KNOWLEDGE AND ATTITUDE OF STUDENTS TOWARDS HIV VOLUNTARY COUNSELLING AND TESTING AMONGS STUDENTS IN OSUN STATE COLLEGE OF EDUCATION, ILESA

KNOWLEDGE AND ATTITUDE OF STUDENTS TOWARDS HIV VOLUNTARY COUNSELLING AND TESTING AMONGS STUDENTS IN OSUN STATE COLLEGE OF EDUCATION, ILESA

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CHAPTER ONE

INTRODUCTION

Background to the Study

Globally about 70 million people have been infected with HIV virus while 35 million people have died of AIDS and 34million people were living with HIV by the end of 2011(WHO, 2014). An estimate of 0.8% of adults aged 15 – 49 years worldwide are living with HIV with variation in epidemics between countries and regions. Sub-Saharan Africa remains most affected with nearly 1 in every 20 adults living with HIV and accounting for 69% of people living with HIV worldwide (WHO, 2014). In Africa, an estimate of 1.7 million young people is infected annually (WHO /UN Joint Programme on HIV/AIDS, 2006). Many youths engage in risky behaviors, with fewer than 10% of the sexually active adolescent females from countries in sub-Saharan Africa reporting condom use (Human Development Report, 2004). In Nigeria 3.4million people are living with HIV/AIDS (UNAIDS, 2013).Thus voluntary counselling and testing (VCT) for young people have been recognized as a major priority within the Nigerian HIV- prevention programme.

Voluntary counselling and testing (VCT) for Human immunodeficiency virus (HIV) and Acquired immune deficiency syndrome (AIDS) is the process whereby an individual or couple undergo counselling to enable him/her make an informed choice about being tested for HIV ( Federal Ministry of Health, 2003). VCT is a major strategy designed by programme planners to combat the pandemic of HIV/AIDS in Africa (Bruce and Stellenberg, 2007). It involves community mobilization, education, increase in VCT sites, reduction of stigma, policies that protect human rights, counselling, rapid tests and confidentiality. VCT activities are implemented with other measures like sexual abstinence, marital fidelity, condom use and anti-retroviral drugs. Voluntary HIV test is an active search for HIV among healthy people and is therefore a fundamental aspect of primary, secondary and tertiary prevention of HIV infection and AIDS (Park, 2007 and Ikechebelu, Udigwe, Ikechebelu & Imo, 2006). It offers holistic approach that can address HIV in the broader context of people’s lives. HIV screening is advocated for every individual from early teen years of  life especially those who are sexually active or exhibit high risk behaviours ( injection - drug users and their sex partners, sex partners of HIV – infected persons and heterosexual persons with more than one sex partners). The age group coverage for voluntary HIV test is as low as 15 years in developing world since there is evidence that 25% of them have initiated sex by then (HDR, 2004). Apart from early exposure, young people are at risk of HIV infection because of  lack of skill to negotiate safe sex behaviour and vulnerability to sexual abuse. This has necessitated the campaign on youth friendly programmes to encourage youths know their HIV status. According to WHO (2003), regardless of test result after the first test, routine check continues regularly at least every 6 months, but every 3 months for those that are sexually active. Each HIV test follows the process of pretest counselling, test and post test counselling. 

Voluntary counselling and testing is being advocated for because it has been shown to enable individuals, whether HIV positive or negative to change their behaviour appropriately (Okojie and Omume, 2004).Healthy lifestyle is achieved during interaction with service providers as the individual understands the need to maintain his or her HIV status. Although knowing HIV status is regarded as an important component of a healthier lifestyle, the decision to undergo VCT is entirely that of the individual being tested (FMOH, 2003). The willingness to do HIV test may be because of HIV services that are accessible, affordable and with observed confidentiality that will increase the clients trust or as routine during antenatal care, for premarital decision, or an institutional requirement. People’s willingness also depends on public awareness programmes that will give understanding of what VCT is.VCT education is one major component in the strategy of voluntary counselling and testing programme, which one is expected to acquire either from formal school or from other sources that include community, mass media and churches.

Attitude of students towards VCT for HIV/AIDS is the willingness of an individual to undergo the process of knowing own HIV status correctly. It is influenced by knowledge of the procedure, benefit of the test, perception of the test, cost, and accessibility of the services and fear of positive result. Individual characteristics such as age, gender, social support, personality trait and personal beliefs about health are associated with people’s attitude to medical advice. Rejection of HIV screening has been linked to psychological trauma, infringement on fundamental human rights, fear of living with positive screening and stigmatization at place of work (Omoigberale, Abiodun and Famodu, 2006). 

One hundred and nineteen countries reported a total of 95 million people that tested for HIV in 2010 (WHO, 2014). The attitude of  Nigerians to voluntary counselling and testing for HIV/AIDS has improved with time although it is still on low side compared to its population of 150,000,000 (National Population Commission, 2009). A comparism of the 2003 and 2007 result of the proportion of Nigerians who took HIV test increased from 6.6% to14.4% for females and from 7.7% to14.17% in males (National Policy on AIDS, 2009). An estimate of 2.2 million people aged 15years and above received HIV testing and counselling in 2010, which amounts to only around 31 people per 100,000 of the total adult population (WHO/UNAIDS/UNICEF, 2011). In 2010 National Action Committee on AIDS (NACA) launched a comprehensive strategic framework with the aim to reach 80% of sexually active adults and 80% of most at risk population with HIV counselling and testing by 2015. This is to reinforce the existing guideline addressing the needs of young people. (National  Strategic Framework 2010-2015, 2009). However, the success of VCT programme will depend to a large extent on the political will driving its implementation and client attitude to VCT. 

