ABSTRACT
This study assessed socio-demographic
variables of sex, age, school location, and school type predicting HIV/AIDS
awareness and preventive measures among senior secondary school students in Edo
State using correlational survey design. The research participants were 937
senior secondary school students in Edo State. These respondents were sampled
from the three senatorial districts of Edo State using multi stage stratified
simple random sampling. The instrument used in the study was an adopted
questionnaire titled HIV/AIDS Awareness and Preventive Measures Scales
Questionnaire which was validated by two experts from the Department of
Community Health Medicine, Ambrose Alli University, Ekpoma. The data collated
were analyzed using percentage, mean, standard deviation and logistic
regression.
The findings revealed that
the socio-demographic variables significantly predict HIV/AIDS awareness and
preventive measures among senior secondary school students in Edo State. In
addition, it was also established that socio-demographic variables of age and
school location were the potent predictors of HIV/AIDS awareness and preventive
measures among senior secondary school students in Edo State. It was further
revealed that the odds of the students within the age bracket of 12 to 15 years
having good awareness of HIV/AID was 14.020 times higher than the odds of those
within the 16 and above years age bracket and that the odds of students in
rural schools having good awareness of HIV/AIDS was 11.021 times higher than
the odds of those in urban schools.
Based on the findings it
was recommended that there should be creation of more public awareness on
HIV/AIDS targeted particularly at the senior secondary school students with age
and school location bias, particularly on causes, mode of transmission, sex
education, management and control of HIV/AIDS. In addition, it was also
recommended that more public awareness on HIV/AIDS preventive measures targeted
particularly at the senior secondary school students within the lower age group
and those in the rural schools should be created. Government at all levels
should put policies in place to provide free HIV voluntary counselling for
students. Finally, HIV/AIDS education and HIV voluntary counselling training
should be intensified in the senior secondary schools curriculum to create HIV/AIDS
awareness and preventive measures among the senior secondary school students in
Edo State.
CHAPTER ONE
INTRODUCTION
Background to the Study
Human Immune-deficiency Virus and
Acquired Immune Deficiency Syndrome commonly known as HIV/AIDS has become one
of the leading causes of death in the world. HIV/AIDS is one of the most
challenging health problems of our era. HIV weakens the immune system, making
the body susceptible to opportunistic diseases that often lead to death. The
predominant mode of transmission is through heterosexual contacts followed in
magnitude by perinatal, transmission, where the mother passes the virus to the
child during pregnancy, delivery or breastfeeding. Other modes of transmission
are through infected bloods and unsafe injections (Nambatya, 2010).
The
global prevalence of HIV and AIDS shows that an estimated 39.5 million people
were living with HIV at the end of 2014 with 4.3 million people newly infected
with the virus. According to United Nation Programme of HIV/AIDS (UNAIDS, 2011)
there are over 25 million people living with HIV in sub-Saharan Africa, and
forty-five percent of new infection occurred in young people aged 15-24years.
In Nigeria, an estimated 4.1million people are living with HIV (UNAIDS, 2014).
Even though there is a decrease in the prevalence rate of HIV infection
worldwide, the pandemic continues to pose serious challenges to individuals,
families, communities and the nation, more so with new infections commonly
found among young people aged 15 to 24 years. HIV/AIDS therefore remains one of
the biggest social, economic and development challenges in Nigeria,
particularly among young people (Falaye and Adeleke, 2012). According to Shika (2014) young people are,
an important group and potential resource for prevention of HIV/AIDS, as it is
the younger generation that is most infected and affected. Young people are particularly
affected because many of them participate in risky activities including
unprotected sex with multiple partners. The situation is more compounded in
developing countries where many factors combine to contribute to their risk for
sexual and health problems such as sexually transmitted infections (STIs), and
early pregnancies. Young people are disproportionately affected by factors that
increase vulnerability to poor sexual and reproductive health. Due to their
physiological make up, adolescent girls are more susceptible to HIV infection
than adolescent boys. Age and gender differences, early marriage and poverty in
particular, influence sexual behaviour of young people (Dehne & Reidner,
2015).
