A STUDY OF HIV/AIDS AWARENESS AND PREVENTION AMONG ABIA STATE UNIVERSITY S

A STUDY OF HIV/AIDS AWARENESS AND PREVENTION AMONG ABIA STATE UNIVERSITY STUDENTS i | P a g e TITLE PAGE A STUDY OF HIV/AIDS AWARENESS AND PREVENTION AMONG ABIA STATE UNIVERSITY STUDENTS BY OLEKANMA ONYEDIKACHI MATRIC NO: 2017/111191/REGULAR BEING A PROJECT PRESENTED TO THE DEPARTMENT OF PUBLIC HEALTH, FACULTY OF HEALTH SCIENCES IN PARTIAL FULFILMENT OF THE REQUIUREMENTS FOR THE AWARD OF B.Sc (HONS) DEGREE IN PUBLIC HEALTH (SUPERVISOR) DR. AGBAI JOHNSON UKWA SEPTEMBER, 2022. ii | P a g e CERTIFICATION This is to certify that this research proposal was originally carried out by OLEKANMA ONYEDIKACHI with matriculation number 2017/111191/REGULAR of the department of Public Health Science in Abia State University, Uturu. The proposal was supervised and approved by: ________________________ _______________ Dr. Agbai Johnson Ukwa Date (Supervisor) ________________________ ________________ Prof. E. E. Enwereji Date (Head of Department) iii | P a g e DEDICATION This work is humbly dedicated to Almighty God who is the source of wisdom and who has also led me throughout the preparation of this research proposal. This work is also dedicated to my lovely children and my friends for their encouragement and support. iv | P a g e ACKNOWLEDGEMENT I humbly express my sincere and profound gratitude to Almighty God who sustained me in all ramifications throughout the period of this study. I thank my humble and able supervisor, Dr, Agbai Johnson Ukwa whose special guidance and fatherly handling acted as a pillar for reaching this stage. I also express my gratitude to all the lecturers in the Department of Public Health Science for their encouragement, inspiration and co-operation which had helped in producing this work. May God bless you all. I am also grateful to my dearly and numerous friends and relations who contributed in the development of this research. I thank you all in Jesus name. Finally, my wonderful and lovely children are not left out as I thank and bless them for the support and prayers they showered on me throughout the research. I love you all so much. v | P a g e ABSTRACT The purpose of this research work was to examine the HIV/AIDS awareness and prevention among Abia State University, Uturu students. The problem of HIV/AIDS is alarming that the researcher tried to find out the actual awareness level of HIV/AIDS among students in Abia State University, Uturu. The objectives of the study are to ascertain the level of awareness on the causes of HIV/AIDS, the behaviour that leads to high risk of the infection, signs and symptoms and preventive measures used in reducing HIV/AIDS among students in Abia State University, Uturu. For a representative view, the researcher randomly selected her samples and administered structured questionnaire on 431 students. All the respondents returned completed copies of the questionnaire which were found usable because the items were properly and completely answered. Four research questions and hypotheses were set for this research. They focused on the level of awareness of HIV/AIDS among students in Abia State University, Uturu. Frequency counts, percentages and independent t-test were the statistical tools used in the analysis of data procured from the research questions and hypotheses. The findings were firstly that there was significant difference in the knowledge of the causes of HIV/AIDS among students in Abia State University, Uturu. Secondly, there was significant difference in the knowledge of behaviour that leads to high risk of HIV/AIDS infection among the subjects. Thirdly, there was no significant difference in the awareness of preventive measures adopted to reduce HIV/AIDS among students in Abia State University, Uturu. It was concluded that there was need for HIV/AIDS counselling for students in general. The main recommendation was that information about HIV/AIDS should be made available to students in their schools, hostels, homes, libraries, public gatherings and places of worship. Curriculum experts in public health education are to incorporate concepts and topics on HIV/AIDS education in the contents of their textbook. vi | P a g e TABLE OF CONTENT TITLE PAGE ............................................................................................................................. i CERTIFICATION...................................................................................................................... ii DEDICATION .......................................................................................................................... iii ACKNOWLEDGEMENT ......................................................................................................... iv ABSTRACT ............................................................................................................................. v TABLE OF CONTENT ............................................................................................................ vi CHAPTER ONE ....................................................................................................................... 1 INTRODUCTION ...................................................................................................................... 1 1.1 Background of the Study ................................................................................................. 1 1.2 Statement of the Problem ............................................................................................... 2 1.3 Research Questions ....................................................................................................... 3 1.4 Objective of the study ..................................................................................................... 3 1.5 Research Hypotheses ..................................................................................................... 3 1.6 Basic Assumptions .......................................................................................................... 4 1.7 Significance of the study ................................................................................................. 4 1.8 Scope of the Study .......................................................................................................... 4 1.9 Definition of Terms .......................................................................................................... 4 CHAPTER TWO....................................................................................................................... 6 LITERATURE REVIEW ........................................................................................................... 6 2.0 Introduction ..................................................................................................................... 6 2.1 The Concept of Human Immuno Deficiency Virus/Acquired Immuno Deficiency Syndrome (HIV/AIDS) ........................................................................................................... 6 2.1.1 Origin of HIV/AIDS ................................................................................................ 