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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 2  |  Page : 117-124

Knowledge, attitude, and behavioral practices pertaining to human immunodeficiency virus/acquired immune deficiency syndrome among secondary school adolescents in makurdi, Nigeria


1 Department of Chemical Pathology, Federal Medical Centre, Makurdi, Nigeria
2 Department of Veterinary Pathology and Microbiology, Federal University of Agriculture, Makurdi, Nigeria

Date of Web Publication14-Mar-2017

Correspondence Address:
Ayu Agbecha
Department of Chemical Pathology, Federal Medical Centre, Makurdi
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_112_16

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  Abstract 

Background: Adolescents knowledge with their safe practices pertaining to human immunodeficiency virus (HIV) has a critical impact on the prevention of contracting and spreading HIV. Reports have shown that adolescents in the general setting engage in activities that enhance the spread of the virus. Aim: The study assessed school adolescent's HIV/acquired immune deficiency syndrome (AIDS) knowledge, with its impact on their behaviors and attitudes regarding the infection. Materials and Methods: Two hundred randomly selected adolescent students from 10 different schools in the city metropolis were involved in the cross-sectional study. Primary data were collected using a validated self-administered questionnaire on students HIV/AIDS knowledge, attitude toward people living with HIV/AIDS (PLWHA), and safe practices preventing the spread of HIV/AIDS. Results: The study observed that majority of the students had good knowledge about HIV/AIDS, had good attitude toward PLWHA, and engaged in safe practices that prevent the spread of HIV. The sources of HIV/AIDS information were hospital, school, home, electronic, and print media. The study also found that HIV/AIDS knowledge instilled good attitudes and behavioral practices in the students. Conclusion: The study shows that school sex education, as well as health promotion campaigns through media platforms, could impact positively on the knowledge, attitude, and behavioral practices of adolescents in curbing the spread of HIV/AIDS.

Keywords: Attitude, human immunodeficiency virus/acquired immune deficiency syndrome, knowledge, students


How to cite this article:
Agbecha A, Gberindyer JS. Knowledge, attitude, and behavioral practices pertaining to human immunodeficiency virus/acquired immune deficiency syndrome among secondary school adolescents in makurdi, Nigeria. CHRISMED J Health Res 2017;4:117-24

How to cite this URL:
Agbecha A, Gberindyer JS. Knowledge, attitude, and behavioral practices pertaining to human immunodeficiency virus/acquired immune deficiency syndrome among secondary school adolescents in makurdi, Nigeria. CHRISMED J Health Res [serial online] 2017 [cited 2017 Apr 27];4:117-24. Available from: http://www.cjhr.org/text.asp?2017/4/2/117/201986


  Introduction Top


Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are one of the major health challenges in the world. Due to its potential negative impact on economic development, the prevention of new infections and further spread of the pandemic makes it one of the ten-millennium development goals.[1] Sub-Saharan Africa bears the greatest burden of the disease where 22.5 million people lived with HIV/AIDS at the end of 2007.[2],[3]

Adolescents are defined by the World Health Organization as persons between 10 and 19 years of age.[4] The incidence of new HIV infections is high among young people aged between 15 and 24 years. Youths account for 60% of people living with HIV/AIDS (PLWHA) and 40% of new infections in Africa.[2],[3],[5] Many adolescents around the world are sexually active and because many sexual contacts among them are unprotected, are at risk of contracting sexually transmitted diseases (STDs). Another reason given for their vulnerability to STDs is the lack of sex education and STD prevention.[6] Most parents do not discuss topics related to sexual issues, and hence many teens turn to peers and the media to get inaccurate information. Lack of close bond between children and parents is among the factors for increased vulnerability of youths to HIV/AIDS.[2],[7] Lack of parental responsibility is due to various reasons such as poverty, declining values, marital separation, and domestic violence.

School children of recent are exposed to the risk of being victims of HIV/AIDS, which was quite unknown to their predecessors a few decades ago. Program managers and policy makers have often recommended that schools could act as the center point for disseminating information and education on HIV/AIDS. Hence, school education has been described as a social vaccine and can serve as a powerful preventive tool. As children are a valuable resource for the future of a country, it is imperative that they are equipped with ample amount of information so as to protect themselves and their counterparts from falling prey to this incurable killer disease. To devise effective interventions for protecting youths from HIV/AIDS infection, understanding their level of knowledge on the infection and their sexual behaviors are important since little may be known on these aspects in the study group.

