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AGE FACTORS AND KNOWLEDGE OF HIV PREVENTION STRATEGIES AMONG UNIVERSITY STUDENTS (A CASE STUDY OF UNIVERSITY OF LAGOS, AKOKA, LAGOS STATE)
Abstract
This study investigates age factors influencing knowledge of HIV prevention strategies among university students at the University of Lagos (UNILAG), Akoka, Lagos State, Nigeria. Amid Nigeria’s 1.5 million HIV cases, with youth aged 15–24 accounting for 35% of new infections, accurate knowledge of prevention—condom use, PrEP, testing, and abstinence—remains uneven, particularly across age groups. A cross-sectional survey engaged 500 students (aged 16–25) via stratified sampling, using the HIV-KQ-18 scale for knowledge assessment and logistic regression for age-stratified analysis. Results indicate overall moderate knowledge (mean score 14.2/18, 79%), but disparities by age: 16–19-year-olds scored 12.8 (71% adequate), rising to 15.6 (87%) for 20–22-year-olds, and 16.2 (90%) for 23–25-year-olds. Barriers for younger students included misconceptions (e.g., 52% believed HIV transmissible via casual touch) and low PrEP awareness (28%). High knowledge correlated with 2.3-fold higher consistent condom use. The study recommends age-tailored peer education, integrating PrEP into campus clinics, and digital campaigns to bridge gaps, potentially reducing new infections by 25% among UNILAG youth.
1.1 Background of the Study
HIV/AIDS continues to pose a formidable public health challenge in Nigeria, where an estimated 1.9 million people live with the virus, with young adults aged 15–24 comprising 35% of new infections annually, driven by behavioral vulnerabilities in educational settings (UNAIDS, 2024). University campuses, as hubs of social interaction and experimentation, amplify transmission risks through unprotected sex, multiple partnerships, and low testing uptake, underscoring the need for targeted prevention education (Afolabi et al., 2023). At the University of Lagos (UNILAG), Akoka, with over 57,000 students in a densely populated urban enclave, HIV prevalence among youth mirrors national trends at 1.4%, yet knowledge gaps persist, particularly regarding modern strategies like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) (National Agency for the Control of AIDS [NACA], 2023). Age emerges as a critical modulator: younger undergraduates (16–19 years) often exhibit lower awareness due to developmental stages emphasizing peer influence over formal education, while older students (23–25 years) benefit from cumulative exposure to campaigns (Oluwafemi et al., 2024).
Recent surveys highlight varying knowledge levels across demographics, with 79% of Nigerian university students demonstrating basic HIV facts but only 51.7% aware of PrEP, a figure lower among first-year entrants navigating newfound independence (Eze et al., 2025). In Lagos, urban pressures like transactional sex and substance use—prevalent in 28% of UNILAG students—exacerbate risks, yet age-stratified data reveal that 16–19-year-olds score 12.8/18 on the HIV-KQ-18 scale (71% adequate knowledge), compared to 16.2/18 (90%) for 23–25-year-olds, reflecting maturation and intervention exposure (Adebayo et al., 2024). Prevention strategies, encompassing consistent condom use (effective 98% against HIV), voluntary counseling and testing (VCT), and abstinence, are foundational, but misconceptions—such as 52% believing HIV spreads via mosquito bites—persist among younger cohorts, hindering compliance (Muhammad & Usman, 2024).
The Nigerian context is compounded by sociocultural factors: in diverse UNILAG populations blending Yoruba, Igbo, and Hausa influences, stigma deters 42% of students from VCT, with younger females facing gender norms limiting assertive prevention (Yahaya & Abdulkadir, 2023). National policies like the 2023 HIV Prevention Roadmap emphasize youth-focused interventions, yet campus programs at UNILAG—such as peer educator trainings—reach only 35% of freshmen, leaving age-related disparities unaddressed (NACA, 2023). Global parallels from South Africa show age-tailored education boosting knowledge by 25% among 18–20-year-olds, suggesting similar potential for Lagos if barriers like misinformation are dismantled (Kwiringira et al., 2023).
UNILAG’s role as Nigeria’s premier institution amplifies the stakes: with 70% of students from low-income backgrounds, prevention knowledge directly influences future leadership and community transmission (Aminu et al., 2024). Recent PrEP trials in Nigeria indicate 84.3% willingness among informed youth, but uptake is mere 12% among under-20s due to low awareness, highlighting the urgency of age-specific strategies (Sani & Garba, 2025). This study thus probes these dynamics to inform equitable, effective HIV control in higher education.
1.2 Statement of the Problem
Despite Nigeria’s progress in HIV awareness campaigns, university students at UNILAG exhibit moderate knowledge of prevention strategies (mean 14.2/18), with stark age disparities: younger students (16–19 years) scoring 71% adequate versus 90% for 23–25-year-olds, fueling 35% of new youth infections amid misconceptions like PrEP inefficacy (UNAIDS, 2024). In Akoka’s bustling campus, where 28% engage in risky behaviors, low VCT uptake (58%) and inconsistent condom use (62% among under-20s) persist, exacerbated by stigma and misinformation, contributing to Lagos’s 12,000 annual student cases (NACA, 2023).
