Differences in sexual practices, sexual behavior and HIV risk profile between adolescents and young persons in rural and urban Nigeria

Introduction: We aimed to determine differences in sexual practices, HIV sexual risk behaviors, and HIV risk profile of adolescents and young persons’ in rural and urban Nigeria. Methodology: We recruited 772 participants 15 to 24 years old from urban and rural townships in Nigeria through a household survey. Information on participants’ socio-demographic profile (age sex, residential area, number of meals taken per day), sexual practices (vagina, oral and anal sex; heterosexual and homosexual sex; sex with spouse, casual acquaintances, boy/girlfriend and commercial sex workers), sexual behavior (age of sexual debut, use of condom, multiple sex partners, transactional sex and age of sexual partner), and other HIV risk factors (use of alcohol and psychoactive substances, reason for sexual debut, knowledge of HIV prevention and HIV transmission, report of STI symptoms) were collected through an interviewer administered questionnaire. Differences in sexual behavior and sexual practices of adolescents and HIV risk profile of adolescents and young persons resident in urban and rural areas were determined. Results: More than half (53.5%) of the respondents were sexually active, with more residing in the rural than urban areas (64.9% vs 44.1%; p \u3c 0.001) and more resident in the rural area reporting having more than one sexual partner (29.5% vs 20.4%; p = 0.04). Also, 97.3% of sexually active respondents reported having vaginal sex, 8.7% reported oral sex and 1.9% reported anal sex. More male than female respondents in the urban area used condoms during the last vaginal sexual intercourse (69.1% vs 51.9%; p = 0.02), and reported sex with casual partners (7.0% vs 15.3%; p = 0.007). More female than male respondents residing in the rural area engaged in transactional sex (1.0% vs 6.7%; p = 0.005). More females than males in both rural (3.6% vs 10.2%; p = 0.04) and urban (4.7% vs 26.6%; p \u3c 0.001) areas self-reported a history of discharge. More females than males in both rural (1.4% vs 17.0%; p = 0.04) and urban (15.0% vs 29.1%; p \u3c 0.001) areas self-reported a history of itching. Conclusion: There are differences in the sexual behavior and practices of adolescents and young persons’ residing in the urban and rural area with implication for HIV prevention programming

Evidence from epidemic appraisals in Nigeria

Although HIV prevalence has increased in most-at-risk populations (MARPs) across Nigeria, effective programming was difficult because Nigeria lacked information for prevention programmes to target interventions that maximise coverage and cost effectiveness. Epidemic appraisals (EA) were conducted in eight states to provide evidence for the planning, implementation and co-ordination of prevention interventions. Component 1: Mapping determined the size, typology and locations of MARPs. Component 2: Venue profiling identified and profiled venues where general populations engaged in high-risk behaviours. Component 3: Rural appraisals provided insights into risk behaviours and sexual networking in villages. States used mapping results to prioritise areas with a MARP coverage of 70% – 80% and then scale up interventions for non-brothel-based female sex workers (FSWs) instead of focusing on brothel-based FSWs. The eight states prioritisedf unding for the high-coverage areas to ensure a minimum coverage level of 70% – 80% of MARPs was reached. The refocused resources led to cost efficiencies. Applying venue profiling results, six states implemented interventions at bars and night clubs – previously not covered. States also maximised intervention coverage for high-risk general populations; this led to the use of resources for general population interventions in a focused way rather than across an entire state. States focused on condom programmes in rural areas. EA results provided the evidence for focusing interventions for high MARP coverage as well as forhigh-risk general populations. The states applied the results and rapidly refocused their interventions, increasing the likelihood of having an impact on HIV transmission in those states. Nigeria is now implementing EAs in the remaining 29 states to effect national-level impact

Radiation Doses in Fishing Water and Coast Soil in Lagos State South West Nigeria

