Published on International Journal of Social, Politics & Humanities
Publication Date: January, 2020
Chukwuemeka Oteh & Ebisi Njideka T.
Department of Sociology, Madonna University
Department of Sociology, Chukwuemeka Odumegwu University
Igbariam, Anambra State, Nigeria
This research work investigated the factors attributed to the high prevalence rates of HI V/AIDS in the two selected communities (Umudim and Otolo) in Nnewi. The research methodologies used for the data collection from the inhabitants of the selected communities were in-depth interview, questionnaire and focus group discussion. Some factors found to be responsible for the high HJV prevalence rates in these test communities are c1assfied into: behavioural, economic, cultural and social factors; examples of these factors are: age, income-level, single parenthood practice and location. The impact of high HIV prevalence on development outcomes in the communities studied got across demographic, social/ psychological, economic, political and health impacts. Finally, Chi square method of analysis was used in testing f there was a signflcant difference between the high HIV prevalence rates in Umudim and Otolo communities and also, in testing if there was a signficant relationship of the high HIV prevalence between the socio economic-cultural factors available in the study locations. The test results for the null hypotheses which are. that, the high prevalence rate of HI V is not related to the socio-economic and cultural factors of the study locations and that, there is no signficant difference between the HIV prevalence rates in Umudim and Otolo, were rejected. In other words, the alternative hypotheses that, the high HIV prevalence rates in Umudim and Otolo are related to the socio-economic and cultural factors of the study locations and, that there is signflcant dfference between the HIV prevalence rates in Umudim and Otolo were accepted. Some of the policy recommendations from the study are: eradication of some of the cultural practices such as single parenthood practice with greater vigor and also, strengthening of socio-economic, nutritional and psychosocial support at state, local and community levels. These should become issues of policy priority in the state.
Keywords: Prevalence rates, socio-economic and cultural factors & HIV prevalence.
AIDS was first recognized as a new distinct clinical entity in 1981 in the United States of America. During the next several years, as researchers sought to identify and isolate the etiologic agents, AIDS was beginning to be recognized in the other parts of the world. Central Africans residing in Europe were presenting clinical signs and symptoms similar to those of AIDS, and early reports from Kinshasa, Zaire. The Democratic Republic of Congo suggested high AIDS rates in association with a newly isolated virus, now known as Human Immunodeficiency Virus (HIV).
Globally, the pandemic of HIV and AIDS has continued to constitute serious health and socio-economic challenges for more than two decades. In underdeveloped and developing countries, it has reserved many of the healthy and developmental gains over the past three decades as reflected by the indices such as life expectancy and in fact, mortality rate among others. The epidemic has also facilitated the emergence of other disease conditions. While the rate of AIDS continues to rise, the effect of the disease on families is increasingly being noticed. This has led to serious decline in communities’ productivity because a lot of the public spending which are supposed to have been expended on other developmental projects are channeled towards prevention of HIV/AIDS, and care (WHO, 2000). As at the end of 2007, about 33.2 million persons were estimated to be infected with Human Immunodeficiency Virus (HIV) globally. Of these, 22.5 million were in sub- Saharan Africa, and about 3.0 million in Nigeria (UNAIDS, 2007).
HIV prevalence was recently estimated using a population-based survey. In addition, the Federal Ministry of Health conducted antenatal surveillance. Based on this new data, approximately 3 million Nigerians are HIV infected. Of these, about 220,000 are pediatric cases (UNAIDS 2008). The most recent population based survey and antenatal surveillance results found a prevalence of 3.6 percent among those 15-49age range and 4.6 percent among women in antenatal clinics. These results have not yet been analyzed to generate prevalence estimated for individual states, but in 2005, study of HIV at antenatal sites reported large variation in prevalence from high of 10% in Benue to a low of 1.6% in Ekiti (FMOH, 2008).
Anambra state has the highest HIV prevalence rate in the South East geopolitical zone of Nigeria. Documented HIV prevalence in the state rose from 1.3% in 1991 to 10.2% in 1995-1996 and from then fell to 5.2% in 2001, 4.9% in 2003.In the year 2005, it increased to 6.5% and declined again to 5.8% in 2008. A further breakdown showed that 4,629 and 6,719 persons infected with the virus are youths aged 15 -24 years and pregnant women respectively. The increasing infection rate has been attributed to early sex debut, child marriage, wife inheritance and multiple sex partners (FMOH, 2003). Others include lack of women empowerment to negotiate sexual matters, polygamy, and wife sharing and pervading poor access of women to sustainable income generating activities, widowhood practice, female genital cutting and lack of legislation on women rights.
Communities such as Umudim and Otolo with significantly high HIV prevalence rates are located at inter-state border posts/areas highways; these sites are characterized with intense night long commercial activities. There is a high level of transit population including the Long Distance Drivers (LDD with overnight stay) in these communities. What is yet uncertain are the factors precisely influencing the differential high prevalence rates among certain populations or persons in Anambra state particularly, “these hot spots” of the state. Is it age, culture, income or location? To this end, the import to design and conduct survey at these locations that can test given hypotheses as to generate verifiable information that will be used to develop evidence based HIV interventions and programme design that will be used by programme implementers become imperative (CDC,2002).
