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  • The Internet Journal of Health
  • Volume 14
  • Number 1

Original Article

Pattern Of Risk Behaviour For HIV Infections Among Undergraduates In A University

G D Mukoro, U Ogbuku, B Tabowei

Keywords

hair dressing needle, hiv, perception, risk factor

Citation

G D Mukoro, U Ogbuku, B Tabowei. Pattern Of Risk Behaviour For HIV Infections Among Undergraduates In A University. The Internet Journal of Health. 2013 Volume 14 Number 1.

Abstract

HIV/AIDS prevalence is highest among young people between the ages of 20 and 24.  Over 60% of new HIV infections in Nigeria are in the 15-24 year age range.
     The study done in at a tertiary Institution in Nigeria,  examined the pattern  of risk factors for HIV infection,  knowledge of HIV/AIDS,  sexual behavior, life style, stigma and discrimination among  the undergraduates, whose  VCT uptake  has been evaluated and reported. 
     It was a cross-sectional study. A semi-structured, self-administered, pre-tested questionnaire was used among undergraduate students. Student size was estimated using sample size formula. Hostels selected by ballot method while room was selected by abridge table of random sample. Data was summarised into simple frequencies, and percentages. Cross tabulations were made, further analysis done, using Microsoft-Excel 2007 Version for Pearson’s product correlation coefficients.
       A total of 378 students were recruited. Most participants were single 366(96.83%), with male to female ratio at 1:1.33 a nd  63.49% were within the 20–24 years of age. Data showed  persistence of risk behaviors  among undergraduates dsespite  sound knowledge of HIV route of transmission and preventive measures. Newly emanating  social risk behavior such as sharing of hair dressing needles was discovered among the studied participants.   
Further-analysis  revealed  that  independent  frequencies of self Perception of contracting HIV infection correlate to those who have multiple sexual partners and inconsistent use of barrier contraceptive such as condom at correlation co-efficient of (p=0.9965 and 0.4487) respectively.
       Pre and post-counseling sessions with emphasis on abstinence might influence risk behaviors  among these vulnerable age group that was studied.

 

Introduction


      For HIV to be transmitted from one person to another, there must be an exit point for the virus to pass out of the infected person and an entry point into the body of the uninfected person1. HIV is transmitted through the following ways: unsafe sexual intercourse (heterosexual and homosexual, intercourse without the use of a condom) with an infected person, injection or transfusion of contaminated blood 2 or blood products and through the sharing of unsterilized infected needles/other sharp objects, from an infected mother to her child during pregnancy, childbirth or breastfeeding3. Less commonly, HIV infection is also known to occur  through artificial insemination, skin graft and organ transplant4. There may be occupational exposure through which health care workers are exposed to  injuries from needles or other sharp objects.
There are concerns that there may be other routes of transmission of the virus, but currently, it is known that HIV is NOT transmitted through mosquito5 or other insect bites, sweat, saliva6, tears6, urine, feaces or everyday casual contact. Such casual contacts include sharing lecture rooms and other facilities like sanitary conveniences as well as shaking hands and hugging. People giving or receiving tattoos, piercings, and scarification are theoretically at risk of infection but no confirmed cases have been documented.7 Factors contributing to the spread of HIV in Nigeria include lack of sexual health information, education and HIV testing, as well as Cultural practices and poor health system8, Up until recently there was little or no sexual health education for young people and this has been a major barrier to reducing rates of HIV and other STDs. UNAIDS estimate that only 18 percent of women and 21 percent of men between the ages of 15 and 24  could correctly identify ways to prevent HIV9. Lack of accurate information about sexual health has meant there are many myths and misconceptions about sex and HIV, contributing to increasing transmission rates as well as stigma and discrimination towards people living with HIV/AIDS. Another contributing factor to the spread of HIV in Nigeria is the distinct lack of voluntary and routine HIV testing. In a 2003 survey, just 6 percent of women and 14 percent of men had ever been tested for HIV and received the results10. In 2005, only around 1 percent of pregnant women were being tested for HIV10. Over the last two decades, Nigeria's healthcare system has deteriorated as a result of political instability, corruption and a mismanaged economy 8. A large parts of the country lack  basic healthcare facility, making it difficult to establish HIV testing and prevention services, Sexual health clinics providing contraception, testing and treatment for other STDs are also few and far between11. This makes it difficult to keep the spread of the epidemic under control.
    Risk behaviors associated with  HIV infection have long been established, and more are yet to be investigated even as human civilization advances . Some behaviors  are wrongly  perceived  due to stigmatization of the disease by the  society. Over-enthusiasm to prevent  the disease has lead to the poor perception15 towards  PLWHA.

