The Association Of Hiv Knowledge, Attitudes, And Beliefs With Sexual Behavior Among A Sample Of Adolescents And Young Adults In Nigeria
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Type of WorkText
DepartmentPublic Health and Policy
ProgramDoctor of Public Health
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In 2005, more than 25 million adults and children worldwide were living with HIV/AIDS and more than 75% of these were in sub-Saharan Africa. Studies indicate that the incidence of HIV infection and the prevalence of high-risk behaviors among young populations continue to rise in developing countries. AIDS has severe economic impacts, especially in high-risk countries such as Nigeria. This dissertation project used secondary data from the 2003 Nigeria Demographic and Health Survey. The 2003 NDHS is a cross-sectional, multistage, stratified survey with systematic sampling that was designed to obtain information on key population and health indicators such as sexual activity, knowledge about AIDS and other STDs, and behavior associated with AIDS and other STDs for the entire Nigerian population, including people living in rural areas, urban areas, and six major geographic regions. Analyses were restricted to sexually active adolescents and young adults 15 to 24 years of age who are Nigerians living in Nigeria in 2003. The sample size was (n=2,418), of which 2,009 are females and 409 are males. Non-Nigerians and Nigerians in Diaspora were excluded in the original design of the survey. Also, those younger than 15 years or older than 24 years were excluded in this study. This research examined the association between independent variables and other covariates with risky sexual behaviors such as lack of condom use and multiple sex partners, as well as possible difference by gender. Odds ratios (ORs) were calculated using multivariate logistic regression models, adjusting for age, education and religion. All tests were done at 95% significant level. A descriptive analysis of variable number of sex partners showed that about 32% of participants had multiple sex partners. Among those who had access to condom 34% also reported having multiple sex partners. Results of multivariate analyses indicated that gender was significantly associated with multiple sex partners but females have lower odds of having multiple sex partners, compared to males (OR=0.48; CI=0.40, 0.56; p=<0.001). Adjusting for all covariates greatly increased the odds for multiple sex partners for females (aOR=1.09, CI=0.82, 1.46, p=0.538). Adjusted odds ratios demonstrated strong association between multiple sex partners and religion, marital status, region, place of residence, wealth index, lack of perceived threats, and lack of self-efficacy (aOR=1.22, CI=0.81, 1.84, for perceived threats & aOR=1.21, CI=0.69, 2.11, for self-efficacy). The summary odds ratios showed that unmarried youth had lower odds of multiple sex partners, compared to currently married youth (aOR=0.02, CI=0.01, 0.03, p=<001). Rural resident youth had two times higher odds of multiple sex partners, compared with urban residence youth (aOR=2.07, CI=1.25, 3.44, p=0.005). The summary odds ratios demonstrated all associations between the independent variables/or other covariates and lack of condom use were statistically significant except for age, behavior change, and attitudes towards people with. Results also showed that the odds for lack of condom use among females were 1.34 times higher, compared to their male counterparts, controlling for age, education, and religion (aOR=1.34, CI=1.10,1.64). This study concludes that HIV knowledge, attitudes, and beliefs are associated with risky sexual behavior among young people and that HIV/AIDS epidemic is also driven by young people. Therefore, interventions must respond to the low condom use among adolescents and young adult population. In addition, HIV/AIDS knowledge information must include awareness messages about the risks of multiple sex partnerships. Finally, this study concludes that, in Nigeria, high-risk behavior commences for most part during adolescence, and large proportions of these high-risk populations are younger than 25 years.