sexual intercourse.
15 respondents (18.75%) agree that they don’t know how to put on condom before having sexual intercourse.
13 respondents (16.25%) strongly agree that they don’t know how to put on condom correctly before having sexual intercourse.

FIGURE 4.0.1; I do not enjoy sex while using condom.

Figure 4.0.1 shows that majority of the respondents do not enjoy sex while using condom
30% respondents (108◦) strongly agree that they do not enjoy sex while using condom, 32.5% (117◦) agreed that they do not enjoy sex while 13.75% (49.5◦) disagreed and 23.75% (85.5◦) strongly disagreed.
FIGURE 4.0.2; I do not satisfy / please my partner when I use condom.

40% (144◦) of the respondents agreed that they do not satisfy their partner when using condom, 21.25% (76.5◦) strongly agreed while 17.5% (63◦) disagreed about it and 21.25% (76.5◦) strongly disagreed.

FIGURE 4.0.3; My partner feels uncomfortable when I use condom

18.75% (67.5◦) of the respondents disagreed that their partner feels uncomfortable when they use condom, 20% (72◦) strongly disagreed while 27.5% (103.5◦) agreed and 32.5% (117◦) strongly agreed.

FIGURE 4.0.4; I don’t have erection if I use condom

103.5 of the respondents agreed that they do not have erection if they use condom, 49.5 of them strongly agreed while 72 disagreed and 135 strongly disagreed.
This shows that majority of them disagreed that they do not have erection if they use condom.

FIGURE 4.0.5; I do not maintain erection if I use condom

From the above, 32.5% of the respondents strongly disagree that they do not maintain erection if they use condom. 25% of them disagreed. 17.5% of them strongly agreed that they do not have erection if they use condom while 25%of the respondents agreed.
This implies that a larger percentage of the respondents do maintain erection if they use condom.

TABLE 4.0.6; Incidence of condom burst or tear

From the table above, 37.5% of the respondents strongly disagree with incidence of condom burst/tear, 27.5% disagreed, 20% of the respondents strongly agreed with incidence of condom burst / tear with the incidence of condom tear.

FIGURE 4.0.7; I react to condom badly

27.75% of the respondents strongly disagree to reaction to condom badly, 22.5% of them disagreed to reaction to condom, 21.25% strongly agreed and 28.75% agreed.
This implies that average of the respondents agreed and average disagreed to condom reaction.

FIGURE 4.0.8; Confidence in condoms effectiveness against HIV transmission
Q; I do not believe condom can prevent sexually transmitted infections

31.25% of the respondents strongly believe that condom can prevent sexually transmitted infections, 25% believed while 16.25% strongly disbelieved that condom can prevent sexually transmitted infections and 27.5% disbelieved.
Larger percentage of the population believed in its effectiveness against HIV transmission.

FIGURE 4.0.9; Assurance of condom protection against HIV/AIDS infections
Q; I feel protected when I use condom as a protection against sexually transmitted infections

Recurrently, 43.75% of the respondents agreed to the assurance of condoms prevention against sexually transmitted infections, 28.75% of the respondents strongly agreed while 13.75% disagreed and 13.75% strongly disagreed.
This shows that majority of the respondents have the assurance of condoms prevention against HIV /AIDS and feel protected using it.

TABLE 4.0.5; Factors that determine condom usage during sexual intercourse S/N | VARIABLE | FREQUENCY | PERCENTAGE (%) | 1 | CONDOM USE IS AGAINST MY CULTURAL / TRADITIONAL BELIEFS/VALUES | | | | STRONGLY DISAGREE | 36 | 45 | | STRONGLY AGREE | 10 | 12.5 | | AGREE | 13 | 16.25 | | DISAGREE | 21 | 26.25 | | TOTAL | 80 | 100 | 2 | MY RELIGION DOES NOT ALLOW ME TO USE CONDOM | | | | AGREE | 15 | 18.75 | | DISAGREE | 18 | 22.5 | | STRONGLY AGREE | 3 | 3.75 | | STRONGLY DISAGREE | 44 | 55 | | TOTAL | 80 | 100 | 3 | MY FAMILY BACKGROUND DOES NOT ALLOW ME TO USE CONDOM | | | | STRONGLY DISAGREE | 47 | 58.75 | | STRONGLY AGREE | 2 | 2.5 | | DISAGREE | 22 | 27.5 | | AGREE | 9 | 11.25 | | TOTAL | 80 | 100 |

