Influence of Demographic and Socio-Cultural Variables on Non-Adherence to Anti-Retroviral Therapy (ART) Among HIV/AIDS Patients Attending a Government Owned Hospital, Ondo State, Nigeria (Published)
An anti-retroviral therapy adherence of at least 95% has been proven necessary in order for treatment to be effective. Failure to meet this level leads to poor immunological and virological outcome. This study assessed the influence of demographic and socio-cultural variables on non-adherence to anti-retroviral therapy (art) among HIV/AIDs patients attending a government owned hospital in Ondo State, Nigeria using a descriptive research design. A total number 110 respondents were recruited using a convenience sampling techniques. Questionnaire with reliability index of 0.70 was used as an instrument for data collection. Data were analyzed using statistical package for social science (SPSS). Descriptive and inferential statistics were used to test the hypotheses. Results were presented in tables and figures. Findings showed that 66(60%) adherence to anti-retroviral therapy which is below 95% adherence rate and 44(40%) do not adhere to ART. The outcome of this study further established that there was a significant relationship between gender (p=0.00), level of education (p=0.00), family support ( p=0.00), cultural factor( p=0.00), religion (p=0.00), employment status ( p=0.00), poverty ( p=0.00) and noncompliance with ART, however, there was no relationship between age (p= 0.26 ), access to clinic (0.31) and non-adherence to ART. This study concluded that, HIV/AIDS patients should therefore be supported in all aspects to promote compliance with the use of Anti-Retroviral Drugs.
Factors Influencing Non-Compliance to Exclusive Breastfeeding among HIV Positive Mothers Attending Selected Government Owned Hospitals in Lagos State, Nigeria (Published)
The objective of this study was to evaluate the factors influencing non-compliance to exclusive breastfeeding among HIV positive mothers attending selected government owned hospitals in Lagos state. This study is a descriptive study carried out among 297 HIV positive mothers selected using multi stage sampling technique. Structured questionnaires were used for data collection with reliability index of 0.95. Data obtained was analyzed using descriptive and inferential statistic and data were presented in tables and figures. The outcome of the study shows that 35.7% of respondent only breastfed their babies while 64.3% practiced mixed feeding. The factors identified to influence compliance include: Fear of transmitting HIV infection through breast milk, Cultural factor (df=1, P<0.001), level of education (df=3, P<0.001), social stigmatization and discrimination (df=1, P<0.001), spousal and family support (df=1, P<0.001), and maternal knowledge about HIV transmission (df=1, P=0.029). it is therefore important to work on those factors identified in this study by individual, organization and government towards the improvement of practice of exclusive breastfeeding among HIV positive women.
This article examines the transmission dynamics of HIV/AIDS with treatment effects. The total population ( ) was grouped into four compartments namely susceptible individuals at time t ( ), infected humans at time t ( ), individuals on treatment at time t ( ), and the AIDS carriers at time t ). A first order deterministic mathematical model for the case is formulated and analyzed to gain insight into the qualitative features of the local stability and disease free equilibrium which enable us to understand the transmission dynamics of the disease. The numerical simulation of the model was carried out to investigate the sensitivity of some threshold parameters on spread rate of the disease. We also investigated the impact of early detection of HIV cases and compliant behavior of patients on treatment. Our results from numerical simulation and early detection of HIV case/ compliant behavior of patients on treatment show that early detection of HIV case and compliant behavior of patients on treatment reduce spread of the disease and minimize rate at which people develop AIDS.
