ABSTRACT
Human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has become a global worrisome issue. This study was a survey research aimed at determining the level of awareness and preventive strategies of HIV and AIDS among in-school adolescents in Nsukka Education Zone of Enugu State. Mult stage random sampling technique was adopted in selecting 400 (200 males and 200 females) senior secondary two (SS2) students from 58 public secondary schools in Nsukka Education Zone of Enugu State. A researcher-made Awareness and Preventive Strategies for HIV and AIDS Questionnaire (APSHAQ) with reliability coefficient value of 0.79 was used for data collection. Research questions were analyzed by Mean and Standard Deviation while t-test statistics was used to analyzed the three null hypotheses.
Result of t-test analysis revealed a significant gender difference with regards to mode of transmission of HIV and AIDS disease but no significance difference existed between male and female students on source of information and preventive strategies of HIV and AIDS. These findings show there is need for proper awareness on mode of transmission and preventive strategies of HIV and AIDS among secondary school students who are sexually active and are at high risk of HIV infection. It was recommended among others that counsellors should effectively sensitize students on preventive strategies in order to curb HIV and AIDS spread and its associated health and psychological trauma. Also constant enlightenment campaign on the negative of HIV/ AIDS should be carried out in schools and communities to educate the youths, villagers, parents on the dangers of HIV and AIDS diseases.
CHAPTER ONE
INTRODUCTION
Background of the Study
The menace of HIV has affected every body in one way or the other in the whole world. Some children are rendered orphans, shops are closed, some schools are closed down due to few students in attendance, and some government offices are shut down due to death of the workers. Infact, all works of life are affected by HIV and AIDS particularly, the young people in schools. Alubo (2001) attested that adolescents because of their assertive and curious nature tend to explore, change, shape and confirm their ideas about life through experimentation. Hence, they have multiple sexual partners which expose them to the risk of contacting HIV and AIDS.
The word HIV and AIDS is an acronym for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). HIV is a virus that replicates in the body and can develop into acquired immunodeficiency syndrome (united national joint programme on HIV and AIDS, 2009). There are two types of HIV. HIV-1 and HIV -2. HIV-1 is the cause of the current worldwide pandemic while HIV-2 is found in West Africa and rarely else where. HIV-2, which is transmitted in the same ways as HIV-1, causes AIDS much more slowly than HIV-1 but clinically the diseases of both are very similar. HIV-1 and HIV-2 are thought to have arisen from two natural hosts both harboring simian immunodeficiency virus (SIV). HIV-1 resulted from human infection by SIVcpz that infects chimpanzees and HIV-2 resulted from infection by SIVsmm harbored by sooty mangabeys. (Goudsmit, 1997)
| 1 |
| 1 |
HIV-1 and HIV -2 have the same mode of transmission. According to Anike (2008) unprotected sexual intercourse is the main mode of HIV transmission through exchange of body fluid during sexual intercourse. This account for 80% chance of contacting HIV and
AIDS. Anongu (2007) stated that HIV can be transmitted through contaminated blood transfusion, or transfusion of infected blood and blood products, when the skin is pierced by needles, tattooing equipment, sharp barbing instrument like razor, clipper blades that have been contaminated with blood containing HIV. Also through mother to child during pregnancy, delivery or breastfeeding are the major mode of transmission of HIV. Some people fear that HIV might be transmitted in some other ways, however, no scientific evidence support any of those fears. Therefore, HIV cannot be transmitted through the following way, embracing, shaking, hands, living in the same house, sitting, eating, sleeping, working with an infected person, it cannot be spread through insect bites such as mosquitoes and bedbugs (Ryan, 2004). When infection with Human Immunodeficiency virus occurs through any of the mention routes of transmission, it infects attacks and gradually destroys vital cell such as CD4+T Helper cells (CD4+tIymphochytes) and monocytes and macrophages that regulate and coordinates the other cells. Once inside the cell HIV reproduce rapidly and massively destroy the cells. The dead cells releases HIV which infects the surrounding cells and the infections continues. The viruses are also attracted to the monocytes and macrophages, hide in them and are carried to the brain, lungs and Lymph nodes (World Health Organization, 2004). As CD4+T- cells are required for the proper functioning of the immune system, when enough CD4+T-cells have been destroyed by HIV, the immune system function poorly and result in the development of opportunistic infections such as Tuberculosis, kaposis, saccoma (a painful skin tension) fungal infections like candida, desophagites infection like puenmocy, stick and carmphenmonia that can kill the patient if not placed on treatment early and also result to AIDS. (World Health Organization, 2004).
