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Original Article

Assessment of Community‑Based Intervention Programs on the

Knowledge and Risk Perception of Allied Workers on HIV/AIDS

Abstract Ali Johnson Onoja,

Background: Adequate knowledge of HIV is an important tool in preventing and control of the Felix Olaniyi
virus. Workers in rural communities may not have assessed to adequate education and counseling Sanni1, Paul
on preventing themselves from acquiring the disease unless there is an intervention. This study
sought to assess the impact of 3‑year community‑based intervention programs on the knowledge Olaiya Abiodun2,
and risk perception of allied workers about HIV/AIDS in Bonny Kingdom. Methodology: This is a John Shaibu,
quantitative study that employed a structured questionnaire among a representative sample of allied Daniel Oguche,
workers aged 15–49  years. The data obtained included the sociodemographic characteristics such Imam Adamu,
as age, sex, education, occupation, and marital status and information related to HIV/AIDS. Data Sheila Onoja
were analyzed using SPSS version 25.0. Results: This study comprised baseline and postintervention
Department of Research, African
surveys with 419 and 587 respondents, respectively. The overall knowledge of HIV in both the
Health Project, Abuja Nigeria,
surveys was 77.3% and 86.4%. Baseline respondents showed a poor knowledge of mother‑to‑child 1
Department of Public Health,
transmission of HIV  (28.2%) and injection route of the disease  (37.7%) as compared to 66.9% and Triune Biblical University
73.4% among the intervention group. About 64.0% of the baseline respondents were at significantly Global Extension, NY, USA,
higher risk of acquiring HIV as compared to 18.1% among postintervention group (P < 0.001). 2
Department of Specimen
Thirty‑two (7.6%) had multiple sexual partners at baseline, while 21 (3.6%) had in postintervention. Referral, Axios International,
The proportion of respondents who had transactional sex or sex with sex workers was 13.4% in Abuja, Nigeria
baseline and 2.4% in the postintervention survey. Conclusion: This study has found a significant
improvement in the knowledge about HIV and reduction in risky sexual behavior among the allied
workers in an African rural community; it is advocated that this program be extended to other rural
communities on a regular basis.

Keywords: Condom, HIV/AIDS, intervention program, sexual behaviors

Introduction lack or poor knowledge of HIV and lack of

Adequate knowledge of HIV is an
important tool in preventing and control of
the disease. Nigeria is ranked number one
highest rate of HIV epidemic in sub‑Saharan
Africa and the second largest in the world,
yet many infected people are unaware of
their status.[1] Not <1.9 million people are
currently HIV positive in Nigeria though
Nigeria’s HIV prevalence is lesser among
adults than other sub‑Saharan African
countries.[1] While the prevalence of HIV
among adults in Nigeria is 1.5%, far below
20.4% and 11.3% among South Africa and
Zambia adults, respectively, 7% of the
Nigerian population aged 15–19  years are
HIV positive.[2]
The increasing HIV vulnerability, especially
among young people and rural dwellers, has
been associated with several factors such as
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knowledge of suitable sexual reproductive
health services.[1,3] The 2017 report of the
National Health Survey revealed that a very
low knowledge of HIV among Nigerians
aged 15–24 as only 29% of women and
27.9% of men in this age group could
rightly identify ways of preventing sexual
transmission of HIV.[4]
Submitted: 27-May-2020
Several studies have addressed the Accepted: 19-Jun-2020
Published: 11-Sep-2020
knowledge of HIV and sexual behaviors
among workers in urban settings and
migrant workers.[5‑9] Workers in rural Address for correspondence:
communities may not have assessed to Dr. Ali Johnson Onoja,
Research Department, African
adequate education and counseling on Health Project, Abuja, Nigeria.
preventing themselves from acquiring the E‑mail: onojaali@yahoo.com
disease unless there is an intervention.
Studies in this category are very few,
particularly in Nigeria. Allied workers Access this article online
constitute a very large proportion of Bonny Website: www.jscisociety.com
population due to the oil boom in the DOI: 10.4103/jss.JSS_46_20
environment, and the cultural and social Quick Response Code:
How to cite this article: Onoja AJ, Sanni FO,
Abiodun PO, Shaibu J, Oguche D, Adamu I,
et al. Assessment of community-based intervention
programs on the knowledge and risk perception of
allied workers on HIV/AIDS. J Sci Soc 2020;47:116-21.