Multidrug Resistance Profile and Extended-spectrum Beta-lactamase Production in Faecal Escherichia coli Isolated From HIV and TB Patients in Ekiti-State, Nigeria (Published)
With the increasing use of antibiotics and widespread of antibiotics resistance which has been amplified by the production of ESBLs in clinical isolates; the study was to determine the multidrug resistance Profile and Extended-spectrum Beta-lactamase production in faecal Escherichia coli isolated from HIV and TB Patients in Ekiti-State, Nigeria. Three hundred isolates of E. coli were obtained from the stool samples of HIV/AIDS patients, TB patients and apparently healthy individuals. The sample was cultured on Eosin-Methylene Blue (EMB) agar plate and incubated at 37ºC for 24 hours. The colony showing greenish metallic sheen was identified using the conventional biochemical. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique. Bacteria showing resistance to at least three different classes of antibiotics were considered multidrug resistant (MDR). Extended spectrum beta-lactamase production was detected by combined disc method using ceftriaxone/cefotaxime and Amoxicillin/clavulanic acid discs.A total of 141(47%) males and 159(53%) female patients were involved in the study. Based on the age distribution, age group 30-39(n=80) has the highest percentage while age group 60 and above (29) has the lowest participation among the age groups. E. coli isolated from HIV/TB co-infected reveals 40(80%), 26(52%), 21(42%) and 37(82%) resistant to SXT, AMC, SAM and AZM respectively while 24(48%), 36(72%), 23(46%) and 26(52%) of E. coli isolated from HIV patients on treatment were resistant to SXT, AMC, SAM and AZM. Tuberculosis patients on anti- TB treatment had 45(90%), 34(68%), 36(72%) and 44(88%) of the isolates resistant to SXT, AMC, SAM and AZM respectively while E. coli isolated from newly diagnosed HIV patients were 31(62%), 29(58%), 15(30%) and 27(54%) of the E. coli were resistant to SXT, AMC, SAM and AZM. Similarly, 33(66%), 36(72%), 15(30%) and 39(78%) of the isolated E. coli from newly diagnosed TB patients showed resistance to SXT, AMC, SAM and AZM respectively. Among the 148 multiple antibiotic resistant E. coli isolates 38 (23.75%) were found to be Extended β-lactamase (EBLS) positive with majority of the positive EBSL E. coli isolate from TB and TB associated patients. The increase in the prevalence of ESBL among faecal E. coli, an indicator organism for enteric pathogens, however, express the urgent need for serious antibiotics stewardship and control among clinicians and other health personnel especially in developing and under developed countries for proper management of the immune-impaired individuals.
Attitude and Sexual Behaviour of the Residence of Ijebu North Local Government Area of Ogun State on the Awareness of HIV/AIDS (Published)
This study sought to find out the Attitude and Sexual Behaviour of the residence of Ijebu North local Government Area of Ogun State towards people living with HIV/AIDS. Descriptive survey research design was adopted for the study. Accident sampling was used to sample 1,520 respondents in the local government. A self developed questionnaire was used as research instrument to sample 1,520 respondents. Simple percentages were used in analyzing the data. The result indicated that 1,520 respondents representing 100% the entire population were in support of campaigning and treatment programme for HIV/AIDS patients and also ready to encourage HIV/AIDS patients to spend the rest of their lives as loved ones 1328 respondents representing 87.36% of the entire population have changed from their promiscuous life style by being faithful to their sexual partners ,while192 respondents representing 12.64 were still engaging in promiscuous life style .Majority of the respondents that constitutes 85 .52%(1300) believed that abstinence remains the best option to avoid the infection while few respondents representing 14.48%(220) found it difficult to practice abstinence ,in other words they are not afraid of being exposed to HIV/AIDS. It was established that the people of Ijebu North local government have positive attitude towards people living with HIV/ AIDS. And were ready to encourage HIV/AID S patients to spend the rest of their lives as loved ones, the awareness of HIV/AIDS have positively influenced their sexual behaviour with the opposite sex which made them to abstain from unhealthy sexual behaviours and embrace abstinence to be healthy. It was recommended among others that government and non government agencies should make people awareness that HIV/AIDS is real and has no cure up to data. Health personnel should be moving from place to place to enlighten the rural dwellers about HIV/AIDS, and the consequences of exposure to the virus and ways of prevention and control of the infection that, if they are not infected they can be affected in many ways .
