A STUDY OF HIV RISK BEHAVIOUR AND UPTAKE OF SCREENING

SERVICES AMONG STUDENTS

{62 PAGES}

DEPARTMENT OF PUBLIC HEALTH

SCHOOL OF HEALTH TECHNOLOGY
 ABSTRACT

The overall purpose of the study was to assess the forms of HIV risk behaviours and uptake of
screening services among undergraduate students. Specifically, the study identified the level of
uptake of screening services among undergraduate students; presents the determinants of
screening uptake among these students; examined the peer influence on HIV risk behaviour
among the students; and ascertained the relationship between indulgence in HIV risk behaviour
and uptake of screening services among students. A total of 392 students constituted the sample
size for the study. Data for the study were collected through structured questionnaire. Frequency,
Percentage, Mean statistics, Pearson’s correlation and ANOVA were used in data analyses.
Result showed that the majority (60%) of the students were male students with average age of 20
years; and majority (77%) of them frequently attend religious programs. The majority (80%) of
the students have tested for HIV and have known their status, due to the fear of the disease
and/or medical reasons; majority (87%) of the students have indulged in sexual intercourse, and
maintained an average of two sexual partner since the last 1 month. The majority (37%) of the
students use condom sometimes during sexual intercourse, and 73% have indulged in sexual
intercourse for money or material gratification. Data also showed that the majority (47%) of the
students indulge in casual sex, and 47% had their first sexual intercourse at age less than 18
years. The majority (57%) of the students have engaged in sex urged by alcohol or drug, whereas
in average, they consume alcohol up to 3 times in a month. All the students denied to have
shared syringe and needles with anybody. Result on peer influence revealed that the majority
(60%) of the students have not been persuaded by peers to have sexual intercourse, whereas 80%
of the students have greater than 5 sexually active friends, and (53%) have had sexual intercourse
with prostitute friends. The analyses of the study reveals that there is a significant association
between HIV risk behaviours and uptake for screening services. It is therefore recommended that
students should curtail to the barest minimum their level of indulgence in HIV risk behaviours
and always go for HIV counselling and screening in order to live healthy lifestyle.
 TABLE OF CONTENTS

CERTIFICATION
DEDICATION
ACKNOWLEDGEMENT
ABSTRACT
TABLE OF CONTENTS
LIST OF TABLES
CHAPTER ONE: INTRODUCTION
1.1 BACKGROUND
1.2 STATEMENT OF PROBLEM
1.3 JUSTIFICATION OF THE STUDY
1.4 RESEARCH QUESTIONS
1.5 OBJECTIVES
1.6 HYPOTHESIS OF THE STUDY
1.7 SCOPE/DELIMITATION OF STUDY
1.8 LIMITATION
CHAPTER TWO: LITERATURE REVIEW
2.1 INTRODUCTON
2.2 HIV RISK BEHAVIOUR DEFINTION
2.3 DETERMINANTS OF HIV RISK BEHAVIOUR
2.4 TYPES OF HIV RISK BEHAVIOURS
2.5 HIV SCREENING
2.6 HIV COUNSELLING
2.7 THE PAST AND THE CURRENT STATE OF HIV SCREENING SERVICES
2.8 IMPORTANCE OF SCREENING IN HIV CONTROL
2.9 OBSTACLES AFFECTING VCT UPTAKE
CHAPTER THREE: MATERIALS AND METHODS
3.1 STUDY DESIGN
3.2 AREA OF STUDY
3.3 STUDY POPULATON
3.4 SAMPLE SIZE AND SAMPLING METHODS
3.4.1 Sample Size
3.4.2 Sampling Methods
3.5 INSTRUMENT FOR DATA COLLECTION
3.5.1 Validity of The Instrument
3.5.2 Reliability of Instrument
3.6 METHOD OF DATA COLLECTION
3.7 METHOD OF DATA ANALYSIS
3.7.1 Decision Rule
3.8 ETHICAL CONSIDERATIONS AND INFORMED CONSENT
CHAPTER FOUR: RESULT AND DISCUSSION
4.1 SOCIO-DEMOGRAPHIC CHARACTERISTICS
4.2 LEVEL OF UPTAKE FOR SCREENING SERVICES
4.3 DETERMINANTS OF SCREENING UPTAKE
4.4 PEER INFLUENCE ON HIV RISK BEHAVIOUR
4.5 RELIABILITY ANALYSIS
4.6 RELATIONSHIP BETWEEN INDULGENCE IN HIV RISK BEHAVIOUR AND
UPTAKE OF SCREENING SERVICES
4.7 TEST OF HYPOTHESIS
CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATION
5.1 SUMMARY OF THE FINDINGS
5.2 CONCLUSION
5.3 RECOMMENDATIONS
REFERENCES
QUESTIONNAIRE
 CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND

