COMPLETE SCHOOL PROJECT TOPICS & MATERIALS :
CHAPTERS: Chapter 1-5
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ABSTRACT
Knowledge, attitudes and sexual behavior change towards HIV/AIDS remains a primary goal of HIV prevention efforts. HIV and AIDS is one of the leading health problems in Nigeria where nearly 7.1% of the population had been infected by the disease in 2012. Thus, the purpose of this study was to evaluate the determinants of HIV/AIDS spread among youths (18-26) in Ikot Ekpene LGA of Akwa Ibom. The objective of the study was to ascertain knowledge of HIV prevention, the sexual behavior, the beliefs and practices linked with sexual promiscuity, to assess how the knowledge on HIV/ AIDS, social conditions, attitudes and the sexual behaviors of youths influence their spread of HIV/ AIDS. The literature reviewed indicated that the knowledge or information that high school youths have about HIV and AIDS is not accurate since they still have misconceptions about the diseases. Youths engage in sex from the age of 11 years (early adolescence). This exposes them to the risk of acquiring HIV due to the inaccurate knowledge that they have about prevention of the disease. Social conditions such as poverty also prevent youths from accessing VCTs and condoms, which they require to prevent the spread of the disease. Negative attitudes towards people living with HIV and AIDS hinder prevention of the disease by encouraging stigmatization. The study used a descriptive research design. The target population was youths in Ikot Ekpene LGA. The data was collected from a sample of 371 youths who were selected through a stratified sampling technique. The data was collected using questionnaires with structured and unstructured questions. Data analysis was conducted through descriptive statistics. The study found that 100% of the youths had heard about HIV and AIDS. At least 80% of the youths were aware of the major modes of HIV transmission, which include unprotected sex, sharing sharp objects, and blood transfusion. The study found that 44.7% of the youths strongly agreed that if a member of their family was HIV positive, the information should remain secret. Moreover, 63.1% of the youths strongly agreed that condom use education should be introduced in their schools and locale. The study found that 63.1% of the youths had had sex at least once in their lifetime and 56% of them used a condom in their last sexual intercourse. Moreover, 81.1% of the youths had gone for HIV tests. 53.8% of the youths stated that having unprotected sex was the main adverse social condition that exposed them to the risk of acquiring HIV. In addition, 27.1% were likely to acquire HIV/AIDS because of risky leisure activities such as drinking alcohol. The study concluded that the youths lack accurate information/ knowledge on HIV/ AIDS. The quality of information about the disease among youths should be improved to prevent the spread of the disease. Youths’ sexual behaviors and social conditions also expose them to the risk of acquiring HIV/ AIDS. Thus, youths should be encouraged to use condoms and refrain from risky leisure activities such as drug abuse. The government in collaboration with the community should address the stigma associated with HIV and AIDS to enhance its prevention.
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
HIV/AIDS has in the past decades had devastating effects on the youthful population, especially, youths by causing deaths and stigmatization. Prevention of HIV/ AIDS is critical for creating a healthy and productive population. According to WHO[i], 95% of the world population should have accurate knowledge about HIV and AIDS to prevent new infections. However, in low and middle-income countries only 24% and 36% of young women and men respectively have accurate knowledge about the disease. Lack of adequate knowledge prevents individuals from taking preventive measures such as using condoms to avoid acquiring HIV and AIDS.
A positive attitude towards HIV/ AIDS and the people living with it is required to enhance prevention. A positive attitude eliminates stigma and discrimination, thereby allowing individuals to go for HIV tests and seek medication. In the contrary, the negative attitude associated with the disease when it emerged in early 1980s still exists today. This is reflected in the stigma, fear, and discrimination that HIV/ AIDS patients face today. Individuals believe that HIV/ AIDS is a life threatening condition associated with death. They also associate the disease with behaviors that people disapprove such as homosexuality, drug use, sex work, and infidelity. The resulting increase in fear, discrimination, and stigmatization prevent individuals from going for HIV tests, disclosing their HIV status, and taking antiretroviral drugs[ii]. Reluctance to go for HIV test means that individuals are diagnosed late, making treatment less effective and increasing the likelihood of transmitting the disease.