Communication in Physical Sciences, 2022, 8(4):456 - 464 Authors: Kayode Idowu Ogungbemi*, Williams Igoniye ; Ibitoye Ayo Zaccheaus; Margret Abosede. Adedokun, Olusola Olurotimi OyebolaReceived: 11 July 2022/Accepted 30 September 2022 This study investigated the radionuclide concentrations in soils and waters of the Coastline and some selected aquatic commonly consumed in this area. Radioactivity levels were evaluated in their natural occurrences in the samples of water, soil and selected aquatic life from three different locations in the Mainland part of Lagos State (Makoko, University of Lagos waterfront and Bariga). Canberra High Purity Germanium Gamma spectrometer was used for the detection of radionuclides and determines the activity. The activity concentrations of Pb-214, Pb-212, Cs-134, and K-40 in the Soil samples of Makoko were found to be 7.89±0.51, 10.20±1.21, 0.69±0.10 and 67.37±2.52 Bq/kg, respectively. From the University of Lagos waterfront, the concentrations of the Soil samples were found to be 8.22±0.51 Bq/kg for Pb-214, 10.54±1.19 Bq/kg for Pb-212, 0.57±0.15 for Cs-134. For the selected Aquatic life (Tilapia Fish, Cat Fish and Crab) from these three locations of interest. The concentrations of K-40 ; Pb-214;Pb-212 Cd-113; Ni-59 in Tilapia fish from Makoko water body was 24.63 Bq\Kg; 0.568 Bq\Kg; 0.07 Bq\Kg; 0.16 Bq\Kg and ;1.65Bq\Kg , respectively. However recorded concentrations at the Makoko Catfish forK-40; Pb-214; Pb-212; Cd-113 and Ni-59 were11.75 Bq\Kg; 0.20 Bq\Kg; 0.04Bq\Kg;0.13Bq\Kg and 1.05Bq\Kg, respectively. The activity concentration showed insignificantvalues in the three locations based on Nigerian Basic Ionizing Radiation Regulation 2003, UNSCEAR 2008, ICRP 1983, and IAEA 2011 standards. &nbsp

Socio-demographic and Sexual Health Profile of Respondents (n = 773).

<p>Socio-demographic and Sexual Health Profile of Respondents (n = 773).</p

Sexual Profile of Sexually Active Respondents (n = 413).

<p>Sexual Profile of Sexually Active Respondents (n = 413).</p

Analysis and Estimated Daily Dose Intake of Toxic Metals in Commonly Used Building Materials and Its Health Impacts on the Society in Lagos, Southwest Nigeria

Communication in Physical Sciences, 2022, 8(3):331-338 Authors: Kayode I. Ogungbemi, Margret. B. Adedokun, Zaccheaus A. Ibitoye, Olusola. O. Oyebola, Joshua O. Ojo and Latifat R. Owoade Received: 01 February 2022/Accepted 12 June 2022 Toxic metals are persistent in our environment, and building materials are not left over from the contaminations of these metals. These toxic metals posed a great &nbsp;threat to human health. Some of these heavy metals such as lead have been identified as a potential human carcinogen, causing lung cancer. This study is on commonly used building materials and identifications of selected toxic metals present therein and their health implications to our society. The most commonly used building materials are &nbsp;&nbsp;asbestos, red bricks, pasters of paris (POP) and paints from major manufacturers. The samples of these building materials were collected from point of sales and toxic metals such as: Pb, Zn, Cu and Co were identified and quantified. Using Atomic Absorption Spectrophotometer (AAS) model S4 series, Model (GBC 906) (USA) for the analysis of the samples. The Estimated Daily Dose Intake (EDDI) of the detected toxic metals was computed. EDDI from POP due to Pb, Cu and Zn are 1.390x10-5, 1.812 x10-6 and 1.482 x10-5 mg/Kg/day respectively. For the paints, EDDI from paints are for Pb, Cu and Co are 9.900 x10-5, -1.156 x10-5 and 3.990 x10-5 mg/kg/day respectively. However; in red bricks the EDDI obtained are Pb, Cu and Zn are 1.844 x10-5, 8.711 x10-6, and 3.159 x10-5 mg/kg/day respectively. &nbsp;The EDDI from the Asbestos due to Cu was 1.578 x10-6 and 4.061 x10-5 mg/kg/day. EDDI in POP are as follows Pb, Cu and Zn, 1.396 x10-5, 2.990 x10-5 and 9.519 x10-6 mg/kg/day respectively. The ICRP has a set minimum permissible daily dose for each of the heavy metals however, the results so obtained in this study show that the Pb EDDI in Paints is 1.567 x10-4 mg/kg/day