116 © 2020 Journal of the Scientific Society | Published by Wolters Kluwer - Medknow
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Onoja, et al.: Knowledge and Risk Perception of Allied Workers on HIV/AIDS
behavior of these workers may on average represent the
entire population of the community.
A very large proportion of allied workers are sexually
active and work in the rural community where there are
vulnerable women that are ready to exchange sex for gift
or money. Besides, the vast majority of males among these
workers are separated from their families which provide
them ample opportunities to engage in a sexual relationship
with nonregular sexual partners and sex workers. Hence,
they are at higher risk of acquiring the disease. This study
sought to assess the impact of 3‑year community‑based
interventions programs on the knowledge and risk
perception of allied workers about HIV/AIDS in Bonny
Kingdom.
Methodology
This study was conducted in Bonny Kingdom located in the
coastal part of Rivers State. It occupies an area of about 2.72
sq/km and the population is slightly above 30,000 people. Due
to the oil boom in this area (some $ 30 Billion investment in
oil terminals and natural liquid gas production), Nigerians of
“all walks of life” from other tribes and professional foreign
expatriate staff employed by the company  (allied workers)
have settled in either on permanent or transient bases.
Interestingly as witnessed in other parts of the globe, the
presence of  Nigeria liquefied natural gas (NLNG) has also
attracted other service‑based industries. Anecdotal evidence
shows that several of the immigrant residents do not have
their families staying with them on the Island.
Due to the high incidence of HIV in Bonny Kingdom, a
preintervention survey was carried out in 2006 by the
Society for Family Health which was used as a base
document in the initiation of a 3‑year (2008–2011)
HIV/AIDS prevention intervention program. This survey of
HIV/AIDS‑related information was important to create an
effective HIV/AIDS intervention in the Island, and accurate
baseline data were obtained from the different risk and
work‑related groups.
The community‑based interventions include enlightenment
programs, training, free tests, and logistics supplies. After
3  years of intervention, the effectiveness or benefit of
the various kinds of interventions was assessed on key
elements on knowledge, attitudes, and practices and beliefs
using information extracted from this postintervention
survey.
This quantitative survey was carried out among allied
workers in the Bonny Kingdom, using a structured
questionnaire among a representative sample of the general
population aged 15–49  years. The aim is to compare the
findings of the survey before intervention with the findings
of the present survey (after intervention) to assess the
impact of the intervention program. The sample size
comprised 419 allied workers in the preintervention survey
and 587 in the postintervention survey. Data were inputted
Journal of the Scientific Society | Volume 47 | Issue 2 | May-August 2020
with CSPro and transferred to IBM® SPSS® Statistics
software version 25.0.
Ethical approval was obtained from the National Health
Research Ethics Committee, Federal Ministry of Health,
for the seroprevalence aspect of the study. In addition, in
line with the National Guidelines for mobile Voluntary
Counseling and Testing (VCT), the respondents’ informed
consent was sought and signed before the test was
administered. Respondents also had the option of opting
out or up taking the test after the counseling process and
confidentiality was strictly preserved with the client not
forced to give out names as their VCT forms were assigned
codes. Although the code was linked to the questionnaire
number, this has no link to the person and confidentiality
was guaranteed.
Results
This study comprised a baseline survey (before intervention)
and postintervention survey with 419 and 587 respondents,
respectively. The baseline survey comprised 221  (52.7%)
males and 198  (47.3%) females, while the postintervention
survey had 338  (57.6%) males and 247  (42.4%) female
participants. The age of the respondents in both the surveys
ranged from 15 to 49 years.
Respondents’ knowledge of HIV and AIDS
The level of knowledge of HIV among the workers
was high in both the surveys, though it was higher
in the postintervention survey. A higher proportion of
males showed a better knowledge of HIV/AIDS than
females in the postintervention survey as compared
to the baseline survey. The overall knowledge of HIV in
the baseline survey was 77.3% as compared to 86.4% in
the postintervention survey [Table 1].
Respondents’ knowledge of the routes of HIV infection
As shown in Table 2, the majority of the baseline (90.2%)
and postintervention  (97.4%) survey participants were
aware that one can acquire HIV through sexual intercourse.
Respondents from both the surveys were also aware that
HIV can be contracted through sharing sharp objects.
However, the baseline respondents showed a poor
knowledge of mother to unborn child transmission of
HIV  (28.2%) and injection route of the disease  (37.7%)
as compared to 66.9% and 73.4% among the intervention
group. Subknowledge  (51.6%) of acquiring HIV through
blood transfusion was also seen in the baseline survey
result as compared to 72.6% in the postintervention survey.
Respondents’ risk perception of contracting HIV
When asked whether the spread of HIV can be minimized
by sticking unto only one faithful uninfected sexual
partner, using a condom, only 55  (13.0%) respondents
agreed in the baseline as compared to 480  (81.7%) in the
postintervention survey. This poor perception at the baseline
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Onoja, et al.: Knowledge and Risk Perception of Allied Workers on HIV/AIDS