Methodology:   
    The research was conducted in a tertiary Institution (University) of Nigeria. Few hostels were selected at random by ballot method. The student rooms which the questionnaires was applied was selected by random sampling method using the Abridge table of sampling, between the month of February to August 2009. The University lies along the east west road. The Youth-friendly centre is located in the delta campus, opposite the main administrative block, the centre provide services such as VCT service for HIV, recreation and internet service.
     A semi-structured, self-administrable, Pre-tested questionnaires was designed and used to collect information on the knowledge of HIV/AIDS identified risk behaviors, and VCT uptake among undergraduates. Student size was determined by the formula

Figure 1

Student size was determined by the formula


Description:
n = required sample size
t = confidence level at 95% (standard value of 1.96)
p = estimated prevalence of malnutrition in the project area
m = margin of error at 5% (standard value of 0.05)
     Individual consents were sought from participants by  pre-consent statement before the questions were answered in the questionnaire. 378 questionnaires were used, 162 (43%) males and 216 (57%) females’ undergraduates, who were in the hostel on campus, eventually were included.
      The study was a  descriptive cross sectional survey. Random sampling method was employed; a sample frame was drawn containing comprehensive list and  hostels was selected by balloting  method.                             
      Data collation was done manually by sorting, and some variable recounted and cross-checked for errors. Summary statistics, simple frequencies, percentages, cross tabulations, were all computed.

Results

SOCIO-DEMOGRAPHIC CHARACTERISTICS OF PARTICIPANTS
A total of 378 proposed undergraduate students from University of Portharcourt community were enrolled in the study. There were 162 (43%) males and 216 (57%) females, giving a sex ratio of 1:1.33. Most of the students were single 366 (96.83%). 240 (63.49%) were within the 20–24 years of age, 372 (98.4%) were Christians followed by Muslims 4(1.06%) and few 2 (0.53%) belonged to other denomination. The distribution of students is shown in Table 1

TABLE 1

Socio-Demographic characteristics of participants

KNOWLEDGE OF RISK FACTORS FOR   HIV INFECTION AND PERCEPTION OF PREVENTIVE  MEASURES AMONG UNDERGRADUATES
            378 (98.68%) have heard about HIV/AIDS while 1.32% claimed ignorance. Furthermore, 360 (95.24%) agreed that HIV is contracted via sexual intercourse with infected individual, while greater than 70% of the total populations have the knowledge that the virus could be transmitted thru injections, blood transfusion, sharing clippers, and sharps/piercing objects respectively. 81 (21.43%) believed ,it could be contracted from kissing while only 4persons(1.06%) thinks ,it could be transmitted by eating and drinking with infected persons. Among the studied group only 155 (41.01%) have knowledge about VCT as preventive measure. Abstinence (85.9%),use of condom (50.26%) ,being  faithful to one partner (65.43%) were the most perceived measures of prevention. See chart 1,and 2. Questions giving rise to chart 1& 2 were multiple answer questions.

Figure 2

Chart 1: Bar Chart  of knowledge of risk factors among undergraduates

Figure 3

Chart 2: Bar Chart  of perception of preventive measures among undergraduates

RISK ASSESSMENT AND PERCEPTION OF CHANCE OF CONTRACTING HIV AMONG UNDERGRADUATES
Prevailing risks factors practiced among undergraduates students in the past six months were sharing of hair dressing needles, had tattoo or skin marks with sharp object, had received blood transfusions or had sexual activity under alcohol influence with rates at 48.41%, 5.03%, 14.81% and 9.26% respectively.  Among  the 378 students, 17 (4.50%) of them felt they have a good chance of contracting HIV, 68 (17.99%)  felt  moderate chance, while 266 (70.37%)  felts there was no chance of contracting HIV .see table 2 & 3
39 (33.91%) have multiple sexual partner table 3, 28 (24.35%) do not use condoms at all , 47 (40.87%) of them uses condom sometimes, while 38 (33.03%) used condom always See table 4   . The level of sharing information about VCT between sexual partners was high 61(53.04%), however only 48(41.74%) knew their partners sero-status see table 2.
More ‘so, statistic analysis revealed that the frequency of multiple sexual partners which is independent to their perception of contracting HIV correlates but to a lesser degree in terms of consistency in the use of condom. See table 4

Table 2

SHOWS SCENARIO OF SOME OF THE BEHAVIOURS OF UNDERGRADUATES THAT PUTS THEM AT RISK OF CONTRACTING HIV/AIDS.