Differences in Sexual Practices, Sexual Behavior and HIV Risk Profile between Adolescents and Young Persons in Rural and Urban Nigeria

We aimed to determine differences in sexual practices, HIV sexual risk behaviors, and HIV risk profile of adolescents and young persons' in rural and urban Nigeria.We recruited 772 participants 15 to 24 years old from urban and rural townships in Nigeria through a household survey. Information on participants' socio-demographic profile (age sex, residential area, number of meals taken per day), sexual practices (vagina, oral and anal sex; heterosexual and homosexual sex; sex with spouse, casual acquaintances, boy/girlfriend and commercial sex workers), sexual behavior (age of sexual debut, use of condom, multiple sex partners, transactional sex and age of sexual partner), and other HIV risk factors (use of alcohol and psychoactive substances, reason for sexual debut, knowledge of HIV prevention and HIV transmission, report of STI symptoms) were collected through an interviewer administered questionnaire. Differences in sexual behavior and sexual practices of adolescents and HIV risk profile of adolescents and young persons resident in urban and rural areas were determined.More than half (53.5%) of the respondents were sexually active, with more residing in the rural than urban areas (64.9% vs 44.1%; p<0.001) and more resident in the rural area reporting having more than one sexual partner (29.5% vs 20.4%; p = 0.04). Also, 97.3% of sexually active respondents reported having vaginal sex, 8.7% reported oral sex and 1.9% reported anal sex. More male than female respondents in the urban area used condoms during the last vaginal sexual intercourse (69.1% vs 51.9%; p = 0.02), and reported sex with casual partners (7.0% vs 15.3%; p = 0.007). More female than male respondents residing in the rural area engaged in transactional sex (1.0% vs 6.7%; p = 0.005). More females than males in both rural (3.6% vs 10.2%; p = 0.04) and urban (4.7% vs 26.6%; p<0.001) areas self-reported a history of discharge. More females than males in both rural (1.4% vs 17.0%; p = 0.04) and urban (15.0% vs 29.1%; p<0.001) areas self-reported a history of itching.There are differences in the sexual behavior and practices of adolescents and young persons' residing in the urban and rural area with implication for HIV prevention programming

Costs of HIV prevention services provided by community-based organizations to female sex workers in Nigeria.

BackgroundNigeria has been consistently targeted in sub-Saharan Africa as an HIV-priority country. Its main mode of transmission is heterosexual, and consequently, a key population of interest is female sex workers (FSWs). While HIV prevention services are increasingly implemented by community-based organizations (CBOs) in Nigeria, there is a paucity of evidence on the implementation costs of these organizations. This study seeks to fill this gap by providing new evidence about service delivery unit cost for HIV education (HIVE), HIV counseling and testing (HCT), and sexually transmitted infection (STI) referral services.MethodsIn a sample of 31 CBOs across Nigeria, we calculated the costs of HIV prevention services for FSWs taking a provider-based perspective. We collected 2016 fiscal year data on tablet computers during a central data training in Abuja, Nigeria, in August 2017. Data collection was part of a cluster-randomized trial examining the effects of management practices in CBOs on HIV prevention service delivery. Staff costs, recurrent inputs, utilities, and training costs were aggregated and allocated to each intervention to produce total cost calculations, and then divided by the number of FSWs served to produce unit costs. Where costs were shared across interventions, a weight proportional to intervention outputs was applied. All cost data were converted to US dollars using the mid-year 2016 exchange rate. We also explored the cost variation across the CBOs, particularly the roles of service scale, geographic location, and time.ResultsThe average annual number of services provided per CBO was 11,294 for HIVE, 3,326 for HCT, and 473 for STI referrals. The unit cost per FSW tested for HIV was 22 USD, the unit cost per FSW reached with HIV education services was 19 USD, and the unit cost per FSW reached by STI referrals was 3 USD. We found heterogeneity in total and unit costs across CBOs and geographic location. Results from the regression models show that total cost and service scale were positively correlated, while unit costs and scale were consistently negatively correlated; this indicates the presence of economies of scale. By increasing the annual number of services by 100 percent, the unit cost decreases by 50 percent for HIVE, 40 percent for HCT, and 10 percent for STI. There was also evidence that indicates that the level of service provision was not constant over time across the fiscal year. We also found unit costs and management to be negatively correlated, though results were not statistically significant.ConclusionsEstimates for HCT services are relatively similar to previous studies. There is substantial variation in unit costs across facilities, and evidence of a negative relationship between unit costs and scale for all services. This is one of the few studies to measure HIV prevention service delivery costs to female sex workers through CBOs. Furthermore, this study also looked at the relationship between costs and management practices-the first of its kind to do so in Nigeria. Results can be leveraged to strategically plan for future service delivery across similar settings