6 2.1.2 Causes of HIV/AIDS ............................................................................................. 8 2.1.3 Effects of HIV/AIDS .................................................................................................. 8 2.1.4 Spread of HIV/AIDS .................................................................................................. 9 2.1.5 Symptoms of HIV/AIDS .......................................................................................... 10 2.1.6 Prevention of HIV/AIDS .......................................................................................... 11 2.1.7 HIV Tests ................................................................................................................ 12 2.1.8 Things that Cannot Lead to Contacting HIV/AIDS .................................................. 12 2.2 The Concept of Guidance and Counselling................................................................... 13 vii | P a g e 2.3 The Concept of Students .............................................................................................. 14 2.3.1 Students’ Ignorance of HIV/AIDS ............................................................................ 15 2.3.2 Teaching Sexuality Education in School ............................................................. 16 2.4 Theoretical Framework ................................................................................................. 17 2.5 Review of Previous Studies .......................................................................................... 20 2.6 Summary....................................................................................................................... 22 CHAPTER THREE ................................................................................................................. 23 RESEARCH METHODOLOGY .............................................................................................. 23 3.0 Introduction ................................................................................................................... 23 3.1 Research Design .......................................................................................................... 23 3.2 Population ..................................................................................................................... 23 3.3 Sample and Sampling Techniques ............................................................................... 23 3.4 Instrumentation ............................................................................................................. 24 3.4.1 Description of instrument ........................................................................................ 24 3.4.2 Scoring of the instrument ........................................................................................ 24 3.4.3 Validity of the Instruments .................................................................................. 25 3.4.4 Reliability of the Instruments ................................................................................... 25 3.5 Administration ............................................................................................................... 25 3.6 Procedure for Data Analysis ......................................................................................... 25 CHAPTER FOUR ................................................................................................................... 27 RESULTS AND DISCUSSION .............................................................................................. 27 4.0 Introduction ................................................................................................................... 27 4.1 Demographic Data ........................................................................................................ 27 4.2 Research Questions ..................................................................................................... 28 4.3 Hypotheses Testing ...................................................................................................... 31 4.4 Summary of Major Findings .......................................................................................... 34 4.5 Discussion of Results .................................................................................................... 35 CHAPTER FIVE ..................................................................................................................... 37 SUMMARY, CONCLUSIONS AND RECOMMENDATIONS ................................................. 37 5.0 Introduction ................................................................................................................... 37 5.1 Summary....................................................................................................................... 37 5.2 Counselling Implications ............................................................................................... 38 5.3 Conclusions .................................................................................................................. 38 viii | P a g e 5.4 Recommendations ........................................................................................................ 38 5.5 Suggestion for Further Study ........................................................................................ 39 REFERENCES ....................................................................................................................... 40 APPENDIX ............................................................................................................................. 44 1 | P a g e CHAPTER ONE INTRODUCTION 1.1 Background of the Study HIV (human immunodeficiency virus) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or HIV medicine to prevent or treat HIV), or through sharing injection drug equipment. If left untreated, HIV can lead to the disease AIDS (acquired immunodeficiency syndrome). First identified in 1981, HIV is the cause of one of humanity’s deadliest and most persistent epidemics. The human body can’t get rid of HIV and no effective HIV cure exists. So, once you have HIV, you have it for life. AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. In the U.S., most people with HIV do not develop AIDS because taking HIV medicine every day as prescribed stops the progression of the disease. A person with HIV is considered to have progressed to AIDS when: the number of their CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3). (In someone with a healthy immune system, CD4 counts are between 500 and 1,600 cells/mm3.) OR they develop one or more opportunistic infections regardless of their CD4 count. This means that without HIV medicine, people with AIDS typically survive about 3 years. Once someone has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. HIV medicine can still help people at this stage of HIV infection, and it can even be lifesaving Human Immunodeficiency Virus has emerged as a major health and development concern among adolescents worldwide because as HIV epidemic spreads, younger age groups who are sexually active become exposed to the risk of infection because of their unprotected sexual behaviour. Studies have