E-SKYworld: E-SKY DEGREE AWARD FINAL YEAR PROJECT, OAU.

KNOWLEDGE AND SEXUAL BEHAVIOUR TOWARDS HIV/AIDS AMONG UNDERGRADUATES OF OBAFEMI AWOLOWO UNIVERSITY

SALIS KOLAWOLE YUSUF

EFC/2007/186

AN ESSAY SUBMITTED TO THE DEPARTMENT OF

EDUCATION FOUNDATIONS AND COUNSELLING,

FACULTY OF EDUCATION,

OBAFEMI AWOLOWO UNIVERSITY, ILE-IFE,

OSUN STATE, NIGERIA.

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF BACHELOR OF SCIENCE DEGREE IN EDUCATION ECONOMICS {B.SC.ED.ECONOMICS}

FEBRUARY, 2012.
CHAPTER ONE

INTRODUCTION

Background to the Study

In Nigeria and many other countries of the world, the prevalence of the ugly and life claiming disease of HIV/AIDS has constituted menace and rather becoming unbearable in our society. Among other health issues, HIV/AIDS epidemics remain one of, if not the greatest obstacle combating the world. The Joint United Nations Program on HIV/AIDS, (UNAIDS) and World Health Organization, (WHO) affirmed that a primary source of risk of HIV/AIDS is unprotected and indiscriminate sexual activity which is said to be prominent among youths. In Nigeria, most adolescents are sexually active by the time they are 18 years. Among the various groups considered, the college or higher institution environment was found to provide great opportunity for HIV high-risk behaviours, including unsafe sex and multiple partnerships (Adefuye, Abiona, Balogun & Lukobo-Durrell, 2009). This necessitates the need to study the knowledge and sexual attitudes of students in Nigeria higher institutions towards the Sexually Transmitted Diseases (STDs) of HIV/AIDS.

AIDS stand for Acquired Immune Deficiency Syndrome. It is a pattern of devastating infections caused by the Human Immunodeficiency Virus (HIV), which attacks and destroys certain white blood cells that are essential to the body’s immune system. Over the years, several medical researches have been conducted to find a lasting remedy for the deadly disease but there have been no effective or permanent cure for HIV/AIDS other than prevention. Today,

HIV prevention remains one of the world’s most important priorities.

The rampant nature of sexual insanity among students in Nigeria higher institutions which they are rather reluctant to discuss except in the close circle of violators of common norms, have place them at risk for Sexually Transmitted Diseases (STDs). University students for instance display sexual behaviour and developmental characteristics such as unprotected sex, heterosexual and indiscriminate sexual activities which make them liable to easily contact HIV/AIDS. This also results into unwanted pregnancy thereby promoting mother-to-child HIV/AIDS transmission, through which the disease is spread across the population.

In Nigeria, an estimated 3.1 percent of adults between ages 15-49 are living with HIV and AIDs. Approximately 170,000 people died from AIDS in 2007 alone. With AIDS claiming so many lives, Nigerians’ life expectancy has declined significantly. Life expectancy in 2007 is 46 years for women and 47 years for men. Despite positive intentions for tackling the epidemic, in 2006 it was estimated that just 10% of HIV-infected women and men were receiving antiretroviral therapy and only 7% of pregnant women were receiving treatment to reduce the risk of mother-to-child transmissions. HIV is primarily transmitted through heterosexual sex. Blood transfusion accounts for just 10% of new HIV infections. Another route is mother-to-child transmission; an estimated 220,000 children are living with HIV, most of who became infected from their mothers. Factors contributing to these methods of spread in Nigeria include lack of sexual health education and information because sex is seen as a private subject, existence of many misconceptions about sex and HIV, stigma and discrimination of the infected person, lack of voluntary and routine HIV testing, poor healthcare system and lack of motivated health care providers. Cultural practices also contribute to the spread of HIV/AIDs in Nigeria. Women account for 58% of all adults aged 15 and above living with HIV (AVERT, 2009).

Akwara, Madise &Hinde (2003), explained that the meaning and context of sexuality differ across populations and cultures and this has greatly affected the understanding of sexual attitude/behaviour. Quoting Bongaarts (1995) they opined that “sexual attitude or behaviour is probably responsible for much of the differences in heterosexual HIV/AIDS epidemics among countries, as well as for the equally large differences among regions and demographic groups within countries”.

Our universities are now witnessing a general moral sexual decadence and illicit sexual relationship among students in the name of “Boyfriend” and “Girlfriend” which has promoted the spread of HIV. According to Durojaiye (2009), HIV/AIDS remains incurable and devastates many communities and nations. He explained that since the disease was first reported in the United States of America in 1981, it has spread unremittingly to many parts of the world with Africa which has just over 10 percent of world’s population remaining the most affected region.

The latest report by the Global HIV prevention working group (PWG) focuses specifically on behaviour change and change in sexual attitudes. It is expected that when one has the knowledge of HIV/AIDS, the accompanying behaviour would be logical. That is having the knowledge of prevention, transmission and other facts would motivate logical safe sex behaviour, most especially among higher institution students.

Nigeria has entered a stage where the epidemic could increase at an exponential rate unless adequate national and regional responses are mounted to stem the spread of HIV/AIDS most especially in our tertiary institutions.

In an attempt to eradicate HIV, there is a need to educate people, most especially the youths who are very sexually active and increase students’ knowledge as well as modify their sexual attitudes which constitute the crux of most HIV/AIDS education campaign.

The issue of students’ sexual attitudes and the spread of HIV/AIDS is no longer peculiar to individual concern alone, rather a general concern of educators, Counselors and the society at large. Thus, there is lack of balance between the knowledge of HIV/AIDS and the advancement in sexual behaviour of many youths and university students. It is in the light of the above analysis that this study tend to investigate the knowledge and sexual attitudes of students towards contacting the pandemic HIV/AIDS in “AWO VERSITY”.

Statement of the Problem

HIV/AIDS epidemics and its continuous spread in Nigeria’s tertiary institutions is indeed a problem and causes great impediment to smooth learning. Many students have lost confidence in themselves, show little or no interest towards school activities and have also lost hope in their future careers due to the hazardous infection of HIV/AIDS which remain incurable. Many students frequently fall sick due to HIV infection thereby missing lectures, assignments and even exams which have made many students drop-out from the school system. The statistics on HIV/AIDS transmission in Nigeria is alarming, coupled with the fact that adults, adolescents, and children are all at risk. Lack of information, misconceptions, stigma and discrimination, lack of voluntary testing and discrete sexual attitudes of students are some of the contributing factors. Sex is the primary route of the transmission of HIV in Nigeria higher institutions as it had been established.

Many Obafemi Awolowo University students are mainly teenagers, leaving secondary schools with restrictive rules and regulations that bear on their sexual attitudes. Even those in their early twenties still blindly fall in love and engage in illicit sexual activity that put them at the risk of HIV/AIDS which jeopardizes their future. These students are probably going to be faced with situations and circumstances that require informed decision on how to lead a sexually-responsible life.

Objectives of the study

The main objective of this study is to investigate and evaluate the knowledge and perception of male and female undergraduate students of the Obafemi Awolowo University, with regards to HIV/AIDS and determine their sexual attitudes and behaviours. More precisely, the study was carried out to:

ascertain the level of knowledge of Obafemi Awolowo University students on the risk behavior that promote HIV/AIDS transmission.

2. identify the differences between the level of knowledge of male and female students of Obafemi Awolowo University on risk behaviours that promote HIV/AIDS transmission.

3. investigate the kind of sexual attitudes that students of Obafemi Awolowo University have towards the infection of HIV/AIDS.

4. Identify the possible ways of preventing and curbing HIV/AIDS transmission.

Research Questions

From the statement of the problems, the following research questions were raised;

1. What is the level of knowledge of Obafemi Awolowo University students towards the risk sexual behaviours of HIV/AIDS transmission?

2. Does the level of knowledge of HIV/AIDS differ between male and female students of Obafemi Awolowo University on the risk behaviours that promote HIV/AIDS transmission?

3. What are the different sexual attitudes of students of Obafemi Awolowo University?

4. What are the possible ways of preventing and curbing HIV/AIDS transmission in Obafemi Awolowo University?

Research Hypothesis

Based on the research questions formulated above, the following hypotheses can be formulated for questions 2 and 3.

Hypothesis 1:

H₀: There is no significant difference between the level of knowledge of male and female students of Obafemi Awolowo University on the risk behavior that promote HIV/AIDS transmission?

H₁: There is a significant difference between the level of knowledge of male and female students of Obafemi Awolowo University on the risk behavior that promote HIV/AIDS transmission?

Hypothesis 2:

H₀: There is no significant difference between the sexual attitudes of male and female students of Obafemi Awolowo University.

H₁: There is a significant difference between the sexual attitudes of male and female students of Obafemi Awolowo University.

Decision Rule: Accept H₀ if P-Value is greater than 0.05 and reject H₀if P-Value is less than 0.05.