Early marriages for girls and wide
age difference between them and their male partners could increase the
possibility of sexual coercion and reduce their skill of negotiation. Also, due
to poverty, young girls are forced into prostitution as a means of survival
(World Health Organization, 2012; Falaye & Adeleke, 2012). Other factors
documented contributing to young people’s risks for sexually transmitted
infections including HIV are risky sexual behaviour (UNAIDS/WHO, 2014),
incorrect and incomplete information (Lynn, Walberg & Margarine, 2016),
poor access to youth friendly services and low perception of risks (Faleya,
2008).
Agitation
for a change in the risky sexual behaviour among active population of Nigerian
society has led to series of conferences and seminars’ some of these are the
initiative taken by the Association of Commonwealth Universities (ACU) and
Association of African Universities (AAU) with a view to providing leadership
and developing policy papers for fighting the HIV/AIDS pandemic in Africa. The
conferences identified ways in which HIV/AIDS pandemic could be reduced if not
completely eradicated. One of such ways
is awareness which specifically was identified as the key to prevention of the
dreaded HIV/AIDS scourge (Ngarari, 2010).
Unfortunately, most young people who are basically worst hit, by the
HIV/AIDS scourge are unaware that, a healthy looking person can be living with
HIV/AIDS, and that their exposure to unprotected sex and other risky behaviour
are dangerous (Akisolu, 2014).
Demographic
is the study of a population based on factors such as age, race and sex among
others. The term socio demographic therefore, refers to a group defined by its
sociological and demographic characteristics. Socio-demographic variables then, are seen as personal statistics that
describe a specific population, income, level, gender, educational level, age,
location, race, ethnicity and family size.
Awareness
is the ability to integrate sensations to social environment in order to guide
behaviour. It includes the public or common knowledge or understanding about a
social, scientific or political issue. It is the ability to generate emotions
for the purpose of understanding relevant issues in one’s environment. It
follows that since awareness is the product of the cognitive process, it has a
relationship with human behaviour (Akinyemi & Okpechi, 2011). The awareness
possessed by a community refers to the understanding of that topic or issue. In
this case awareness is the ability of the secondary school students to know the
mode of transmission, prevention, control and management of HIV/AIDS.
The
way human beings respond to the events in their social environments is a
function of their awareness of the events. Thus, awareness of HIV/AIDS can be
high, moderate or low. A high awareness signifies that one has a good
understanding of the HIV/AIDS issue. With such high level of awareness he can
have a well informed opinion about it as well as respond appropriately to
effective measures. Average awareness means moderate knowledge of HIV/AIDS,
while low awareness implies that the individual finds it difficult to have a
good understanding of the issues relating to HIV/AIDS – the mode of
transmission, prevention, and therefore cannot respond to them appropriately by
taking the right steps. The concern to eradicate HIV/AIDS and the fact that
there is no cure yet for the disease has made prevention of HIV/AIDS infections
a cherished strategy. Awareness of HIV/AIDS is critical in the preventive
measures and treatment of HIV/AIDS
because it helps the individual, to make an informed decision about carrying
out any of the preventive measures, assess personal risk for HIV and further
develop a risk reduction strategy which will lead to behaviour change,
subsequent contribution to the reduction of HIV transmission.
Preventive measures of HIV/AIDS are
simply steps taken by anyone to checkmate the spread of HIV/AIDS. It may be
done by individuals to protect their own health and the health of those in
their community or may be instituted by government or other organizations as
public health policies. Preventive measures can either seek to control or aim
to empower. Awareness is necessary to enable an individual assume
responsibility to stop transmission of HIV/AIDS. There is no cure for HIV/AIDS
as at now, it is therefore possible to protect oneself and others from being
infected through self-education and behaviour that does not put an individual
at risk of infection and its attendance consequences (Centre for Disease
Control (CDC) 2011). The unabated spread of HIV/AIDS led to the introduction of
different preventive measures to mitigate the spread of HIV/AIDS. Some of these
preventive measures introduced by government and non-governmental organizations
are HIV voluntary counselling and testing, condom use, and sex education
(Centre for Disease Control, 2012).