Psychosocial Perspectives of Stigmatization and Discrimination of Persons Living With HIV and AIDS: The Case of Winneba Municipal Hospital (Published)
The study explored the psychosocial perspectives of stigmatization and discrimination of Persons Living with HIV (PLWHA) in the Effutu Municipality with Winneba Municipal Hospital in focus. The research design employed was the descriptive survey using the explanatory mixed method approach which utilized questionnaire and interview as the research instruments for data collection. Two (2) research questions and two (2) hypotheses guided the study. Fifty-three (53) participants comprising fifty-one (51) PLWHA and two (2) HIV counsellors were sampled using the convenience, purposive, and snowball sampling techniques. Data were analyzed using inferential statistics (t-test & regression) to test the hypotheses while the qualitative data were analysed thematically with verbatim quotations from participants to support issues as they emerged. The study revealed that stigmatization and discrimination against PLWHA are not significant even though there was evidence of their existence in the areas of employment and workplace, community contexts, family contexts, and access to healthcare. It was, therefore recommended that the local authorities together with the District Ghana AIDS Commission should strengthen the awareness creation on the need for harmonious living with PLWHA in the community and the District Ministry of Health should employ more health personnel to engage in follow up services to PLWHA patients.
Attitude and Sexual Behaviour of the Residents of Ijebu North Local Government Area of Ogun State, Nigeria on the Awareness of Hiv/Aids (Published)
This study sought to find out the Attitude and Sexual Behaviour of the residents of Ijebu North local Government Area of Ogun State towards people living with HIV/AIDS. Descriptive survey research design was adopted for the study. Accident sampling was used to sample 1,520 respondents in the local government. A self developed questionnaire was used as research instrument to sample 1,520 respondents. Simple percentages were used in analyzing the data. The result indicated that 1,520 respondents representing 100% the entire population were in support of campaigning and treatment programme for HIV/AIDS patients and also ready to encourage HIV/AIDS patients to spend the rest of their lives as loved ones 1328 respondents representing 87.36% of the entire population have changed from their promiscuous life style by being faithful to their sexual partners ,while192 respondents representing 12.64% were still engaging in promiscuous life style .Majority of the respondents that constitutes 85 .52%(1300) believed that abstinence remains the best option to avoid the infection while few respondents representing 14.48%(220) found it difficult to practice abstinence ,in other words they are not afraid of being exposed to HIV/AIDS It was established that the people of Ijebu North local government have positive attitude towards people living with HIV/ AIDS. And were ready to encourage HIV/AID S patients to spend the rest of their lives as loved ones, the awareness of HIV/AIDS have positively influenced their sexual behaviour with the opposite sex which made them to abstain from unhealthy sexual behaviours and embrace abstinence to be healthy. It was recommended among others that government and non government agencies should make people aware that HIV/AIDS is real and has no cure up to data. Health personnel should be moving from place to place to enlighten the rural dwellers about HIV/AIDS, and the consequences of exposure to the virus and ways of prevention and control of the infection that, if they are not infected they can be affected in many ways
Availability of HIV/AIDS Information to Women in Ikom Local Government Area of Cross River State, Nigeria (Published)
The study was carried out to determine how HIV/AIDS information was made available to women in Ikom Local Government Area. Survey method was used through the administration of questionnaire. 300 copies of the questionnaire were distributed. The return was 90%. It was revealed that, due to poverty and the low level of education, the women found it very difficult to have access to available HIV/AIDS information whenever it was made available. It is therefore, recommended that adult schools should be established in all Local Government Areas of Cross River State especially Ikom Local Government Area to educate the women and sensitize them about the dangers of this deadly disease and how to prevent it especially from mother-child. By educating the women, it will enable them access available HIV/AIDS information at the appropriate time. Women should be empowered so that, they do not rely entirely on men financially.