Significance of the Study

This study is of great importance to students, lecturers, school authority, parents, guidance and Counsellors, as well as Government etc. However, this study aims at reversing the spread of HIV/AIDS infection among students of Obafemi Awolowo University.

The study is also targeted at providing the students with correct and adequate knowledge of the prevention of HIV/AIDS epidemics as well as increases their perception on the risk behaviour that could promote HIV transmission. It will also enable the students to develop good sexual attitudes and motivate logical sexual behaviours in them.

This study will identify and compare the level of knowledge and kind of attitudes that male and female students of Obafemi Awolowo University have towards risk behaviours that promote HIV/AIDS transmission.

The findings of this study might provide useful data for health care providers of the university, researchers and lecturers at the university, student support personnel at the university, and the university administration, with which to design appropriate intervention and programs that will promote HIV/AIDS risk behaviour reduction among the students, as they spend their life within and outside the university community.

The study highlighted the setback that HIV/AIDS epidemics cause on educational development and students’ academic career. The study will also provide some recommendations and possible solutions that are effective in curbing the problem.

In addition, it will also provide insight to Government and Counsellors to fashion out strategies to end HIV infection through a more appropriate behavioural change programme. This will gear the government and policy makers towards the entrenchment of sexuality education into the curriculum of all schools in Nigeria so as to promote healthy life style among youths.

Scope of the Study

The investigation is restricted to male and female students such that some faculties were randomly selected across Obafemi Awolowo University.

Therefore students’ responses on how much knowledge they have on risk behaviours that promote HIV/AIDS transmission and what kind of attitude they posses towards these risk behaviours were analyzed to determine the level of significance in relation to their knowledge and sexual attitudes towards HIV/AIDS.

Operational Definition of Terms

KNOWLEDGE: information, understanding, skills or experience about something.
ATTITUDE: the way you behave, feel or think towards something or somebody.
HIV: Human Immunodeficiency Virus (HIV), which attacks and destroys certain white blood cells that are essential to the body’s immune system.
AIDS: a deadly and incurable disease termed; Acquired Immune Deficiency Syndrome.
SEX: physical activity between two people in which they touch each other’s sexual organ
SEXUAL ATTITUDE: the way people behave, think or feel towards the activity of sex and fusion of male and female cells.
HETEROSEXUAL: a person who is sexually attracted to people of the opposite sex.
EPIDEMIC/PANDEMIC: a large number of cases of a particular disease or a disease that spread over a country or worldwide.
INFECTION: disease or virus that causes illness.
TRANSMISSION: the process of passing something from one person or place to another.
ILLICIT: a dishonest act that is not allowed and such act is forbidden by law.
INDISCRIMINATE: action done without careful thought about what the result may be or the harm it might cause on people.
STIGMA: feelings of disapproval that people have about certain illness.

CHAPTER TWO

LITERATURE REVIEW

This chapter reviews the literatures that are relevant to this study. This review is presented under the following headings:

· The pandemic of HIV/AIDS

· HIV/AIDS Prevalence in Nigeria

· Knowledge and awareness on HIV/AIDS

· Sexual attitudes/behaviours

· Impact of HIV/AIDS on education

· Education and Counsellors as tools for change

· Prevention of HIV/AIDS and risky sexual attitudes

· Rationale and summary

THE PANDEMIC OF HIV/AIDS

AIDS has become one of the major public health threats of the twentieth century. Over two decades ago since HIV/AIDS was first identified, the body of research into the pandemic disease has been steadily growing. Today this research covers a wide range of topics ranging from strictly medical studies to the educational, social and demographic implications of the study as well as to research into interventions and best practices that may help to curb the spread of the disease. HIV expanded to an epidemic because of a combination of different simultaneous factors: the liberation of sex behaviour, the development of prevention pills, mass tourism, increasing common mobility, the use of intravenous drugs and the American lower cultures of homosexual men (Löytönen 1993).

Acquired Immunodeficiency Syndrome (AIDS), caused by the Human Immunodeficiency Virus (HIV), was first diagnosed in the United States in 1981 (Gottlieb et al., 1981). Since the first cases were diagnosed in North America, AIDS has grown into an international pandemic (Chin, 1990). Adolescents and young adults are at high risk for sexually transmitted diseases (STD), including HIV, since they are at an early stage of sexual behaviour, changing partners frequently. They thus constitute a group of the 4, 250 000 cases of AIDS that have been reported to the Centers for Disease Control and Prevention in the United States since 1981, fewer than 1% have occurred among 13 to 19-year-olds, and about 20% among 20 to 29-year-olds (Centers for Disease Control, 1993). Given that the median duration of the incubation period, between infection with HIV and onset of AIDS, is nearly 10 years, many 20 to 29 years with AIDS may have been infected during adolescence (Morris et al., 1993). In 1989, AIDS ranked as the sixth leading cause of death among 15 to 24-year-olds in the US (National Center for Health Statistics, 1994).

Two-thirds of the reported AIDS cases among adolescents have resulted from sexual behaviour. Adolescents with AIDS are less likely than adults to have acquired HIV from sex between men or by injected drug use. Instead they have been most likely to acquire HIV from heterosexual contact and, before 1985, from transfusion of blood (Ver- mund et al., 1989).

Unlike other diseases, HIV is severe in that it is able to modify its structure, which is one of the reasons that make it so difficult to develop a suitable vaccination against it. HIV is a member of the genus Lentivirus, part of the family of Retroviridae. Two species of HIV infect the humans: HIV-1 and HIV-2. HIV-2 is less transmittable than HIV-1 and is largely confined to West-Africa. HIV-1 is more virulent and easily transmitted. HIV-1 is the cause of the majority of HIV infections globally (Leinikki 1993). Infection with HIV-1 is associated with CD+4T cell count and an increase in viral load. The stage of infection can be determined by measuring the patient’s C+4T cell count and the level of HIV in blood (Aitken 2005, UNAIDS 2007).

Women between the ages 15–19 are two to four times more likely than males to become infected with HIV through unprotected sex and mostly in heterosexual relationships. Many women do not know how their partners have been infected. Montgomery et al. (2003) reported of men with bisexual identity and heterosexual behaviour. Only a few of the HIV infected men who had sex with men identified themselves as heterosexuals. Their female partners may not know of their bisexual behaviour. As the HIV infection is asymptomatic for a long period of time the people living with it may not be aware of being infected (Holmström 2002, UNAIDS 2007).

There is currently no vaccine or cure for HIV or AIDS (UNAIDS 2002, Ristola & Sutinen 2002). At the end of the 1980s zidovudine was the first medicine to have an effect on HIV. The current treatment for HIV consists of highly active antiretroviral therapy (HAART). HAART is a combination of at least three HIV drugs. In countries 22 where the HAART treatment has been widely introduced, AIDS mortality has fallen by 50–75% since 1995. HIV medication means that the patients stay in a better condition and in-patient care is not needed and the progression from HIV to AIDS takes longer. The results of HAART are due to medication intolerance and side effects. HAART medication is expensive and available only in the developed industrial countries (Ristola & Sutinen 2002). Some HIV/AIDS patients remain free of serious symptoms for a long time while some of them suffer frequent complications and symptoms throughout their infection. Palliative care for HIV/AIDS is a balance between acute treatment and attending to the control of chronic symptoms and conditions unlike that for other diseases.

Most people with HIV/AIDS suffer from many symptoms including pain. The symptoms can occur at the same time and lead to other symptoms such as anxiety and depression. HIV/AIDS patients should be helped to understand the limits of the treatments. The most common symptoms are: pain, tiredness, anxiety, sore mouth, sadness, weight loss, nausea, fever, coughs and depression (UNAIDS 2000). The study of Selvyn et al. (2003) showed that a need for palliative care services for HIV/AIDS patients should be increased because AIDS evolves into a more chronic disease. In the study of Karus et al. (2005) pain, lack of energy and worrying were reported by a majority of the patients. On average the patients reported 10.9 to 12.7 symptoms. Results showed that despite the availability of more efficacious treatments, many HIV/AIDS patients experienced that their symptoms not being treated.

In the developing countries the spread of the heterosexual HIV is heterogeneous. Factors that explain the wide diversity of the prevalence of HIV in different countries may be underdetermined.

HIV/AIDS PREVALENCE IN NIGERIA

HIV/AIDS was first diagnosed in Nigeria in the early 1980s, the country embarked on health-focused initiatives to combat the epidemic. However, the rapid and alarming spread of the epidemic which saw the prevalence rate rise from 1.8% in 1998 to 5.8% in 2001 caused the government to shift to mechanisms and strategies to prevent the spread, mitigate its consequences and provide care and support for people living with or affected by AIDS.

