Implementation of Family Life and HIV/AIDS Education in Nigerian Schools: A Qualitative Study on Scope, Delivery and Challenges

This study utilized data from Focus Group Discussions and In-depth Interviews among secondary school students and teachers to examine the scope, delivery and challenges of FLHE implementation within states and across geopolitical zones in Nigeria. Structural Functionalism, Rational Choice and Differential Association theories were adopted as theoretical framework. Results show that several patterns in classroom teaching of FLHE are identifiable across the country. The study found that FLHE is taught at the Junior Secondary and Senior Secondary levels with variations among States on the beginning levels. The main mode of FLHE delivery is classroom instruction; other modes include assembly talk and sensitization by organizations. Despite paucity of Information, Education and Communication materials and inadequate personnel requirement, different stakeholders noted that FLHE has been beneficial to students. Therefore, effective implementation of FLHE will go a long way to ensuring that young people in Nigeria are equipped with necessary information to enable them exhibit the right attitude and behaviour towards sexuality issues. Keywords: FLHE implementation, reproductive health, young people, youth corpers, sexual attitude.RésuméCette étude a utilisé des données provenant des groupes de discussion à cible et des entrevues en profondeur entre élèves et enseignants des écoles secondaires afin d'examiner la portée, l’actualisation et la mise en oeuvre de défis de la VFES au sein des Etats et entre les zones géopolitiques au Nigeria. Le fonctionnalisme structural, le choix rationnel et les théories l’association différentielle ont été adoptés comme cadre théorique. Les résultats montrent que plusieurs tendances dans l'enseignement en classe de la VFES sont identifiables à travers le pays. L'étude a révélé que la VFES est enseigné dans les deux cycles de l’école avec des variations entre les États à l’égard du niveau de commencement. Le principal mode de la réalisation de la VFES est l'enseignement en classe; d'autres modes comprennent des discours pendant la réunion matinale et la sensibilisation par les organisations. Malgré la rareté de l'information, l’éducation et les matériels de communication et les besoins insuffisants en personnel, les différents intervenants ont noté que la VFES a été bénéfique pour les élèves. Par conséquent, la mise en oeuvre effective de la VFES aidera beaucoup à assurer que les jeunes gens au Nigeria sont équipées d’informations nécessaires pour leur permettre de démontrer une bonne attitude et un bon comportement à l'égard des questions de sexualité. Mots-clés: la mise en oeuvre FLHE, santé de la reproduction, les jeunes, jeunesse, attitude sexuell

Age of Sexual Debut and Patterns of Sexual Behaviour in Two Local Government Areas in Southern Nigeria

The study examines the age of sexual debut and patterns of sexual behavior in Ugep, Cross River State, and Badeku and Olunloyo in Oyo State. A survey of households and individuals was conducted in the three communities; qualitative data were also collected through in-depth interviews and focus group discussion. The median age of first sex among never-married males and females were 17 years and 18 years respectively; more than one in five adolescents have had sex before age 16. Nevermarried males and females initiated sex earlier than ever-married, older respondents. That 14 percent of married men keep other sexual partners besides their wives is indicative of substantial extramarital relationship; also 12 percent of never-married male respondents with regular sex partners have other sexual partners. Condom use is fairly high, especially in sexual relations involving non-regular partners. The higher likelihood of alcohol use in sexual liaison with non-regular sex partners is suggestive of high prevalence of transactional sex and spontaneous or unplanned sex under the influence of alcohol, with their implications for the spread of HIV and AIDS. The study underscores the need for adolescent sexual and reproductive health education and behaviour change communication among all segments of the population and inculcation of values less favourable for the spreadof sexually transmitted infection.(Afr J Reprod Health 2012; 16[4]: 81-94)

A population-based cross-sectional study of age-specific risk factors for high risk human papillomavirus prevalence in rural Nigeria