shown that young people are particularly vulnerable to HIV infection as a result of the physical, psychological, social and economic attributes of adolescents which expose them to risky sexual behaviours. Adolescents who begin sexual activity early in life are likely to have sex with multiple partners including those exposed to HIV infection. Thus, the 2 | P a g e need for HIV prevention programs to delay in-school adolescents' sexual debut. Individual behaviour change, especially sexual behaviour change, appears to be the most effective means to prevent further spread of HIV infection among these adolescents. Education creates awareness and knowledge, and it is a weapon to fight ignorance of any type including AIDS. The Nigerian school system especially in public health, has sexuality education as part of its curriculum. This has to do with teaching and acquiring knowledge in various health issues including HIV/ AIDS. Knowledge of HIV/ AIDS is a part of reproductive health education. Sexuality education and reproductive health connote the same issues. According to Araoye (2018), “reproductive health education involves the provision of adequate and accurate information on matters related to the productive system and its functions.” She stated further that “sexuality involves aspect of body growth and changes associated with puberty, menstruation, ovulation, as well as socio-cultural aspect of gender”. Where adolescent interact such as in the tertiary institution, the tendency is towards engaging in high-risk behaviour that are likely to increase the prevalence of HIV/AIDS. Hence Getso (2014) asserted “tertiary institution as a cohort zone for being influenced by economic status especially the females”. 1.2 Statement of the Problem In our society, children are sometimes exposed at an early age to all sorts of dangers arising from malnutrition, diseases and various temptation of surviving due to lack of adequate knowledge of their surroundings. These are not very good events as they tend to expose the child to future issues. A child not properly guided will grow up into an unguided youth which will exhibit traits of lackadaisical attitudes. The danger in this is that, the type of attitude portrayed can impact negatively on the society at large as youths are the leaders of tomorrow. A situation where a youth is not well informed and grounded in the area of HIV/AIDS simply spells doom and is a ticking time bomb waiting to explode, hence, it becomes very and highly imperative that HIV/AIDS awareness programme be as a matter of urgency introduced and fast tracked in the universities and at other levels of academia to forestall the spread. 3 | P a g e 1.3 Research Questions The following research questions are formulated to guide this study. 1. What is the awareness level of HIV/AIDS among students in Abia State University Uturu? 2. What is the awareness level of HIV/AIDS among students in Abia State University Uturu on the behaviours that lead to high risk of HIV/AIDS infections? 3. What is the awareness level of HIV/AIDS among students in Abia State University Uturu on the signs and symptoms of HIV/AIDS? 4. What is the awareness level of HIV/AIDS among students in Abia State University Uturu on the preventive measures to be used to reduce HIV/AIDS infection? 1.4 Objective of the study The main objective of this research work includes the following; • To ascertain the level of awareness on causes of HIV/AIDS among students in Abia State University Uturu • To identify the level of awareness on the behaviour that leads to high risk of HIV/AIDS infection among students in Abia State University Uturu • To ascertain the level of awareness on the signs and symptoms of HIV/AIDS among students in Abia State University Uturu. • To identify the level of awareness of preventive measures used in reducing HIV/AIDS among students in Abia State University Uturu. 1.5 Research Hypotheses The following null hypotheses were formulated and tested to guide the study. 1. There is no significant difference on the awareness level of the causes of HIV/AIDS among male and female students in Abia State University Uturu. 2. There is no significant difference on the awareness level of behaviours that lead to high risk of HIV/AIDS infections among male and female students in Abia State University Uturu. 4 | P a g e 3. There is no significant difference on the awareness level of the signs and symptoms of HIV/AIDS among students in Abia State University Uturu. 4. There is no significant difference on the awareness level on preventive measures to reduce HIV/AIDS among students in Abia State University Uturu. 1.6 Basic Assumptions This study is based on the following assumptions: 1. The students of Abia State University Uturu will be fully aware of the implications of HIV/AIDS infection. 2. The teachers can also inculcate the knowledge of HIV/AIDS prevention in students. 1.7 Significance of the study The purpose of this study is to carry out research on HIV/AIDS awareness and prevention among Abia state university students. This is with a view to suggesting ways of minimizing and overcoming the problem. As known by all public health workers, health is wealth. The importance of a healthy human cannot be overemphasized. To attain good health, a good awareness of the prevention of illness is paramount. Especially in the case of a deadly disease such as HIV/AIDS. Some of the factors that undermined the awareness of this disease which consequently affect the prevention are the main reason for this study. If these concerns are handles it will go a long way in curbing the spread of this disease. 1.8 Scope of the Study This study tends to focus on the study of HIV/AIDS awareness and prevention among Abia state university students. This study seeks to find out what effect awareness has as regards prevention of the disease as the title of the research reads, the researcher will be limited to Abia state university students and it should be noted that the work may not represent some areas in the institution. 1.9 Definition of Terms HIV – Human immunodeficiency virus is an infection that attacks the body's immune system, specifically the white blood cells called CD4 cells. 5 | P a g e AIDS – Acquired Immune Deficiency Syndrome is the late stage of HIV infection that occurs when the body's immune system is badly damaged because of the virus 6 | P a g e CHAPTER TWO LITERATURE REVIEW 2.0 Introduction In this chapter, some related studies, both outside and inside Nigeria are reviewed. The following sub-headings are reviewed in this chapter: the concept of (HIV/AIDS), concept of Guidance and Counselling, the concept of adolescence, students’ ignorance of HIV/AIDS/STDs, empirical studies, theoretical framework, and summary. 2.1 The Concept of Human Immuno Deficiency Virus/Acquired Immuno Deficiency Syndrome (HIV/AIDS) Human Immuno Deficiency Virus/Acquired Immuno Deficiency Syndrome (HIV/AIDS) are two different acronyms describing two related concepts. There are different illnesses caused by viruses which may not be HIV. These include, cold (catarrh), measles, hepatitis A, B, and C, Chicken pox, polio and so on. The human immunodeficiency virus that causes AIDS is a type of virus called retrourus. It is very tiny to see with the naked eyes except with the help of an instrument called microscope. Garland (2003) posited that HIV is so small that 230,000 viruses could be compared to the point of a pen or a full stop at the end of a sentence. 