The general purpose of the study is to assess knowledge and its impact on attitude of secondary school adolescents regarding HIV/AIDS infection.

This study sought to find answers to the following research questions;

  1. What are student's sources of information about HIV/AIDS?
  2. What is the student's state of knowledge on HIV/AIDS transmission and prevention?
  3. How is the attitude of students toward PLWHA?
  4. How are the behavioral practices of students pertaining to HIV/AIDS spread?
  5. Is there any relationship between students HIV/AIDS knowledge and attitudinal behaviors.


The study tested two hypotheses;

  • Hypotheses 1: There is no significant relationship between students HIV/AIDS knowledge and attitude toward PLWHA
  • Hypothesis 2: There is no significant relationship between students HIV/AIDS knowledge and safe practices preventing the spread of HIV/AIDS.



  Materials and Methods Top


The population of study comprised all secondary schools in Makurdi metropolis. The use of this population enabled the researcher to have a fair picture of the level of HIV/AIDS knowledge of secondary school adolescents in Makurdi metropolis. Written informed consent was obtained from each subject at the time of selection. Ethical clearance was obtained from the state health ministry's Ethics Committee. The sample comprised 10 secondary schools with 220 students, randomly selected for the study.

The instrument for data collection in this study was an “HIV/AIDS knowledge and attitude questionnaire.” The Questionnaire consisted of five sections: A, B, C, D, E, and F. Section A measured the sociodemographic characteristics of students. Section B measured sources of information about HIV/AIDS. Section C measured HIV/AIDS transmission knowledge, Section D measured HIV/AIDS prevention knowledge, Section E measured the attitude of students toward PLWHA, and Section F measured the behavioral practices of students regarding the spread of HIV/AIDS. Section B to Section F was based on a 4-point Likert scale which ranged from, strongly disagree (scaled as one point) to strongly agree (scaled as four points). Totally, 220 copies of a structured questionnaire were distributed to students and were to be answered and returned the next day. Only 212 copies of the questionnaire were returned, and of this number, 12 were wrongly completed and therefore discarded. The 200 correctly completed and usable copies of questionnaire represented a response rate of 90.90%.[Additional file 1]

The statistical package IBM SPSS version 21 (IBM Armonk, New York, USA) was used in analyzing the data generated. Descriptive statistics were used in determining the means and percentages of responses. A decision cutoff mean was 2.00 (on a 4 point Likert scale) and percentage cutoff value of 50. Mean and percentage scores above the cutoff value were adjudged good (agreed), while mean and percentage scores below were adjudged poor (disagreed). Chi-square was used in determining the relationship between students HIV knowledge and attitude toward PLWHA/behavioral practices enhancing HIV/AIDS spread of comparing the means of parameters in CHBV and control groups. A two-tailed P< 0.05 was indicative of statistical significance.


  Results Top


The frequency distribution of respondents according to school is presented in [Table 1] while the demographic characteristics are presented in [Table 2].
Table 1: Frequency distribution of respondents according to school

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Table 2: Demographic characteristics of respondents

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Results in [Table 3] provide the answer to the research question, “What are student's sources of information about HIV/AIDS?” A high mean and percentage score was observed in all the sources of information about HIV/AIDS. This shows that hospital, television, relations, teachers, newspaper or magazines, friends, and radio were student's source of information about HIV.
Table 3: Student's sources of information about human immunodeficiency virus/acquired immune deficiency syndrome

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[Table 4] and [Table 5] provide the answer to the second research question, “What is the student's state of knowledge on HIV/AIDS transmission and prevention?” Results show that majority of the students demonstrated good knowledge on the modes of transmission and prevention of HIV/AIDS. Only 17.25% and 14.95% of students had poor knowledge on HIV/AIDS transmission and prevention, respectively.
Table 4: Student's human immunodeficiency virus/acquired immune deficiency syndrome transmission knowledge

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Table 5: Student's knowledge on human immunodeficiency virus/acquired immune deficiency syndrome prevention

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[Table 6] provide the answer to the third research question, “How is the attitude of students toward PLWHA?” Results show that majority of the students had good attitude toward PLWHA while 15.22% of students demonstrated poor attitude toward PLWHA.
Table 6: Student's attitude toward people living with human immunodeficiency virus/acquired immune deficiency syndrome