45% of the respondents strongly disagreed that condom use is against their cultural / traditional beliefs / values, 26.25% of the respondents disagreed while 12.5% of the respondents strongly agreed that condom use is against their cultural / traditional beliefs / values, 16.25% of the respondents agreed.
Can be deduced that majority disagreed that condom use is against their cultural / traditional beliefs / values.
55% of the respondents strongly disagreed that their religion does not permit them to use condom, 22.5% disagreed while 18.75% agreed, 3.75% strongly agreed.
Implying that larger percentage of the respondents disagreed that their religion does not permit them to use condom.
58.75% of the respondents strongly disagreed that their family background does not permit condom use, 27.5% of the respondents disagreed while 2.5% strongly agreed that their family background does not permit them and 11.25% of the respondents agreed.
This shows that majority of the respondents are not influenced by family background in using condom.

4.1 ANSWER TO RESEARCH QUESTIONS
QUESTION 1
Do the students have adequate knowledge about sexually transmitted infections?
It was revealed in this research work that the respondents have adequate about sexually transmitted infections including HIV/AIDS and its transmission. A greater percentage of the students 81.25% (table 4.2) explained sexually transmitted infection as an infection that can be contacted during sexual intercourse, 5% explained it as a fungal disease that infects both man and plants, 3.75% said that it is a common disease that can be cured and 10% had no idea what sexually transmitted infection was. It was also discovered in this work that 73.75% (table 4.3) of them believed that sexually transmitted infections cannot be contacted through other means than sexual intercourse while 26.25% of them said it can be contacted through other means than sexual intercourse. This research study also showed that 68.75% believed it can be contacted at first sexual intercourse while 31.25% believed that it cannot be contacted at first sexual intercourse. Also 67.5% believed that sexually transmitted infections can also be contacted if an individual has intercourse not only with infected multiple partners while 32.5% believed otherwise. This data showed that students have adequate knowledge about sexually transmitted infections.

QUESTION 2
Do students of Osun State College of Education Ilesha accept the use of condom as a means of preventing or protecting themselves from being infected?
It is revealed that majority of the respondents believed that condom use can prevent sexually transmitted infections, this is shown in figure 4.8 where 31.25% of the respondents strongly agreed, 25% agreed while 16.25% strongly disagreed and 27.5% disagreed.
Larger percentage of them has the assurance that condom use can serve as prevention against sexually transmitted infections including HIV/AIDS. This is shown in figure 4.9 where 28.75% of the respondents strongly agreed, 43.75% agreed while 13.75% strongly disagreed and 13.75% agreed.

QUESTION 3
Does their gender influence the use of condom as a preventive measure against sexually transmitted infections? As shown in table 4.1, 55% of the students that took part in the research are male, 45% are female. Majority of the female students believed that sexually transmitted infections can be contacted at first sexual intercourse while a few of the male students believed that it can be contacted at first sexual intercourse which will influence their use of condom during sexual intercourse as a preventive measure against sexually transmitted infections.

4.2 HYPOTHESIS TESTING Hypothesis 1
There is no significant difference in the opinion about use of condom among students of diverse subject combination in Osun State College of Education, Ilesha.
Answer to this hypothesis was presented to the research hypothesis in the table 4.7 below:
TABLE 4.2.1
ANOVA OF THE DIFFERENCES IN THE OPINION ABOUT USE OF CONDOM AMONG THE STUDENTS OF OSUN STATE COLLEGE OF EDUCATION, ILESA. Source | Sum of square | Degree of freedom | Mean square | F- ratio | Probability | | Between group | 922.030 | 12 | 76.836 | 0.988 | 0.470 | | Within group | 4821.917 | 62 | 77.773 | | | | Total | 5743.947 | 74 | | | | | | | | | | | |

The hypothesis that there is no significant difference in the opinion about use of condom among students of diverse subject combination in Osun State College of Education, Ilesha was rejected. [df :12,74; F = 0.988; P > 0.05.]

Hypothesis 2
There is no significant difference between male and female students’ opinion about use of condom.
Answer to this hypothesis was presented in the table below.
TABLE 4.2.2 t-TEST COMPARISON OF MALE AND FEMALE STUDENTS’ OPINION ABOUT THE USE OF CONDOM Source of difference | N | -- X | Standard deviation | Standard error of mean | Standard error of difference btw mean | t-test calculated | Degree of freedom | Sig. (2-tailed) | Male | 44 | 47.81 | 8.49 | 1.29 | 2.06 | 1.002 | 78 | 0.32 | Female | 3 6 | 49.88 | 9.22 | 1.63 | | | | |

The hypothesis that there is no significant difference between male and female students’ opinion about use of condom was confirmed. {df ( 78) = 1.002; P > 0.05}.