2.1.1 Origin of HIV/AIDS The origin of HIV/AIDS is not known, but scientists have proposed theories about the origin of HIV/AIDS none of which has yet been proven. Haan (2004) stated that the earliest known case of HIV was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. The genetic analysis of this blood sample suggested that HIV – 1 may have stemmed from a single virus in the late 1940s or early 1950s. Haan (2004) went on to state that the virus existed in the United States by the mid to late 1970. Doctors in Los Angeles and New York reported illnesses of Pneumonia, Cancer and others among people with healthy immune system. In 1982, AIDS was used by health officials to describe the occurrence of such opportunistic infections as Kaposis sarcoma and pneumocystic carnnii (pneumonia) in previously healthy people. That was the year the formal tracking (surveillance) of AIDS cases began in the United States of America. 7 | P a g e However, scholars claimed that the ultimate source of HIV/AIDS was the SubSaharan African continent. It is said that this region continues to be deeply ravaged by the disease. Bankole & Singh(2004) confirmed the above statement and added that SubSaharan Africa has been more devasted by the HIV/AIDS epidemic than any other region of the world. Garland (2003) presented explanation of the HIV/AIDS acronym thus: H – Stands for Human – the Virus is only found in humans; it is not found in animals or insects. I – Stands for immuno deficiency: this means, the virus reduces the immune system. White blood cells in the blood are part of the immune system. They are the soldiers that attack germs that enter the body. V – Stands for Virus: This means that they are the smallest of all micro-organisms and hundred of times smaller than a bacterium or malaria parasite. The Acquired Immune Deficiency Syndrome (AIDS) is the final stage of the disease. It continues in the human body till death. It can be explained thus: A – Stands for Acquired: this indicates that its victims did not inherit it. I & D – Stand for Immune Deficiency respectively: this shows that its victims have a common characteristic of a breakdown in their body immunity. S – Stands for syndrome: It covers the case of rare but ravaging diseases that take down defence systems. Raen (1993) on the other hand stated that the disease is a syndrome because it consists of several signs and symptoms. Both mean the same as the signs and symptoms are as a result of the different kinds of diseases that attack the body. HIV is said to attack the body defences (white blood cells) especially the type called CD4 cells which are like the coordinators of the immune system where they serve as eyes and ears or rather telephone of the body’s army. Garland (2003) stated that the HIV virus attaches itself to the cell and later penetrates into it. Having entered the CD4 cell, it quickly multiplies by using the cells’ own production “factories” to make copies of itself, and eventually kill the CD4 cells. The CD4 working in the body of a healthy person is supposed to be between 650 and 1250. When a person’s count drops below 200, the person is said to have AIDS, but when the count drops to about 350, doctors usually prescribe some anti-retroviral drug therapy. When the CD4 8 | P a g e cells are destroyed, the whole immune system does not work in harmony; this allows many different infections to enter the body and destroy it. Ahmadu (1977) stated that there are two genetically and immunologically distinct human deficiency viruses, which have been discovered as causing HIV/AIDS disease. These are HIV – 1 and HIV – 2 which remain the dominant virus associated with AIDS in West Africa. An increasing number of different strains of both HIV – 1 and HIV – 2 are identified by molecular virology and by phenotype in cells culture. This increase is due to minor differences in the molecular structure of the virus. Ahmadu (1997) added that HIV is capable of altering its antigens composition or its structure to avoid immune destruction and so continues to weaken the infected person’s immunity. Therefore, HIV virus is cunning, crafty and deceiving, even to the body’s immune system. Raen (1993) described the HIV/AIDS virus as a gang of robbers which attack the human system. The virus has so many strategies that it adopts, that makes it widespread. When it enters the body, it starts fighting the white blood cells (lymphocytes: CD4 or T4) which normally protects the body against diseases or germs. The infected person can look and feel very well for many years. It can take 5 to 10 years or even longer and during that period of silence, the infected person can easily infect other people without knowing. 2.1.2 Causes of HIV/AIDS HIV/AIDS is caused by infection with the human immunodeficiency virus (HIV). HIV/AIDS is most often contracted through sexual contact. Any person who engages in sexual activity, including vaginal, oral, or anal sex, can contract and pass on an HIV infection. This includes heterosexual, homosexual, and bisexual men and women. The more sexual partners a person has, the greater the risk of catching and passing on HIV/AIDS (http://www.bettermedicine.com/article/hiv-aids) 2.1.3 Effects of HIV/AIDS AIDS is a deadly disease caused by a virus. The virus infects the human body and causes serious damage to the body’s immune system by destroying the defensive mechanism of the body (cells), which can fight against other diseases. Once it has destroyed most of the defence 9 | P a g e cells of the body, the body no longer fights other infections like tuberculosis, hepatitis, diarrhoea, and other cancers. The victim is vulnerable to any form of minor disease and therefore, the person develops full blown AIDS or successive illnesses and dies. 2.1.4 Spread of HIV/AIDS The HIV/AIDS virus can be transmitted or spread from one person to the other through the following ways:- First having sex, (i.e. penetrative sexual contact through vaginal, oral or nasal) with an infected person. In Nigeria, about 85% of AIDS infection is through sexual intercourse with infected persons (NERDC, 1995). Momoh (2004) added that sexual intercourse is the primary way of contracting HIV/AIDS because it involves the exchange of bodily fluid. Odey (2004) supported the above assertion by emphasizing that sex is the major mode of transmission of HIV/AIDS. In realization of this mode of HIV/AIDS transmission, scholars have recommended that people should keep only one sex partner. But if they must have sex with an irregular partner, condom should be used though the church, especially the Catholic Church highly forbids the use of condom. Another major mode of the spread of HIV/AIDS is through contact with HIV infected blood and blood product such as semen, vaginal secretion, etc, through blood transfusion, the use of unsterilized needles, knives, blades, syringes etc. Daudu (2005) and Raen (1993) asserted that HIV/AIDS is contracted through direct contact with blood infected by the virus through blood transfusion or through infected needles, razors, and instruments used for ear piercing, circumcision, barbing, traditional birth attendants, blood covenants, scarification (tribal marks) and careless handling of patients by health workers. Mother to child transmission is another major way by which HIV is contracted. Raen (1993) and the AIDS Alliance in Nigeria (2000) stated that women with HIV/AIDS can transmit it to their babies while in the womb or during birth, though there is limited risk of infection through breast feeding. For this reason, breast feeding is recommended because the risk of death through diarrhoea from bottle feeding is still greater. Garland and Haan (2004) added that mother to child infection accounts for about 10% of total HIV infections which is approximately 3 out of every 10 children born to an infected mother. 