Social Marketing Campaign as a Tool for Reducing Financial Cost of HIV/AIDS Pandemic in Nigeria (Published)
In this study the impact of social marketing campaign as a tool for reducing the financial costs of HIV/AIDS on people in Nigeria is explored. This was motivated by the excruciating financial, social ostracization and psychological burdens of stigmatization (costs), people living with HIV (PLIs) and their families are saddled with in the country. The study objectives were to: ascertain the effect of social marketing campaign messages of abstinence for reducing the financial costs of HIV/AIDS on people in Nigeria; determine the impact of social marketing campaign tools of counselling for reducing the social ostracization of people living with HIV (PLIs) by their families in Nigeria; and assess the effect of social marketing campaign tools of Africa traditional media (oramedia) for reducing the stigmatization of people living with HIV (PLIs) in Nigeria. The area of study was three big cities in Nigeria: Calabar, PortHarcourt and Enugu, reputed as having very high students and youths’ population, considered as endemic group. A sample size of 300 was purposively determined and proportionately allocated to the 3 cluster cities. The instrument for data collection was structured questionnaire in Likert’s 4-points scale, which was also used in analysing the data. Results obtained indicate that: Social marketing campaign messages of abstinence was significantly effective for reducing the financial costs of HIV/AIDS on people in Nigeria; social marketing campaign tool of counselling was significantly effective for reducing the social ostracization of people living with HIV (PLIs) by their families in Nigeria; social marketing campaign tools of Africa traditional media (oramedia) were significantly effective for reducing the stigmatization of people living with HIV (PLIs) in Nigeria. Based on these results, governmental agencies, health marketers and behaviour-change agents in the country were advised to emphasize the use of these tools in other to reduce the costs of the HIV/AIDS burdens on the PLIs.
Belief in Spiritual Healing, Gender and Adherence to Medication among HIV/AIDS Patients in Benue State, Nigeria (Published)
This study examined belief about spiritual healing, gender and adherence to medication among 143 HIV/AIDS patients attending General Hospital Sankera in Benue State. The respondents were in the age range of 20-67 with a mean age of 33.4 years. Out of this number, 69 (48.3%) were males while 74 (51.7%) were females. Morisky Adherence to Medication Scale (MAMS) and Perceived Potency of Spiritual Healing Questionnaire (PPSHQ) were used for data collection. The results of the Analysis of Variance (ANOVA) indicated that perceived potency of spiritual healing and gender produced main effects on adherence to medication among HIV/AIDS patients. The implications of the study to health professionals were discussed, limitations were highlighted and suggestions for further studies were offered.
HIV/Aids Knowledge and Accessibility to HIV Information among Women in Obudu Local Government Area of Cross River State, Nigeria (Published)
The study was to determine HIV/AIDS knowledge and accessibility to HIV information among women in Obudu Local Government Area of Cross River State, Nigeria. A total of 402 women were recruited using multi-stage random sampling technique. A structured questionnaire was designed to generate data from the respondents. Data collected were entered and analysed using SPSS (version 20.0) and results were presented in tables and charts. Chi-square was used to test for association between variables at 5% level of significance. Findings from this study revealed most study participants (25.6%) were within the age bracket of 35-39 years, (91.8%) Christians, (71.9%) married and (43.3%) had undergone secondary education. Most respondents were civil servants (32.6%), traders/business women (15.7%), farmers (9.7%) and 20.3% were low income earners. Respondents exhibited high knowledge level of HIV/AIDS as the media (39.1%), health workers (18.7%) and HIV/AIDS campaigns (15.0%) were their major sources of information. About 54.5% respondents reported that they currently have access to HIV/AIDS information and other reproductive health services with primary health centers (21.4%) and hospitals as their top source of information centers. Intensifying HIV/AIDS awareness campaigns and improving access to reproductive health services are core strategies in averting HIV morbidity and mortality among women domiciling in semi-urban and remote settings.