CHAPTER FIVE
This chapter discusses the findings of the study, summary, conclusion, implications and recommendations for further studies. 5.0 DISCUSSION.
The discussion of findings revealed in this research work is designed for the purpose of highlighting some cogent research variables and the results obtained thereof, vis -a - vis the objectives of the study while relying upon the data obtained from the study samples.
The study reveals that most of the respondents are male 44 (55%) and 36 (45%) are female. The age range of the respondents is from 18 to 40 years and above with majority of respondents falling under the age range of 18-30 years (86.25%) , majority of the respondents (93.75%) are single. Academically majority of the respondents (71.25%) are of 100 level and most of the respondents belong to Yoruba ethnic group.
The analysis shows that 81.25% of the respondents are knowledgeable about what sexually transmitted infections means as they agreed with the definition of Basavanthappa (2009) that sexually transmitted infections are infections that can be transmitted from one person to another with heterosexual intercourse or intimate contact with the genitalia.
Notably as well, a few but important respondents 7 (8.75%) did not have the clear knowledge of sexually transmitted infections while 8 (10%) of the students claimed ignorant of the infection. Therefore, in simple ratio; 8 of 10 students have a fair knowledge of sexually transmitted infections, enough to influence their sexuality and risk perception to determine their opinion on condom usage.
Evaluating their knowledge about its transmission, majority of the students gave right responses with the highest number selecting its possibility of transmission at first sexual intercourse 55 (68.75%), followed by its transmission from sexual intercourse with infected multiple partners 26 (32.5%) and 21 (26.25%) of the students believed that it can be contacted through other means than sexual intercourse, a larger percentage of them disagreed that it can be transmitted at first sexual intercourse 25 (31.25%) and 54 (67.5%), this however showing that the students have less knowledge about its transmission.
Considering the level of condom acceptability and usage among the students as a means of prevention against sexually transmitted infections, a larger percentage of the students 56.25% believed that condom use can prevent sexually transmitted infections which influences its acceptability and usage this is in accordance with the submission of Shukla (2004) that condom serves as a protection against sexually transmitted infections although it should be noted that in comparism with the 56.25% respondents who have correct idea of this fact, significant 43.75% of the students who disbelieved in its ability to prevent sexually transmitted infections still need adequate awareness and education.
In collaboration with the statement of Novak (2009) that condom serves as a protection against sexually transmitted infections, the respondents (72.5%) agreed that they feel protected when using condom as prevention against sexually transmitted infections.
Out of the 80 students involved in this study, 44 of them male while the remaining 36 are female. In scientific form, the male represents 55% of the study sample while females being 45%. Under the given circumstances, the research work can best be adjudged as taken a fair consideration of both sex and their corresponding opinion given the minimal / negligible difference in the male - female ratio of respondents.
Male – female ratio among students of each level has a very minimal diversity when reviewed, for instance, there exist 31 males and 26 females of the total 57 students in 100 level, 13 males and 9 females in 200 level and just a female in 300 level without any male from the study level.
Also, 54% of the 100 level students are male while 46% being female, in 200 level, male represent 59% while female being 41%, 300 level recorded 100% female (one person only).
Relating the subject combination to gender, 10 (56%) of the students in ART/SOS are male while 8 (44%) being female. In PES /YOR, 8 (73%) represents the male sex while 3 (27%) being female. 18 (55%) of students in ENG department are male while 15 (45%) being female.
Finally, the male population in POL SCI department is 8 (44%) while 10 (56%) of the students in the department are female.
With regards to the fore goings, it is evidently shown that the male – female ratio in 3 departments – ART/SOS, PES/YOR, and POL/SCI is very close to each other devoting fair and equitable sex distribution. However, in PES/YOR departments with male (73%) and female (27%), there exist a wide disparity in the sex distribution which wasn’t on purpose but eventual.
On the ability or otherwise of the respondents to enjoy sex while using condom, the statistics reveals that 29 (36%) of the entire sample study reveal that they do not enjoy sex using condom with 17 (59%) being male and 12 (41%) being female.
20 (25%) of the total students resolved strongly that they derive less pleasure in sex involving condom with 12 (60%) being male and 8 (40%) being female.
In the same vein, just 12 (15%) of the total respondent disagreed that they do not enjoy sex using condom with an even male – female distribution of 6 (60%) each of both sex.
A total of 19 (24%) of the respondent strongly disbelieved that sex involving condom gives less pleasure/satisfaction with a fairly even male – female ratio of 9 (47%) male and 10 (53%) female.
On these premises, it can be deduced that majority of the respondents are of the opinion that they do not enjoy sex while using condom.
This findings suggest the high risk sexual behaviour of Ijesa youths as a typical Nigerian youth which also corresponds to the submission of Owuamanam (2005) who identified a male urban respondent who had had sex with multiple sexual partners without condom use, stating that they do not enjoy sex using condom.
While appraising the respondents; opinion on not enjoying sexual intercourse using condom, subject orientation was also used to know the level of disparity of their various opinions as it varies from one level to another.
For instance, in 100 level which comprises of 57 students, 27 students shares the opinion that they do not enjoy sex using condom with 17 (63%) being male and 10 (37%) being female. Six out of 100 level students strongly believes sex is less enjoyed while using condom with just 1 male (17%) and 5 (83%) female sharing this school of thought.
In 200 level which comprises of 22 students, a total of 7 students believe they do not enjoy sex using condom with a male – female ratio of 5 (71%) to 2 (29%) respectively. 8 students strongly believes they do not enjoy sex using condom with a 50 – 50 male – female ratio of 4 (50%) of each sex.
However, just 1 male and no female disagreed on the subject matter while 6 students comprising of 3 males and 3 females (50%) each strongly disagreed that they do not enjoy sex using condom.
Also, there exist 17 (68%) male and 8 (32%) female who strongly believe in the ability of condom to prevent HIV/AIDS.
On the contrary opinion, 15 (68%) of the 22 students who lacked confidence in condom’s effectiveness are male leaving the remaining 7 (32%) as female. However, all the 13 respondents that strongly disbelieve the efficacy of condom against HIV/AIDS are female.
The only student in 300 levels opposes that condoms are effective against HIV/AIDS.
Therefore it can be inferred that more males believe in the efficiency and use of condom than females, in terms of their level and subject combination.