In a recent release by the Federal Government of Nigeria, the Director-General of the National Action Committee on AIDS, Prof. John Idoko on Monday 13^th February, 2012 in Abuja declared that the country records 281,000 new HIV infections annually and of about 3million affected, only 400,000 are currently receiving drugs (Punch Newspaper, Friday 14^th February, 2012). In this regard, education was identified as the critical means for achieving behaviour change in and out of the classroom.

The National Health Sentinel Survey (NHSS) 2008 Sentinel Survey on HIV prevalence by age indicated that young adults between the ages of 25- 29 are mostly affected as shown in the table below:

Age Group (Years)

Fig: HIV Prevalence by age in Nigeria

Source: NHSS 2008 Sentinel Survey

The graph above shows that young people especially those at the late adolescent and early adulthood are mostly affected by the disease and since a majority of these individuals are sexually active. The major medium through which the infection is spread is by heterosexual intercourse; more young people between the ages of 15-39 are going to be affected by the disease. This is because they constitute the most sexually active and economically productive segment of the society. Anyiam-Osigwe & Okudo, 2006 revealed that youths are more susceptible to AIDS and that every 15 seconds; one young person is infected with HIV and that 60% of all newly infected HIV/AIDS victim on annual basis are under 30 years of age.

The first national workshop on HIV/AIDS and education was held in Abuja, Nigeria in June 2002 organised by UNESCO and the Federal Ministry of Education with support from UNAIDS and DFID. The aim of the workshop was to identify appropriate preventive education responses to HIV/AIDS challenges in Nigeria. As a demonstration of its commitment to addressing HIV/AIDS on the continent, Nigeria hosted the African Union (OAU) special summit on HIV/AIDS in June 2001 during which the Abuja declaration was made. The declaration of commitment by the United Nations General Assembly Special Session of June 2001 emphasized a multi-sector approach in which preventive HIV/AIDS education and empowerment of youth are important strategies. In the same vein, Anti- Retroviral Therapy in Federal Government of Nigeria designated centres since December 25, 2005. 2006 has witnessed a massive up scaling of Anti- Retroviral Therapy in Nigeria.

KNOWLEDGE AND AWARENESS ON HIV/AIDS

Knowledge describes what people think. It is a cognitive component of attitude. Knowledge and information about HIV/AIDS have been shared through several information sources and media. Requirements for sexual education and study material on HIV/AIDS and other sexual disease are continuously growing. Quantitative and qualitative studies over the past decade and a half contributed to our understanding of the factors that influence HIV/AIDS related behaviour. The first important aspect is the strong and consistent link that has been found in a number of studies between the level of knowledge of HIV/AIDS and sexual activity (Magnani, 2002).

In general, studies of college students indicate that they have a relatively high level of knowledge, including general knowledge, knowledge about HIV/AIDS transmission and prevention (Svenson and Varnhagen, 1990; Green et al., 1991). Most of the studies, however, report some caveats in knowledge which lead to significant misconceptions and risky behaviour. In one of these studies, for example, only 61% knew that people with the AIDS virus do not necessary look sick (Greenlee and Ridley, 1993). Mass- media-television, magazines, newspapers and pamphlets rather than family members, friends or medical personnel, are the major sources of information about AIDS-related issues for adolescents and young adults (DiClemente et al., 1986; King et al., 1988; Green et al., 1991). Relatively high percentages of adolescents (20-45%) report that they do not receive information from parents or medical professionals (Hingson and Strunin, 1992).When asked, young adults express the wish to learn more about the disease, and from medical sources, which they see as more reliable than the mass media (King et al., 1988; Green et al., 1991).

According to Becker and Maiman (1975), knowledge about disease prevention and personal concern about disease contraction should lead to disease prevention behaviour. However, the high level of general knowledge about AIDS-related risky behaviours, including knowledge about the effectiveness of condom use, as well as concern about being at risk for HIV infection, are often reported to be unrelated to safe sexual behaviour (Svenson and Varnhagen, 1990; Varnhagen and Svenson, 1990; Carmel et al., 1992; Oswald and Pforr, 1992; Greenlee and Ridley, 1993). Hence, efforts in the direction of increasing awareness and concern about the disease among university students, although necessary, are not sufficient to promote the desired behaviour without proper education on the need for healthy sexual attitudes and safer sexual behaviour.

SEXUAL ATTITUDES/BEHAVIOURS

Sexual attitudes describe the way people behave, think and feel towards the activity of sex, which have been found to have a great link with the spread of HIV/AIDS in our society. In spite of the AIDS pandemic, studies of adolescents in Western countries report that their sexual activity has increased during the last 10 years. The reported changes include having first sexual intercourse at a younger age and an increase in the reported numbers of sexual partners (Hingson et al., 1990a, b; Carmel et al., 1992; Oswald and Pforr, 1992).

With regard to patterns of sexual activity, frequency of sexual intercourse among adolescents is reported to be associated with the number of years of sexual activity and the number of years of dating. Baldwin and Baldwin (1988) found that university students who had sexual intercourse at a young age and those who have had many sexual partners continue to have a high number of sexual partners, regardless of their level of knowledge concerning AIDS. This is consistent with the findings of DuRant and Sanders (1989) who also found that frequency of sexual intercourse among adolescents was associated with the number of years of sexual activity and the number of years of dating. Significant differences in sexual behaviour among subgroups of adolescents within societies and among societies are also detected (Traeen et al., 1992a). In an Israeli study on 18 to 19-year-olds, males consistently report being more sexually active than females: They start having sex at a younger age and report having more sexual partners (Carmel et al., 1992). In North American studies of adolescents, however, there are reports of either an opposite trend, i.e. of women being more sexually active than men (Leland and Barth, 1992; Traeen et al., 1992a), or of no significant gender differences in sexual behaviour (Caron et al., 1993). Such differences are mainly explained on the basis of age, ethnicity and culture (Carmel et al., 1992).

Since HIV is communicated by specific patterns of indiscriminate attitude and risky behavior, it can be prevented by appropriate behavioural change. For example, when practiced with HIV infected partners, anal intercourse, vaginal intercourse, and the sharing of unclean needles have been identified as behaviour that pose very high risk of HIV transmission (R A. Coates & Schechter, 1988; H. G. Miller. & Moses. 1990). It is possible for people to avoid these behaviour, or to engage in safer variants of them (e.g. to use condoms when engaging in potentially risky sexual acts, to clean needles with bleach before sharing them), and thus to reduce their risk of HIV infection. However, behaviour change in the direction of prevention remains inconsistent among gay men. Change in attitudes among heterosexually active high school and college students has been small to non-existent. In view of the persistence of AIDS-risk behaviour, it is evident that research on methods for encouraging widespread attitudinal change must remain a priority for the behavioral science community and for the global fight against AIDS (Albee, 1989; Coxon & Carballo, 1989; Institute of Medicine 1986, 1988). Today, there have been numerous attempts by behavioural scientists to formulate interventions to reduce sexual and HIV-drug-related AIDS-risk behavior within various populations, and they have been quite variable in the sophistication of their theoretical basis and in their impact on attitudinal change.

IMPACT OF HIV/AIDS ON EDUCATION

The epidemics of HIV/AIDS have constituted great menace to our educational system at all levels. More importantly our higher institutions of learning are now witnessing a general moral sexual decadence, indiscriminate sexual attitudes and illicit sexual relationship among students. Many students now live with HIV without being aware of it and consequently they engage in sexual activities with others, thereby promoting the deadly disease as a result of illicit sexual attitudes.

According to Clement (2002), ‘there is a growing awareness of the magnitude of the impact of HIV/AIDS on the various segments of the population most at risk.’ However, intervention programs for in-school youths have met with several challenges such as lack of political will, funds, motivation, facilities and sustainability issues. Consequently, very few studies appeared to have been conducted on the impact of the epidemic on the Nigerian populace.

According to the former Minister of Health, Prof. ‘Beko Ransome–Kuti (1999), “Over 60% of patients presented at Nigerian hospitals with abortion complications are adolescent girls, abortion complications account for 72% of all deaths among young girls under the age of 19 years and 50% of the deaths in Nigeria’s maternal mortality rate are adolescent girls, due to illegal abortion. Of 127 pregnant schoolgirls, 52% were expelled from school. 20% were too ashamed to return, 15% would not return because their parents refused to pay tuition, and 8% were forced to marry. One of these alternatives is to give knowledge about sexuality to young people so that they can take responsibility for their actions. Allowing them to live and act in sexual ignorance is destructive to them and society. The problem of AIDS affects all aspects of the life of young people. They bear the greatest brunt of the disease and its spread is most rapid among them. They are therefore at the centre of the epidemic.”

Consequently, at the 46th Session of the National Council on Education in March 1999, approval was given for the incorporation of Sexuality Education into the national school curriculum. So, the Nigerian Educational Research and Development Council (NERDC) collaborated with other government agencies, NGOs and UN agencies to develop a curriculum on Sexuality Education which is considered critical in helping young people with the acquisition of adequate knowledge, skills and responsible sexual attitudes needed to prevent and reduce sexually transmitted infections (STI) including HIV/AIDS.