According to[iii], safe sexual behaviors should be adopted to prevent the spread of HIV/ AIDS. This includes avoiding unprotected sex, anal sex, and having multiple sexual partners. Risky sexual behavior is still an obstacle to prevention of HIV/ AIDS since only 51% of individuals aged 15-49 years use condoms in Sub-Sahara Africa, Middle East, and Latin America[iv]. Globally, risky behaviors such as anal sex, oral sex, and having multiple sex partners are still common in most countries. CDC 2012 notes that poverty is one of the major social conditions that promote the spread of HIV and AIDS in urban and rural communities. Poor people might not be able to access condoms, information about HIV/ AIDS, and antiretroviral drugs due to limited financial resources. HIV patients who are not able to meet basic housing needs often find difficulties in maintaining regular care and adherence to medication. This increases their viral load and chances of transmitting the disease to others. Family rejection is another social condition that prevents the spread of HIV/ AIDS. According to UNAIDS[v], lesbians, gays, and bisexuals who are rejected by their families or caregivers are 3.4 times more likely to engage in risky sexual behaviors. Also, globally 34 million people were living with HIV at the end of 2011. An estimated 0.8% of adults aged 15-49 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions. Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults (4.9%) living with HIV and accounting for 69% of the people living with HIV worldwide[vi]. The number of people infected by HIV and AIDS in Sub-Sahara Africa is five times higher than in South, Southeast, and East Asia. According to UNAIDS[vii] worldwide number of people newly infected by the disease continues to fall. However, the rate of decline varies across regions and countries with the Caribbean and Sub-Saharan Africa having recorded the highest decline rates of 42% and 25% between 2001 and 2011 (UNAIDS 2012). However, the number of new infections in the Middle East and North Africa has increased by over 35% between 2001 and 2011. Similarly, the infection rate has been increasing steadily in Eastern Europe and Central Asia since 2007 (UNAIDS 2012). Overall, developed countries such as the US and Japan have the least prevalence of HIV and AIDS, whereas developing countries in Africa and the Middle East are the most affected. Developed countries have low prevalence rates because of access to advance and affordable health care services that have helped to control the spread of the virus. In most African countries, the prevalence is high due to poor health care systems and lack of access to medication such as ARVs and services such as HIV testing and counseling. Cultural practices such as wife in heritance have also increased the rate of infection in Africa.
In the African region, the prevalence of HIV/ AIDS has either decreased or remained stable in most countries in the last five years. In Nigeria, the national infection rate has declined from 10% in the late 1990s to approximately 5% in 2011[viii],[ix]. The decline is attributed in part to the increase in the use of condoms among the sexually active youths and adults[x]. In Uganda, the national HIV prevalence declined from 18.5% in 1992 to 5% in 2000[xi]. The remarkable decline was achieved through a strong political leadership that encouraged sexual behavior change among the youth to control the spread of the virus. Other causes of the decline included open discussions to share knowledge about HIV/ AIDS, as well as, a strong decentralized multi-sectoral and community response to the epidemic. By 2005, the prevalence rate had stabilized at around 6.4%. However, it rose to 6.7% in 2012 partly because of the government’s decision to promote abstinence only rather than safe sex as a prevention measure.
In Tanzania, the prevalence is high among the old age groups and women who have limited access to medication and information about the disease. Overall, Tanzania’s national prevalence rate is nearly 6.5% as at 2011[xii]. Rwanda has a low prevalence of only 3%, with women having a higher infection rate than men as at 2010. Over 60% of the adult population has satisfactory knowledge about HIV transmission and prevention in Rwanda[xiii]. In addition, the number of people going for HIV tests increased by 38% in 2010, thereby allowing the infected persons to seek medication in time. Somalia has the lowest prevalence rate of nearly 2%. However, knowledge of HIV transmission is poor and condom use is uncommon. The youths (18years and above) are among the most vulnerable groups because of their risky sexual behaviors, attitudes towards prevention of HIV/ AIDS, and inadequate knowledge about the disease[xiv]. Among the 15-19 years old, 70 percent are sexually active and the first sexual intercourse occurs before the age of 15 years among the girls. HIV/AIDS is mainly transmitted through sexual intercourse in the area[xv]. Thus, urgent intervention is needed to reduce the infection rate among youthful population.
1.2 Statement of the Problem
HIV/ AIDS remain one of the major health challenges that Nigeria is trying to deal with. The infection rate in the southern region is 26.3%, which is almost double the prevalence level. About 70% of 18-30 years olds are sexually active and the first sexual intercourse occurs before the age of 15 years among the girls[xvi]. The fact that HIV and AIDs is mainly transmitted through sexual intercourse is well documented. In this regard, majority of the youth in schools are at risk of being infected with HIV/ AIDS since they are sexually active. At least 95% of the youth should have accurate knowledge about HIV and AIDS to prevent the spread of the disease. In Nigeria, the government has embarked on improving the knowledge of the youth by introducing HIV/ AIDS education programmes in schools. This has increased the general awareness about HIV and AIDS among the youth. However, the information that the youth have is not accurate since they still hold myths and misconceptions about the disease. Lack of adequate and accurate knowledge prevents the youth from taking preventive measures such as using condoms to avoid acquiring or spreading HIV/ AIDS.
