Background: There is limited scientific evidence supporting the efficacy of aphrodisiacs and more worrying is the fact that potential adverse health effects could result from the abuse of aphrodisiacs. Despite the safety concerns raised by the FDA on the abuse of unregistered sex enhancing products, the patronage remains high amidst debilitating side effects. We explore the factors influencing the use of aphrodisiacs while assessing the prevalence of aphrodisiac usage among men in the Ashaiman Municipality of Greater Accra Region, Ghana. Methods: A cross-sectional study was carried out between January and March 2018 at the Ashaiman Municipality. Structured questionnaires were administered to 370 consented and purposively selected adult males (18 years and above) through interviews. Data on variables such a s respondent’s socio-demographic characteristics, sexual characteristics, knowledge and use of aphrodisiacs were obtained. Analysis was done with aphrodisiac use as the main outcome of interest. A bivariate statistical analysis was done with aphrodisiac use as the main outcome of interest. Results: Out of the 352 men, 52.6% reported ever using aphrodisiacs at some points in their lives. Majority (68.7%) of the users first used aphrodisiacs between the ages of 18 and 25 years. Usage was found to be higher among those with lower educational attainment. Number of sexual partners, the presence of sexual problems, advertisement, and knowledge of side effects were statistically associated with the use of aphrodisiac (p < 0.05). About 50% of the aphrodisiac users had no sexual problems indicating recreational use. Majority of the responders (52.4%) acquired the aphrodisiacs from drug peddlers. Conclusions: This study revealed the use of aphrodisiac is still high among adult males, and that the participants’ levels of education and knowledge of side effects serve as a protective factor to the likelihood of using aphrodisiacs. There is a need for health institutions to embark on extensive educational programmes to educate the public on the devastating health consequences from the indiscriminate use of aphrodisiacs without medical indication.
Men and women throughout history have continually pursued various means to enhance, maintain and bring back their sexual ability or stimulate their sexual desire for the opposite sex. Sexual function and health is an essential component of life [
The study was conducted in the Ashaiman Municipal, which lies within the south-eastern part of Ghana and is one of the municipalities within the Greater Accra Region. Ashaiman, the capital of the municipality is a vibrant commercial city and densely populated where both day and night life is very active. Ashaiman used to be a sub-district under the Tema Metropolitan Health Directorate, however, it was carved out of Tema as a Municipal in July 2008. The municipality is about 30 km away from Accra, the administrative capital city of Ghana, and spans over a land size of 45 km2. Currently, Ashaiman is the 5th densely populated city in Ghana and the fastest growing urban city in the country. The 2010 Population and Housing Census shows the total population of the municipality is 190,972 with males constituting 49.1% and females 50.9% [
A cross-sectional study was employed to collect data from selected sub-municipals (Tsinaiagber, Amui Jor, Blakpatsona) in the Ashaiman Municipality. Males above 18 years were sampled using a multi-stage sampling technique and included in the study. A questionnaire was used as the principal data collection instrument, information on the study subjects regarding their demographic characteristics, benefits derived from use of aphrodisiacs, the role of advertisements in the use of aphrodisiacs, help-seeking behaviour for sexual problems, knowledge level of health complications and other factors influencing the use of aphrodisiacs were obtained through interviews.
The utilization of aphrodisiacs was the dependent variable used in the logistic regression analysis in this study. The following were the explanatory variables explored;
1) Demographic characteristics such as; age, educational level, marital status, ethnicity, religion, level of education and occupation.
2) Prevalence of aphrodisiac usage. This captured previous usage and current usage of aphrodisiacs as well as the various types of aphrodisiacs used (whether herbal or orthodox). The sources of information and sources of acquisition for these aphrodisiacs were also included in the analysis because they were perceived to play an essential role in the use of aphrodisiac.
3) Reasons for use of aphrodisiacs. This took into consideration the proportion using aphrodisiac for medical reasons and those using it for recreational purposes. Recreational use was analyzed as the proportion using aphrodisiacs to gratify sexual partners, for prolonged sexual intercourse, for pleasure, insecurity, as a result of influence from friends and advertisements in the media. The relationship between help-seeking behaviours for sexual problems and use of aphrodisiacs was also explored.
4) Knowledge and perceptions of effects. Awareness of side effects from the use of aphrodisiacs was considered an important determinant and various health complications captured were headaches, fast heartbeat, sustained erection, impotence, heart attack, kidney failure and sudden death.