Based on an empirical study, Federal Ministry of Health [2002] speculated that HIV/AIDS could have the following impacts on the education system:

- Decrease in supply of teachers;

- Increase in the training costs for teachers;

- Less public funding for schools;

- Drop in school enrolment, especially for girls;

- Loss of financial, material and emotional support for orphans towards successful schooling.

EDUCATION AND COUNSELLORS AS TOOLS FOR CHANGE

The focus on education makes sense objectively and intuitively when one considers that education system reaches the majority of people in most countries and that almost every prevention effort depends on education and communication in some way or another (Kelly, 2003; UNAID, 1997; UNESCO 2002). Education is also necessary to combat the culture of silence, attitude, stigmatization and discrimination that is associated with HIV/AIDS (UNESCO 2002). The responsibility of promoting change through education system falls on the shoulders of teachers and counsellors. Policy and program documents analyzed for the purpose of this study consistently suggest that the role of teachers in combating HIV/AIDS should involve at least the following three key elements:

· Creating preventive awareness of the disease by generating knowledge and understanding

· Promoting attitude development and change; and,

· Ensuring that people (especially youths) develop skills that will allow them to be competent and assertive in managing relationships and sexual issues (UNESCO 2002).

Knowledge about HIV and AIDS is centered on disseminating information about the modes of transmission, means of prevention and attitudes/behaviours that enhance susceptibility. Attitudes typically concern not only the overall attitude towards the disease, but also encourage tolerance and understanding of those that have been affected by HIV. In practice, however, a lot of the teaching about HIV/AIDS in schools still focuses only on the knowledge dimension of HIV/AIDS (Action Aid, 2003).

The task for teachers and counselors is, however daunting from various perspectives. Teachers often lack the curricular time and orientation to adequately address the issue within schools (Kelly 2002). In addition, studies have also shown that most teachers routinely do not even get the information, training or support that they need in order to be able to implement their work (Malambo, 2000). Teachers often rely on rote learning, which promotes an academic/overly scientific interpretation of the subject without ensuring that students have a true understanding of the factors that affect transmission of the disease and which still leaves them relatively unequipped to prevent becoming effected.

Another complicating factor is that teaching students (especially children) about HIV/AIDS goes against the predominant view in most societies in which sex is a taboo topic that should not be discussed at any cost. Kelly notes that although educators are usually aware of the knowledge and information gap that exists between the home and the school, they are very often because of the reason mentioned above, unable to make provision for it. A tension arises between how disease is interpreted in terms of values attitudes and beliefs in the home environment and the scientific way in which it is presented in the schools. At the same time, the nature of the disease is such that open discussion is tremendously important since it is the silence about the disease and its effects that facilitates its spread and leads to stigmatization. (Kelly, 2003; Macintyre, Brown, Sosler, 2001). Some researchers therefore argue that education about HIV/AIDS and related areas should therefore not be seen as an “optional extra … (but as) … a matter of life and death” (Kelly, 2002, p. 11). An additional complicating factor is that teachers are feeling the strain of the pandemic too, and according to some sources are being disproportionately affected by it (Coombe & Kelly, 2001).

The World Bank (2002) sums up the current situation by stressing that HIV/AIDS has a heavy impact on the education system from three perspectives:

- the first is the demand for education, since infected students are getting sick, leading to absenteeism and dropping out of school

- the second impact is on supply of education as a result of sickness, death and psychological and economic strain on teachers

- the third is the combined effect of the impact on supply and demand is having a considerable impact on the costs of education, as sick days go up and new teachers have to be trained to substitute for those that are falling sick and dying.

As a result, Kelly (2003) notes that the education system will need to establish programs and activities that run on a continuum from prevention to care, so as to be able to prevent the spread of the pandemic among both students and teachers, and to provide effective care and support for those among these two groups that are already affected by the pandemic. The World Bank estimates that an additional 550 million dollars per year will be needed for the low income countries to achieve the objectives of Education for All.

There is a serious concern about the capacity of willingness of many teachers to engage in life skills programs or to provide the complementary care and counseling support (Coombe 2002). In addition, most of the research on HIV/AIDS education in schools has focused on assessing the change in the target group (i.e. students) in terms of knowledge, attitudes, and intended or actual behaviour (cf. Horizons, 2001; Venier, Ross & Akande, 1997).

Far fewer studies have specifically and systematically examined:

(i) teachers’ knowledge, attitudes and behaviour with regards to HIV/AIDS education

(ii) how teachers are juggling this complicated task of contributing towards the fight against HIV and AIDS in their schools and communities

(iii) how they perceive the impact of the disease.

As it is noted in a recent report by Action Aids, “very limited research has been devoted to the implementation of HIV/AIDS in the classroom” and most of what is known about what happens in school is based on anecdotal evidence (Kelly, 2000). There appears to be an implicit assumption that once teachers are given the right training and support (curriculum and materials), they will necessarily become effective vehicles for contributing to promoting the envisioned change in the “window of hope” target group.

To this effect, the role of teachers and counsellors towards a positive and effective change in sexual attitudes and developing good sexual behaviours among students will go a long way in curbing the alarming spread of HIV/AIDS in our various schools and the society at large.

PREVENTION OF HIV/AIDS AND RISKY SEXUAL ATTITUDES

The goal of preventing HIV/AIDS is to help an individual to take responsibility for the well-being and health of their own as well as that of their partners. Young adults (especially higher institution students) need adequate prevention against the indiscriminate sexual attitudes that have pervaded our institutions of learning. For a successful prevention program, there is need for high commitment, political will and positive change in attitude of people.

The UN Population Fund, UNFPA, has listed sixteen ways of preventing HIV/AIDS (Kiviluoto 2002). The factors have also been considered important for the prevention by other studies. The young everywhere need information as well as open and comprehensive, non-moralizing sex education. The provision of sexual education should also support the self-esteem and life skills of the young. The media and the way the sexually transmitted diseases are informed of and dealt with in the media have an influence on the attitudes and the common reaction of the young regarding HIV and HIV-positives (Holmström 2002).

Change in the sexual attitude is focused on the counselling on prevention at the individual level. Routes of transmission and methods of prevention are also stressed. Prostitution is one of the most important sources of infection in many countries. The amount of sexually transmitted HIV infections can be lowered by decreasing the number of sex partners, avoiding sexual contacts with individuals who have several partners and also by having safer sex. Prevention and treatment of other sexually transmitted diseases is important since the diseases increase the risk of becoming infected. An important factor in the prevention of HIV is to increase the opportunities of women and children to refuse to engage in risky sex and other demands for contraception. According to Fako (2006) the importance of sexual activity, the number of partners, happiness with life in general, level of attachment to father and physical fights with other children were identified as the social and psychological predictors of willingness to be tested for HIV. The study shows the importance of continued education in voluntary counselling and testing among active young people, especially those from poorer backgrounds in the rural areas (Kiviluoto 2002, Roark et al. 2005).

The availability of male and female condoms and other preventive methods including Contraceptive use and Abstinence have to be increased. Voluntary testing, availability of condoms (male and female), counselling and good health care services are the basics of HIV prevention. According to Brown and Wimberly (2005) female condoms are regarded as a solution in promoting safe sex. The most efficient and recommended means to reduce the chances of contracting HIV is condom use. Reported condom use by adolescents and young adults is rather low, ranging from 10 to 66% (Strunin and Hingson, 1987; Kegeles et al., 1988). Male circumcision (genital cutting) is recommended as a prevention method in researches in Uganda, Kenya and Nigeria. The effect of male and female circumcision in virgins as prevention against HIV was studied by Brewer et al. in Kenya. The conclusion was that in eastern and southern Africa HIV transmission may occur through circumcision related blood exposure. Bailey et al. (2007) regarded male circumcision to be a recommendable preventive method carried out in safe services and integrated with other preventive methods (Gray et al. 2007, Vardi et al. 2007).

The prevention of infections among pregnant women and the prevention of transmission of actual infection to foetus and neonates are important both in the industrial and in the developing countries. Besides drug therapy, mother-to-child transmissions have been prevented in the rich industrial countries by means of section births and by refraining from breast-feeding. The risk of breast-feeding varies from 14% to 29% depending on how much virus the mother has in her blood (Vuorenkoski et al. 2002, Lounamo 2007).

There are several studies which showed the importance of prevention programmes for men who have sex with men (MSM). Young people are remarkably vulnerable because the young often perceive the risk of acquiring HIV. Particularly vulnerable are the young girls who have started their sexual activity earlier than average and are still unable to protect themselves against sexually transmitted diseases. The information concerning the prevention of HIV should include also other vulnerable groups such as prostitutes, users of intravenous drugs and men who have sex with men. In the prevention there is a need to take into account the sexual health of people in exceptional and refugee situations. The list of the UNFPA also includes suggestions as to increasing co-operation between the sources of funding, governments, organisations and other bodies for the political support and commitment as well as the training of the health care personnel. The co-operation is also important for the understanding of the extent of the epidemic, the influence of poverty and social circumstances as well as effects on sustainable development (Kiviluoto 2002).

