SEXUAL RISK BEHAVIOURS AND COMPULSIVE SEXUAL BEHAVIOUR DISORDERS AMONG MILITARY PERSONNEL IN IBADAN

---

A.A. Adetoro, A.M. Adebayo, O.A. Atariata

Department of Community Medicine, University College Hospital, Ibadan, Nigeria.

Abstract

Background: Military personnel (MP) are exposed to situations such as loneliness and alcohol use that lead to sexual risk behaviours (SRBs) with serious implications for the spread of sexually transmitted infections (STIs). Compulsive sexual behaviour disorder (CSBD) is a psychosexual condition that is characterized by a consistent failure to control sexual behaviour and continuation of the behaviour despite the consequences. The prevalence of CSBD is underreported due to the sensitive nature of the behaviour. This study thereby assesses SRBs and CSBD and associated factors among MP.

Methods: A cross-sectional study among 406 MP in Ibadan using a convenient sampling method to select the personnel serving in the two military barracks in Ibadan. MP available on the days of data collection were interviewed. A semi-structured, interviewer-administered questionnaire was used to obtain information on SRBs and CSBD. Descriptive and inferential statistics were done and the Chi-Square test was used to test for association between independent and outcome variables at p < 0.05.

Results:The mean age of respondents was 30.1±10.1 years. Above half (52.7%) were aged 20 – 30 years, 70.7% were males, and 56.6% were not living with a partner. The prevalence of SRBs among respondents was 79.6% while the prevalence of CSBD was 6.4%. Gender and marital status were predictors of SRBs.

Conclusion: The majority of MP engaged in SRBs while less than one-tenth had CSBD. Gender and marital status were predictors of SRBs. Risk reduction counseling was recommended for MP.

Keywords: Sexual risk behaviours, Compulsive sexual behaviour disorder, Military personnel

Introduction

The attainment and maintenance of sexual health require an optimistic and respectful approach to sexuality and sexual relationships, and the possibility of having pleasurable and safe sexual experiences that are free of coercion, discrimination, and violence.¹ Sexual activity is the most intimate of human relationships while sexual behaviour is the most intimate of human interactions.²

Military personnel (MP) belong to the sexually active age group and also the high risk-taking group due to the nature of their job. Nigerian Military Personnel (NMP) are easily influenced by peer pressure rather than social convention.³ Sex with multiple partners is a tradition that has also persisted in the Nigerian Navy even in the era of Acquired Immunodeficiency Syndrome (AIDS).³ Other SRBs common among MP include multiple sexual partnering, concurrent sexual partnership, engaging in sexual activity under the influence of drugs or alcohol⁴, and extreme forms of sexual behaviour such as rape and compulsive sexual behaviour disorder (CSBD).

CSBD is characterized by a persistent pattern of failure to control intense sexual impulses or urges, failing to control repetitive sexual behaviour that is evident over an extended period (e.g., 12 months), and causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.⁵ It may involve a variety of commonly enjoyable sexual experiences.⁶ It engulfs various types of problematic sexual behaviours, including excessive masturbation, cybersex, excessiv or problematic pornography use, telephone sex, strip club visitation, and other behaviours.⁷

Evaluation of the prevalence of CSBD is difficult due to the embarrassment and shame frequently reported by individuals with CSBD, as well as its lack of awareness and perceived prevalence in society. An estimated CSBD prevalence of 1% to 3% is present among the U.S. adult population⁸. A much higher prevalence of CSBD was found among a sample of US male military veterans⁹. According to Derbyshire¹⁰, many have argued that the prevalence of CSBD maybe underreported in the general population due to the sensitive nature of sexual behaviour¹⁰. A prevalence of CSBD among a sample of US male veterans recently returning to civilian life at baseline was estimated as 16.7%.¹¹

The stigma of not being able to control sexual impulses carries with it a connotation of depravity and moral selfishness. Stigmatization in the media and criminalization of “sexual offenders” create an atmosphere that does not promote treatment and prevention. As a result, access to care and seeking care, even when one recognizes that sexual behaviours are out of control, is a decision faced with barriers and limitations.¹²

Most research has focused on SRBs and their association with HIV and STIs7. Behaviours such as CSBD may be inadvertently overlooked by clinicians focusing on other more acute psychiatric problems and disorders such as Post Traumatic Stress Disorder (PTSD), and alcohol use disorder among others.¹³

While MPs engage in SRBs and experience frequent co-occurrence of CSBD with psychiatric disorders and traumatic experiences ¹⁴, there is a huge gap in knowledge on SRBs and CSBD among MPs across different populations.

Across the African continent, there are only very few studies documenting the lifetime or current prevalence of CSBD. Most of what is known about the epidemiological nature of this disorder are from clinical treatment programmes focused on sexual addiction and a couple of studies conducted in the U.S. and Sweden.^13,15 It is therefore imperative to assess the prevalence and factors associated with SRBs and CSBD in a developing country like Nigeria with the aim of addressing the knowledge gap and proffering solutions.