HIV Knowledge and Acceptance of Provider Initiated HIV Testing and counseling Among Antenatal Care Attendees at General Hospitals in Lagos, Nigeria

Background: Most HIV infected pregnant women may not be aware of their positive status.Most of the children living with HIV today got infected as a result of mother to child transmission. Provider Initiated HIV testing and counseling is one of the strategies to improve uptake of HCT aimed at achieving zero new HIV infection among children.Objective: This study was carried out to assess the knowledge and acceptance of provider initiated HIV testing and counseling among pregnant women attending General Hospitals in Lagos State.Methods:This cross sectional study was carried out in July 2013. Using a multi-stage sampling method, 326 pregnant women seeking ante-natal care (ANC) in General Hospitals in Lagos State were selected. Information was collected with interviewer-administered questionnaires and data analyzed with Epi-info version 3.5.1. Chi square test was used to test for associations at a significance level of 5%.Results: Majority of the respondents were married (92.6%), Christians (81.0%),employed (71.2%), had tertiary education(77.9%), primips (53.4%) and the mean age was 29.89years.Knowledge of the various routes of MTCT was poor: during pregnancy 59.7%, vaginal delivery 37.1%, and breastfeeding 63.5%, Majority (70%) had good knowledge generally of HIV, MTCT and PMTCT. Majority(98.1%) accepted to be tested for HIV;among this group 85.5% accepted to be tested to enable themknow their status. Respondents who had tertiary education (p<0.001) and previous pregnancy (p=0.013) were more likely to have good knowledge of PITC. Good knowledge was associated with acceptance of PITC (p<0.001).Conclusion: Acceptance of provider initiated HIV testing and counseling was high among our study population. There is however a need to provide comprehensive information to improve their knowledge of specific routes of MTCT.Key words: PITC, MTCT, HIV, Nigeri

Burden of intimate partner violence in a Local Government Area, South-West, Nigeria- a cross sectional study of pregnant women

Background: Intimate Partner Violence (IPV) has become one of the most important reproductive and public health issue attracting global attention. Women may  experience violence at any point in their lives, but IPV during pregnancy is a  focused attack that puts not just one, but two lives at risk, the pregnant woman and the unborn foetus. The objective of this study was to ascertain the burden of intimate partner violence amongst pregnant women in Oyo East Local Government of Oyo State, Nigeria.Methods: This was a descriptive cross-sectional study. Three hundred and fifty  pregnant women aged 18-49 years were consecutively recruited from the sole secondary health care facility and 3 primary health care facilities randomly selected by balloting. A pre-tested semi-structured questionnaire adapted from the WHO Multi-Country Study on Women's Health and Domestic Violence was used to collect data. Data were analysed with SPSS version 16. Descriptive statistics, Chi square test and logistic regression were used to analyse the data at 0.05 significance level.Results: Majority of the respondents (72.0%) reported intimate partner violence,  while prevalence of 24.2% was obtained in the index pregnancy. Psychological  forms of intimate partner violence were the commonest and physical forms, the  least. The main types of physical violence experienced were slaps (72.0%), being hit (40.0%) and being kicked (34.7%). The main partner characteristics significantly associated with IPV included age 25-34 years, history of previous violent behaviour with other people and report of extra-marital affairs. Predictors of experience of physical IPV included: being in a polygamous family (OR= 0.3, 95% CI 0.1-0.8), being a skilled worker (OR= 7.2, 95% CI 1.9-27.4) and having a partner who abuse alcohol (OR=5.1, 95% CI 1.2-20.8).Conclusion: Intimate partner violence is common among pregnant women and is a threat to women's health

Use of HIV Screening Services and Sexual Behavior of In-School Adolescents in Surulere LGA, Lagos State