There are many VCT centres in Osun state that extends to the local government areas. This resulted from the effort of the government and interest of different nongovernmental organizations. Some of the VCT centres are located near these campuses, there are two main VCT centers close to Osun state college of education, Ilesa, these include:  General hospital, Ilesha and Holy trinity hospital, Ilesha. These two hospital are located at Ilesha where the campus reside.

Statement of the problem

The burden of HIV/AIDS disease is felt in economically depressed countries like Nigeria (National Policy on AIDS, 2009 and UNAIDS, 2007). A lot of money has been spent by government of Nigeria and agencies concerned with HIV/AIDS in a bid to inform people of what voluntary HIV counseling and testing is and its importance in HIV control. This is evidenced in the strategies to improve access to VCT services through increase in sites, increase in awareness campaign, simple rapid test and test results, free test services, training of service providers and protection of rights of victims of AIDS diseases (National Policy on HIV/AIDS, 2009).

The social position of adolescents which is characterized by dependency, physical and emotional immaturity makes youths vulnerable to sexual and reproductive diseases. They lack skill to negotiate safe sexual behaviours, have poor access to contraceptives and are vulnerable to sexual abuse. Despite their high risk for HIV infection there is low National prevalence of VCT among youths (15-24 years) of 2.6% with regional variations (Nwachukwu & Odumegwu, 2011).

Osun state government, college of education, Ilesha government and agencies concerned with HIV/AIDS have floated many programmes on awareness and prevention of HIV/AIDS in Osun

State college of education, Ilesha which usually end up with free HIV test services (EBOSACA, 2009).Aside such programmes are numerous VCT service centres that are in the state.

These programmes and services are expected to yield positive results in order to meet NACA target of 80% HIV counselling and testing among the sexually active and at risk group by 2015.

The researcher severally observed low turnout and participation of student during HIV preventive programmes in the college of education. Moreso, in one of the VCT centres of about 100metres from Campus, only 0.8-12% of the total population that have HIV test between 2009 to 2011 are undergraduates of Osun state college of education.(State public VCT Centre). This informed the research to know the knowledge OSCOE undergraduates have about VCT for HIV and their level of attitude.

Purpose of the Study  

The purpose of the study is to determine the knowledge and about voluntary counselling and testing for HIV/AIDS among Osun State College of education, Ilesha undergraduates and to assess their level of attitude to testing.   

Specific objectives of the study includes to;

1.                  Determine the knowledge that  OSCOE undergraduates have about VCT for

HIV/AIDS.

2.                  Determine the level of attitude with VCT for HIV among undergraduates.

3.                  Explore what prompts undergraduate to engage in VCT for HIV/AIDS.

4.                  Identify factors that would make OSCOE undergraduates use VCT services for HIV test. 

Significance of the study

Findings from this study will provide the following:

(i)                 Show the level of knowledge about VCT among OSCOE undergraduates and show their attitude level to the test. It will also show students condition for attitude and factors that will improve VCT attitude.  The college of education, Ilesha by this discovery may plan and introduce programmes that will improve students’ knowledge and attitude to VCT for HIV/AIDS

(ii)               When the result of this study is utilized by Osun State and agencies concerned with HIV/AIDS, other strategies to improve student’s knowledge and attitude to VCT services will be incorporated into their programme so as to increase the prevalence of  VCT. This will in effect lead to early detection and treatment of HIV clients.

(iii)             This study will spur other researchers to carry out further studies on the topic.

Hypotheses

The following null hypotheses were tested at 0.05  level of significance:-

1.                  There is no significant association between gender and knowledge of VCT for

HIV/AIDS of OSCOE students.

2.                  There is no significant association between campus location and knowledge of

VCT for HIV/AIDS  of  OSCOE students.

3.                  There is no significant association between campus location and attitude to

VCT for HIV/AIDS  among OSCOE students.

4.                  There is no significant association between gender and attitude to VCT for

HIV/AIDS among OSCOE students.

Scope of the study

The study is delimited to 200-500 level undergraduates of Osun State College of education, Ilesha. One hundred level students were excluded from the study because most of them do not have class rooms. 

Some of them have not fully settled with school registration requirement. Four campuses were used and include: the permanent site( school of education), school of science and technical education, GTTC, Cappa campus and school of agriculture and home economics. It covers their knowledge of voluntary counselling and testing for HIV/AIDS, attitude to voluntary counselling and testing services, factor that made them comply/not comply and under what condition those who received testing were tested. 

Operational Definition of Terms.

1. Knowledge of VCT for HIV/AIDS

   For this study knowledge is graded in levels according to the number of question answered correctly (< 3 - 5 correct answers – poor level of knowledge, 6 - 8 correct answers – moderate level of knowledge, 9-12 correct answers – good level of

knowledge). It will be assessed by respondents’ ability to:

(i)                   Accurately state what VCT for HIV/AIDS means

(ii)                 Accurately recall one importance of VCT.

(iii)               Identify a body fluid that can be used for HIV/AIDS test.

(iv)               Identify the type of test used during VCT for HIV/AIDS

(v)                 State correctly, what is done during pre-test and post-test counselling for               

               HIV/AIDS.

(vi)               State the time interval between each VCT visit.

(vii)             State the implication of a positive test result.

Attitude to VCT for HIV/AIDS

Attitude is graded as

i.                    Partial – attitude: – those that did HIV test once. 

ii.                  Moderate – attitude: – those that did HIV test more than once but at intervals above 6 months.

iii.                Total – attitude:- those that voluntarily received VCT services for HIV/AIDS

2 times and more at 3 and 6 months interval.

Voluntary counselling and testing

A confidential client/provider interaction that results in a client willingly offering to do

HIV test.





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