Table 3

 SEXUAL BEHAVIOURS AND SELF PERCEPTION TO CONTRACTING HIV

Table 4

SEXUAL BEHAVIOR AND SELF PERCEPTION OF CONTRACTING HIV

DISCUSSION


     HIV  pandemic is  worst among youth  as a result of persistent risk behavior practiced among them as depicted  by the results of this study and also confirmed by other studies 12, 
     The study showed that students have some knowledge about HIV and its  routes of transmission. This fact have also been reported by other studies13,14 .Although some students perceive kissing  as a means of transmission of the disease while  quite a few  believed eating and drinking with HIV/AIDS  victim as means of transmission of the virus. Misconceptions13 are abound to occur in health issues associated with stigmatization. False believe such as eating and drinking with HIV victim as a mean of transmission could  be due to  poor perception 15  towards PLWHA.
       Most of the students believe that HIV is contracted through sexual intercourse. However, among the  HIV  preventive strategies abstinence is held in high esteem while only a handful of students. Worthy of note  from the study, two out of every five students consider VCT as a way of preventing  transmission of HIV virus16 . The drawback aforementioned showed the  fact that  important benefits of VCT services have not been appreciated by  students as buttresses by Mgosha et al 17. The study  also revealed that less than halve of these students with sexual partner knows their partner status. Attitude such as this could  be a setback for faithfulness to one partner. A little above  fifty percent told  their partner about VCT. 
      A third  portion 115 (30.42%) of the studied population had sexual partners in the past 6 months, 39:33.91% of them had multiple sexual  partners when compared with higher  proportion of 196 (65.3%) reported among Tanzania  health  care professional students 17. Risky behaviors in regards to their sexual life style appears to be at low level in this studied population when compared to the aforementioned Tanzania study. There is a frequency correlation between the degree of self perception of contracting HIV and number of sexual partners as well as frequency of use of condom see table4. The level of sharing information about VCT service between sexual partners is high but, less than half of those who had a sexual partner(s) in the past 6 months have knowledge about  their sexual partners HIV sero- status. See table 2    
      Approximately half  believed  in condoms as a preventive means to HIV/AIDS.  Almost a third of the students have  sexual partners. Two-third of these group either  inconsistently or do not use of condom. This fact undermine the  strategic effect of  pre and posttest-counselling sessions which was to in-still or re-enforce non-risky behaviors .
    The prevailing  risks factors among undergraduates students in the past six months were sharing of hair dressing needles , had tattoo or skin marks with sharp object, blood transfusions or sexual activity under alcohol influence with rates of these risks among 378 students at 48.41%, 5.03%, 14.81% and 8.44% respectively. Therefore  more work is yet to be  done to internalize the consequence associated with these risks behavior into the mind of the students. A high proportion of the sampled students perceive themselves to have no chance of contracting HIV. Mgosha et al   17 noted that only few students mentioned benefits such as change of behavior, getting support, early treatment for infected. Its worthy to note that  the relationship between knowledge and awareness and other behavioral factors is complex since there is no direct relationship. However this study showed that there is some degree of correlation between risk perception for contracting HIV to risk behavior but not individualized , even if their knowledge appears adequate to a large extent. 
     Further analysis  of results showed that despite the education status  and  sound  knowledge about HIV/AIDs among the studied group there was  still  risk behaviors practiced among them. This  might  have been  influenced  possibly by the kind of social interactions and practice. An example of such was sharing of hair dressing needle. Other risks behaviors are sexual activity under-alcohol influence and use of sharp object for inscribing tattoo. If this social activities are investigated further they may be  contributing significantly to the transmission of the virus significantly without notice.
To sustain preventive behaviors and attitude — such as delayed sexual debut  by youth, UNAIDS advocates a mix of mutually reinforcing approaches including youth-friendly services, sexual health education, and social mobilization.18
 

Conclusions

Conclusively , society and nongovernmental organizations and governments of every nation need to act urgently to secure the future  of youth thereby protecting  leaders of tomorrow through re-enforcing practice of good behaviors , enacting policies that would culminate in  reduction of  HIV burden among youths.