2. HIV/AIDS and Factors for the Epidemic
In Nigeria, HIV is primarily, transmitted through blood contact via transfusion of blood, and unprotected sexual intercourse. Factors contributing to this epidemic include: lack of information about sexual health and HIV, lack of voluntary and routine HIV testing, cultural practices and poor health system.
3. Lack of sexual health information and education
Sex is traditionally a very private subject in Nigeria and the discussion of sex with teenagers is often seen as inappropriate. Not until recently, there was little or no sexual health education for young people and this has been a major barrier to reducing rates of HIV and other STDs. Around 20% of women and 25% of men between the ages of 15 and 24 correctly identify ways to prevent sexual transmission of HIV and who rejected too, misconceptions about HIV transmission. Lack of accurate information about sexual health has meant that there are many myths and misconceptions about sex and HIV, contributing to increasing transmission rates as well as stigma and discrimination towards people living with the virus (UNAIDS 2005).
4. Lack of voluntary and routine HIV testing
In 2007, 3% of health centre’s had HIV testing and counseling services and only 8.6% of women and men aged 15-49 years had received an HIV test and found out the results. In 2006, President Olusegun Obasanjo publicly received an HIV test and counseling on World AIDS Day in order to promote the services and information available to people in Nigeria. “He stated that a great majority of Nigerians have come to accept the reality of AIDS”. However, the statistics showed that the Nigerian government desperately needs to scale up HIV testing rates in order to bring the epidemic under control (UNDP, 2004).
5. Cultural Practices
Women are particularly affected by the epidemic in Nigeria. In 2007, women accounted for 58% of all adults aged 15 and above living with HIV. Traditionally, women in Nigeria marry young although the average age at which they marry varies between states. A 2007 study revealed that 54% of girls from North West aged between 15 and 24 years were married by age 15 and 81% were married by age 18 ( CDC, 2008). The study showed that the younger married girls lacked knowledge on reproductive health which included HIV/AIDS. They also tend to lack the power and education needed to insist upon using condoms during sex. Coupled with the high probability that the husband will be significantly older than the girl and therefore, is more likely to have had more sexual partners in the past, young women are more vulnerable to HIV infection within marriage (UNAIDS, 2007).
6. Poor health care system
Over the last two decades, Nigeria’s health care system has deteriorated as a result of political instability, corruption and a mismanaged economy. Large parts of the country lack even basic health care provision making it difficult to establish HIV testing and prevention services such as those for the Prevention of Mother to Child Transmission (PMTCT). Sexual health clinics providing contraceptives, testing and treatment for other STDS bare also few and far between. This makes it particularly difficult to keep the spread of the epidemic under control (FHI, 2006). Also, the use and abuse of blood products is rife in Nigeria. Blood transfusion poses serious threat to the health of Nigerians because the skills and the facilities needed for screening blood products are either not available or have deteriorated and/or broken down. Many unscrupulous Nigerians have further compounded the situation by selling infected blood products to unsuspecting clients. The urban poor and rural dwellers are at a particular risk of contracting HIV/AIDS from such sources.
7. HIV/AIDS and Anambra state experience
Recent research in these two selected communities indicates that the differential high prevalence rates are attributed to so many factors which include Behavioral, Economic, Cultural and Social factors.
8. Sexual behavioural factor
The spread of HIV in these selected communities are facilitated mostly by sexual networking among men and women. These studies also documented the varied reasons men and women in these localities engage in such activities. These include, the desire for sexual variety, need for companionship, peer pressure, travelling from home to a foreign place. It was discovered that they have low level of knowledge and high prevalence of sexually transmitted infections and existence of HIV/AIDS in relation to a high degree of sexual activity and high risk behaviour (WHO, 2000). In a survey on the reproductive health of adolescents in the two selected communities, it was found out from their perspective that HIV/AIDS is not really a risk since no young person knew anyone who has acquired HIV. Furthermore, they did not regard AIDS as a pressing problem rather they have the impression that all STIs could be prevented through personal hygiene or taking antibiotics after sex (WHO, 2000).
Lastly, most of them argued that there appeared to be a misconception about the mode of transmission of HIV and in particular, the potential for the spread among heterosexual population was not appreciated. A number of them believe that HIV can only be transmitted by sharing drinking glasses, eating utensils using the same toilet with the infected person or through mosquito bites (WHO,2000).
The urgent need to educate and organize people for the successful prosecution of the fight against HIV/AIDS cannot be over emphasized on account of certain strong reasons cutting across behavioral, economic, cultural and social factors. In view of the negative impacts on development, the study makes the following recommendations:
a. Eradication of some cultural practices such as single parenthood, wife inheritance and sharing practices should be pursued with greater vigour;
b. Strengthening socio-economic, nutritional and psychosocial support programmes at the state, local and community levels for women and children mostly because of their vulnerable situations should become issues of policy priority;
c. Development of mechanisms to prevent new infections by supporting any programme that will help to reduce the number of new infections in the future.
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