Acquired immune deficiency syndrome (AIDS) is the last stage of Human Immunodeficiency virus (HIV), when a person’s immune system is severely damaged and has difficult fighting disease (Ejoka, 2006). Presently, HIV and AIDS is incurable, affecting all population groups, sexes age, races and socio-economic levels, (Okafor 1997). Commenting on this, Kaiser family foundation (2011) stated that HIV and AIDS causes have been reported in all regions of t he world, but most people living with the diseases reside in low and middle income countries. AIDS is now the leading cause of death and the fourth biggest globa killer in sub-saharan Africa (Kaiser, 2012).
United Nationals Joint Programme on HIV and AIDS stated that 22.5million people are Currently living with the virus in West Africa, Nigeria the most populous country in Africa has the highest number of 3.6 million of the patients in West Africa (UNAIDS, 2011). Nigeria ranks as one of the countries with the highest burden of the virus in the world, next only to India and South Africa. The report further stated that within the population of people living with HIV in Nigeria, females constitutes almost three fifth 58.3%, as about 1. 72 million women and girls are infected with HIV. Even more alarming is the fact that the highest prevalence rate of 5.6% occurs among the age groups of 14-24 years. Thus young people are infected with HIV in Nigeria. The report equally reveal that the April 2009 HIV and AIDS update indicated that an estimate 2.99 million consisting of 1.38million males and 1.61 females have so far died from HIV related causes in Nigeria. According to Kaiser, (2011) 220,000 people died from AIDS in Nigeria in 2009. With heterosexual sex factor accounting for an approximated 80-95 percent of infections in Nigeria. Apart from heterosexual sex factors, other factors include lack of information about sexuality, sexual health and sources of HIV transmission. Mother to child transmission each year is around 57,000 babies in Nigeria are born with HIV. It is estimated that 360,000 children are living with HIV in the country. In Nigeria, the prevalence varies among the geopolitical zones and states for instance, the prevalence ranges from as high as 10% in Benue State (North Central), 8% in Akwa Ibom State (South South Zone), 6.1% in Taraba State (North East Zone), 1.8% in Jigawa State (North West Zone), 1.6% in Ekiti State (South West Zone), and 6.5% In Enugu State (South East Zone) (Federal Ministry of Health, 2005).
Enugu state is one of the States in Nigeria that prevalence rate of HIV and AIDS is high. According to Enugu State Action Committee on HIV and AIDS (2011) report, out of 3.2 million people in the state the estimated number of people living with the virus is between 94,000-96,000 while the number of HIV negative people is about to 3.1 million. Investigation by ENSACA shows that the high prevalence rate of Acquired Immune Deficiency Syndrome in Enugu State was due to low knowledge about the disease by the majority of the people in the state. A review indicated that low risk perception; the belief by many people that they cannot contact the disease, further contributed to the spread of the scourge especially the rural people. The state with 6.5 percent prevalence rate has the highest in the South East and Fourth in the Nation and the pandemic is feared to be on the increase in recent times following indiscriminate sexual activities of teenagers and young adults who constitute a larger portion of the population.
High prevalence rate of HIV and AIDS in Enugu State lead to the formation of Enugu State action committee on HIV and AIDS, (ENSACA). They were charged with the responsibility of reducing the infection of HIV and AIDS in Enugu State. They urged those who have the virus not to panic but should join a support group where they would access HIV and AIDS drugs easily. In other to reduce the rate of HIV and AIDS in Enugu State, community health workers carried health education talks in schools, and health centres in communities on HIV and AIDS. Example, in Amanasato community in Aninri Local Government Area of Enugu State, two hundred and sixty-five person participated where 231 women, 45 were men and 5 were youth, they participated and benefited in the awareness talk on HIV and AIDS prevention education. In Opi Nsukka Local Government Area one hundred and twenty (120) community members were educated, majority of the participants were women with 93 in number, followed by 19 men and youth with only 10 people. At Ehandiagu in Nsukka Local Government Area a total of two hundred and fifteen (215) community members were educated, in attendance were 153 women, 39 men and 23 youths. Enugu State Government has Singed a memorandum of understanding with Excellence community education welfare Schem (ECEWS) to enable the organization have access and improve on the health facilities within Enugu State particularly in the prevention and transmission of HIV and AIDS (Arure, 2012).
Excellence Community Education Welfare Scheme (ECEWS) partnership with Americas Centre for Disease Control (CDC) would enable it resolve most of HIV and AIDS related problem. The State Commissioner for Health Dr Okey Eze regretted that the scourge of HIV and AIDS has made orphans even as the disease remains an enigma to confront. The effort of Enugu State Government and other non-governmental organization to combat HIV and AIDS were brought to lime light. Despite their efforts HIV and AIDS remain unabated.