<p>Abstract</p> <p>Background</p> <p>Cervical cancer, caused by persistent infection with carcinogenic human papillomavirus (HR-HPV), is particularly prevalent in Sub-Saharan Africa and is associated with a high mortality rate. Some studies in West Africa, including our own, have found unusually high HR-HPV across all ages with a slight peak in older women. This increased prevalence at older ages may complicate screen-and-treat programs, which are implemented in regions where HPV prevalence declines with age and typically target women between 30-49 years. A better understanding of the determinants of high HR-HPV prevalence at older ages is needed. The goal of this study is to explore risk factors for HR-HPV prevalence by age among women in our population-based study in Irun, a rural town in southwestern Nigeria.</p> <p>Methods</p> <p>1,420 women were administered a clinic-based questionnaire regarding sexual and reproductive behavior, marital status (including co-wives), and malaria exposure. Logistic regression compared questionnaire responses and PCR positivity for a set of 13 carcinogenic HR-HPV types. Results were stratified by age (15-29, 30-45, 46-55, and 56+ years).</p> <p>Results</p> <p>Birth control use and age at first pregnancy were associated with HR-HPV (<it>p-value </it>= 0.03 and 0.05, respectively). Early age at sexual debut and multiple sex partners were risks for HR-HPV, but did not reach significance (<it>p-value </it>= 0.1 and 0.07, respectively). Neither self-reported malaria nor presence of co-wives in the household was associated with HR-HPV (<it>p-value </it>= 0.85 and 0.24, respectively). In age sub-categories, early age at sexual debut was a significant risk factor for HR-HPV among women 35-45 years (<it>p-value = 0.02</it>). Early age at first pregnancy remained a significant risk factor for women aged 56+ years (<it>p-value </it>= 0.04). Greater than 2 sex partners and use of birth control were associated (though not significantly) with HR-HPV in women aged 30-45 (<it>p-value </it>= 0.08, respectively).</p> <p>Conclusions</p> <p>In this high-risk region with elevated HR-HPV prevalence at older ages, we confirmed previously described, behavioral determinants of HR-HPV. There was no association with self-reported malaria or co-wives, which we had hypothesized might correlate with HR-HPV at older ages.</p

Predictors of early sexual initiation among a nationally representative sample of Nigerian adolescents

<p>Abstract</p> <p>Background</p> <p>Early sexual debut among adolescents is associated with considerable negative heath and development outcomes. An understanding of the determinants or predictors of the timing of sexual debut is important for effective intervention, but very few studies to date have addressed this issue in the Nigerian context. The aim of the present study is to examine predictors of adolescent sexual initiation among a nationally representative sample of adolescents in Nigeria.</p> <p>Methods</p> <p>Interviewer-collected data of 2,070 never-married adolescents aged 15–19 years were analysed to determine association between age of sexual debut and demographic, psychosocial and community factors. Using Cox proportional hazards regression multivariate analysis was carried out with two different models – one with and the other without psychosocial factors. Hazard ratio (HR) and 95% confidence interval (CI) were calculated separately for males and females.</p> <p>Results</p> <p>A fifth of respondents (18% males; 22% females) were sexually experienced. In the South 24.3% males and 28.7% females had initiated sex compared to 12.1% of males and 13.1% females in the North (p < 0.001). In the first model, only region was significantly associated with adolescent sexual initiation among both males and females; however, educational attainment and age were also significant among males. In the second (psychosocial) model factors associated with adolescent sexual debut for both genders included more positive attitudes regarding condom efficacy (males: HR = 1.28, 95% CI = 1.07–1.53; females: HR = 1.24, 95% CI = 1.05–1.46) and more positive attitudes to family planning use (males: HR = 1.19, 95% CI = 1.09–1.31; females: HR = 1.18, 95% CI = 1.07–1.30). A greater perception of condom access (HR = 1.42, 95% CI = 1.14–1.76) and alcohol use (HR = 1.90, 95% CI = 1.38–2.62) among males and positive gender-related attitudes (HR = 1.13, 95% CI = 1.04–1.23) among females were also associated with increased likelihood of adolescent sexual initiation. Conversely, personal attitudes in favour of delayed sexual debut were associated with lower sexual debut among both males (males: HR = 0.36, 95% CI = 0.25–0.52) and females (HR = 0.38, 95% CI = 0.25–0.57). Higher level of religiosity was associated with lower sexual debut rates only among females (HR = 0.59, 95% CI = 0.37–0.94).</p> <p>Conclusion</p> <p>Given the increased risk for a number of sexually transmitted health problems, understanding the factors that are associated with premarital sexual debut will assist programmes in developing more effective risk prevention interventions.</p