Education is highest in the developed countries. In these countries it is possible to influence the sexual attitudes of people with preventive procedures. The main resources have been focused on information on HIV-related prevention. The prevention, treatment and care of HIV/AIDS in developing countries like Nigeria can also take holistic dimension. In our schools (especially colleges and higher institutions) there is an urgently increasing need to educate students who are mostly adolescents and young adults, about the prevention, treatment and care of HIV/AIDS leading to an effective change in their sexual attitudes.

RATIONALE AND SUMMARY

The above literature review outlined the main strengths and limitations of the research that has been conducted to date. It describes and provides explanation on students’ attitudes (knowledge, feelings and behaviour) towards HIV/AIDS. Explanatory factors associated with the sexual risk behaviour are also identified. Students sexual attitudes are classified into cognitive, affective and behaviour components as reported in various paragraphs.

The devastating impacts of HIV/AIDS on the education system which includes, drops in school enrollment, poor performance of students in academic work and loss of support towards successful schooling, were discussed. This chapter also views education and counselors as tools for creating preventive awareness of the disease, promoting attitude development and change as well as developing skills of managing relationship and sexual issues among students.

Finally, various methods of HIV/AIDS prevention which includes increased knowledge of the disease among students, condom use, contraception, abstinence etc were analyzed. It however provides insight into students and teachers’ willingness to communicate about HIV/AIDS.

CHAPTER THREE

RESEARCH METHODOLOGY

Introduction

This chapter deals with the details of the procedures for this research work. It describes; Research design, population and sample, Research instrument, Validity of the research instrument, Data collection and Data analysis.

Research Design

A survey research design was adopted for the study. The descriptive survey was used to provide structure to the research and show how the criterion variable is influenced by the exogenous variables. The criterion variable (dependent variable) was HIV/AIDS, while the exogenous or independent variables include knowledge, feelings, beliefs and attitudes of male and female students.

Population and Sample

The population for this study consisted of all undergraduate students of Obafemi Awolowo University Ile-Ife, Osun state. The sample comprised two hundred (200) students selected by Simple Random technique. Out of the thirteen faculties in the university, five (5) faculties were selected through a Stratified Random Sampling technique. The five faculties selected are Science, Health sciences, Social science, Technology and Education. However, forty (40) students were randomly selected from each of the five faculties making a total of two hundred (200) students.

Research Instrument

A self constructed questionnaire was designed which consisted of 35 items on the characteristics, level of knowledge and sexual attitudes of male and female students towards HIV/AIDS in Obafemi Awolowo University. The questionnaire contains close ended questions that are structured into three sections. Section A: This part shows the characteristics of students such as age, gender, marital status, religion, faculties/departments etc with eight (8) questions.

Section B: This has eleven (11) items on the possible causes and the level of knowledge of the students on the risk behaviours that promote the spread of HIV/AIDS. The students were asked to respond by marking any of the three options; AGREE, DISAGREE or NEUTRAL as appropriate. Section C: This comprised eleven (11) items on the various sexual attitudes of students toward HIV/AIDS. Section D: this five (5) items on the possible ways of curbing HIV/AIDS transmission. Students are expected to indicate their views as they choose options that they consider most effective in curbing HIV/AIDS transmission.

Validation of Research Instrument

Both the face and content validity of the research instruments were considered in gathering the needed information which is based on experts’ judgment. Some items were modified, some were added while some were removed based on experts’ assessment. However, items in the questionnaire are shown on two pages.

Data Collection

The researcher tried to establish rapport with the respondents before distributing questionnaire to them. The researcher went to faculties of the students, departments, lecture rooms and other social gathering on campus to administer the questionnaire.

The researcher explained briefly how the respondents are expected to respondents are expected to respond to the items in the four sections on the questionnaire. He added that the questionnaire is strictly for research purpose and that information supplied would be treated with maximum confidentiality and with no implication at all. Efforts were made to ensure that each respondent fill the questionnaire independently based on his/her own view without any interference. The questionnaire were later retrieved from the students and collated for further analyses.

Data Analysis

The data were analyzed by using the Statistical Package for the Social Sciences (SPSS) version 16. A Descriptive statistics and Frequency analysis was used to find the simple percentages of males and female students on the level of knowledge and various sexual attitudes practiced in Obafemi Awolowo University. The knowledge and sexual attitudes towards HIV/AIDS were assessed using the three point scales; “AGREE, DISAGREE, NEUTRAL”. To obtain the percentage analysis, the responses were rated 3:2:1 respectively. The YES/NO items on the questionnaire were analysed using percentage, with ‘YES’ rated as ‘1’ and ‘NO’ as ‘o’.

The Mean procedure was adopted to calculate the mean perception score of both male and female students on the knowledge and sexual attitudes towards HIV/AIDS transmission. The mean scores obtained revealed the agreement or disagreement of the knowledge and sexual attitudes of male and female students towards HIV/AIDS transmission in Nigeria tertiary institutions with reference to Obafemi Awolowo University, Ile-Ife.

Analysis of Variance (One-Way ANOVA) was however employed to test for the significant differences between the level of knowledge of male and female students, as well as the sexual attitudes of male and female students.

Also, simple frequency/percentage distribution was devised to ascertain the effective ways of preventing and curbing HIV/AIDS transmission.

CHAPTER FOUR

DATA ANALYSIS AND RESULT

Introduction

This chapter deals with the analysis of data generated from the research study based on the responses obtained from the questionnaires administered. Appropriate Descriptive and Inferential statistics are adopted to analyse the research items raised for the purpose and objective of the study. Hence, the results generated were adequately discussed.

Table one presents the demographic distribution of respondents.

Table 1:

Variable		Frequency (Number of respondents)	Percentage
Gender	Male	100	50.0%
Gender	Female	100	50.0%
Total		200	100.0%
Age	15-19	28	14.0%
	20-24	100	50.0%
	25-29	61	30.5%
	30+	11	5.5%
Total		200	100.0%
Faculty	Education	40	20.0%
	Health sciences	40	20.0%
	Science	40	20.0%
	Social science	40	20.0%
	Technology	40	20.0%
Total		200	100.0%
Marital status	Single	163	81.5%
Marital status	Married	37	18.5%
Total		200	100.0%
Religion	Christianity	116	58.0%
	Islam	72	36.0%
	Traditional	12	6.0%
Total		200	100.0%

Percentage Distribution of Respondents Characteristics

From table 1. above, the demographic distribution of the respondents show that an aggregate of two hundred (200) students were randomly selected, involving one hundred male (100) or 50% and one hundred female students (100) or 50%. Also, the ages of the respondents revealed that 28 or 14% fall between 15-19 years, 100 or 50% are between 20-24 years, and 61 or 30.5% ranges between 25-29 years, while the remaining 11 or 5.5% were 30 years and above. From the study, a total of 200 students were randomly selected across five faculties in Obafemi Awolowo University, which included 40 students (20%) from Education, 40 students (20%) from Health sciences, another 20% or 40 students from Science, also 40 students (20%) from Social sciences and 40 students (20%) from faculty of Technology. The marital status of the respondents depict that 163 or 81.5% are single and 37 or 18.5% are married. Also, 116 or 58% of the students practice Christianity, while 72 or 36% practice Islam and 12 or 6% do Traditional religion.

Variable		Frequency (Number of respondents)	Percentage
Valid	Yes	200	100.0%
Valid	No	0	0.0%
Total		200	100.0%

Table 2: Have you heard about HIV/AIDS before?

Table 3: If yes, how did you hear about it?

Variable		Frequency (Number of respondents)	Percentage
Valid	Home	42	21.0%
	School	44	22.0%
	Media	93	46.5%
	Friends	13	6.5%
	Others	8	4.0%
Total		200	100.0%

Table 4: Have you gone for HIV test before?

Variable		Frequency (Number of respondents)	Percentage
Valid	Yes	96	48.0%
Valid	No	104	52.0%
Total		200	100.0%

Table 2 and table 3 above revealed that all the 200 respondents examined indicated that they have heard about HIV/AIDS epidemics before with 200 or 100% “Yes” and 0.0% “No”. Similarly, from the total 200 students that have heard about HIV before, 42 or 21% heard about it from Home, with 44 or 22% hearing about it in School, while the Media had the largest proportion of 93 or 46.5%, also 13 or 6.5% heard from Friends and 8 or 4% picked Others.

From table 4 above, it was gathered that out of the total 200 students examined, only 96 or 48% have gone for HIV test before while a larger proportion of 104 students (52%) have never gone for HIV test before.

RESEARCH QUESTION ONE:

What is the level of knowledge of Obafemi Awolowo University students on the risk behaviors that promote HIV/AIDS transmission?