Table 1: Respondents’ knowledge of HIV/acquired immune deficiency syndrome

Characteristics Baseline (419) Postintervention (587)
Healthy‑looking HIV does HIV can Number of Healthy‑looking HIV does HIV can Number of
person can not have lead to respondents person can have not have lead to respondents
have HIV cure death HIV cure death
Sex
Male 84.2 62.7 86.0 221 91.4 75.6 97.7 338
Female 83.5 61.0 85.9 198 86.4 71.2 96.0 249
Level of education
No education/primary 78.6 56.4 85.1 88 80.7 72.7 97.7 52
Secondary 83.3 61.2 86.2 204 87.3 75.5 97.1 354
Postsecondary 89.2 67.6 86.0 127 97.6 70.9 96.1 181
Age group
15-24 84.1 58.9 84.6 99 80.8 71.7 99.0 165
25-34 83.9 63.5 88.8 191 91.6 75.9 96.9 182
35‑above 83.8 63.0 84.7 129 91.5 71.3 95.3 240
Marital status
Single 87.4 64.8 42.8 203 86.7 75.4 97.5 229
Ever married 80.7 58.9 86.1 216 91.2 71.8 96.3 338
Length of stay in bonny
<1 year 79.5 68.1 89.1 99 89.9 72.7 98.0 92
1-3 years 85.8 61.4 87.0 129 86.8 74.4 98.4 214
4 years‑above 74.8 60.2 84.3 191 90.1 73.3 95.3 281
Total 83.9 61.9 86.0 419 89.0 73.4 96.9 587

survey was observed across both sexes, all age groups,
level of education, marital status, and the length of stay
in Bonny (P  >  0.05). The perception of postintervention
survey participants was equally higher across all
sociodemographic characteristics than the baseline but
significantly higher among married respondents than the
singles (P < 0.05), [Table 3].
Respondents’ risk assessment
Respondents’ responses to personal risk assessment
questions, as shown in Table  4, revealed that 64.0% of
the baseline respondents were at significantly higher
risk of acquiring HIV as compared to 18.1% among
postintervention group (P  <  0.001). Thirty‑two  (7.6%) had
multiple sexual partners in the baseline, while 21  (3.6%)
had in postintervention. The proportion of respondents who
had transactional sex or sex with sex workers was 13.4% in
baseline and 2.4% in the postintervention survey.
Discussion
The results of these surveys revealed the positive impact
of community‑based interventions on the knowledge
about HIV among allied workers in Bonny Island. High
knowledge of HIV was seen in baseline and postintervention
surveys. Other studies have reported similar findings.[10‑16]
While the majority of the study participants in the
baseline survey had a good knowledge of HIV, they had
a poor knowledge of the mode of transmission of the
disease, even the majority exhibited a poor knowledge
of HIV transmission from mother to child. However,
good knowledge was observed among the group with
interventions. This study is in agreement with previous
studies that have found a poor knowledge of respondents
about the mode of transmission of HIV (mostly without
intervention),[16‑18] especially the transmission from mother
to child.[14,19] This emphasizes the need for intervention
in rural communities in the quest to end HIV by the year
2030.
High‑risk sexual behavior was seen among the baseline
participants in this study. More than three of every five
respondents were at risk of acquiring HIV in this arm of
the survey. The level of transaction sex and sex without
condoms is a subject of concern. A similar high level of
risky sexual practices has been reported in Nigeria[19‑21] and
in other places.[22‑24]
However, there were significantly reduced risky sexual
practices among the respondents at the intervention
arm. Previous studies have found positive impacts of
interventions in the improvement of people’s knowledge of
HIV infection and the declining prevalence.[25‑28] This has
been possible because community‑based interventions for
the prevention and control of HIV enable people to have
access to information and health‑care services.
Conclusion
This study has found a significant improvement in the
knowledge about HIV and reduction in risky sexual