Gender-related power differences, beliefs and reactions towards people living with HIV/AIDS: an urban study in Nigeria

<p>Abstract</p> <p>Background</p> <p>Although there are an increasing number of studies on HIV-related stigma in Nigeria, very little research has focused on how power differences based on gender perpetuate the stigmatization of people living with HIV/AIDS (PLWHA) and how these gender differences affect the care that PLWHA receive in health care institutions. We explore gender-related beliefs and reactions of society, including health care professionals (HCPs), with regard to PLWHA, using Connell's theoretical framework of gender and power (1987). With Connell's structural theory of gender and power (financial inequality, authority and structure of social norms), we can describe gender differences in stigmatization of PLWHA.</p> <p>Method</p> <p>We conducted in-depth semi-structured interviews, lasting 60 to 90 minutes, with 100 persons (40 members of the general public, 40 HCPs and 20 PLWHA) in Port Harcourt, Nigeria. The interviews were tape-recorded and transcribed verbatim. The Nvivo 7 computer package was used to analyze the data.</p> <p>Results</p> <p>There are similarities and differences between the general public and HCPs towards PLWHA in gender-related beliefs and reactions. For instance, although association with promiscuity and power differences were commonly acknowledged in the different groups, there are differences in how these reactions are shown; such as HCPs asking the female PLWHA to inform their partners to ensure payment of hospital bills. Women with HIV/AIDS in particular are therefore in a disadvantaged position with regard to the care they receive.</p> <p>Conclusion</p> <p>Despite the fact that men and women with HIV/AIDS suffer the same illness, clear disparities are apparent in the negative reaction women and men living with HIV/AIDS experience in society. We show that women's generally low status in society contributes to the extreme negative reactions to which female PLWHA are subject. The government should create policies aimed at reducing the power differences in family, society and health care systems, which would be important to decrease the gender-related differences in stigma experienced by PLWHA. Interventions should be directed at the prevailing societal norms through appropriate legislation and advocacy at grassroots level with the support of men to counter laws that put women in a disadvantaged position. Furthermore, development of a policy that encourages equality in access to health care for all patients with HIV/AIDS by applying the same conditions to both men and women in health care institutions is recommended. There is a need to protect women's rights through implementing support policies, including paying attention to gender in the training of HCPs.</p

Epidemic History and Evolutionary Dynamics of Hepatitis B Virus Infection in Two Remote Communities in Rural Nigeria