The analysis of the responses obtained on this research question revealed that students of Obafemi Awolowo University have adequate and high level of knowledge of HIV/AIDS transmission. This is presented in table 5 below:

Table 5: Percentage Distribution of Knowledge on Possible Causes of HIV/AIDS

S/N	Knowledge/Possible Causes Of HIV/AIDS	Agree		Disagree		Neutral		Total
S/N	Knowledge/Possible Causes Of HIV/AIDS	Freq	%	Freq	%	Freq	%	Freq	%
1	A healthy looking person can be HIV positive.	168	84%	18	9%	14	7%	200	100%
2	AIDS can be cured.	40	20%	119	59.5%	41	20.5%	200	100%
3	AIDS is fatal and not curable.	117	58.5%	57	28.5%	26	13%	200	100%
4	HIV can be transmitted through unprotected sex.	175	87.5%	19	9.5%	6	3%	200	100%
5	One can get HIV by sharing meal with an HIV infected person.	24	12%	160	80%	16	8%	200	100%
6	A person can get HIV by shaking or hugging an infected person.	18	9%	175	87.5%	7	3.5%	200	100%
7	Transfusion of unscreened blood can transmit HIV infection.	171	85.5%	20	10%	9	4.5%	200	100%
8	HIV/AIDS can be contacted through sharing razor blade or using already used injection needle.	176	88%	14	7%	10	5%	200	100%
9	A pregnant woman can transmit the virus to her unborn child.	149	74.5%	31	15.5%	20	10%	200	100%
10	HIV/AIDS is more often transmitted through unprotected sex than other means.	169	84.5%	19	9.5%	12	6%	200	100%
11	The spread of HIV/AIDS can cause great impediment to smooth learning.	123	61.5%	48	24%	29	14.5%	200	100%

Source: Field survey of OAU students, 2011.

From table 5 above, the study revealed that out of the 200 students examined, most of the respondents, 168 (84%) agreed that a healthy looking person can be HIV positive. Also, a larger number of 119 students or 59.5% disagreed that AIDS can be cured, while 117 (58.5%) agreed that AIDS is fatal and not curable. It was gathered that most of the respondents, 175 (87.5%) agreed that HIV can be transmitted through unprotected sex. Meanwhile, 160 out of 200 respondents (80%) disagreed that one can get HIV by sharing meal with an HIV infected person and 175 (87.5%) also disagreed that a person can get HIV by shaking or hugging an infected person. The study shows that transfusion of unscreened blood can transmit HIV infection with 171 or 85.5% agreed responses, while 176 or 88% also agreed that HIV/AIDS can be contacted through sharing razor blade or using already used injection needle and it was supported by 149 or 74.5% agreed responses that a pregnant woman can transmit the virus to her unborn child. The study identified that most of the students (169 or 84.5%) agreed that HIV/AIDS is more often transmitted through unprotected sex than other means and their responses (123 or 61.5%) also indicated that the spread of HIV/AIDS can cause great impediment to smooth learning.

RESEARCH QUESTION TWO:

Does the level of knowledge of HIV/AIDS differ between male and female students of Obafemi Awolowo University on the risk behaviours that promote HIV/AIDS transmission?

In answering this question, the mean score of both male and female students on the knowledge of HIV/AIDS was calculated and Analysis of Variance (ANOVA) was used to determine the significant difference. The result however unfolds that the level of knowledge of HIV/AIDS does not differ between male and female students. This is presented in table 6 and table 7 below:

Table 6: Mean Response Score of Respondents’ Knowledge of HIV/AIDS

S/N	Knowledge/Possible Causes Of HIV/AIDS	Male			Female
S/N	Knowledge/Possible Causes Of HIV/AIDS	Number (N)	Mean (X)	Standard Deviation	Number (N)	Mean (X)	Standard Deviation
1	A healthy looking person can be HIV positive.	100	2.7600	0.62150	100	2.7500	0.57516
2	AIDS can be cured.	100	1.9600	0.63437	100	2.0400	0.65010
3	AIDS is fatal and not curable.	100	2.4400	0.70094	100	2.4700	0.73106
4	HIV can be transmitted through unprotected sex.	100	2.8200	0.47948	100	2.8700	0.39325
5	One can get HIV by sharing meal with an HIV infected person.	100	2.0600	0.46753	100	2.0200	0.42593
6	A person can get HIV by shaking or hugging an infected person.	100	2.1100	0.37322	100	2.0000	0.31782
7	Transfusion of unscreened blood can transmit HIV infection.	100	2.7900	0.51825	100	2.8300	0.47258
8	HIV/AIDS can be contacted through sharing razor blade or using already used injection needle.	100	2.7900	0.51825	100	2.8700	0.46395
9	A pregnant woman can transmit the virus to her unborn child.	100	2.6200	0.70754	100	2.6700	0.60394
10	HIV/AIDS is more often transmitted through unprotected sex than other means.	100	2.7000	0.62765	100	2.8700	0.41815
11	The spread of HIV/AIDS can cause great impediment to smooth learning.	100	2.4100	0.82993	100	2.5300	0.62692
	Total (Mean score)	100	2.4964	0.58897	100	2.5382	0.51626

Source: Field survey of OAU students, 2011.

From table 6 above, the mean and standard deviation of 100 male and 100 female students on the knowledge of HIV/AIDS transmission were generated. It shows a comparison of the mean and standard deviation of the responses of both male and female students on each item. The overall mean for 100 male gives X = 2.4964 and gives X = 2.5382 for 100 female students sampled.

Table 7: Analysis of Variance (ANOVA) of the Mean Response of Male and female students on the Knowledge of HIV/AIDS

Gender	Mean (X)	Standard Deviation (SD)	Source	Sum of Squares	Degrees of Freedom (df)	Mean Square	F	Sig. (P-Value)
Male (N=100)	2.4964	0.58897	Between Group	.2895	1	.2895	1.392	.4286
Female (N=100)	2.5382	0.51626	Within Group	63.76	198	.3221	1.392	.4286
			Total	64.0495	199	.6116

Hypothesis Testing:

H₀: There is no significant difference in the level of knowledge of male and female students of Obafemi Awolowo University on the risk behaviours that promote HIV/AIDS transmission.

H₁: There is a significant difference in the level of knowledge of male and female students of Obafemi Awolowo University on the risk behaviours that promote HIV/AIDS transmission.

Decision Rule: Accept H₀ if P-Value is greater than 0.05, if otherwise reject H₀and accept H₁.

Interpretation: The One-Way ANOVA comparison of the group mean score of male and female students in table 7 above revealed a P-Value =0.4286, since P > .005, we accept the Null hypothesis (H₀) and conclude at five percent (0.05) level of significance that there is no significant difference in the level of knowledge of male and female students of Obafemi Awolowo University on the risk behaviours that promote HIV/AIDS transmission.

RESEARCH QUESTION THREE:

What are the different sexual attitudes of students of Obafemi Awolowo University?

In answering this question, the sexual attitudes of the students were identified based on the items with the highest percentage. Some of the sexual attitudes of Obafemi Awolowo University students include; kissing and hugging, keeping to one sexual partner, engaging in frequent sexual intercourse etc. This is displayed below:

Table 8: Percentage Distribution of Respondents’ Sexual Attitudes

S/N	SEXUAL ATTITUDE	Agree		Disagree		Neutral		Total
S/N	SEXUAL ATTITUDE	Freq	%	Freq	%	Freq	%	Freq	%
1	Sexual partners should engage in kissing and hugging.	125	62.5%	38	19%	37	18.5%	200	100%
2	A man should keep to only one sexual partner.	161	80.5%	22	11%	17	8.5%	200	100%
3	A lady should have only one sexual partner.	164	82%	20	10%	16	8%	200	100%
4	Sexual relation with more than one sexual partner is more preferable.	35	17.5%	147	73.5%	18	9%	200	100%
5	Regular sexual intercourse with one’s sexual partner enhances the relationship.	76	38%	59	29.5%	65	32.5%	200	100%
6	Sexual intercourse should be frequent at least weekly or monthly.	80	40%	47	23.5%	73	36.5%	200	100%
7	Ladies are sexually motivated when they receive gift, favour or money from their sexual partners.	79	39.5%	62	31%	59	29.5%	200	100%
8	Sexual partners should engage in oral genital sex.	36	18%	106	53%	58	29%	200	100%
9	Condom should be used during sex for protection.	139	69.5%	27	13.5%	34	17%	200	100%
10	Condom is not reliable.	123	61.5%	41	20.5%	36	18%	200	100%
11	Condom interferes with sexual pleasure.	82	41%	39	19.5%	79	39.5%	200	100%

Source: Field survey of OAU students, 2011.