Socio-Economic Factors and Awareness of HIV/AIDS among Rural Women Farmers in Ebonyi State, Nigeria: Issues for Guidance and Counselling (Published)
This study analyzed the socio-economic factors influencing rural women farmers’ awareness of HIV/AIDs in Ebonyi State, Nigeria: Issue for Guidance and Counseling. The study employed purposive and multi-stage random sampling techniques in the selection of 120 rural women who formed the sample size. Primary data used for the study were collected using questionnaire and interview schedule. These were analyzed with descriptive and inferential statistics. The result of data analysis showed that the rural women in the study area were knowledgeable on mode of transmission of HIV/AIDs such as: mother-child (94.17 percent), sexual-intercourse ( 93.33 percent), contaminated sharp (piercing ) instruments (91.67 percent) among others. The result of multiple regression analysis indicated a coefficient of multiple determination R2 of 68.5 percent. This means that about 68.5 percent of the level of awareness of HIV/AIDs in the area was influenced by the socio-economic characteristics of the respondents. Most of the explanatory variables were statistically significant and met a priori expectations. The null hypothesis tested at 5 percent level of significance was rejected. This shows that there is significant relationship between the socio-economic characteristics of the rural women and their level of knowledge of HIV/AIDs in the area, hence the need for counseling. Further analysis identified lack of adequate information (3.64), remoteness of the rural areas (3.10), cost of information access (3.12) among others as major obstacles which limited rural women knowledge of HIV/AIDs in the area. It was concluded that improving the knowledge of HIV/AIDs through constant guidance and counseling would minimize the spread of the scourge and as well improve the contribution of the women to agricultural development in the study area. Necessary recommendations such as improving the educational status of the women farmers among others were made.
The Psychosocial Effects Of People Living With HIV/AIDS At The Niger Delta University Teaching Hospital Okolobiri, Bayela State Nigeria (Published)
The psychosocial effects of the people living with HIV/AIDS have been acknowledged in sociological literature with few or little empirical study to justify its consequences on the affected people in contrast to its biomedical effects. This paper acknowledges that the biomedical consequences of people living with HIV/AIDS (PLWHA) is still essential, but focuses more on the psychosocial effects of PLWHA that aggravate their health conditions. Engel’s biopsychosocial model was utilized as analytical framework and a descriptive research design for the study. One hundred and fifty (N=150) respondents participated in the study in a chain-referral technique at the Niger Delta University Teaching Hospital, Okoloibiri Bayelsa State using a structured questionnaire as instrument of data collection. Frequency and percentage distribution tables were used to present and analyzed the quantitative data collected for the study using SPSS version 17.0. Findings showed that there were psychosocial effects that aggravate the conditions of PLWHA ranging from depression and perhaps self-destruction arisen from stigmatization, discrimination, denial, loss of relationships and social disarticulation among others. The paper concluded that though the biological determinants of the transmission of the disease need to be emphasized and discouraged among people of the society through campaign and sensitization across board, but more emphasis and attention should be laid on efforts to embrace those already affected with HIV/AIDS by eradicating all forms of stigmatization, discrimination, deprivation through love and supports for them rather than disarticulating them from the members of the society.
PERCEPTION AND AWARENESS OF HIV/AIDS AMONG WOMEN FARMERS IN EBONYI STATE NIGERIA: NEED FOR COUNSELLING AND VOLUNTARY TESTING (Published)
Perception and level of awareness of HIV/AIDs among women farmers in Ebonyi State, Nigeria was studied. The study employed purposive and multi-stage random sampling techniques in the selection of 120 rural women farmers. Primary data were collected using a well-structured questionnaire and interview schedule. These were analyzed with descriptive and inferential statistics. The result of data analysis showed that majority 38.33 percent of the women farmers fall within age bracket of 26-35 years; their farming experience ranged 5-10 years with 36.67 percent; while their farm size ranged between 1.1-1.5 hectares. Majority 60.82 percent of the women were married and completed primary education with 38.33 percent. Majority 41.67 percent of the farmers live with between 4-6 persons in their household and earned between N80, 000-N100, 000 per annum. About 66.66 percent of the women belonged to 3-4 social organizations. Major sources of information on HIV/AIDs prevention to the rural women were: Ebonyi State Ministry of Health (2.90), religious institutions (3.12), social organizations (2.84), radio (3.67) and Ebonyi State Action Committee on Aids (EBOSACA) (3.66) among others Further analysis indicates that majority 100 percent of the respondents’ perceived that an HIV victim can live long on a special type of drug and hygienic condition (100 percent), HIV/AIDs is a viral disease (91.67 percent) while 85 percent perceived that HIV/AIDs exist and has no cure. All the women in the study area had knowledge of measures of HIV prevention such as total abstinence from sex, having one sex partner and screening of blood before transfusion. Majority 81.67 and 76.67 percent of the respondents were willing to be tested and would recommend it to their friends and family members. It was concluded that though the general level of awareness about HIV/AIDs was high, the perceptions of the respondents were faulty in some cases because of some misconception about causes and therapy to the disease. Necessary recommendations such as intensified awareness creation by the NGOs and concerned agencies, provision of infrastructures as well as education of farmers were made among others.