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 Table 2: Demographic distribution of respondents who know how a person can get the virus
Characteristics Baseline (419) Post‑intervention (587)
Sexual Sharing Mother Injections Blood Total Sexual Sharing Mother Injections Blood Total
Intercourse sharp to unborn transfusion respondents Intercourse sharp to unborn transfusion respondents
object child object child
Sex
Male 92.8 79.6 24.9 35.7 53.8 221 97.5 92.1 69.8 77.2 74.1 338
Female 87.4 76.8 31.8 39.9 49.0 198 97.8 92.7 62.7 78.3 76.2 249
Level of education
No education/primary 80.7 59.1 17.0 26.1 33.0 88 91.3 79.1 56.1 51.2 60.0 52
Secondary 90.2 81.9 23.5 40.2 44.1 204 97.9 92.6 63.6 80.0 74.8 354
Postsecondary 96.9 85.8 43.3 41.7 76.4 127 98.8 95.2 75.0 80.0 79.1 181
Age group
15-24 84.8 74.7 23.2 34.3 36.4 99 96.0 88.0 67.9 71.3 75.7 165

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25-34 90.6 79.1 29.8 35.6 54.5 191 97.6 93.5 62.7 76.6 70.4 182
35‑above 93.8 79.8 29.5 43.4 58.9 129 98.7 94.5 68.7 82.8 78.0 240
Marital status
Single 90.6 81.8 26.1 37.9 47.3 203 97.3 93.4 67.2 80.8 80.5 229
Ever married 89.8 75.0 30.1 37.5 55.6 216 97.7 91.4 66.0 78.2 71.0 338
Length of stay in bonny
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<1 year 91.9 75.8 29.3 35.4 48.5 99 100.0 81.0 73.7 55.0 76.2 92
1-3 years 90.7 84.5 31.8 39.5 52.7 129 98.6 94.7 68.5 76.4 72.4 214
4 years‑above 89.0 75.4 25.1 37.7 52.4 191 95.5 83.1 63.3 77.4 61.7 281
Total 90.2 78.3 28.2 37.7 51.6 419 97.4 90.5 66.9 73.4 72.6 587
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Onoja, et al.: Knowledge and Risk Perception of Allied Workers on HIV/AIDS

Table 3: Respondents’ perception of reducing the spread of HIV by having sex with only one faithful partner and
using condoms
Baseline (419) Post‑intervention (587)
Agree (%) All respondents χ2 (P) Agree (%) All respondents χ2 (P)
Sex
Male 33 (14.9) 221 1.334 (0.248) 265 (78.5) 338 2.409 (0.121)
Female 22 (11.1) 198 208 (83.7) 249
Level of education
No formal education/primary 4 (4.5) 88 7.423 (0.024) 42 (80.0) 52 3.050 (0.218)
Secondary 30 (14.7) 204 279 (78.8) 354
Postsecondary 21 (16.5) 127 154 (84.9) 181
Age group
15-24 13 (13.1) 99 0.099 (0.952) 125 (75.9) 165 3.694 (0.158)
25-34 26 (13.6) 191 151 (83.0) 182
35‑above 16 (12.4) 129 198 (82.3) 240
Marital status
Single 29 (14.3) 203 0.463 (0.496) 174 (75.9) 229 5.228 (0.022)
Ever married 26 (12.0) 216 283 (83.7) 338
Length of stay in bonny
<1 year 17 (17.2) 99 4.356 (0.113) 79 (85.7) 92 1.034 (0.596)
1-3 years 20 (15.5) 129 183 (85.3) 214
4 years‑above 18 (9.4) 191 232 (82.5) 281
Total 55 (13.0) 419 480 (81.7) 587

Table 4: Respondents’ risk assessment

Personal risk assessment Baseline (419) Postintervention (587) χ2 P
Have multiple sexual partners 32 (7.6) 21 (3.6) 227.58 <0.001
Do not use condom with non‑regular sex partner/sex workers 41 (9.8) 16 (2.7)
Use intravenous injection 14 (3.3) 9 (1.5)
Partner has other partners 32 (7.6) 6 (1.0)
Had untested blood transfusion/injection 4 (1.0) 5 (0.9)
Had sex with SW/transactional sex 56 (13.4) 14 (2.4)
Had contact with PLWHA 26 (6.2) 23 (3.9)
Had suspicious partners 63 (15.0) 12 (2.0)
Overall 268 (64.0) 106 (18.1)
PLWHA=People living with HIV and AIDS

behavior among the allied workers in an African rural
community; it is advocated that this program be extended to
other rural communities on a regular basis. This will have
an overall positive impact on the prevention and control of
HIV in sub‑Saharan Africa and other low‑resource settings
across the globe.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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