The target sample size was determined based on the reported usage prevalence of about 61% from an earlier study conducted among selected men in Ghana [
n = Z 2 p ( 1 − p ) e 2 = 1.96 2 × 0.61 × 0.39 0.05 2 = 366
where, n = the required sample size, p = prevalence of aphrodisiac usage, Z = score at 95% confidence level, and e = margin of error. The sample size was then rounded up to the nearest ten, bringing the total required sample size to 370 study participants.
All analyses were done using STATA statistical software package (StataCorp. 2007. Stata Statistical Software. Release 14. StataCorp LP, College Station, TX, USA). Descriptive analysis of the various socio-demographic characteristics was done to generate percentages, frequencies, means, etc. Bivariate and multivariate logistic regression analyses were used to tease out potential association among selected socio-demographic characteristics and predict factors that statistically influence the use of aphrodisiacs at a predetermined significance level (α) less than 0.05.
Ethical and administrative approvals were obtained from the Ensign College of Public Health, Ethics Review Board. Permission was also sought from the Ashaiman Municipal Health Directorate and local authorities in the three sub-municipals. Participants were selected based on their willingness to partake in the study and signed individual informed consent was sought from each participant before enrolment into the study. As the consumption of aphrodisiacs is usually considered private and confidential, participants were assured of their anonymity and therefore no names were written on the questionnaires. Study subjects who were identified to be using aphrodisiacs detrimental to their health were referred for counselling at pre-identified health facilities.
Out of the 370 respondents, 352 actively responded to the survey, generating a 95% response rate. The ages of the respondents ranged from 18 to 70 years with a mean age of 29.3 ± 7.9 years. While 34.1% of the respondents were married, 11.1% were co-habiting and 4% were divorced. Majority (50.8%), reported being single at the time of the study. Sixty-nine percent of the respondents professed faith in Christianity, 21.6% were Moslems and 9.3% belonged to other religious faiths. Majority of the respondents were of the Ewes and Akans ethnic backgrounds.
Many of the respondents reported some level of formal education with only 14.5% having no formal education. The employment status of the participants showed that 16% of the respondents were unemployed whilst the rest were either artisans, drivers, civil servants (
The results from the study showed that almost all the respondents 337 (95.7%) had some knowledge of aphrodisiacs. About a half 185 (53%), reported ever using aphrodisiacs, with 78 (42%) out of the 185 being one time users whilst the rest currently use aphrodisiacs. On the question regarding the form of aphrodisiac ever used, 42.2% admitted having used an orthodox form of aphrodisiac, 15.1% used herbal aphrodisiacs, 24.3% used herbal with alcohol base (“bitters”), and the remaining reportedly used aphrodisiacs that came in form of sprays or creams. Of the 185 users, only 3.2% were using aphrodisiacs based on recommendation by a health professional, 69.2% indicated recommendation was by friends and family, 17.8% by sexual partners and 9.6% used them based on
Variable (N = 352) | n (%) |
---|---|
Age group (years) 18 - 25 26 - 35 36 - 45 46 - 70 | 121 (34.38) 168 (47.73) 52 (14.77) 11(3.13) |
Marital Status Single Co-habiting Married Divorced | 179 (50.85) 39 (11.08) 120 (34.09) 14 (3.98) |
Religion Christianity Islamic Traditionalist | 243 (69.03) 76 (21.59) 33 (9.38) |
