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Liberia Substance Abuse at the Secondary School Level
Introduction/History ,[object Object]
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 strata Inform future research Direct 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 Behaviors Inform future research Design 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  * Total population percentage
Cigarettes and Marijuana Low Usage Rates 6.8% of population has ever tried cigarettes 9.7% of population has ever used marijuana  Gender and Age  Males are more likely to try both Those 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 ,[object Object]
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.,[object Object]
Χ²=16.827			           p<.001
Discussion Lack of infrastructure Alcohol use at higher rates than other African nations  Substance abuse as self-medication in dealing with distress Counseling services availability Rate of early sex higher than other African nations

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Harris substance abuse in liberia

  • 1. Liberia Substance Abuse at the Secondary School Level
  • 2.
  • 3. In 1989 Liberia entered a period of Civil War which continued through 2003
  • 4. 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
  • 5. Civil War: 1989-2003 Casualties Displacement Psychological Distress
  • 6. University of Liberia begins research exploring current social climate
  • 7. Present Research Aims Determine rate of Substance Abuse (SA) among Monrovian secondary schools(Study 1) Gauge level of use across economic and social strata Inform future research Direct 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 Behaviors Inform future research Design targeted
  • 8. 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
  • 9. 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
  • 10. Alcohol Significant Findings * Total population percentage
  • 11. Cigarettes and Marijuana Low Usage Rates 6.8% of population has ever tried cigarettes 9.7% of population has ever used marijuana Gender and Age Males are more likely to try both Those over 19 are more likely to have used both
  • 12.
  • 13. Of those active, 96% report having sex at least once a month
  • 14. 21% reported never using a condom
  • 15.
  • 16.
  • 17. Χ²=16.827 p<.001
  • 18. Discussion Lack of infrastructure Alcohol use at higher rates than other African nations Substance abuse as self-medication in dealing with distress Counseling services availability Rate of early sex higher than other African nations
  • 19. Study Limitations Cross Sectional Design Social Desirability Bias Survey Device Terminology
  • 20. 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
  • 21. 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.
  • 22. 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 school students 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

Editor's Notes

  1. Casualties: Around 200,000 killed15,000 Child soldiers used in armed combatDisplacement: Near a million citizens displaced to refugee campsMany still live outside their home nationPsychological Turmoil: Common Post-War expressions of distressPost-Traumatic Stress disorderDepressionTraumaSubstance Abuse
  2. With support from president Ellen Johnson Sirleaf the nation has been working to rebuild to a pre-war state. In order to understand the extent of the damage done and the resources necessary to aid the population, research is now underway exploring the youth and their current social state.
  3. Sample taken from
  4. 6 Public Schools- Tuition: $21 Semester10 Private Schools- Tuition:$142 Semester48% Male47% Female4% Missing from final data
  5. Data was not significant for variables measuring: Continued use and Usage during the previous month
  6. Under 18-4.1% have smokedOver 19- 8.9% have smokedMales-9.1% have smokedFemales-3.9 have smokedUnder 18-5.8% used marijuanaOver 19-12.7% used marijuanaMales-13.3% used marijuanaFemales-5.8% used marijuana
  7. In population percenages
  8. No current support for intervention programs or sexual education Recent study has shown rate of Kenyan secondary school alcohol consumption at a rate of 5.4 % Current Study showed near 50% rate of same population in Monrovia (cited in articles)Sex before age 15- Zambia: 9.4%------Current Monrovia Study: Near 50% (cited in articles)
  9. Cross Sectional: Used to gather info. quickly, easily, w/out ethical issues-does not demonstrate cause and effect-more risk factor data needed-findings cannot be applied outside sample area/can’t be generalized to wide pop.Social Desirability Bias: Relates to self report design-Conducted at school w/in presence of peers-Data skews may be present due to subjects desire to downplay substance usageSurvey-Did not specify amount of substances used (i.e. amount of drinks, blackout history, etc.)-Terminology: Cultural confusion may have occurred in referencing substances (culturally specific slang) -Definition of “Sex” not explicitly made. Respondents may have answered differently based on personal definition.