5.1 SUMMARY
This descriptive research had successfully and vividly presented the opinion on the use of condom in preventing sexually transmitted infections including HIV/AIDS among students of Osun state college of education, Ilesha.
The students of college of education were the target population, however due to the limitations of the research, only 80 students were studied.
The research instrument used was a self developed and carefully structured questionnaire containing 32 questions in 3 sections.
The data collected were collated, analyzed using percentages and statistical graphical (bar charts, pie charts) for vivid interpretation.
In chapter one, the researcher after strong observation of the society, formulated the background of the study. It also includes the statement of problem, objective of the study, purpose of the study, research hypothesis, significance of the study, research questions, scope of the study, limitations of the study, and definition of operational terms used in the research study.
Chapter two deals with the review of relevant facts and figures extracted from submitted literatures by both Nigerian and African researcher.
Chapter three discusses the research methodology with clear description of the research design, research setting, target population, sampling technique used, instrument for data collection, reliability of instrument, method of data collection, method of data analysis and ethical considerations.
Chapter four deals with the analysis of data collected and collated in tables, percentages and charts.
Chapter five includes discussion of findings, summary, and implication for nursing, conclusion and recommendation.

5.2 CONCLUSION
In conclusion, this research study shows that students in Osun State College of Education, Ilesha do not differ in the opinion about use of condom. Majority of the students were aware about sexually transmitted infections, although a few of them are aware of its transmission and preventive measures (condom) making it necessary for health education into details.
However, larger percentage of them believed in its effectiveness especially the male based on their level and subject combination, averagely they react to condom use.
Finally, the acceptability of the use of condom in the prevention of STIs including HIV/AIDS among the students cannot be over – emphasized. Its best adjudged as a common practice in which their level of compliance and trust as regards its effectiveness in prevention of same is to a large extent unquestionable.

5.3 IMPLICATIONS FOR NURSING PRACTICE
From the findings of this research work, nurses should make it their responsibility as an educator to ensure sex education, and Sexually Transmitted infections (its transmission and prevention) should be given to young people and students of various higher institution of learning.
Also, during sex education in the schools, the importance of Sexually Transmitted Infection prevention should be included as one of the health talks to boost people’s awareness.
More so, sex education including Sexually Transmitted infections (its transmission and prevention) should be included in Nursing and Midwifery Council Curriculum for student nurses to be able to help people in the area in educating them on Sexually Transmitted infections (its transmission and prevention).

