Risky Behaviours: Alcohol, Smoking, Drug Use and Sexuality among High School Students in the Urban District of Antananarivo

Aims: (i) Describe the attitudes and practices of students in terms of alcoholism, smoking, drug use and sexuality, (ii) identify the factors that influence the practice of single and multiple risky behaviours, (iii) provide recommendations to control risky behaviours among students based on the results.
Study Design: We conducted a cross-sectional, school-based survey.
Place and Duration: The study was carried out in the high schools of the Urban District of Antananarivo, Madagascar. Data collection lasted 2 weeks (January 27, 2014 to February 7, 2014), using questionnaires filled out by each student individually.
Methodology: We included 231 high school students in Seconde, Première and Terminale levels, male and female, in general education and aged 12 to 24 (68.6% from private institutions and 31.4% from public ones). Data was analysed using comparison techniques and each hypothesis was tested using a .05 level of significance.
Results: The prevalence of risky behaviours among high school students differs according to the nature of the risk. Use of alcohol prevalence is 80%; 95% CI [73.9 - 84.7]. Two in five high school students have smoked cigarettes (40%; 95% CI [36.0 - 49.1]). About sexual activity and drug use, prevalences are respectively estimated at 22%; 95% CI [16.9 -20.0] and 13%; 95% CI [8.6 -17.5]. As for the practice of multiple risks, prevalence is 50%; 95% CI [44.0 - 57.3]. Male gender (P < .001), living with separated parents (P = .02), obtaining some pocket money (P < .04), having a job (P = .05), high level of education (P < .02), and studying in religious schools (P < .04) enhance the practice of multiple risks.
Conclusion: Influenced by their peers, while having the possibility to afford alcohol, drugs or cigarettes, urban high schools students in Antananarivo engage in risky practices early. Thus, a multidisciplinary strategy should be taken into account.