Ethnicity Akan Ewe Ga Hausa Others | 98 (27.84) 101 (28.69) 59 (16.76) 64 (18.18) 30 (8.52) |
Educational Level No Education Primary/JHS SHS/Tech/Voc. Tertiary | 52 (14.49) 71 (20.17) 126 (35.80) 104 (29.55) |
Occupation Artisan Civil Servant Petty Trader Driver Others Unemployed | 65 (18.47) 53 (15.06) 69 (19.60) 36 (10.23) 73 (20.74) 56 (15.91) |
recommendation from the media. Regarding the benefits derived from usage, about half (52.4%) reported prolonged sexual intercourse as a positive outcome from usage, followed by improved performance (18.9%), the gratification of sexual partner (15.1%) and 13.5% reporting enhanced erection. When asked about any known side effect from usage, 58.9% of the aphrodisiac users indicated the experienced effects of severe headache, general weakness and sustained erection from the use of aphrodisiacs (
A bivariate analysis (
Variable (N = 352) | n (%) |
---|---|
Knowledge of aphrodisiacs No Yes | 15 (4.26) 337 (95.74) |
Ever Used aphrodisiacs No Yes | 167 (47.44) 185 (52.56) |
Among only those reporting ever used (N= 185) | |
Age (years) at first use 18 - 25 26 - 35 36 - 40 | 127 (68.65) 51 (27.57) 7 (3.78) |
Current use of aphrodisiac Yes No | 107 (57.84) 78 (42.16) |
Type being used Orthodox capsule/pill Herbal Herbal with an alcohol base Cream/Spray | 78 (42.16) 28 (15.14) 45 (24.32) 34 (18.38) |
Who recommended use Friends/Family Media Health professional Sexual partner | 128 (69.19) 18 (9.73) 6 (3.24) 33 (17.84) |
Source of acquisition Pharmacy/Drug store Open market/Drug peddlers Drinking bars | 51 (27.57) 97 (52.43) 37 (20.00) |
Perceived benefits from aphrodisiac use Improved erection Prolonged sexual intercourse Gratification of sexual partner Improved performance | 25 (13.51) 97 (52.43) 28 (15.14) 35 (18.92) |
Experienced effect from aphrodisiac use Severe headache General weakness Sustained erection No effect | 40 (21.62) 40 (21.62) 29 (15.68) 76 (41.08) |
A multivariate logistic regression model was then used to ascertain the strength of association between selected independent variables with aphrodisiac usage. In an adjusted model (
Aphrodisiac Use | |||
---|---|---|---|
Variable Aphrodisiac use (N = 352) | Yes n = 185 (%) | No n= 167 (%) | P-value |
Age group (years) 18 - 25 26 - 35 36 - 45 46 - 70 | 57 (30.81) 85 (45.95) 34 (18.38) 9 (4.86) | 64 (38.32) 83 (49.70) 18 (10.78) 2 (1.20) | 0.031* |
Marital Status Single Co-habiting Married Divorced | 80 (43.24) 33 (17.84) 62 (33.51) 10 (5.41) | 99 (59.28) 6 (3.59) 58 (34.73) 4 (2.40) | <0.001* |
Religion Christianity Islamic Traditionalist | 124 (67.03) 36 (19.46) 25 (13.51) | 119 (71.26) 40 (23.95) 8 (4.79) | 0.015* |
Educational Level No Education Primary/JHS SHS/Tech/Voc. Tertiary | 26 (14.05) 48 (25.95) 64 (34.59) 47 (25.41) | 25 (14.97) 23 (13.77) 62 (37.13) 57 (34.13) | 0.029* |
Occupation Artisan Civil Servant Petty Trader Driver Others Unemployed | 31 (16.76) 27 (14.59) 52 (28.11) 24 (12.97) 29 (15.68) 22 (11.89) | 34 (20.36) 26 (15.57) 17 (10.18) 12 (7.19) 44 (26.35) 34 (20.36) | <0.001* |
Number of sex partners 1 ≥2 | 118 (63.79) 67 (36.21) | 135 (80.84) 32 (19.16) | <0.001* |
Sexual problem No Yes | 94 (50.81) 91 (49.19) | 157 (94.01) 10 (5.99) | <0.001* |
Doctor’s inquiry about sexual health during routine visits No Yes | 150 (81.08) 35 (18.92) | 151 (90.42) 16 (9.58) | 0.003 |
Think doctor should routinely ask about sexual function No Yes | 54 (29.19) 131 (70.81) | 57 (34.13) 110 (65.87) | 0.319 |
Frequency of adverts on aphrodisiacs Never Everyday Weekly Occasionally | 2 (1.08) 137 (74.05) 24 (12.97) 22(11.89) | 13 (7.78) 105 (62.87) 18 (10.78) 31 (18.56) | 0.003 |
Knowledge of side effects No Yes | 66 (35.68) 119 (64.32) | 13 (7.78) 154 (92.22) | <0.001* |
*Statistically significant effect at a 95% Confidence Interval.