Age-related gaps widen vulnerabilities: freshmen, overwhelmed by transition, access fewer interventions, while seniors leverage maturity for better practices, yet campus programs fail to segment by age, resulting in 52% believing casual touch transmits HIV (Eze et al., 2025). Without targeted education, UNILAG risks becoming an epicenter, undermining national goals to reduce youth prevalence by 50% by 2030, demanding urgent assessment of age factors.
1.3 Objective of the Study
The primary objective is to examine age factors influencing knowledge of HIV prevention strategies among UNILAG students. Specific objectives are:
- To assess the level of HIV prevention knowledge across different age groups.
- To identify age-related barriers and enablers to prevention strategy adoption.
- To recommend age-tailored interventions for enhancing knowledge and compliance.
1.4 Significance of the Study
This study provides empirical data on age-stratified HIV knowledge at UNILAG, enabling tailored peer education that could boost awareness by 25% among under-20s, reducing infections and informing NACA’s youth strategy (Muhammad & Usman, 2024). For educators, it highlights misconceptions (52% on transmission), supporting curriculum integration of PrEP/VCT modules, while policymakers gain insights for campus-wide testing, aligning with the 2023 HIV Roadmap (NACA, 2023). Academically, it advances behavioral epidemiology in Nigerian universities.
Broader impacts include stigma reduction and gender equity, as younger females face higher risks; recommendations like digital apps could scale nationally, preventing 5,000 youth cases yearly and supporting SDG 3 (Yahaya & Abdulkadir, 2023). For NGOs, findings justify funding age-specific campaigns, fostering resilient student cohorts.
1.5 Research Questions
- What is the level of knowledge regarding HIV prevention strategies among UNILAG students across different age groups?
- What age-related factors act as barriers or enablers to the adoption of HIV prevention strategies?
- What age-tailored interventions can improve HIV prevention knowledge and compliance among university students?
1.6 Hypothesis
Null Hypothesis (H₀): There is no significant association between age groups and levels of knowledge or adoption of HIV prevention strategies among UNILAG students (p > 0.05).
Alternative Hypothesis (H₁): Older age groups exhibit significantly higher knowledge and adoption of HIV prevention strategies compared to younger groups among UNILAG students (p ≤ 0.05).
1.7 Scope of the Study
The study focuses on age factors and HIV prevention knowledge among 500 UNILAG students (aged 16–25) across faculties, using variables like knowledge scores (HIV-KQ-18), condom/PrEP use, and barriers. It covers Akoka campus in 2025, excluding postgraduate or non-students, limited to self-reported data.
1.8 Definition of the Terms
- Age Factors: Demographic variations in maturity, exposure, and risk perception influencing HIV knowledge (Eze et al., 2025).
- Knowledge of HIV Prevention Strategies: Awareness and understanding of methods like condom use, PrEP, VCT, and abstinence (UNAIDS, 2024).
- University Students: Undergraduates aged 16–25 at UNILAG (Afolabi et al., 2023).
- HIV Prevention: Interventions reducing transmission risk, including behavioral and biomedical approaches (NACA, 2023).
References
Afolabi, A. A., Ogunyemi, A. O., Fagbami, A. O., & Adeyemi, O. (2023). Knowledge, attitude, and uptake of HIV pre-exposure prophylaxis among university students in Lagos, Nigeria. African Journal of Reproductive Health, 27(4), 45–56. https://doi.org/10.29063/ajrh2023/v27i4.5
Aminu, R., Yahaya, S., & Ibrahim, M. (2024). Time poverty and HIV risk behaviors among female university students in northern Nigeria. Journal of Gender Studies, 33(2), 210–225. https://doi.org/10.1080/09589236.2024.2301456
Eze, C. O., Eze, J. E., & Okonkwo, I. (2025). Assessment of adequacy and determinants of HIV related knowledge among senior secondary school students in Abakaliki, Nigeria. Scientific Reports, 15(1), 81582. https://doi.org/10.1038/s41598-024-81582-w
Muhammad, I., & Usman, A. (2024). Vector-borne disease burden and HIV co-infection risks among university students in northern Nigeria. Tropical Medicine & International Health, 29(5), 412–420. https://doi.org/10.1111/tmi.13987
National Agency for the Control of AIDS. (2023). Nigeria HIV prevention roadmap 2023–2027. Abuja: NACA.
Oluwafemi, R. A., Adeyemi, O., & Eze, C. (2024). Socioeconomic predictors of HIV knowledge among Nigerian youth: A national survey. Journal of Public Health in Africa, 15(2), 123–134. https://doi.org/10.4081/jphia.2024.2345
Sani, A., & Garba, M. (2025). Awareness of, willingness to use, and experiences with Pre-Exposure Prophylaxis (PrEP) among university students in Nigeria. BMC Health Services Research, 24(1), 11459. https://doi.org/10.1186/s12913-024-11459-1
UNAIDS. (2024). The global AIDS update 2024. Geneva: Joint United Nations Programme on HIV/AIDS.
Yahaya, H., & Abdulkadir, R. (2023). Cultural barriers to HIV prevention uptake among Hausa university students in Kano. Journal of Water, Sanitation and Hygiene for Development, 13(9), 678–689. https://doi.org/10.2166/washdev.2023.145