Table 8 above presents that out of the total 200 students sampled, more respondents 125 or 62.5% agreed that sexual partners should engage in kissing and hugging, 161 (80.5%) agreed that a man should keep to only one sexual partner and 164 (82%) also agreed that a lady have only one sexual partner. It shows that 147 (73.5%) disagreed that sexual relation with more than one sexual partner is more preferable while 35 (17.5%) supported it. The study unfolds that 76 (38%) agreed that regular sexual intercourse with one’s sexual partner enhances the relationship, 65 (32.5%) are neutral about it and 59 (29.5%) disagreed, while record shows 80 (40%) agree, 73 (36.5%) neutral and 47 (23.5%) disagree on the view that sexual intercourse should be frequent at least weekly or monthly. More students, 79 (39.5%) agreed that ladies are sexually motivated when they receive gift, favour or money from their sexual partners, while 106 (36.5%) disagreed that sexual partners should engage in oral genital sex. Many students 139 (69.5%) agreed that condom should be used during sex for protection, as 123 (61.5%) supported that condom is not reliable and 82 respondents agreed that condom interferes with sexual pleasure while 79 are neutral about it.

However, the difference in the sexual attitudes of male and female students can be verified in table 9 and table 10 as follows:

Hypothesis Testing:

H₀: There is no significant difference in the sexual attitudes of male and female students of Obafemi Awolowo University towards HIV/AIDS transmission.

H₁: There is a significant difference in the sexual attitudes of male and female students of Obafemi Awolowo University towards HIV/AIDS transmission.

Decision Rule: Accept H₀ if P-Value is greater than 0.05, if otherwise reject H₀and accept H₁.

Table 9: Mean Response Score of Respondents’ Sexual Attitudes

S/N	SEXUAL ATTITUDE	Male			Female
S/N	SEXUAL ATTITUDE	Number (N)	Mean (X)	Standard Deviation	Number (N)	Mean (X)	Standard Deviation
1	Sexual partners should engage in kissing and hugging.	100	2.3900	0.79003	100	2.4900	0.78490
2	A man should keep to only one sexual partner.	100	2.6900	0.67712	100	2.7500	0.53889
3	A lady should have only one sexual partner.	100	2.7300	0.60059	100	2.7500	0.59246
4	Sexual relation with more than one sexual partner is more preferable.	100	2.0700	0.53664	100	2.1000	0.48200
5	Regular sexual intercourse with one’s sexual partner enhances the relationship.	100	1.9200	0.82487	100	2.1900	0.83720
6	Sexual intercourse should be frequent at least weekly or monthly.	100	2.0100	0.85865	100	2.0600	0.89691
7	Ladies are sexually motivated when they receive gift, favour or money from their sexual partners.	100	2.0500	0.88048	100	2.1500	0.77035
8	Sexual partners should engage in oral genital sex.	100	1.9100	0.72607	100	1.8700	0.63014
9	Condom should be used during sex for protection.	100	2.5300	0.77140	100	2.5200	0.77172
10	Condom is not reliable.	100	2.3000	0.82266	100	2.5700	0.71428
11	Condom interferes with sexual pleasure.	100	1.9000	0.90453	100	2.1300	0.88369
	Total (Mean score)	100	2.2273	0.76300	100	2.3255	0.71841

Source: Field survey of OAU students, 2011.

From table 9 above, the mean and standard deviation of 100 male and 100 female students’ responses on sexual attitudes were generated. It shows a comparison of the mean and standard deviation of the responses of both male and female students on each item. The overall mean for 100 male gives X = 2.2273 and gives X = 2.3255 for 100 female students sampled. The overall standard deviation was also calculated which indicates SD = 0.76300 for 100 male and SD = 0.71841 for 100 female students sampled.

Table 10: Analysis of Variance (ANOVA) of Mean Response Score of Respondents’ Sexual Attitudes

Source	Sum of Squares		Degrees of Freedom (df)	Mean Square	F	Sig. (P-Value)
Between Group	1.0355		1	1.0355	1.5744	.4676
Within Group	111.7236		198	.5642	1.5744	.4676
Total	112.7591	199		1.5997

Interpretation: From table 10 above, the One-Way ANOVA comparison of the group mean score of respondents’ sexual attitudes generate a P-Value =0.4676, since P > .005, we accept the Null hypothesis (H₀) and therefore conclude at five percent (0.05) level of significance that there is no significant difference in the sexual attitudes of male and female students of Obafemi Awolowo University towards HIV/AIDS transmission.

RESEARCH QUESTION FOUR:

What are the possible ways of preventing and curbing HIV/AIDS transmission?

In an attempt to answer this question, each item the on possible ways of curbing HIV/AIDS was considered in relation to the percentage score. This is presented below:

Table 11: Percentage Distribution of Possible Ways of Preventing and Curbing HIV/AIDS Transmission

S/N	Curbing HIV/AIDS Transmission	Agree		Disagree
S/N	Curbing HIV/AIDS Transmission	Freq	%	Freq	%
1	Avoid sharing items like razor blade, needle, tooth brush, clipper etc with others.	184	92%	16	8%
2	Not having more than one sexual partner.	156	78%	44	22%
3	There should be appropriate use of condom.	162	81%	38	19%
4	Sexual partners should go for voluntary counseling and testing before engaging in sexual activity.	172	86%	28	14%
5	Abstinence.	161	80.5%	39	19.5%

Source: Field survey of OAU students, 2011.

From table 11 above, the study established that a larger number of 184 students (92%) agreed that an effective way of curbing HIV/AIDS transmission is to avoid sharing items like razor blade, needle, tooth brush, clipper etc. Similarly, 156 or 78% respondents indicated that HIV/AIDS can be prevented by not having more than one sexual partner while only 44 or 22% disagreed. The study shows that 162 or 81% respondents agreed that there should be appropriate use of condom while just 38 or 19% disagreed. It was also recommended that sexual partners should go for voluntary counselling and testing before engaging in sexual activity as agreed upon by 172 or 86% respondents while only 28 (14%) disagreed. The respondents also suggested abstinence as an effective way of curbing HIV/AIDS transmission as agreed upon by 161 or 80.5% while 39 or 19.5% oppose it.

Discussion of Findings

The result of the research findings carried out within the context of Obafemi Awolowo University Ile-Ife, ascertained that; all the respondents examined are aware of HIV/AIDS pandemic and that a larger percentage of the students heard about the disease from the media, this is in line with assertions of Diclemente et al., and King et al., that “mass media; television, magazine, newspapers and pamphlets rather than family members, friends or medical personnel are the major sources of information about AIDS-related issues for adolescents and young adults.” It was also revealed that many students of Obafemi Awolowo University have not gone for HIV test before while only few have done so.

The responses of the students affirmed that a healthy looking person can be HIV positive, this is in line with the declarations of Holmstrom (2002) and UNAIDS (2007) that “as the HIV infection is asymptomatic for a long period of time, the people living with it may not be aware of being infected.” Similarly, the findings affirmed that AIDS is fatal and not curable which tallies with the claims of Durojaiye (2009) that “HIV/AIDS remains incurable and devastates many communities and nations.” The result shows that HIV/AIDS is more often transmitted through unprotected sex than other means, this corresponds with the affirmations of the Joint United Nations Program on HIV/AIDS, UNAIDS and WHO that “a primary source of risk of HIV/AIDS is unprotected and indiscriminate sexual activity which is said to be prominent among youths.”

It was identified that the spread of HIV/AIDS can cause great impediment to smooth learning, as also stressed by the World Bank (2002) that HIV/AIDS has a heavy negative impact on the demand, supply and cost of education.

The findings ascertained that the students are aware of HIV/AIDS epidemic and that there is high level of knowledge of the disease, this is in line with the work of Svenson, Varnhagen (1990) and Green et al., (1991) in a study of college students which indicates that they have a relatively high level of knowledge including general knowledge, knowledge about HIV/AIDS transmission and prevention. It also shows that there is no significant difference between the level of knowledge of male and female students.

Investigation unfold that the sexual attitudes often practiced by the students include kissing and hugging, engaging in regular and frequent sexual intercourse, keeping to only one sexual partner, the use of condom for protection during sex and that ladies are sexually motivated when they receive gift, money or favour from their sexual partners. Meanwhile, there is no significant difference in the sexual attitudes of male and female students.

The findings further identified some possible and effective ways of curbing HIV/AIDS transmission which are; avoid sharing items like razor blade, needle, toothbrush, clipper etc, sexual partners going for voluntary counselling and testing before engaging in sexual activity, abstinence and not having more than one sexual partner. The result also suggests that there should be appropriate use of condom for protection during sex; this agrees with the avowal of Brown and Wimberly (2005) that condoms are regarded as a solution in promoting safe sex.

CHAPTER FIVE

SUMMARY AND CONCLUSION

Introduction

This chapter presents a sum up of the research study. It also draws conclusion from the research findings and relevant recommendations were also made in the light of the study.

Summary

This research study explores the knowledge and sexual attitudes of students towards HIV/AIDS within the context of Obafemi Awolowo University campus, Ile-Ife, Osun state.