Variables N = 352 | OR | (95% CI) | P-value | AOR | (95% CI) | P-value |
---|---|---|---|---|---|---|
Marital Status Single (Ref) Co-habiting Married Divorced | 1.0 6.8 1.3 3.1 | - (2.72, 17.05) (0.83, 2.10) (0.94, 10.23) | - <0.001* 0.237 0.064 | 1.0 3.4 2.0 5.2 | - (1.11, 10.59) (1.09, 3.57) (1.29, 21.01) | - 0.031* 0.025* 0.020* |
Educational level No Education (Ref) Primary/JHS SHS Tertiary | 1.0 2.0 1.0 0.8 | - (0.96, 4.21) (0.52, 1.90) (0.41, 1.55) | - 0.065 0.982 0.498 | 1.0 0.6 0.5 0.3 | - (0.23, 1.52) (0.21, 1.06) (0.14, 0.79) | - 0.282 0.069 0.013* |
Number of sexual partners 1 (Ref) ≥2 | 1.0 2.4 | - (1.47, 3.90) | - <0.001* | 1.0 2.4 | - (1.28, 4.34) | - 0.006* |
Sexual problem No (Ref) Yes | 1.0 15.2 | - (7.5, 30.64) | - <0.001* | 1.0 14.4 | - (6.58, 31.37) | - <0.001* |
Chronic health problem No (Ref) Yes | 1.0 2.0 | - (1.11, 3.50) | - 0.02* | 1.0 0.7 | - (0.31, 1.53) | - 0.364 |
Frequency of adverts Never (Ref) Everyday Weekly Occasionally | 1.0 8.5 8.7 4.6 | - (1.87, 38.40) (1.73, 43.32) (0.94, 22.52) | - 0.006* 0.009* 0.059 | 1.0 9.3 8.4 5.8 | - (1.68, 51.51) (1.32, 53.62) (0.94, 36.06) | - 0.011* 0.024* 0.057 |
Knowledge of side effects No (Ref) Yes | 1.0 0.2 | - (0.08, 0.29) | - <0.001* | 1.0 0.2 | - (0.07, 0.33) | - <0.001* |
*Statistically significant effect at a 95% Confidence Interval.
heard occasionally. Very similar observations were made regarding the level of reported educational level attained at the time of the study on usage. Thus, the likelihood of usage of aphrodisiacs turns to progressively reduce from 0.6 to 0.3, as the level of education increases. The higher the level of education the less likely the usage. Making education a protective factor to the usage of the aphrodisiacs. On the other hand, it was observed from the data that study participants with two (2) or more sexual partners and those who reported having sexual problems were 2.4 and 14.4 times more likely to use aphrodisiacs when other covariates were adjusted for compared to those with single partners and those without sexual problems respectively. Individuals co-habiting at the time of the study where 3.4 times more likely to also use the aphrodisiacs when compared to their single counterparts holding other variables constant. Reported knowledge on associated side effects of usage turns to have a protective effect as respondents who have some level of knowledge on the harms were predicted to be 0.8 times less likely to use the drug compared to their counterparts who admitted having no knowledge.
The current study revealed that demographic factors: age, marital status, educational level, occupation, and religion were significantly associated with the use of aphrodisiacs. It was observed that individuals who were cohabiting at the time of the study were 3.4 times more likely to use aphrodisiacs compared to their single counterparts holding all other variables constant. The study again found that the odds of an individual using an aphrodisiac decreased with higher educational attainment. A probable reflection that, the educated men are more likely to access and understand information regarding the possible side-effects from the use of these drugs, hence the low usage rate. This finding, however, contradicts a study in Saudi Arabia which indicated that there is high consumption of sex enhancing medications among highly educated males compared to those with a lower educational attainment [
Usage was found to be higher among those with lower educational attainment. Advertisement was also discovered to significantly influence the use of aphrodisiacs as those who hear or watch these advertisements on a daily basis were more likely to use these drugs compared to those who never heard about them. Other factors such as the number of sexual partners, the presence of sexual problems and knowledge of side effects independently predicted the use of aphrodisiacs. Chronic health conditions were not found to be associated with the use of aphrodisiac after adjusting for possible confounders. The benefits users claimed to have experienced from usage were more recreational and generally, it was perceived that the main reason for use of aphrodisiacs was to achieve prolonged sexual intercourse. The major source of acquiring aphrodisiacs was from the open markets based on recommendations from friends and family. The level of education attained and also the amount of knowledge on the accompanying side effects of using aphrodisiacs were predicted to have a protective effect to usage, thereby making public health education the best route to fighting this menace in the Ghanaian society and beyond.
Despite the contribution of this study to scientific knowledge, it cannot go without mention that information gathered from the respondents could be subjected to sampling and recall biases given the sampling technique adapted and the fact that some of the information was self-reported. Further comprehensive qualitative research work could be done as a follow-up study.
This work was carried out in collaboration between all authors. PAM and SM participated in conceiving the study and in the development of data collection tools. PAM carried out data collection. SM, PAM and GKA participated in the data analysis and drafting of the manuscript. All authors read and approved of the final manuscript.
All authors declare no conflict of interest.
Manortey, S., Mensah, P.A. and Acheampong, G.K. (2018) Evaluating Factors Associated with the Use of Aphrodisiacs among Adult Male Residents in Ashaiman Municipality, Ghana. Open Access Library Journal, 5: e4876. https://doi.org/10.4236/oalib.1104876