A member of the coalition against HIV and AIDS in the State Mr John Arure, blamed inadequate awareness, poor approach and non-involvement of the local government in the crusade against the pandemic HIV and AIDS (Arure, 2012). Ezeh (2005) stated that factors such as poverty, ignorance, early sex debut, multiple sex partners, female genital mutilation unprotected sexual intercourse were the cause of high prevalence rate of HIV and AIDS that Onyeonoru & Adeboyejo (2005) was in the view that the high rate of HIV and AIDS infection was as a result of sexual practices of students. Sexual practices vary from culture to culture and from one location to the other. For examples, location of children, family, home and schools which children attended has been found to contribute to sexual activities. It is argued that the type of home environment as indicated by urban residential neighborhoods in which students live, and possibly work have implications for and may even compound sexual behaviours. Well laid- out- density home environment, characterized by expensive homes, and lawns where students living in separate rooms often beyond parental supervision watchful eyes and with access to product of modern technology, there is ample opportunity for various sexual experimentations among students (Onyeonoru & Adeboyejo, 2005).
Because of the high prevalence rate of HIV and AIDS a study was carried out to ascertain knowledge of sexual transmitted infection among senior secondary school students in Nsukka Urban by Anike, 2008. The findings of the study indicate that the student’s posses low level of knowledge on mode of transmission and preventive strategies of STI. In a study carried out by Akabueze (2006) reveal that majority of adolescents agreed that HIV and AIDS are real but, could not prevent them from having sexual intercourse and they fall between the ages 18-25 years. The available statistical data, write ups, findings from various researchers on HIV and AIDS in Enugu State indicate that HIV and AIDS is on rapid increase among the adolescents. This situation demands for concentrate action on the part of government, private sector and individuals to educate the adolescent on the danger of HIV and AIDS.
Adolescence is a period between childhood and adulthood which generally falls between the ages of 12-19. It spans to period from the appearance of secondary sex characteristics to mature physical growth and is the transition period from childhood to adulthood (Spear, 1996). From the definition it shows that adolescence is the transition period from childhood to maturity. Hanlon (2010) refereed adolescence as a period of sexual drive exploration field by misleading information from peers, prints and electronic media. Many adolescent face pressures to use alcohol, cigarette, or other drugs to initiate sexual relationship at earlier ages, putting themselves at high risk of infection from sexually transmitted infection including human immunodeficiency virus (HIV). Report from United Nations Joint Programme on HIV and AIDS (UNAIDS)(2011) Global summary of HIV and AIDS update indicate that young people between the ages 15-24 years are the people mostly affected by HIV and AIDS throughout the world. This show that adolescents are between the ages mostly affected with HIV and AIDS. It is in this view that awareness campaign against HIV and AIDS has to be intensified. This will help in checking the rapid spread and reduced new HIV infection.
Awareness is the state of ability to perceive fell be conscious of event, object or sensory patterns (Hornby, 2001). Talon, (2009) defined awareness as public, common knowledge or understanding about social, scientific and political issues. Hence many movements try to foster awareness of given subject like AIDS awareness. Awareness is creating and motivating people to get tested and learn their HIV status, as well as educating community members about the importance of the prevention and treatment. (Kevin, 2011) stressed that increasing knowledge and changing risk behaviours of adolescents were needed to stop the spread of HIV and AIDS. Most adolescents have hared of AIDS but there are many wrong ideas and myths about HIV and AIDS and the knowledge to stop the spread are still lacking (Achalu, 1996). Opined that awareness will provide important information Adolescent need to protect their health, love ones and get involved in sensitization of HIV and AIDS prevention strategies. In order to decrease the burden of HIV and AIDS in the world, people must be comfortable talking and learning about HIV, speak out against stigma, racism and other forms of discrimination associated with HIV and AIDS (Kevin, 2011). From my own point of view, Awareness is a common knowledge understanding and disseminating information about HIV and AIDS, its mode of transmission and possible preventive strategies. Diseases that kill people are preventable including HIV and AIDS.
The only vaccine against HIV and AIDS is prevention, since there is neither drugs to cure AIDS nor an effective vaccine to prevent HIV infection. Dunkey, (2000) defined prevention as a practice, strategy aimed at avoiding the occurrence or decreasing the possibility of infection. Disease control is a reactive strategy that adapts preventive measures to stop or reduce the transmission of HIV and AIDS infection or disease. These preventive measures according to him include personnel and environmental hygiene, good nutrition, immunization and utilization of health care services.