The community is expected to develop a positive attitude towards the youth living with HIV/ AIDS to prevent the spread of the disease. Accepting HIV positive youth is expected to eliminate stigma and discrimination, thereby allowing the youth to seek HIV tests and medication. However, stigma, fear, and discrimination continue to limit the participation of the youth in the prevention of HIV/ AIDS in Nigeria. Negative attitudes towards the youth living with HIV/ AIDS increase fear, discrimination, and stigmatization, which in turn prevent the youth from going for HIV tests, disclosing their HIV status, and taking antiretroviral drugs. This promotes the spread of the disease.
The youth are expected to adopt safe sexual behavior to reduce their vulnerability to HIV/ AIDS. The government through its HIV/ AIDS awareness campaign programmes continues to sensitize the public including the youth to avoid risky behaviors such as having unprotected sex. Nonetheless, the youth still engage in risky sexual behaviors due to social and economic conditions such as poverty. Social conditions such as poverty, gender inequality, and sexual violence should be addressed to prevent the spread of the disease. Gender inequality limits women’s ability to negotiate for safe sax with their partners. Pending the discovery of an effective vaccine, therapy, or curative treatment, reduction of risk-taking behavior is the only way through which the spread of HIV/AIDS pandemic can be arrested. In particular, the spread of the disease among the youth in school can be prevented if they avoid risky behaviors such as having unprotected sex. Access to adequate and accurate knowledge about HIV/ AIDS can also enhance prevention. The youth are likely to participate in the prevention of HIV/ AIDS if they have a positive attitude towards the disease. It is against this background that this study sought to evaluate the determinants of HIV/AIDS spread among youths (18-26) in Ikot Ekpene LGA of Akwa Ibom.
[i] WHO, (2014). HIV/AIDS and Adolescents. Retrieved from: http://www.who.int/child-adolescenthealth/ HIV/HIV_adolescents.htm.
[ii] Cameron, E. (2013). Scaling up the response to HIV stigma and discrimination. London: London School of Hygiene and Tropical Medicine.
[iii] Murtala, R. (2012). Knowledge and awareness of HIV/AIDS among some senior secondary school students in Katsina, Nigeria.BayeroJournal of Pure and Applied Sciences, 2(2): 121-126.
[iv] UNAIDS. (2014).Global reports on the AIDS epidemic. Geneva. Joint United Nations Programme on HIV and AIDs.
[v] UNAIDS. (2014).Global reports on the AIDS epidemic. Geneva. Joint United Nations Programme on HIV and AIDs.
[vi] Capacity Building International. (2013). Measuring HIV and AIDS and its socio-economic impacts. Bonn: Capacity Building International.
[vii] UNAIDS. (2012).Global reports on the AIDS epidemic. Geneva. Joint United Nations Programme on HIV and AIDs, pg 15-17.
[viii] NACC & NASCOP (2012), Nigeria AIDS epidemic 2012, Abuja, Nigeria Page 30-31
[ix] NASCOP. (2016). Sentinel surveillance of HIV and AIDS in Nigeria Report. Abuja: Ministry of Health Nigeria.
[x] Peltzer&Promtussananon (2015). HIV/AIDS knowledge and sexual behavior among junior secondary school students in South Africa – Journal of social sciences, 2005
[xi] Uganda AIDS Commission (2012). Global AIDS response progress report. Kampala. Uganda AIDS Commission.
[xii] NACC & NASCOP (2012), Nigeria AIDS epidemic 2012, Abuja, Nigeria Page 30-31
[xiii] NASCOP. (2016). Sentinel surveillance of HIV and AIDS in Nigeria Report. Abuja: Ministry of Health Nigeria.
[xiv] NACC. (2015). Nigeria National HIV/AIDS Strategic Plan 2005/6-2009/10. Abuja: Ministry of Special Program.
[xv] UNAIDS. (2013). Fact sheet on differences in HIV spread in four Sub-Saharan African cities. Retrieved fromhttp://www.data.unaids.org/Publications/IRC-pub03/Lusaka 99_en.html.
[xvi] Capacity Building International. (2013). Measuring HIV and AIDS and its socio-economic impacts. Bonn: Capacity Building International.