10 | P a g e Okpe (2005) stated that the risk of mother to child transmission (M.T.C.F) of HIV varied from one country to another. But it is generally thought to be between 15 and 45%. An HIV infected mother in a developing country faces a higher (25-45%) risk of giving birth to a child who is infected. Okpe also added that prolonged breast feeding adds a risk of 15% or more depending on duration and other factors that scientists are still trying to determine. However, the danger of mother to child transmission is less when HIV positive women exclusively breast feed for the first six months. The risk is however higher with mixed feeding and complications developing from poor breast-feeding techniques, especially in cases where the mother has mastitis or cracked breast nipples. The risk also increases the more when the mother becomes infected with HIV while breast feeding as the viral load in the initial stage of infection is very high. Based on current available figures, Okpe (2005) concluded that without treatment, HIV positive women have an estimated 70% chances of giving birth to a healthy child. This means that up to ⅓ of children born to HIV positive women may be infected with HIV by implication. It means that infected breast-feeding mothers should be encouraged to exclusively breast feed their babies for the first 6 months after which they can stop. 2.1.5 Symptoms of HIV/AIDS Usually, early infection of HIV/AIDS is not noticeable immediately. In most cases, a few months or years (6 months to 12 years) is the incubation period. The period before an individual contacts HIV and when the infection develops to AIDS depends on the defence mechanism (body cell) of the person. There are two categories of AIDS symptoms, minor and major. The minor signs of HIV/AIDS include the following: • Cough for more than one month. • Shortness of breadth • Itching rash • Swollen glands at two or more sites, e.g. in the area under the arm-groin. • Thrush in the mouth and throat. • Thick white coating on the tongue or throat. • Tiredness even when the person has done no work • Consistent headache. 11 | P a g e The major sign of HIV/AIDS includes: • Weight loss – there will be a progressive weight loss of more than 10% of body weight. • Fever – unexplained or recurrent fever or night sweats for more than one month. • Diarrhoea – on a continuous or intermittent form for more than one month. However, a person is diagnosed as having AIDS if he or she has one major sign plus two minor signs. 2.1.6 Prevention of HIV/AIDS According to Awake (2004), there is no confirmed medical cure for HIV/AIDS. At the moment, some drugs called ANTI-RETROVIRAL are on production to fight this deadly disease (AIDS). But these drugs (ANTI-RETROVIRAL) only stop the virus from multiplying but no drug, to date is able to permanently destroy the virus inside the human body. The effective preventive measures against HIV/AIDS are as follows: • Total abstinence from sexual intercourse with casual partners. • Being faithful to one’s sex partner by maintaining a single partner. • Avoiding indiscriminate pre-marital sex. • Insisting on using new sterilized sharp objects such as needle and syringe during injection, immunization and circumcision. This also applies to blades and clippers which must not be shared with anyone to avoid blood contact. • Avoiding contact with infected blood and blood products and receiving only screened blood for HIV/AIDS before transfusion during sickness. • Using condom of approved quality. This becomes a necessity if one cannot avoid sex (intercourse) especially with strangers or if one has more than one sex partner. • By avoiding behaviours that are likely to put one at risk of infection e.g. drug taking, being drunk and cult membership. Reducing one’s sexual risk is one way to prevent the transmission of HIV. Contracting HIV/AIDS can be reduced further by: • Practicing abstinence: Having no sexual contact with another individual ensures a 100 percent protection from contracting HIV through anal, oral, or vaginal sex—which are the main ways that HIV is transmitted. 12 | P a g e • Practicing safer sex: Safer sex is being informed on sexual health and healthy relationships. It also includes talking to one’s partner about same interest, boundaries, and HIV status. Safer sex means one taking extra precautions to protect oneself and partner from sexually transmitted infections (STIs), HIV, and unplanned pregnancy. To reduce the risk of contracting HIV or other STIs, one should use a barrier method (i.e., male/female condom or dental dam) every time one engages in anal, oral, or vaginal sex. Latex condoms are very effective against HIV. Lambskin condoms will not protect you from HIV, because the virus is small enough to slip through the lambskin. • Getting tested: It is important for one to know his or her status—both for one’s health and the health of one’s partner. It is also imperative that one knows his/her partner’s status prior to engaging in sexual activity. This conversation can be difficult or uncomfortable for some, but it can be as simple as saying: “When is the last time that you were tested for HIV,” or “... you don't know your HIV status? We can go get tested together before we move into a sexual relationship.” • Being monogamous. Monogamy means being in a sexual relationship with only one person and you both are having sex only with each other. Having one sexual partner greatly reduces your risk of contracting HIV, assuming neither of you are already infected with HIV. 2.1.7 HIV Tests The most common HIV tests look for HIV antibodies. Enzyme immunoassay (EIA) tests use blood, oral fluid, or urine to detect HIV antibodies and can take up to two weeks. Rapid HIV antibody tests use blood, oral fluid, or urine to detect antibodies and take 10-20 minutes to receive results. If one tests positive for HIV after taking an EIA or rapid antibody test, one will need to take another test, called Western blot test, to confirm that result. It can take up to two weeks to confirm a positive result. 