Since 2000, around 38.1 million people have become infected with HIV and 25.3 million people

have died of AIDS related illnesses (UNAIDS, 2015). AIDS epidemic claimed 1.2 million lives

in 2014 alone and mainly occurs in sub-Saharan Africa that accounts for 66.6% of all people

living with HIV (UNAIDS, 2015). Young people are particularly vulnerable to both acquiring

and transmitting HIV and more than 50% of all new infections worldwide are among young

people between the age of 15 and 24. Based on the world health report, everyday 6000 youth are

infected with HIV (Tan et al., 2007).

The risk of getting HIV varies widely depending on the type of exposure or behaviour. HIV risk

behaviour traditionally includes activities such as unsafe heterosexual intercourse and other

unsafe behaviours like multiple sexual partnerships, inconsistent and incorrect condom use,

casual sex, sex with sex workers, substance use which includes heavy alcohol use before sex.

These behaviours amongst others are mentioned as the main reasons for increased risk of HIV

among youth and invariably drive the spread of HIV in sub-Saharan Africa and specifically in

Nigeria.

The sexual and drug-use activities of adolescents place them at increased risk for acquiring HIV

and other sexually transmitted diseases. Among US high school students in 2009, almost half had

ever had sexual intercourse and 14% had 4 or more sexual partners. Of those identified as being

currently sexually active, 39% did not use a condom the last time they had sexual intercourse

according to the center for disease control, youth risk surveillance (2009).
HIV risk behaviour is a significant problem among undergraduates. However, HIV/AIDS

epidemic is largely ignored and remains invisible to both young people themselves who in most

cases fail to utilize voluntary counselling and testing services and to the society as a whole.

They are more likely to carry the virus for years without knowing they are infected, consequently

the epidemic spreads beyond high risk groups to the broader population of young people thus

making control harder.

Undergraduate students are a unique subpopulation due to variety of factors including

developmental stage, living situation, participation in social networks and new financial

responsibilities which may predispose them to initiate sexual activity and indulge in sexual risk

behaviour that can result in getting HIV.

Determinants of HIV risk behaviour include sex, age, socio-economic status, peer influence,

beliefs and attitudes. Youths and adolescents are at greatest risk of STIs/HIV infection because

of individual, biological and cultural factors. The prevalence of HIV is higher among females

than their male counterparts. This can be attributed to their earlier initiation of sex; those female

youths/adolescents who would have sexual relation with older men usually don’t have

experience in negotiating safer sex.

In the absence of an effective vaccine and cure, voluntary counselling and testing has been used

as an entry point, a gateway to various prevention and curative interventions including

antiretroviral therapy. Testing for HIV antibodies is an important component of prevention and

intervention programmes designed to curb the spread of HIV infection.

Screening is an essential component of an effective response to the AIDS epidemic. It is an HIV-

Prevention intervention that the client initiates. Voluntary Counselling and Testing targets
behaviour change and research in many countries including Nigeria has demonstrated that people

who know their sero-status whether positive or negative drastically change their behaviour and

thus, screening is important in any HIV prevention effort. It also serves as a point of entry into

care and support for those testing positive. Screening gives clients an opportunity to explore their

HIV risks and to learn their HIV test results in complete confidence. It is client-centered in that it

is focused on each client’s unique issues and circumstances related to HIV risk. It is based on a

risk reduction model and the intervention is designed to reduce risk, not necessarily to eliminate

it (NASCOP, 2005).