HIV voluntary counselling and testing
is the process by which individuals or a
group of persons undergo counselling to enable them to make informed choices
about being tested for HIV, adopting healthy sexual behaviour and improving
quality of life if they test positive for HIV/AIDS (UNAIDS, 2012). One to one
preventive counselling has a particular contribution in that it enables frank
discussion of sensitive aspects of a client’s life style, causes, symptoms,
prevention and control of HIV/AIDS. The aims of counselling in HIV infection
are determining whether the life style of an individual places him or her at
risk; working with an individual so that he or she understands the risk;
helping to identify the meanings of high risk behaviour; helping to define the
potential for behaviour change; working with the individual to adhere and
sustain behaviour change and preparing the individual, couple or group for HIV
test through pre and post test counselling (CDC, 2013).
HIV voluntary counselling and testing
as core intervention and preventive measures against the spread of HIV consists
of three key segments; pre-test counselling, post-test counselling and follow
up counselling. Pre-test counselling aims at assessing the client’s motivation
for finding out his or her sero-status. Once the result of the test has been
obtained, the presenting client will enter into post-test counselling session
with his or her consent to receive the result of the test. Follow up
counselling is the continual counselling of people whether sero positive or
sero-negative.
Condom use is another HIV preventive measure
aimed at preventing the spread of HIV/AIDS particularly among the sexually
active men, women, boys and girls. There are both male and female condoms.
Condom is over 90% effective if it is used correctly. Another form of HIV
preventive measure is abstinence. This is the process of abstaining from sex.
It is particularly good for those that are not married but engage in sex for
pleasure and conquest purposes. This HIV preventive measure is 100% effective.
Also very important in HIV preventive measures, are sex and health education.
Health and sex education are prevention practices aimed at implementing a scale
up of these HIV preventive measures at schools, community, local and national
levels. Health and sex education at schools are meant to expose students to the
causes, symptoms, preventive measures, control and management of HIV/AIDS.
Nigeria’s journey in addressing
HIV/AIDS began when the first case was identified in 1986. There was however,
an initial denial about the infection for four years, that is, from 1986-1990.
HIV infection spread unabated among the “at risk population or vulnerable
group” including uniformed men, women, girls, long distance trucks drivers,
youths and workers during the said period. The denial of HIV/AIDs fueled the
spread of the epidemic. The stigma and discrimination faced by the few known
HIV positive individual also drove the infection underground, slowly and
steadily, the number of HIV positive case grew (NACA, 2012).
Nigeria as a country is making
efforts into the world imperatives at ensuring that these measures are taken
into full consideration and implemented accordingly. These, in addition to
ensuring sexuality education is infused into the school curriculum or at least
given attention in schools, as imperative is a way of creating HIV sense of
awareness and preventive measures among students irrespective of their sex,
age, school location and school type. A cross-sectional study of HIV/ AIDS
awareness and preventive measures showed that male students were more likely to
have high awareness of HIV/AIDS but were less likely to have good preventive
measures than the female students. Students who are 35years old were also more
likely to have high awareness of HIV/AIDS preventive measures than students
between 12-17 years old. Since male seems to dominate sexual practices, it is
not unlikely therefore, that the females are always at the receiving end in
terms of number of those infected with the HIV/AIDS disease (Federal Republic
of Nigeria, 2009). Oyo-Ita, Ikpeme, Etokidem, Okokon and Etuk (2005) reported
high awareness of HIV/AIDS among secondary school adolescents in
Calabar-Nigeria. Murtala (2009) carried out studies on HIV/AIDS knowledge and
awareness among young senior secondary students in Katsina, Nigeria. Several
studies carried out to evaluate the knowledge of adolescents mostly under the
school based setting in Nigeria have identified gaps in awareness (Harding,
Anadu, Gray and Champeau 1999, Nwokocha & Nwakoby,2002; Odusanya &
Bankole, 2006). Alika (2013) also carried out studies on HIV/AIDS awareness
level of urban and rural adolescents in Edo State, Nigeria with emphasis on
implication for counselling. Ibrahim, Padeola, Adebayo and Fatuse (2015) carried
out HIV/AIDS awareness among secondary schools’ adolescents in South Western
Nigeria so as to strengthen advocacy and strategic sexuality education
programmes. Oladipo, Malomo and Ishmael (2014) considered demographic factors
of age, gender, religion and institution as a tool for predicting knowledge of
HIV/AIDS among undergraduates in a university in Nigeria
Several efforts have been made by
government and Non- governmental Organizations (NGOs) towards making young
people and adults aware of HIV with a view to preventing the spread of the
dreaded HIV/AIDS, yet it remains unabated as there is a consistent problem with
having an HIV/AIDS free society especially among the youths who are mainly
students in the secondary schools who are more vulnerable because of their
exploratory and experimentation tendencies. Apart from the fact that the lives
of these youths are jeopardized by their risky behaviours, the economic, social
and political life of the countries in which they operate is also jeopardized.