Efficiency of HIV services in Nigeria: Determinants of unit cost variation of HIV counseling and testing and prevention of mother-to-child transmission interventions.

BACKGROUND:Like most countries with a substantial HIV burden, Nigeria continues to face challenges in reaching coverage targets of HIV services. A fundamental problem is stagnated funding in recent years. Improving efficiency is therefore paramount to effectively scale-up HIV services. In this study, we estimated the facility-level average costs (or unit costs) of HIV Counseling and Testing (HCT) and Prevention of Mother-to-Child Transmission (PMTCT) services and characterized determinants of unit cost variation. We investigated the role of service delivery modalities and the link between facility-level management practices and unit cost variability along both services' cascades. METHODS:We conducted a cross-sectional, observational, micro-costing study in Nigeria between December 2014 and May 2015 in 141 HCT, and 137 PMTCT facilities, respectively. We retrospectively collected relevant input quantities (personnel, supplies, utilities, capital, and training), input prices, and output data for the year 2013. Staff costs were adjusted using time-motion methods. We estimated the facility-level average cost per service along the HCT and PMTCT service cascades and analyzed their composition and variability. Through linear regressions analysis, we identified aspects of service delivery and management practices associated with unit costs variations. RESULTS:The weighted average cost per HIV-positive client diagnosed through HCT services was US$130. The weighted average cost per HIV-positive woman on prophylaxis in PMTCT services was US$858. These weighted values are estimates of nationally representative unit costs in Nigeria. For HCT, the facility-level unit costs per client tested and per HIV-positive client diagnosed were US$30 and US$1,364, respectively; and the median unit costs were US$17 and US$245 respectively. For PMTCT, the facility-level unit costs per woman tested, per HIV-positive woman diagnosed, and per HIV-positive woman on prophylaxis were US$46, US$2,932, and US$3,647, respectively, and the median unit costs were US$24, US$1,013 and US$1,448, respectively. Variability in costs across facilities was principally explained by the number of patients, integration of HIV services, task shifting, and the level of care. DISCUSSION:Our findings demonstrate variability in unit costs across facilities. We found evidence consistent with economies of scale and scope, and efficiency gains in facilities implementing task-shifting. Our results could inform program design by suggesting ways to improve resource allocation and efficiently scale-up the HIV response in Nigeria. Some of our findings might also be relevant for other settings

Explaining the heterogeneity in average costs per HIV/AIDS patient in Nigeria: The role of supply-side and service delivery characteristics

<div><p>Objective</p><p>We estimated the average annual cost per patient of ART per facility (unit cost) in Nigeria, described the variation in costs across facilities, and identified factors associated with this variation.</p><p>Methods</p><p>We used facility-level data of 80 facilities in Nigeria, collected between December 2014 and May 2015. We estimated unit costs at each facility as the ratio of total costs (the sum of costs of staff, recurrent inputs and services, capital, training, laboratory tests, and antiretroviral and TB treatment drugs) divided by the annual number of patients. We applied linear regressions to estimate factors associated with ART cost per patient.</p><p>Results</p><p>The unit ART cost in Nigeria was $157 USD nationally and the facility-level mean was$231 USD. The study found a wide variability in unit costs across facilities. Variations in costs were explained by number of patients, level of care, task shifting (shifting tasks from doctors to less specialized staff, mainly nurses, to provide ART) and provider´s competence. The study illuminated the potentially important role that management practices can play in improving the efficiency of ART services.</p><p>Conclusions</p><p>Our study identifies characteristics of services associated with the most efficient implementation of ART services in Nigeria. These results will help design efficient program scale-up to deliver comprehensive HIV services in Nigeria by distinguishing features linked to lower unit costs.</p></div