2.1.8 Things that Cannot Lead to Contacting HIV/AIDS According to Ehizouwa (2011), the following behaviours cannot lead to HIV transmission. These include, shaking hands, hugging, touching an infected person, or casual kissing. Similarly, sleeping on the same bed or eating together cannot transmit HIV/AIDS. In addition, working in 13 | P a g e the same office, attending the same school and class, sharing cutleries (knives, forks, spoons), clothes and sharing the same toilet as well as swimming together in the same swimming pool do not spread HIV. 2.2 The Concept of Guidance and Counselling The concept of guidance and counselling could mean different things to different people depending on the context within which they are used. For example, guidance in everyday language always connotes some form of help given to an individual or a group of individuals in areas like personal, social (giving information, direction and advice) education and vocation. Sambo (2008), Shertzer & Stone (2006) put it that guidance is to direct, pilot or guide. Guidance can be assistance given to people in different ways like helping someone in taking decision in life. Guidance therefore is a directing and piloting assistance. The above definition of guidance is termed by Shertzer & Stone (1986) as a “layman’s” or unprofessional definition. Arbuckle, Peter and Farewell as quoted in Shertzer and Stone (2006) clarified the term by pointing out the distinctive features implicit in the word. These distinctions arise when guidance is used as a: a) Concept (mental image) b) An educational construct (intellectual synthesis) c) Service (actions taken to meet a demand) As a concept, guidance denotes the utilization of a point of view in order to help pupils understand themselves, and as a service, it refers to the procedures and processes organized to achieve a helping relationship. The concept of counselling denotes a wide range of procedures including advice giving, encouragement, information giving, test interpretation and psychoanalysis. English and English (2006) defined counselling “as relationship in which one person endeavours to help another to understand and solve his adjustment problems”. They pointed out that: 1. Areas of adjustment are often indicated (example, educational counselling, vocational counselling, personal social counselling). 2. Reference is usually to “helping” normal counsellee but creeps imperceptibly into the fields of psychotherapy, and 14 | P a g e 3. While everyone occasionally undertakes counselling, the word is preferably restricted to professionally trained persons. Gesinde, in Kolo (2007) viewed the term counselling as “an indepth interaction between two individuals with the intent of assisting the client to better understand himself in relationship to his or her present and future problems”. It is to be noted that out of the guidance services, counselling has been singled out as the basis for both guidance services and the counselling programme. This is because counselling is more crucial to one’s understanding of himself and also the world around him. This concept of counselling has been defined variously. Among the definitions are those of Wolfe (1987) who said that counselling is about helping people to help themselves to live their lives more effectively. Ivey (1980) also defined counselling as the “process concerned with assisting normal people to achieve their goals, or functions effectively”. In counselling, the client’s emotion and feelings are of serious concern. It is because of the counselling service involved in guidance programme that has made many writers to define guidance as the assistance given to the individual to help them understand themselves, their world and to make intelligent adjustments and choices (Alao, 1981, Rao, 1981, and Shertzer and Stone, 2006). Thus, counselling focuses basically on areas of nurturing and healing emotionally, problem management, decision making, crisis management, support and life skills training. 2.3 The Concept of Students Adolescence is a period of transition between childhood and adulthood that involves biological, cognitive and socio-emotional changes. A key task of adolescence is preparation for adulthood. Indeed, the future of any culture depends on how effective this preparation is (Lawson, 2000). Although the age range of the period of adolescence can vary with culture and historical circumstances. In most cultures, adolescence begins at approximately 10-13 years of age and ends between the ages of about 18-22 (Lawson and Sarigiani,2003). Adolescence is one of the most fascinating and complex transitions in the life span of man; a time of accelerated growth and change second only to infancy. Adolescence can also be seen as a time of expanding horizons, self-discovery and emerging independence; a time of metamorphosis from childhood to adulthood. Students are unquestionably at a vulnerable 15 | P a g e developmental stage as they attempt to navigate the difficult transitions from childhood to adulthood (Carnegie Council of New York, 1992). Most young people manage this transformation successfully, but many do experience major stress and find themselves engaging in behaviours that place their wellbeing at risk. More recent writers however, have taken exception to these assumptions. Rather than being the subject of uncontrolled biological impulses, stress and tumult, the vast majority of students fare quite well; only a minority fit the more classic description of “storm and stress” (Gadsby, 2000). It is still correct to assert that there remains a sub group that experiences storm and stress, whose transition to adulthood is marked by turmoil and trial. For instance, only the non-perceptive observer will be unaware of the upsurge of teenage pregnancy, venereal diseases and AIDS, as well as the rising pattern of violence, cultism, drug and alcohol abuse, school dropouts, and delinquency in most countries in Africa. For the sub group, adolescence is an extended period of struggle. During this period of stress and tumult, the ability to draw on effective adaptive coping behaviours is taxed. The resulting maladaptive behaviour risk affects the physical, psychological or social health of the students. 2.3.1 Students’ Ignorance of HIV/AIDS In many African societies, where guidance and counselling has been the onus of the family, sexuality education has been a way of bringing up children in culturally healthy and traditional way till the young people have been married. In the cultural society in Nigeria, sex organs are rarely mentioned. Ohale (1999) argued that sex education is better unveiled to children through the right persons such as the parents and the teachers than for such children to learn about sex from peers and blue films (pornography). According to him, the consequences of the student having the knowledge of sexuality education from the other unauthorized sources are more grievous than formal and organized curriculum. Sexuality education and counselling programmes have been implemented in some states of Nigeria for example, Benue State. However, there have been questions from parents, teachers, and even students themselves as to whether such programmes have been effective in reducing cases of sexual ignorance or HIV/AIDS and STDS among the recipients. Aba (2003) asserted that guidance from the school administrators, teachers, counsellors and the media indicated 16 | P a g e doubt about the effectiveness and efficiency of guidance and counselling services and