Implementation of human rights and rights to health for people living with HIV / AIDS in Albania. (Review Completed - Accepted)
Without doubt , HIV / AIDS is a global epidemic , and is defined by UNDP (2005 ) as a disease ” that caused the change of the single greatest human development in modern history .” UNAIDS Report of the International Day of HIV / AIDS of 2010 on the Global AIDS Epidemic estimated that at the end of 2010 there were 34 million people living with HIV , where the majority has 22.5 million sub-Saharan Africa . It still shows a large number of new infections and a significant expansion of access to antiretroviral therapy , which has helped reduce the number of deaths related to AIDS , especially in recent years . The epidemic of HIV / AIDS is now a global crisis and is part of one of the most difficult challenges for development and social progress . Throughout the years of the war against AIDS has been clear that human rights are essential for an effective response to HIV . In countries where human rights are not protected , people suffer more stigma and discrimination , get ill and are unable to support themselves and their families , and if they do not receive treatment and may die .
HIV / AIDS is an issue of human rights for ( Tallis , 2002 ) :
( i) lack of access to prevention methods , materials and information on the appropriate treatment and care in making that PJHA be a vulnerable population, in turn , HIV- related violations of human rights such as poverty , inequality , racism and sexism .
( ii ) PJHA and those affected by this epidemic are often unable to live a life of dignity , equality and freedom , because their rights are often violated because of their HIV status . This includes the rights to privacy , confidentiality , access to acceptable health care services, sexual and reproductive health , employment , education, freedom of movement .
Besides pain that gives individuals and their families , the epidemic is profoundly social and economic structure of society . HIV / AIDS is a major threat to the world of work : it is affecting the most productive segment of the labor force and reducing earnings , imposing huge costs on enterprises in all sectors through reduced productivity , increased labor costs and loss of skills and experience . In addition, HIV / AIDS is affecting fundamental rights at work , particularly with regard to discrimination and stigmatization of workers and people affected by HIV / AIDS .
The approach based on human rights states that all people should enjoy a pleasant life in which every person is able to develop his human potential . Human rights set global standards for the welfare and human development ( DAW , WHO , UNAIDS, 2000) . As a derivative approach to human rights -based approach is developed in the right to health , which means that the norms and principles of human rights are
integrated in the design , implementation , monitoring and evaluation of health policies and programs .
Historically , approaches to human rights in developing countries have tended to privilege the civil and political rights and socio – economic development. In the early years of the epidemic , attention was focused on PJHA and discrimination against vulnerable groups . For many developing countries as a narrow concept of rights failed to integrate with a full line of social factors , political and cultural , highlighting the vulnerability to HIV and AIDS response ( Heywood & Altman , 2000 ) .
Nigeria: Can Cross River State Achieve The Millennium Development Goals (MDGs) In The Health Sector By 2015? (Published)
The paper reviews outcomes of efforts made by the Cross River State Government towards the achievement of MDGs in the health sub-sector in Nigeria. Using descriptive statistics and comparative analysis to illustrate deviations from set targets the paper reveals that, in spite of the robust effort of government, achieving the MDGs in the health sub-sector in Cross River State by 2015 will be very challenging, partly due to inadequate responses to bring about the required decrease in the burden of malaria, tuberculosis and HIV/AIDS in the State. To bridge the observed gap, the paper recommends rehabilitation of health facilities and provision of equipment and personnel in existing health facilities; increased budget provision for health care services; building strong and robust partnership with support agencies and other sector actors; development of effective health sector policy in the State, as possible quick wins.