It is against this backdrop that this study seek to assess, the
socio-demographic variables (sex, age, school location and school type)
predicting HIV/AIDS awareness and preventive measures among the senior
secondary school students in Edo state.
Statement of the Problem
HIV/AIDS has caused immense human
suffering in the world over. The first case of AIDS in Nigeria was reported in
1986. The number of persons infected with the virus has risen markedly ever
since. In Nigeria, the HIV seropositive is 4.2 percent (Federal Ministry of
Health, 2015). Also UNAIDS (2011) had it that about 3.8 million Nigerians are
living with HIV/AIDS; Adults aged 15-49 prevalence rate is 4 percent; adults
aged 15 and above living with HIV is 3.3million; women aged 15 and above living
with HIV is 1.9 million; children aged 0 to 14 living with HIV is 510, 000;
deaths due to AIDS is 240,000 and orphans due to AIDS aged 0-17 is 2.5million.
The spread of the epidemic in Nigeria has been unprecedented with 1.8 percent
sero-prevalence rate in 1991 to 4.5 percent in 1996. In 2001, the
sero-prevalence was 5.8 percent and at the end of 2003, it was 5.0
percent. The HIV/AIDS epidemic in
Nigeria shows a lot of variation. According to the National AIDS Control Agency
(2016) HIV/AIDS still remain the biggest social economic and development
challenges in Nigeria.
The
impact of the disease has been mainly through the scattering morbidity and
mortality that disproportionately affects women during the prime of their
productive life. The consequences of the epidemy span across all spheres of
life (individuals and communities nationwide). It has imposed a severe and
unsustainable burden on the meagre health sector resources; as funds are
diverted from other areas to HIV prevention and AIDS care and treatment
services (Nambatya, 2010). The obvious effects of HIV/AIDS have been illness
and death. Unfortunately, the impact has not been confined to the health sector
alone; households, schools, workplace and economies have also been badly
affected. In sub-Saharan Africa, people with HIV-related diseases occupy more
than half of the hospital beds. Large number of young people is being directly
affected. The effects of HIV/AIDS on household can be very severe. In most
cases, HIV/AIDS causes the household to dissolve, as parents die and children
are sent to relatives for care and for their upbringing. It is hard to over
emphasize the trauma and hardship young people are forced to bear.
The spread of Human Immuno
-deficiency Virus (HIV), HIV/AIDS awareness and preventive measure has
generated a lot of concern among parents, teachers, counsellors, psychologists,
social workers, behaviour modifiers and government at all levels Akinsolu
(2014). Alemu, Abseno, Degu, Wandmilcum and Amasulu (2004) and Yazazhew and
Geland (2008) attributed the high level of HIV/AIDS prevalence among students
and youth to lack of knowledge of mode of transmission, symptoms, causes and
preventive measures of HIV/AIDS. Despite enlightment campaigns to create
HIV/AIDS awareness, attention on abstinence, sex education and HIV voluntary
counselling and testing, there seems to be no appreciable success in Nigeria.
Many factors have been attributed to the continuous increase; these include
poor circumcision practices, practice of concurrent sexual relationship, in
consistent use and poor practices of HIV voluntary counselling. Interestingly
these same factors are the major drivers of the HIV/AIDS pandemic in Africa.
According to NACA (2016) in its
update on HIV/AIDS programme in Nigeria,
HIV/AIDS is the greatest disease found among certain high burden states which
have high prevalence of infections of which Edo State with prevalence of 5.3%
is listed among the states. Furthermore, the Vanguard newspaper of May 16 2016,
sixteen thousand persons were said to be living with HIV in Edo state. This was
an official report given by Dr. Marietu Binkola, Project Manager Edo State
Agency for the Control of HIV/AIDS (EDO-SACA) at the forum to mark 2016
international AIDS candle light memorial held in Auchi Etsako West Local
Government Area of Edo State.