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The fourth research question, “How are the behavioral practices of students pertaining to HIV/AIDS spread?” is answered by data presented in [Table 7]. Results show that majority of the students engaged in safe practices that prevent HIV/AIDS spread. However, 33.33% engaged in unsafe practices enhancing the spread of HIV. A breakdown of respondent's behavioral practices pertaining to HIV/AIDS spread showed that only 40% of the students had one sexual partner at a time, while 39.75% refused sharing unsterilized instruments in barbing and hairdressing saloons.
Table 7: Student's behavioral practices pertaining to human immunodeficiency virus/acquired immune deficiency syndrome spread

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In testing hypotheses one “There is no significant relationship between students HIV/AIDS knowledge and attitude towards PLWHA.” Data presented in [Table 8] rejects the null hypotheses with a calculated Chi-square value of 15.97 and shows a statistical (P< 0.05) relationship between students HIV/AIDS knowledge and attitude toward PLWHA.
Table 8: Relationship of student's human immunodeficiency virus/acquired immune deficiency syndrome knowledge and attitude toward people living with human immunodeficiency virus/acquired immune deficiency syndrome

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A calculated Chi-square value of 7.98 obtained in the analysis of data presented in [Table 9] rejects hypothesis two of “There is no significant relationship between students HIV/AIDS knowledge and practices enhancing the spread of HIV/AIDS.” Results show a significant (P< 0.05) relationship between students HIV/AIDS knowledge and safe practices preventing HIV/AIDS spread.
Table 9: Relationship of student's human immunodeficiency virus/acquired immune deficiency syndrome knowledge and practices enhancing human immunodeficiency virus/acquired immune deficiency syndrome spread

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  Discussion Top


HIV/AIDS is one of the major health challenges in the world. Reports have shown that adolescents in the general setting engage in activities that enhance the spread of the virus. Adolescent's knowledge with their safe practices pertaining to HIV has a critical impact on the prevention of contracting and spreading HIV.

Seeking an answer to the first research question shows that newspaper/magazines, hospital, television, radio, teachers, friends, and relations were student's source of information about HIV/AIDS. Our finding corresponds to the works of Oladokun et al., who showed the major sources of information about HIV/AIDS as teachers and radio in-school students.[8] Furthermore, a similar study by Asekun-Olarinmoye et al. showed that electronic media (radio/TV) was the most frequent source of information about HIV/AIDS among respondents; other sources revealed by the author were school/teachers, parents, peers/friends, and posters/magazines.[9] A similar finding was reported by a study of sexual behavior, knowledge, and information sources of very young adolescents in four Sub-Saharan African countries which showed that close to 6 in 10 young adolescent's accessed information on sexual and reproductive health from schools in Ghana, Malawi, and Uganda.[3] In the Delta area of Nigeria, the electronic media was reported to be the main source of information about HIV/AIDS among in-school adolescents.[10] This finding is also consistent with findings by other studies.[11],[12],[13] In Malawi, information was obtained from radio, church, and word-of-mouth messages that AIDS is transmitted by easy partners, bar girls, and truck drivers, and from someone who looks very ill from AID.[14] Asekun-Olarinmoye et al. emphasized the importance of media based on the fact that mass media could reach most people in suburban communities in Nigeria for more media-driven health education campaigns.[9] It is apparent that the mass media has succeeded in creating awareness on HIV/AIDS; however, inefficient to impact sufficient comprehensive knowledge that will aid in controlling the disease. Oladokun et al. emphasized the use of the radio rather than other electronic media (e.g., television) as it reaches a wider coverage, it is cost-effective since it does not depend on constant electric power supply lacking in many communities in the country.[8] A school-based HIV prevention and education programs should be in place. The teachers should be empowered to be effective health educators and counselors and need to receive formal education or training in HIV/AIDS.

