SUMMARY

HIV/AIDS in seafaring is a global health issue with adverse effects on the seafarers and the

economy at large. In spite of the role of seafaring in the spread of HIV epidemic, most of the

researches in Nigeria hitherto focused on land-based transport workers. The few available data

on seafaring in Nigeria, was limited to HIV knowledge, attitude and practice, without exploring

the determinants of HIV risk behaviours. This study aimed at determining the prevalence and

determinants of HIV risk behaviours among seafarers in Port Harcourt Port, Rivers State.

A cross sectional study design comprising of quantitative and qualitative components was

employed in the study. Data on socio-demographic characteristics, seafaring related

characteristics, HIV knowledge, attitude and risk behaviours were collected using a validated,

pre-tested and self-administered questionnaire. The level of HIV knowledge were categorized as

good, fair and poor while HIV attitude was classified as either positive or negative attitude. The

qualitative component of the study employed the use of focus group discussion guide. Bivariate

and multivariate analysis were done to explore the determinants of HIV risk behaviours.

The study had a total of 103 seafarers. The mean age ± standard deviation of the seafarers was

38.8 ± 8.51 years. Majority of the seafarers were males (92.2%; n=95) and spent six months or

more on sea voyage (53.4%; n=55). The level of HIV knowledge was good in 68.9% (n=71) of

the respondents while 49.5% (n=51) had comprehensive HIV/AIDS knowledge. Most of the

seafarers had positive HIV attitude (88.3%. n=91). HIV screening among seafarers who

consented to the test (n=92) revealed that one out of the 92 seafarers was positive, giving an HIV

prevalence rate of 1.1%.

The prevalence of multiple sex partnership was 29.1% (n=30); transactional sex was 6.8% (n=7);

homosexuality was 1.0% (n=1) and illicit intra-venous drug use was 2.9% (n=3). Thirty-five of

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the seafarers (34.0%) engaged in one or more HIV risk behaviours and non-condom use among

them was 85.7% (30 out of the 35 seafarers).

Sex, time period on voyage and comprehensive knowledge were significantly associated with

HIV risk behaviours (p<0.05). Multivariate analysis revealed that seafarers who spent six or

more months on voyage were three times more likely to engage in HIV risk behaviours than

those who spent less than six months (Adjusted odds ratio=3.08; 95% confidence interval=1.26-

7.51; p<0.05). Also, seafarers with no comprehensive HIV knowledge were about 2.5 times more

likely to engage in HIV risk behaviours than those with comprehensive HIV knowledge

(Adjusted odds ratio=2.49; 95% confidence interval=1.03-5.96; p<0.05). The qualitative analysis

revealed that long duration on sea, non-allowance of spouse during the voyage trip, presence of

brothels around the port areas, lack of discipline of seafarers and lack of HIV sensitization visits

to seafarers by the port authority were also determinants of HIV risk behaviours.

The prevalence of HIV risk behaviours among seafarers in Port Harcourt Seaport is high and the

determinants of these behaviours include long duration of voyage and lack of comprehensive

knowledge on HIV. The study recommends regular HIV sensitization visits to seafarers to

increase HIV knowledge and discourage HIV risk behaviours. Health education strategies using

behavioural change communication is also advocated.

Keywords: HIV risk behaviours, seafarers, Port Harcourt Port, Nigeria

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CHAPTER ONE

INTRODUCTION

1.1       Background Information

HIV/AIDS is one of the destructive diseases of mankind with profound social, economic and

public health consequences.4 The HIV/AIDS epidemic adversely affects the individuals,

households and nations, reducing by more than half the Gross Domestic Product (GDP) of

severely infected countries and reducing by 480 million people the UN estimate of global

population by year 2050.5 In the countries most heavily affected, HIV has reduced life

expectancy by more than 20 years, slowed economic growth, and deepened household poverty.5

According to the United Nations Development Program (UNDP), HIV has inflicted the “single

greatest reversal in human development” in modern history.6 Furthermore, HIV causes a greater

loss of productivity than any other disease, and is likely to push an additional 6 million

households into poverty unless local and national responses are strengthened.7

Indeed,