the instructional strategies that have been dispensing the programme in the state. Researches by Awai (2003) and Momoh (2004) indicated that a good number of the recipients of sexuality education counselling programme manifested negative sexual and moral behaviour in schools and outside the schools. The moral decadence in both urban and rural schools indicative of a general decline of morality in the society. This result shows the worrisome level of ignorance about the knowledge of HIV/AIDS and STDS among students. Rape and prostitution among the students leading to child abandonment, unprepared marriages due to illegal pregnancies and school-drop-outs are very high among the female students. Furthermore, abortion with its consequences such as death, infertility and poor school attendance are rampant among the students pointing to their ignorance of HIV/AIDS and STDS. In addition to the foregoing manifestation of ignorance among the students are overtly sexual practices, indecent dressings and high prevalence rate of HIV/AIDS and STDS. Awai (2003), in his findings recorded 13.5% of the subjects covered in his study in Benue State who had been infected with the scourge. According to this source, the state of student health care in Benue State is a matter of concern. Moreover, there is a downward trend in societal norms and values. The records of sexual ignorance and its repercussions from a series of ugly trends in schools within the past few decades require a re-examination of sexuality education counselling programme. 2.3.2 Teaching Sexuality Education in School The concept of sexuality education is as chronicle as the dawn of man. It has been defined and explained by various authors; each writer has defined it as he perceived it from the point of view of his discipline. Akpan (1984) opined that some critics defined it as the actual mechanism in sexual activities. Ochai (2003) defined the concept as: the entire knowledge of the advantages and disadvantages one can derive from one’s sexual relationship with one’s sexual partner. Ochai did not however focus on the ideas of family planning, procreation, population policies and all other odds that have been embodied in sexuality education programme. Benedict (2004) 17 | P a g e explained that sexuality education is a way of curtailing sexual excesses in the active population and thus curtailing population growth in the country. He added that it entails the physiology of the reproductive organs and teaching the youngsters about the various acts of sexual intercourse, and its implications which might be negative or positive. It also involves the attainment of life satisfaction, in sexual relationship between legitimate couples. In teaching sexuality education, it should be seen as a necessary step towards curbing the current scourge of HIV/AIDS and STDS. Sexuality education does not only relate to physical satisfaction, but rather, goes beyond the mere genital expression of affection. It is aimed at life- long satisfaction which prevents suspicion between couples and sexual partners. Federal Republic of Nigeria (2004) likened it to English language, Mathematics, Biology, and Chemistry which are given precedence as core courses in the University for Health Science Courses. Sexuality education that is concerned with Student Reproductive Health Care (SRHC) problems requires similar recognition like those core subjects. The justification of the inclusion of sexuality education in the school has been based on the areas of coverage which it embraces. Olayinka (1986) conceded that students need sexuality education at various levels of their educational development, because the frustration resulting from the student reproductive health problems which the teenagers may encounter are enormous. Counselling is very essential for students in order to make them understand themselves and their potentials. Teaching sexuality education will enhance the proper rejuvenation of students as defined by World Health Organisation (1999) as students between 10 and 24 years who are transiting from stress and storms. At this stage, the students have rapidly developing reproductive organs and all essential organs of their bodies which make the youngsters to have various urges which sexuality education can help control. 2.4 Theoretical Framework Model and paradigms according to Doka (1995) have great values in the field of thanatology for both theoretical and clinical response. From a theoretical stand point, models are necessary since they allow an area to organize knowledge and to direct, organize and interpret research. He emphasized that models are clinically useful guides for practices. 18 | P a g e Philips (1991) posited that models help in interventions to promote change in behaviour and for reducing the risk of future illness. Such efforts should be based upon theoretical models that identify the determinants of beliefs and attitude change. Many models pay attention to the importance of socio-cognitive factors in preventive and curative health. Some of these are health belief model of personal choice, health behaviour model, task model, and the causal model for testing counsellors burn out. They also include Mcabee’s theoretical model, Germ theory and multiple causality models. They emphasize the individual ‘s power to decide without being forced to do so as central to all these models. The health belief model was initially developed in the mid- 1950s and is perhaps one of the long-lived paradigms that attempts to identify and critically evaluate the factors responsible for human behaviour as they relate to an individual’s health. Levin (1951) stressed that the model is strongly oriented towards the individual’s personal perceptions of the world and how they motivate people’s behaviour. Furthermore, he stressed that the model emphasizes motivation and the perspective of the individual based on his or her prior experience. Rosenstock (1974) emphasized that they focused on the prevention of disease rather than its control. Discussing on the model, Galli (1978) perceived that threats to health are a person’s perceived vulnerability to threats and the cost benefits pay off that is associated with adopting attitudes. He further explained that in life situation, individuals are pulled towards the forces that are positively valued and away from those that are negative. The model proves that an individual perceives himself or herself to be vulnerable to HIV/AIDS and believes that the disease is a terminal illness and feels better to change his feeling and behaviour than die of HIV/AIDS. The individual is likely to adopt eating balance diet. In addition, a counsellor that perceives a student vulnerable to HIV/AIDS and feels that the disease has no cure may decide to counsel the students seriously based on knowledge experience. Becher (1965) further posited that in reducing the problem of HIV/AIDS, gaining information on the disease and its treatment sharing experience with others in an atmosphere of mutual support is important. The use of counselling services is to clarify personal and emotional issues and developing ways of communicating effectively with counsellors. In addition, discussing with 19 | P a g e