References

1. Teresa Kuret :Dissertation; a pre- and post-test study on the knowledge of grade 6 to 9 learners on HIV/AIDs and sexually transmitted infections .Faculty of Health Sciences, Nelson Mandela Metropolitan University, Supervisor: Dr. D.S. Elkonin, Co-Supervisor: Mr. F. Potgieter ,January 2005.
2. Gallo RC (2006). "A reflection on HIV/AIDS research after 25 years". Retrovirology 3: 72. doi:10.1186/1742-4690-3-72. PMC 1629027. PMID 17054781.
3. Markowitz, edited by William N. Rom ; associate editor, Steven B. (2007). Environmental and occupational medicine (4th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 745. ISBN 978-0-7817-6299-1.
4. Choice HIV/AIDS Initiative: Hiv transmission FAQS ,2009
5. Wayne J. Crans: Why Mosquitoes Cannot Transmit AIDS Rutgers Cooperative Extension Fact Sheet, FS736, begun on 7 July 1996 and last updated on 1 June 2010.
6. Centers for Disease Control and Prevention: HIV and Its Transmission". 2003. Archived from the original on February 4, 2005.
7. Center for Disease Control and Prevention. Basic Information about HIV and AIDS"April 2012.
8. Gemma S., “HIV and AIDS in Nigeria”, Averting HIV and AIDS. 2oo9.
9. Foundation for HIV/AIDs and kidney Dialysis inc: The AIDs epidemic in Nigeria , 2009
10. World Heath Organization, UNAIDS & UNICEF.‘Towards universal access: scaling up priority HIV/AIDS interventions in the health sector’, April, 2007.
11. Sofo, C.A. Ali-Akpajiak and Toni Pyke. ‘Social development and poverty in Nigeria’, Chapter 3 in ‘Measuring poverty in Nigeria', Oxfam Working Paper, 2003.
12. Travis S.,Teresa F., Amy D.,Stephanie B., Melissa C., Elizabeth D., Tricia H., Stacy K., Amy L.: surveillance summaries; Morbidity and Mortality weekly report ;Human Immunodeficiency Virus (HIV) Risk, Prevention, and Testing Behaviors --United States, National HIV Behavioral Surveillance System: Men Who Have Sex with Men, November 2003--April 2005, July 7, 2006 / 55(SS06);1-16.
13. R J DiClemente, C B Boyer, and E S Morales. Minorities and AIDS: knowledge, attitudes, and misconceptions among black and Latino adolescents.. American Journal of Public Health: January 1988, Vol. 78, No. 1, pp. 55-57.

14. Falaye AO, Uwakwe CB; Assessing the uptake of VCT services among Nigerian undergraduates. University of Ibadan, Ibadan, Nigeria, Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. ThPeC7470, International Conference on AIDS (15th : 2004 : Bangkok, Thailand).published 2004
15. Mukoro G D; Perception of Undergraduates Towards Voluntary Counseling and Testing and PLWHA in PortHarcourt Nigeria . African Journal of Applied Zoology and Environmental Biology. 2011.VOL.13. ISSN 1119-023X.
16. Mukoro GD. and Ogbuku U.; Uptake of VCT for HIV infection, Among Undergraduate Students IN Portharcourt, Nigeria ; African Journal of Applied Zoology and Environmental Biology ,2011.VOL.13. ISSN 1119-023X.
17. Mgosha .P .C. , Eliningaya .J. K. , Aneth. M .M., Longin. R. B., Seif. S., Hassan. M. N., Asanterabi .L. and Michael. J. M.: Research article; “Evaluation of uptake and attitude to voluntary counseling and testing among health care professional students in Kilimanjaro region, Tanzania” BMC Public Health 2009, 9:128doi:10.1186/1471-2458-9-128, Tanzania, Published: 9 May 2009.
18. USAID:ABCs of HIV prevention; Report on USAID technical meeting on Behavior change Approaches to primary prevention of HIV/AIDS. Sept 2012.

Author Information

George Duke Mukoro, B.Sc MBBS,MCS0,HSE
Niger-Delta University Teaching Hospital , Okolobiri, Yenogua
Bayelsa State , Nigeria

Uzoma Ogbuku, B.SC MBBS
Department of community medicine, University of Portharcourt
Portharcourt , Nigeria

B.I Tabowei, MBBS,FMCS.
Niger-Delta University Teaching Hospital , Okolobiri, Yenogua
Bayelsa State , Nigeria

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