Although many studies on HIV/AIDS
have been carried out in Nigeria, the studies had focused on such issues as:
acceptability of HIV VCT among medical students; socio-demographic variable as
predictors of knowledge, attitude and behaviour of undergraduates in
reproductive health and HIV prevention; personal risk assessment of HIV/AIDS
infections among Nigeria adolescent girls in secondary schools and attitude
towards people living with HIV/AIDS among others. In the light of the above,
since young people have been identified as most vulnerable to HIV infection, it
is, therefore, pertinent to investigate and document, the awareness and
preventive measures of senior secondary school students in Edo State and also
to identify the socio demographic variables that would predict the HIV/AIDs
awareness and preventive measures. The present study therefore focuses on the
socio-demographic variables predicting HIV awareness and preventive measures
among the senior secondary school students in Edo State?
This study became imperative because in spite
of the high prevalence of HIV/AIDS in Edo State, there have been paucity of
indigenous studies that have examined
socio-demographic variables of sex, age, school location and school type
predicting HIV awareness and preventive measures among the senior secondary schools students in Edo
State. There is, therefore, a gap in knowledge. It was this gap in knowledge
that this study sought to fill.
Purpose of the Study
The broad purpose of this study was
to assess socio-demographic variables predicting HIV/AIDS awareness and
preventive measures among the senior secondary school students in Edo State.
Specifically the study helped to:
i.
ascertain if socio-demographic variables
(sex, age, school location and school type) predict HIV/AIDS awareness among
the senior secondary school students in Edo State;
ii.
find out whether socio-demographic
variables (sex, age, school location and school type) predict HIV/AIDS
preventive measures among the senior secondary school students in Edo State.
Research Questions
The following
research questions guided the study;
1)
Do socio-demographic variables (sex,
age, school location and school type) predict HIV/AIDS awareness among the
senior secondary school students in Edo State?
2)
Do socio-demographic variables (sex,
age, school location and school type) predict HIV/AIDS preventive measures
among the senior secondary school students in Edo State?
Hypotheses
The following hypotheses were tested in the study.
1)
Socio-demographic variables (sex, age,
school location and school-type) do not significantly predict HIV/AIDS
awareness among the senior secondary school students in Edo State.
2)
Socio-demographic variables (sex, age,
school location and school-type) do not significantly predict HIV/AIDS
preventive measures among the senior secondary students in Edo State.
Significance of the Study
The findings of this study is of
immense importance to students, school administrators, counsellors, social
workers, psychologists and other behaviour change agents as it would contribute
to the body of knowledge and increase information in the area of HIV awareness
and preventive measures. The findings will therefore help in planning effective
counselling programmes for secondary school students in Edo State.
It is envisaged that the findings of
this study will help health programme planners, health policy makers, Ministry
of Education and Ministry of Health as it would help them to review services so
as to provide student-friendly services and environment whereby students in
senior secondary schools could comfortably be at ease to undergo HIV voluntary
counselling.
Health Training Institutions will
benefit greatly from the findings of this study as they would incorporate the findings of the study in
their training curriculum, so that better pre-test, post-test and follow-up
counselling approaches could be adopted by the counsellors and nurses who are
the majority of para-counsellors in Nigeria.
The findings of this study are most likely
to be of great importance to different
stakeholders (counsellors, social workers, psychologists and educators) as it
would highlight the difference in HIV awareness and preventive measures in
senior secondary schools in Edo State along the line of demographic variables
of sex, age, school location and school-type.
This will bring to bear areas of concentration in advocacy programmes
aimed at increasing knowledge, positive attitude and practice of HIV voluntary
counselling among senior secondary school students in Edo State.
The findings of this study is also of
benefit to health educators, counsellors and researchers as they would be
provoked by the findings of the study to engage in more research work on HIV
awareness and preventive measures. This will help to produce more empirical
studies in the area of HIV awareness and preventive measures.
Scope of the Study
The
study covers socio-demographic variables predicting HIV/AIDS awareness and
preventive measures among senior secondary school students in Edo State. The
aspects of awareness covered include mode of transmission of HIV/AIDS,
symptoms, causes, management and control. The aspects of preventive measures
covered include: HIV voluntary counselling and testing, condom use and
abstinence.
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