5.4 RECOMMENDATION
In view of the researcher’s finding and observations made during the course of the research study, the following are recommended:
Public awareness of STIs should be sustained and enhanced in order to promote in-depth knowledge of its transmission and prevention among the students of College of Education, Ilesha and beyond.
The government policy on Sexually Transmitted infections (HIV/AID) prevention at all levels should encourage local production of condom through which they can limit their huge expenses on importation of condoms.
The mass media should emphasize the use of condom

REFERENCES
Anne, W., & Allison, G. (2006). Anatomy and Physiology. (10th ed.). London; Churchill Livingstone.
Basavanthappa. (2009). Medical Surgical Nursing. (2nd ed.). Delhi; Replika press.
Brenda, G.B., & Suzane, C.S. (2011). Brunners and Suddarths textbook of Medical Surgical Nursing. (11th ed.). U.S.A; Lippincott Williams and Wilkins.
Centres for Disease Control and prevention. Facts about condoms and their use in preventing HIV infection and other STIs. Retrieved from www.wikipedia.com on 5th of June 2012.
Cunningham, A.; Donaghy, H.; Harman, A.; Kim, M., & Turville S. (2010). Manipulation of dendritic cell function by virus. (6th ed.). Singapore ;FEP International Limited.
Davis, K.R., & Weller, S.C. (2005). The effectiveness of condoms in reducing heterosexual transmission of Sexually Transmitted Infections. U.S.A; Mosby Publishers.
Douek, D.C., Roederer, M., & Koup, R.A. (2009). Emerging concept in the immunopathogenesis of HIV/AIDS. Retrived from www.wikipedia .com on 5th of June 2012.

Kozier, O., & Erb, C. (2008). Fundamentals of Nursing. (8th ed.). Upper Saddle river, New Jersey; Pearson.
Lawn, G. (2004). AIDS in Africa; d impact of co infection on the pathogenesis of HIV Infection. Journal of AIDS Education and prevention. 2006, June; 13(3) Pages 252-258.
Lytle, C.D., & Duff, J.E. (2003) A sensitive method for evaluating condom use as virus barriers. Retrieved from www.wikipedia.com on 29th of April 2012.
Novak, & Warner, L. (2009). Assessing condom use and practises; Implications for evaluating method and user effectiveness. Retrieved from www.wikipedia.com on 11th of August 2012.
Olley B.O and Rotimi O.J (2005); Gender differences in condom use behaviour among students in a Nigerian university. African Journal of Reproductive Health, 2003 April 7(1) Pages 83-91.
Owuamanam, J., & Tzeng, W. (2005).Pathologic basis of diseases, (7th ed.). Elseiver, London; Elseiver Saunders. Sanders, S.A., Crosby, R.A., and Yarber, W.L. (2002). Condom use errors and problems among college students. New York; West Publishing Company. UNAIDS (2004); Report on Global HIV/AIDS Epidemic Weiss, R.A. (2005). How does HIV cause AIDS? American Journal of Public Health. 2009 January; 89(1) Pages 108-110. WHO [World Health Organisation] (2003). Sexually Transmitted Infections amongst adolescents in the developing world; a review of published data. Geneva: WHO Wikipedia, The Internet Encyclopaedia.

APPENDIX A.
QUESTIONNAIRE
Dear Respondent,
I am a final year student . I am conducting a research work on the opinion on the use of condoms in preventing sexually transmitted infections including HIV/AIDS among students of College of Education, Ilesha, Osun State . Kindly endeavour to attend to all items appropriately even as I shall guarantee the utmost confidentiality of such information provided. Also, all information will be solely for research purpose. Thank you.

SECTION A; DEMOGRAPHIC STUDIES
Please tick [ ] as appropriate. 1. Sex; [a] Male [ ] [b] Female[ ] 2. Age; [a] Less than 18 years [ ] [b]18-30years [ ] [c] 31-40years [ ] [d] above 40years [ ] 3. Religion ; [a] Christianity [ ] [b] Islamic [ ] [c] Traditional [ ] [d] Others [please specify] 4. Marital status; [a] single [ ] [b] married [ ] [c] divorced [ ] 5. Ethnicity; [a]Yoruba [ ] [b ]Igbo [ ] [c] Hausa [ ] 6. Academic programme …………………….. 7. Department ……………………….. 8. Course of study………………………. 9. Level…………………