1.2 STATEMENT OF PROBLEM

University going students, the main focus of this paper, are among the most at risk groups in

Nigeria. Studies indicate that a high proportion of university students, ages 17-24 years old are

sexually active with peaks in their first and second year of study (EAC/AMREE, 2010; Gitonga

et al 2012; Othero, Aduma & Opil, 2009). Mean age at sexual debut is 16.5 years which strongly

correlated with increased risk of HIV especially among young women (Gitonga et al 2012;

KNBS 2010).

Universities constitute a fertile breeding ground for HIV and AIDS as previous studies indicate.

Universities bring in close proximity devoid of systematic supervision a large number of young

adults at their peak years of sexual activities and experimentation (katahoire, 2004). Students

experience freedom from parental and school control. Nigerians are knowledgeable about HIV.

Unfortunately having HIV knowledge has not translated to behaviour change. Some students like

the first year female students are coerced and subjected to sexual harassment (Adam & Mutungi

2007). There are also reports of multiple sex partners among the students and inconsistent
condom use (Museve et al., 2013; Othero et al., 2009). Also concerns about relationships

between male and female faculty, not to mention prostitution among females as a means of self-

sustenance (Adam & Mutungi 2007; EAC & AMREF 2010). Given that that university students

are a sexually active group, the need screening services so as to know their HIV status. Only

10% of Nigerians know their HIV status according to the national agency for control of

HIV/AIDS. The utilization of Voluntary Counselling and Testing (VCT) services has continued

to decline. The rate of HIV counselling and testing among undergraduates, is equally low

(KNBS, 2010; NACC & NASCOP, 2012).

Universities show inconsistent in usage of screening services. University students are not

ignorant of the benefits of screening services yet few have utilized the services.

1.3 JUSTIFICATION OF THE STUDY

There are various factors related to the incidence of HIV among youths, but of particular and

worthy note among undergraduate students, include premature sex, sex with multiple partners,

unprotected sex, involuntary sex, intergenerational sex (sex with partners 10 years older), and

transactional sex , thus the need to research on this as:

 This study will help to identify the forms of HIV risk behaviour among students and serve

as a basis for providing health Education for them. The study will also identify the

relationship between student’s indulgence in risk behaviours and uptake of screening

services.

 This study will help to address a perceived gap in knowledge so that policymakers in

Nigeria can work to identify and eliminate the factors that can prevent Voluntary

Counselling and Testing (VCT) uptake among undergraduates and young people.
  The researcher hopes that the findings of this study would be beneficial to the government

and university authorities in formulation of polices and strategies to limit the negative

effects of HIV risk behaviour and non-utilization of screening services among

undergraduates and young adults in Nigeria.

 The researcher also hopes that the findings of this study would contribute to the data base

for further research on this topic in Nigeria.

1.4 RESEARCH QUESTIONS

This study would answer the following questions:

1. What is the level of uptake of HIV screening among youths?

2. What factors influence uptake of screening services among youths?

3. Is there a peer influence on HIV risk behaviour?

4. Is there a relationship between indulgence in sexual risk behaviours and screening uptake

among young people?

1.5 OBJECTIVES

General objective:

To study the forms of HIV risk behaviours and uptake of screening services among

undergraduate students.

Specific objectives:

1. To determine the level of uptake of screening services among undergraduate students.

2. To identify the determinants of screening uptake among these students.

3. To identify the peer influence on HIV risk behaviour among these students.
4. To identify the relationship between indulgence in HIV risk behaviour and uptake of

screening services among these students.

1.6 HYPOTHESIS OF THE STUDY

Ho; There is no significant relationship between indulgence in HIV risk behaviour and uptake

of screening services among these students

1.7 SCOPE/DELIMITATION OF STUDY

The study is limited to undergraduate students and to assess the HIV risk behaviours and its

relationship with utilization of screening services.

1.8 LIMITATION

In conducting a study like this, there are obvious limitations as to ways society perceive and

regard people who indulge in HIV risk behaviour. Students will be reluctant in giving out

information regarding the various HIV risk behaviours which they indulge in.

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