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| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 47
| Issue : 2 | Page : 116-121 |
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Assessment of community-based intervention programs on the knowledge and risk perception of allied workers on HIV/AIDS
Ali Johnson Onoja1, Felix Olaniyi Sanni2, Paul Olaiya Abiodun3, John Shaibu1, Daniel Oguche1, Imam Adamu1, Sheila Onoja1
1 Department of Research, African Health Project, Abuja, Nigeria
2 Department of Public Health, Triune Biblical University Global Extension, NY, USA
3 Department of Specimen Referral, Axios International, Abuja, Nigeria
| Date of Submission | 27-May-2020 |
| Date of Acceptance | 19-Jun-2020 |
| Date of Web Publication | 11-Sep-2020 |
Correspondence Address:
Dr. Ali Johnson Onoja
Research Department, African Health Project, Abuja
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jss.JSS_46_20
Background: Adequate knowledge of HIV is an important tool in preventing and control of the virus. Workers in rural communities may not have assessed to adequate education and counseling 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 and risk perception of allied workers about HIV/AIDS in Bonny Kingdom. Methodology: This is a quantitative study that employed a structured questionnaire among a representative sample of allied workers aged 15–49 years. The data obtained included the sociodemographic characteristics such as age, sex, education, occupation, and marital status and information related to HIV/AIDS. Data were analyzed using SPSS version 25.0. Results: This study comprised baseline and postintervention surveys with 419 and 587 respondents, respectively. The overall knowledge of HIV in both the surveys was 77.3% and 86.4%. Baseline respondents showed a poor knowledge of mother-to-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. About 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 at 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. 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
How to cite this article:
Onoja AJ, Sanni FO, Abiodun PO, Shaibu J, Oguche D, Adamu I, Onoja S. 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 |
How to cite this URL:
Onoja AJ, Sanni FO, Abiodun PO, Shaibu J, Oguche D, Adamu I, Onoja S. Assessment of community-based intervention programs on the knowledge and risk perception of allied workers on HIV/AIDS. J Sci Soc [serial online] 2020 [cited 2020 Oct 26];47:116-21. Available from: https://www.jscisociety.com/text.asp?2020/47/2/116/294800 |
| Introduction | |  |
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 lack or poor knowledge of HIV and lack of 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]
Several studies have addressed the knowledge of HIV and sexual behaviors among workers in urban settings and migrant workers.[5],[6],[7],[8],[9] Workers in rural communities may not have assessed to adequate education and counseling on preventing themselves from acquiring the disease unless there is an intervention. Studies in this category are very few, particularly in Nigeria. Allied workers constitute a very large proportion of Bonny population due to the oil boom in the environment, and the cultural and social 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 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]. | Table 1: Respondents' knowledge of HIV/acquired immune deficiency syndrome
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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. | Table 2: Demographic distribution of respondents who know how a person can get the virus
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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 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]. | Table 3: Respondents' perception of reducing the spread of HIV by having sex with only one faithful partner and using condoms
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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],[11],[12],[13],[14],[15],[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],[17],[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],[20],[21] and in other places.[22],[23],[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],[26],[27],[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 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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[Table 1], [Table 2], [Table 3], [Table 4]
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