SECTION B; knowledge about STIs including HIVAIDS 10. What is sexually transmitted infection (a) It is a common disease that can be cured (b) It is an infection that can be contacted during sexual intercourse (c) It is a fungal disease that infects both man and plants (d) I don’t know 11. Sexually transmitted infections can be contacted through other means than sexual intercourse (a) Yes (b) No 12. Sexually transmitted infections including HIV AIDS can be contacted at first sexual intercourse. (a) Yes (b) No 13. Did you use condom during your first sexual intercourse. (a) Yes (b) No (c) can’t remember 14. Sexually transmitted infections can only be contacted if one has sexual intercourse with infected multiple partners (a) Yes (b) No
SECTION C; Problems confronted by students in using condoms in preventing STIs including HIV/AIDS
Tick any of the following responses as it applies to you:
SA = strongly agree; A = agree; SD = strongly disagree; D= disagree 15. I can’t afford good brands of condom. SA( ), A( ), SD( ), D( ) 16. I know how to put on condoms correctly before having sexual intercourse. SD( ), D( ), A( ), SA( ) 17. I hate using condom. A( ), SA ( ), D( ), SD( ) 18. I do not enjoy sex while using condom. D( ), SD( ), SA( ), A( ) 19. I do not satisfy/please my partner[s]when I use condom. SA( ), SD( ), A( ), D( ) 20. My partner feels uncomfortable when I use condom. SD( ), SA( ), D( ), A( ) 21. I don’t have erection if I use condom. A( ), D( ), SA( ), SD( ) 22. I don’t maintain erection if I use condom. A( ), D( ), SD( ), SA( ) 23. I don’t release sperm on time when I use condom. D( ), A( ), SD( ), SA( ) 24. I have experienced condom tear/burst before. SD( ), SA( ), A( ), D( ) 25. I react to condom badly. D( ), A( ), SD( ), SA( ) 26. There is lack of adequate public enlightenment/education on proper condom use. SD( ), SA( ), D( ), A( ) 27. I do not believe condom can prevent STIs. A( ), D( ), SD( ), SA( ) 28. I feel protected when I use condom as a prevention of STIs including HIV/AIDS. SA( ), SD( ), D( ), A( ) 29. Condom use is against my cultural/traditional beliefs/values. A( ), D( ), SD( ), SA( ) 30. My religion does not allow me to use condom. SA( ), SD( ), D( ), A( ) 31. My family background does not allow me to use condom. D( ), A( ), SA( ), SD( ) 32. I know how to remove condom properly after sexual intercourse. SD( ), SA( ), D( ), A( )

References: Anne, W., &amp; Allison, G. (2006). Anatomy and Physiology. (10th ed.). London; Churchill Livingstone. Basavanthappa. (2009). Medical Surgical Nursing. (2nd ed.). Delhi; Replika press. Brenda, G.B., &amp; Suzane, C.S. (2011). Brunners and Suddarths textbook of Medical Surgical Nursing Cunningham, A.; Donaghy, H.; Harman, A.; Kim, M., &amp; Turville S. (2010). Davis, K.R., &amp; Weller, S.C. (2005). The effectiveness of condoms in reducing heterosexual transmission of Sexually Transmitted Infections Douek, D.C., Roederer, M., &amp; Koup, R.A. (2009). Emerging concept in the immunopathogenesis of HIV/AIDS Kozier, O., &amp; Erb, C. (2008). Fundamentals of Nursing. (8th ed.). Upper Saddle river, New Jersey; Pearson. Lawn, G. (2004). AIDS in Africa; d impact of co infection on the pathogenesis of HIV Infection Lytle, C.D., &amp; Duff, J.E. (2003) A sensitive method for evaluating condom use as virus barriers Novak, &amp; Warner, L. (2009). Assessing condom use and practises; Implications for evaluating method and user effectiveness Olley B.O and Rotimi O.J (2005); Gender differences in condom use behaviour among students in a Nigerian university Owuamanam, J., &amp; Tzeng, W. (2005).Pathologic basis of diseases, (7th ed.). Elseiver, London; Elseiver Saunders. Sanders, S.A., Crosby, R.A., and Yarber, W.L. (2002). Condom use errors and problems among college students UNAIDS (2004); Report on Global HIV/AIDS Epidemic Weiss, R.A WHO [World Health Organisation] (2003). Sexually Transmitted Infections amongst adolescents in the developing world; a review of published data