The study was set out to achieve four main objectives which are; to ascertain the level of knowledge of students on the risk behaviour that promotes HIV/AIDS transmission, identify the differences between the level of knowledge of male and female students on the risk behaviours that promote HIV/AIDS transmission, investigate the kind of sexual attitudes that students have towards the infection of HIV/AIDS and also identify the possible ways of preventing and curbing HIV/AIDS transmission. Following these, an extensive literature review was carried out in order to give insight into the research problem.

A self constructed questionnaire was designed to collect data on the formulated research questions. Two hundred questionnaires were distributed involving one hundred male and one hundred female students across five faculties. The responses obtained were later analysed using simple percentage, mean procedure and Analysis of Variance (ANOVA).

Conclusion on Findings

In line with the research analysis and findings, the following conclusions were drawn:

1. that most students of Obafemi Awolowo University are aware of HIV/AIDS epidemic and that there is high level of knowledge of students on the risk behaviours that promote HIV/AIDS transmission.

2. that there is no significant difference in the level of knowledge of male and female students of Obafemi Awolowo University on the risk behavior that promote HIV/AIDS transmission.

3. that sexual attitudes displayed by Obafemi Awolowo University students include; kissing and hugging, keeping to only one sexual partner, engaging in regular and frequent sexual intercourse to enhance the relationship, going against oral genital sex, the use of condom for protection during sex and that ladies are sexually motivated when they receive gift, money or favour from their sexual partners. Hence, there is no significant difference in the sexual attitudes of male and female students.

4. that the effective ways of preventing and curbing HIV/AIDS transmission include; not sharing items like razor blade, needle, toothbrush, clipper etc, sexual partners going for voluntary counselling and testing before engaging in sexual activity, ensuring appropriate use of condom for protection, abstinence and not having more than one sexual partner.

Recommendation

Following the devastating effect of HIV/AIDS pandemic in our society and the fact that it causes great impediment to smooth learning in our school system, which has significant dreadful implication on the future of our the country. Based on the research findings, the following recommendations were made to Universities, Government, Counsellors, Curriculum Planners, Students, Parents and the society at large, as a way of improving the awareness of HIV/AIDS pandemic and promoting good and healthy sexual attitudes among undergraduate students.

1. Obafemi Awolowo University should intensify more on HIV/AIDS awareness strategies in order to create appropriate awareness on HIV/AIDS risk factors. In effecting this, the University Counselors in conjunction with the Department of Students’ Affairs unit should frequently organize seminars/lectures and workshops on HIV/AIDS risk transmission.

2. Government should launch and improve information campaign on HIV/AIDS on television, radio and distribution of leaflets on its prevention to university students.

3. Sex education and family life should be part of the school curricular. The government should allow the entrenchment of sexuality education into the curriculum of all the schools in Nigeria. This will provide accurate information and knowledge on sexual anatomy, sexual intercourse, sexual reproduction, human sexual behaviour and other aspects of sexuality such as body image, dating, sexual orientation and relationship etc, so as to promote healthy life style among the youths. Since sex is seen as a private subject, sexuality education will make youths to develop objective attitude to sex, get familiar with societal expectations of their future roles as wives and husbands and make right choice of sexual partners.

4. Parents should be awake to their responsibility and teach certain aspects of sexuality at home so that their children will be well prepared for family life.

5. There should be provision of voluntary counselling and routine HIV testing in schools and campuses. To this effect, Government and Counsellors should fashion out strategies to end HIV infection through a more appropriate behavioural change programme. Consequently, a positive sexual attitude could be sustained and increased by organising interactive counselling sessions and services that could be gender specific to allow students air their views publicly on HIV/AIDS related issues and further campaigns to be conducted. More so, counsellors should develop new strategies on campus to interact with undergraduates routinely and develop guidance and counselling programmes that will aid in exposing cultural and religious beliefs that may negatively influence undergraduates’ attitude towards HIV/AIDS campaigns. In this regard, Counsellors should try new strategies like counselling on proper gender role perception and abstinence to help adolescents stay away from sex until they are ready for marriage. They also should encourage the development of skills to help adolescents ward off peers who may intimidate or lure them into wrong sexual practice.

6. The University management should make the university environment (campus) unconducive for actions (behaviours) that could promote sexual immorality.

7. The government should regulate influx of foreign films as well as monitor and censor our local films to protect our adolescents from the adverse effects of exposure to pornographic films.

8. On the campus level, educational programs have to be supported and also increasing the availability and accessibility of condoms, and information about how to get them and how to use them appropriately for protection during sex. In the same vein, abstinence should be encouraged in order to promote a positive sexual behaviour and sexual sanity among students in the age consent.

Above all, a successful prevention program requires high commitment, political will and positive change in attitude of people.

REFERENCE

Abdulraheem, I.S., &Fawole, O.I. (2009). Young people’s sexual risk behaviours in Nigeria: Journal of Adolescent Research, 24(4), 505-527.

Adedimeji, A., 2003. Perception of HIV/AIDS infection and condom use among undergraduates in Nigeria, Department of sociology University of Ibadan Nigeria.

Akande, A. (1994). AIDS-related beliefs and behaviours of students: Evidence from two countries (Zimbabwe and Nigeria). (4) Pg. 285-303.

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Asuquo, P.N. ,Ottoho, C.A., Etudor, E.E. & Asuquo, A. E.(2003). Adolescents’ attitude and sex education. Education for Today, 3(3), 113-119.

Bruce, K.E., & Walker, L.J. (2001). College students’ attitude about AIDS: 1986-2000. AIDS Education and Prevention, 13(5), 428-437.

Charles, Hubert, et. al (eds) (2002): Education Sector’s Response To HIV/AIDS In Nigeria.

Abuja, Nigeria: UNESCO

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Eke-Huber, E., Eaddy, S., & Collins, J.R. (2005). Nigerian college students: HIV knowledge, perceived susceptibility for HIV and sexual behaviours. College Student Journal, 39.

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and Testing.

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Obstetric, Gynecologic, & Neonatal Nursing, 35, 369-375.

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APPENDIX

FACULTY OF EDUCATION

DEPARTMENT OF EDUCATIONAL FOUNDATION ANF COUNSELLING

OBAFEMI AWOLOWO UNIVERSITY, ILE-IFE.

This questionnaire is designed to collect information on the causes of the spread of HIV/AIDS, level of knowledge and the kind of sexual attitudes that students have towards the risk behaviours that promote HIV/AIDS transmission.

Information obtained is mainly for research purpose and will be treated with maximum confidentiality.

SECTION A: PERSONAL DATA

Please tick

√

the appropriate option.

1. Age: 15-19 20-24 25-29 30+

2. Gender: Male Female

3. Marital status: Single Married

4. Faculty: Education Health Sciences Science Social Sciences Technology

5. Religion: Christianity Islam Traditional

6. Have you heard about HIV/AIDS before? Yes No

7. If yes, how did you hear about it? Home School Media Friends Others

8. Have you gone for HIV test before? Yes No

SECTION B:

Mark any of the three point scale following each statement below:

	KNOWLEDGE/POSSIBLE CAUSES OF HIV/AIDS	AGREE 3	DISAGREE 2	NEUTRAL 1
9	A healthy looking person can be HIV positive.
10	AIDS can be cured.
11	AIDS is fatal and not curable.
12	HIV can be transmitted through unprotected sex.
13	One can get HIV by sharing meal with an HIV infected person.
14	A person can get HIV by shaking or hugging an infected person.
15	Transfusion of unscreened blood can transmit HIV infection.
16	HIV/AIDS can be contracted through sharing razor blade or using already used injection needle.
17	A pregnant woman can transmit the virus to her unborn child.
18	HIV/AIDS is more often transmitted through unprotected sex than other means.
19	The spread of HIV/AIDS can cause great impediment to smooth learning.

SECTION C: STUDENTS’ SEXUAL ATTITUDE

What is your view about the following?

	SEXUAL ATTITUDE	AGREE 3	DISAGREE 2	NEUTRAL 1
20	Sexual partners should engage in kissing and hugging.
21	A man should keep to only one sexual partner.
22	A lady should have only one sexual partner.
23	Sexual relation with more than one sexual partner is more preferable.
24	Regular sexual intercourse with one’s sexual partner enhances the relationship.
25	Sexual intercourse should be frequent at least weekly or monthly.
26	Ladies are sexually motivated when they receive gift, favour or money from their sexual partners.
27	Sexual partners should engage in oral genital sex.
28	Condom should be used during sex for protection.
29	Condom is not reliable.
30	Condom interferes with sexual pleasure.

SECTION D:

Tick

√

any of the options you consider effective in curbing the spread of HIV/AIDS

31	Avoid sharing items like razor blade, needle, tooth brush, clipper etc. with others.
32	Not having more than one sexual partner.
33	There should be appropriate use of condom.
34	Sexual partners should go for voluntary counseling and testing before engaging in sexual activity.
35	Abstinence.

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