An answer to the second research question concerned with students preventive and transmission knowledge of HIV shows a high level of HIV prevention and transmission knowledge among the secondary school students. This study is in line with the study of Oladokun et al., that showed a high level of transmission/preventive knowledge and awareness of HIV/AIDS among secondary school students in the north central region of Nigeria.[8] A similar study conducted by Asekun-Olarinmoye et al., in the South-Western region of the country also revealed a high level of HIV/AIDS knowledge.[9] In a study conducted by Nwokocha et al., the majority of the respondents could identify the risk factors for the disease.[15] Similar to this study Asekun-Olarinmoye et al. revealed that majority of the respondents reported that HIV was preventable, while few of them thought it was not preventable or did not know whether it was preventable or not.[9] Responses from Asekun-Olarinmoye et al.'s study also showed that avoidance of sharing of sharp objects, use of condoms, health education, abstinence from sex and faithfulness were the commonly known preventive measures.[9] Several other studies also demonstrated a high level of awareness and knowledge of HIV/AIDS among secondary school students, based on their preventive and transmission knowledge.[16],[17],[18] However, in Nsukka, Eastern Nigeria, a study that assessed HIV/AIDS awareness among teenage students showed that their awareness of HIV/AIDS was low.[2] The difference in the level of awareness observed between our study and the Nsukka study could be because our study was carried out more recently and may reflect the increased and ongoing efforts nation-wide at increasing the level of awareness among the populace. Our study is contrary to the finding from other developing countries where low awareness of HIV has been documented.[19]

Providing an answer to the third research question regarding the attitude of students toward PLWHA, showed that majority of the students had a good attitude toward PLWHA. They expressed concern for PLWHA by agreeing to live in the same community with them, by proposing a social right of study/learning for them, agreeing to render help to them, feeling sorry for them and not discriminating against them. This is in line with the works of Asekun-Olarinmoye et al., who also showed that majority of the respondents had good and positive attitude toward PLWHA.[9] This finding is also consistent with that of Oladokun et al., who revealed the majority of the respondents displaying a positive attitude toward PLWHA, however, compared to HIV/AIDS knowledge, less number of students had a positive attitude toward PLWHA.[8]

The fourth research question regarding the behavioral practices of students preventing the spread of HIV showed that majority of the students engaged in healthy practices that prevent the spread of the virus. The majority of the students responded that they had only one sexual partner at the time, practiced sex abstinence, stuck to only one faithful partner, used condom each time they had sex and refuted sharing unsterilized barbing/hairdressing instruments with other people. However, the students never believed they could ever be infected with HIV. This finding is similar with Asekun-Olarinmoye et al.' s study who revealed fairly good behavioral practices amidst the respondents.[9] Oladokun et al. showed that majority of the respondents had no sexual partners.[8]

In testing the hypothesis of a relationship of students HIV/AIDS knowledge and attitudes, our study revealed that a good knowledge of HIV/AIDS has a positive impact on student's attitude toward PLWHA and behavioral practices preventing the spread of HIV.


  Conclusion Top


HIV/AIDS knowledge is considered as the most important weapon to fight against HIV/AIDS, and all efforts to curb its spread will be in vain unless adolescents including students are knowledgeable about it. Therefore, this study assessed the secondary school students' state of knowledge about HIV/AIDS and its relationship with attitudes. This study clearly showed students' impactful knowledge regarding HIV/AIDS and some modes of disseminating HIV/AIDS information. The study has established the fact that good knowledge has impacted positively on the attitude and behavior of the students. The study has also shown that knowledge alone is not enough to prevent HIV/AIDS, but strategies of instilling a positive attitude and better practices for preventing HIV/AIDS transmission should be implemented. It is quite important that secondary school students understand HIV prevention and transmission and have developed humanistic attitudes. The findings in the present study reiterate the need for re-enforcing school AIDS education by inclusion of sex education in secondary school curriculum, organization of health education/HIV preventive programs for schools, empowerment of teachers as effective health educators and counselors for HIV/AIDS prevention, intensification, and encouragement of the use of mass media in disseminating HIV/AIDS information.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

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Wilson PA, Stabinski L, Ruxin J, Binagwaho A. Meeting the millennium development goal for HIV/AIDS: Recommendations of the millennium project AIDS task force. International Conference on AIDS. Bangkok, Thailand; 2004.  Back to cited text no. 1
    
2.
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6.
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Oladokun RE, Jiboye J, Akinyemi JO. HIV awareness and sexual behaviour among in-school students in North-Central Nigeria. Rev Infect 2010;1:94-9.  Back to cited text no. 8
    
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Nwokocha AR, Nwakoby BA. Knowledge, attitude, and behavior of secondary (high) school students concerning HIV/AIDS in Enugu, Nigeria, in the year 2000. J Pediatr Adolesc Gynecol 2002;15:93-6.  Back to cited text no. 15
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]



 

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