{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:57:15Z","timestamp":1791320235592,"version":"4.3.1"},"reference-count":50,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Lingnan University","award":["102159"],"award-info":[{"award-number":["102159"]}]},{"name":"the Lingnan University","award":["LWI20014"],"award-info":[{"award-number":["LWI20014"]}]},{"name":"Lam Woo Research Fund\u2014Individual Grant (Lingnan University)","award":["102159"],"award-info":[{"award-number":["102159"]}]},{"name":"Lam Woo Research Fund\u2014Individual Grant (Lingnan University)","award":["LWI20014"],"award-info":[{"award-number":["LWI20014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The use and sale of sexual enhancement drugs (particularly unapproved aphrodisiacs) have become a public health concern in Ghana and many other sub-Saharan African countries. While most studies have examined this phenomenon from the level of individual perspectives, this study investigates the multi-dimensional and multi-level factors (e.g., individual characteristics and behaviours, interpersonal factors, community norms and practices, institutional and public policy factors) that influence attitudes, perceptions, and use of aphrodisiacs among men and women in Ghana. Using a concurrent mixed-method design, we derived the data from a semi-structured interview and cross-sectional survey conducted across five administrative regions in Ghana. Interpretative phenomenological analysis and logistic regression techniques were used to analyse the qualitative and quantitative (survey) data, respectively. Approximately 12.6% of participants (17.6% among males and 7.2% among females) had used an aphrodisiac in the six months prior to the study. Approximately 23.4% of the participants had more than one partner during the same period. Among men, being religious (B = \u22120.238, p &lt; 0.05) and having multiple sexual partners (B = 0.481, p &lt; 0.01) were positively associated with the use of aphrodisiacs. For women, being employed (B = \u22121.539, p &lt; 0.01), engaging in physical activities (exercising) (B = \u22120.658, p &lt; 0.05), having good health (B = 0.869, p &lt; 0.05), having multiple sexual partners (B = 1.191, p &lt; 0.01), and taking alcohol (B = 1.041, p &lt; 0.01) were associated with use of aphrodisiacs. Although many participants had used aphrodisiacs, women, in particular, held unfavourable views about the drugs due to perceived negative health implications for themselves and their partners. The findings also show that community-level factors (e.g., social norms and expectations), interpersonal factors (e.g., expectations of partners and friends), public policy (e.g., drug-related regulations), and organisational\/institutional factors (e.g., health system arrangements about access and use of drugs) were critical to the sale and use of aphrodisiacs among both men and women in Ghana. A multi-level analysis of the use of sexual enhancement drugs among men and women is crucial to formulating social and public health policies that aim to improve public knowledge of these drugs, reduce uncontrolled production, and protect population health and well-being.<\/jats:p>","DOI":"10.3390\/ijerph19116521","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T07:05:07Z","timestamp":1653635107000},"page":"6521","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A Social\u2013Ecological Study of Perceptions and Determinants of Sexual Enhancement Drug Use among Men and Women in Ghana"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8730-5805","authenticated-orcid":false,"given":"Padmore Adusei","family":"Amoah","sequence":"first","affiliation":[{"name":"School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong"},{"name":"Institute of Policy Studies, Lingnan University, Tuen Mun, Hong Kong"},{"name":"Department of Applied Psychology, Lingnan University, Tuen Mun, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9672-9079","authenticated-orcid":false,"given":"Stephen Baffour","family":"Adjei","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Studies, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi P.O. Box 1277, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5099-4555","authenticated-orcid":false,"given":"Francis","family":"Arthur-Holmes","sequence":"additional","affiliation":[{"name":"Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jsps.2015.01.018","article-title":"Pharmacovigilance on sexual enhancing herbal supplements","volume":"24","author":"Bhagavathula","year":"2016","journal-title":"Saudi Pharm. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1177\/1060826519887510","article-title":"Masculinity, Male Sexual Virility, and Use of Aphrodisiacs in Ghana","volume":"28","author":"Fiaveh","year":"2020","journal-title":"J. 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