BACKGROUND: In Nigeria, hepatitis B virus (HBV) infection has reached hyperendemic levels and its nature and origin have been described as a puzzle. In this study, we investigated the molecular epidemiology and epidemic history of HBV infection in two semi-isolated rural communities in North/Central Nigeria. It was expected that only a few, if any, HBV strains could have been introduced and effectively transmitted among these residents, reflecting limited contacts of these communities with the general population in the country. METHODS AND FINDINGS: Despite remoteness and isolation, approximately 11% of the entire population in these communities was HBV-DNA seropositive. Analyses of the S-gene sequences obtained from 55 HBV-seropositive individuals showed the circulation of 37 distinct HBV variants. These HBV isolates belong predominantly to genotype E (HBV/E) (n=53, 96.4%), with only 2 classified as sub-genotype A3 (HBV/A3). Phylogenetic analysis showed extensive intermixing between HBV/E variants identified in these communities and different countries in Africa. Quasispecies analysis of 22 HBV/E strains using end-point limiting-dilution real-time PCR, sequencing and median joining networks showed extensive intra-host heterogeneity and inter-host variant sharing. To investigate events that resulted in such remarkable HBV/E diversity, HBV full-size genome sequences were obtained from 47 HBV/E infected persons and P gene was subjected to Bayesian coalescent analysis. The time to the most recent common ancestor (tMRCA) for these HBV/E variants was estimated to be year 1952 (95% highest posterior density (95% HPD): 1927-1970). Using additional HBV/E sequences from other African countries, the tMRCA was estimated to be year 1948 (95% HPD: 1924-1966), indicating that HBV/E in these remote communities has a similar time of origin with multiple HBV/E variants broadly circulating in West/Central Africa. Phylogenetic analysis and statistical neutrality tests suggested rapid HBV/E population expansion. Additionally, skyline plot analysis showed an increase in the size of the HBV/E-infected population over the last approximately 30-40 years. CONCLUSIONS: Our data suggest a massive introduction and relatively recent HBV/E expansion in the human population in Africa. Collectively, these data show a significant shift in the HBV/E epidemic dynamics in Africa over the last century

Like Mother(-in-Law) Like Daughter? Influence of the Older Generation’s Fertility Behaviours on Women’s Desired Family Size in Bihar, India

This paper investigates the associations between preferred family size of women in rural Bihar, India and the fertility behaviours of their mother and mother-in-law. Scheduled interviews of 440 pairs of married women aged 16–34 years and their mothers-in-law were conducted in 2011. Preferred family size is first measured by Coombs scale, allowing us to capture latent desired number of children and then categorized into three categories (low, medium and high). Women’s preferred family size is estimated using ordered logistic regression. We find that the family size preferences are not associated with mother’s fertility but with mother’s education. Mother-in-law’s desired number of grandchildren is positively associated with women’s preferred family size. However, when the woman has higher education than her mother-in-law, her preferred family size gets smaller, suggesting that education provides women with greater autonomy in their decision-making on childbearing

The correlates of premarital sexuality in Nigeria

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An Assessment Of Importance Of Children In Old Age Security Provisions Among The Ijebus Of South-West, Nigeria

The welfare of the elderly persons has received increased attention in recent years and the importance of children in old age security provisions is beginning to generate several public policy and academic concerns. In Africa, the care of older persons is falling on fewer children and those with least resources feel the impact. Hence childlessness in old age has been linked to isolation, ill health and poverty.This study set out to examine the importance of children in old age security provisions in Nigeria. Data was collected through individual-based questionnaire, this was used to elicit response to the above general objective and multi-stage sampling procedure was employed to select local government areas, enumeration areas and individuals for the study. In all, 810 respondents were interviewed. The respondents were elderly men and women aged 60 years and above. The study had mire female and rural respondents than male and urban respondents. Logistic regression model was used to determine the net effects of the explanatory factors on the welfare of the elderly. The data reveals that old age security depends on the level of supports from children (60%). Also, in terms of religion, while Muslims are 1.8 times more likely to, those who are adherents of African traditional religion are 3.5 times more likely to see children as an important source of old age security than those who are Christians. In the female model, those with primary education are 4.3 times more likely to see children as an important source of old age security provisions than those with secondary education. The study found that while education, religion, and family size are significantly related to the perception of children as an important source of old age security in the male model, in the female model, only religion established similar relationship. The study concludes that the welfare of the elderly requires the strengthening of social security system. Keywords: Welfare, Value of children, Old age security, Extended familAfrican Journal for the Psychological Study of Social Issues Vol. 11 (1&2) 2008: pp. 46-6