family members and friends is an example of a positive approach that can be taken in dealing with HIV/AIDS patients. Pokes (1997) observed and expressed that the care of HIV/AIDS can evoke significant emotional stress in the counsellors and nurses who attend to the patients. Since members of the healing profession express delight and happiness with patients who get better, it is not surprising that the treatment of terminally ill people can result in the nurses and counsellors feeling anxious, frustrated and guilty. These feelings may be openly acknowledged or more correctly expressed through behaviour formation. The resulting stress responses may in-turn affect patients’ care and staff relations as well as nurses mental and physical health and family relationships. To help in caring for HIV/AIDS patients, Vernvert (1986) posited that one of the ideal goals should be to allay the physical suffering of patients as best as can and also help them prepare for recognition and acceptance of death. That way they can undertake their last task in life with credit and dignity. In other words, the presence of a counsellor and other care givers can bring comfort and reduce anxiety. The care givers of whom the counsellor is one, have the responsibility to structure schedules and surroundings so that patients have a sense of security and control over life and their environment. The personal choice-model as stressed by Horn (1976) is that an unhealthy behaviour might be a means by which some individuals deal with various life situations and thus, is a psychological mechanism. This helps individuals to cope with circumstances. He explained that for such unhealthy behaviour to be changed, alternative psychological mechanisms must be developed and substituted to resolve all the contingencies of the problematic situations. This means, for example, a person may realize that obesity is not only unhealthy, but it is also unattractive. In addition, the threat of cardiovascular disease may be understood and accepted at a universal and personal level. Alternative action can be planned to alleviate the problem, but the unhealthy behaviour might have originated as a mechanism to cope with environment stress, Commenting on this, Galli (1978) posited that the health care personnel model focuses on threat to an individuals health and does not recognize other forces that are influential in modifying health beliefs. They emphasized on the idea that the person must perceive a personal threat to 20 | P a g e his or her health if constructive measures are to be taken to avoid a health problem. Galli (1978) further explained that four conditions are necessary if the individual is going to engage in self protective behaviour. They include: being aware of the threat and accepting the importance of it; the threat must have personal meaning for the individual; the person must recognize that alternatives exist to alleviate the threatening situation and feel capable of altering his behaviour. Finally, the personal-choice model concerns those factors that facilitate or inhibit continued reinforcement of a specific behaviour. He posited that television, radio, advertisement and peer pressure are factors that influence positively and negatively people’s original behaviour. 2.5 Review of Previous Studies Onuorah & Eze (2005) surveyed Nigerian students’ awareness of various modes of HIV/AIDS transmission and strategies for preventing its acquisition. Two research questions and two research hypotheses were raised to guide the study. The research questions were answered using mean, while the research hypotheses were tested using – test statistic at 0.05 level of confidence. The sample comprised 315 students of tertiary institutions in Enugu North Local Government Area of Enugu State. The findings showed, among others, that male and female students of tertiary institutions are to a great extent aware of the ways by which HIV/AIDS can be transmitted. A significant difference existed in their knowledge of the modes of transmitting HIV/AIDS virus. It was concluded that counsellors should organize group counselling sessions/workshops/ seminars/ conferences for students and parents to educate them on HIV/AIDS transmission and the relevant skills they need on HIV/AIDS prevention. To obtain amore representative picture on HIV/AIDS among students, Baba & Omotara (2001) said education remains one of the effective measures against HIV/AIDS infection. This study aimed at determining the sources of information of HIV/AIDS among the students and to assess the effects of the information. The results showed that out of 354 respondents, 316 (89.3%) were informed about AIDS as an incurable and killer disease. Among those informed, 50.6% educated other family members on the disease. Television was the major source of information in all the schools studied. Friends/relatives and newspaper/magazines were also important sources. The effect of this information yielded positive reaction in only 26% of the respondents who opted for preventive measures. In addition, 84.8% of the respondents who had sex education were willing to avoid casual sexual relationship. Therefore, we assume that success 21 | P a g e in “vaccinating” the students against AIDS through education programme could be attained when the correct message reaches the target population through the target’s most preferred source of information. Nnabueze (2000) investigated AIDS awareness among students of Enugu State, using gender as a factor. This study was investigated using a survey research design. The research tool used for data collection was the questionnaire: Information was collected from a total of 2,000 respondents selected from the four tertiary institutions in Enugu State. Frequency and percentages were used to answer the two research questions. Chi square test was used to test the two hypotheses. Results showed that most of the undergraduate students of Enugu State tertiary institutions are aware of the Acquired Immune Deficiency Syndrome (AIDS). Their sources of information are more from the print media, their friends and peers than the electronic media, parents and elderly relatives. Considering the respondents’ gender as a factor in this study, there was no difference in their responses, though more of the male respondents seemed to know about the causes of AIDS than their female counterparts. Isaac and Olabode (2006) had a study on perception and attitude towards unprotected sex among students of Kwara State College of Education, Ilorin. A descriptive cross – sectional survey of 360 students, in a classroom setting was carried out, using a multi-stage and proportionate sampling technique to obtain 158 males and 222 females. The research tools were, a 6-item self-administered structured questionnaire for students and an in-depth interview for the Director of Health Services. The response rate was very high at 96%. The findings revealed a preponderance of students perceiving unprotected sex as capable of promoting the increased incidence of HIV/AIDS in the community and a generally high tendency towards the practice of high-risk behaviour among students. However, a significantly greater number of males show this inclination (p