Background: The health and development of populations irrespective of where they live is dependent on their behaviour. Adolescents constitute a huge chunk of the global population. A high proportion of the burden of diseases therefore occur in this age group as well. The maturation process occurs throughout this period and behaviours adopted often last for life and are determinants of healthy adult life. High prevalence of Sexually Transmitted Infections including Human Immunodeficiency Virus has been documented in adolescents.Objective: This study was carried out to assess the use of HIV screening services and sexual behaviour of in-school adolescents in Surulere an urban community in Lagos State, Nigeria.Methods: Cross sectional descriptive study design was used. Simple random sampling was used to select 9 public senior secondary schools in Surulere Local Government Area. All the enrolled and willing students in SSS3 who were available during the period of data collection were included in the study (1,029). Information was collected with a self-administered questionnaire. Data analysis was done with Epi info version 3.5.4. Frequency tables were generated and analysis was explored using chi square at p<0.05.Results: The mean age was 16years.Majority of the students were in the 15-19years age bracket, females, Christians and lived in monogamous homes. All the three arms namely commercial class, arts class and science class were included. Less than one tenth of the students 90 (8.9%) had been screened for HIV infection. Among this group, more than half had tested once and 37.8% tested because they had participated in risky behavior. Fifteen percent were sexually active, among this group 20% engaged in transactional sex. Only 36.8% used condom at first sex which increased to 57.2% at last sex, however consistent condom use was practiced by 22.4%. Students who are sexually experienced (p<0.001) were more likely to have been screened while those in science class (p=0.012) were more willing to screen for HIV. Male students were more likely to have had sex (p<0.001).Compared to Science and Commercial students, those in Arts class were more likely to have had sex (p=0.004), use condoms (p=0.017) and use it consistently (p<0.001).Conclusion: Even though the adolescents in this study engage in risky sexual behaviour, use of HCT services and other STI prevention strategies was poor. It is essential that young people have access to and utilize all HIV prevention tools at their disposal.Keyword: HIV screening, sexual behaviour, adolescent, Nigeri

Sexually transmitted infections knowledge, practices and treatment: assessing facility treatment gap among female sex workers in Lagos, Nigeria

Background:  Globally as significant progress was made in reducing new cases of viral STI specifically HIV and HPV, new strains of antibiotic resistant STI causing organisms emerged. Key population having high burden of bacterial STI also have high prevalence and incidence of HIV. This study was carried out to assess knowledge about STI, HIV and HCT as well as to identify prevention and treatment practices for STI among brothel based female sex workers in two urban communities in Lagos state.Materials and Method: A cross sectional descriptive study design was used; sample size of 300 was calculated. The study population is females who sell sex in brothels in two communities in Lagos. Simple random sampling was used to select 15 brothels from the list of brothels compiled in each local government through community mapping. The rooms in the brothel were the unit of sampling, 10 female sex workers were interviewed in each of the brothels using a pre tested questionnaire. Data analysis was done with IBM SPSS statistics version 20. Frequencies percentages and means were generated. Relationship was demonstrated using Chi square at p<0.05Results: The mean age was 27.77 + 6.16, majority were less than 30years of age (72.0%), single (75.7%), from the southsouth zone of Nigeria (57.0%) and had at least a secondary school education (51.7%). Three quarters of the single FSW had steady sexual partners. A high proportion of the respondents still have misconceptions about routes of transmission and prevention of HIV. About half (53.3%) had good knowledge of HIV/AIDS, 90.0% knew that Ebola Virus Disease can be sexually transmitted and 62.0% had good knowledge of the symptoms of STI. A high proportion reported symptoms of STI (25.0% genital itching, 14.7% genital discharge). Treatment was obtained mostly from the chemist (44.0%) followed by self-medication (42.7%) and health facility (38.7%). Over two thirds have been tested for HIV. All the respondents reported condom use with paying and non-paying casual partners but consistent use was higher with paying partners. A high proportion (77.0%) reported burst condom which was treated by using antibiotics. FSW who were single (p=0.002) and those from the South South-zone of Nigeria (p=0.010) were more likely to be knowledgeable about STI symptoms. Young FSW (<24years) were more likely to use female condoms (p=0.023) and get tested for HIV (p=0.008).Conclusion: FSW in this study had high burden of STI and poor treatment practices. A high proportion also had poor knowledge of HIV and STI. Health workers did not play a major role in giving information about HIV/HCT and STI or in providing treatment. There is a need to promote referrals, linkages and contact between healthcare workers and this vulnerable group to ensure access to correct information and appropriate treatment.Keywords: STI, Female Sex Workers, Lago