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HIV voluntary counselling and testing and behaviour changes among youths in Nigeria

Published online by Cambridge University Press:  14 August 2019

Clifford O. Odimegwu
Affiliation:
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
Chukwuechefulam K. Imo*
Affiliation:
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa Department of Sociology, Adekunle Ajasin University, Akoko-Akungba, Nigeria
Emmanuel O. Amoo
Affiliation:
Demography and Social Statistics, Covenant University, Ogun State, Nigeria
*
*Corresponding author. Email: [email protected]

Abstract

Voluntary counselling and testing (VCT) for HIV has been promoted as a strategy to prevent HIV pandemics by changing sexual behaviour. Despite the provision of VCT in countries with generalized or high-burden epidemics, including Nigeria, the extent of its influence on behavioural change remains a conjecture. The main objective of this study was to examine the influence of HIV VCT on sexual behaviour changes among youths in Nigeria. The study utilized 2013 Nigeria Demographic and Health Survey (NDHS) data. Data were analysed from a nationally representative sample drawn from 8046 females and 6031 males aged 15–24 giving a total sample of 14,077 never-married youths. Descriptive and analytical analyses were carried out, including multivariate logistic regression. The study found a low uptake of HIV VCT and regional variation in behavioural changes between female and male youths. Voluntary HIV counselling and testing was found to be a protective factor for condom use at last sex for female youths, but significantly reduced the likelihood of primary sexual abstinence for both females and males, as well as having a single sexual partner for female youths. After controlling HIV VCT with other variables, certain socioeconomic factors were found to be significantly associated with behavioural changes. Thus, the attitudes of most Nigerian youths towards voluntary HIV counselling and testing needs to be improved through socioeconomic factors for healthy sexual activity. To achieve this, government and non-governmental organizations, as well as religious leaders and policymakers, should engage in appropriate and long-term activities directed at the sexual health needs of never-married youths, through voluntary HIV counselling and testing, to encourage them to change their sexual behaviour.

Type
Research Article
Copyright
© Cambridge University Press 2019

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References

Akwara, AP, Madise, JN and Hinde, A (2003) Perception of risk of HIV/AIDS and sexual behaviour in Kenya. Journal of Biosocial Science 35(3), 385411.CrossRefGoogle ScholarPubMed
Anarfi, JK and Owusu, AY (2011) The making of a sexual being in Ghana: the state, religion and the influence of Society as agents of sexual socialization. Sexuality and Culture 15(1), 118.CrossRefGoogle Scholar
Arthur, G, Nduba, V, Forsythe, S, Mutemi, R, Odhiambo, J and Gilks, C (2007) Behaviour change in clients of health centre-based voluntary HIV counselling and testing services in Kenya. Sexually Transmitted Infections 83(7), 541546.CrossRefGoogle ScholarPubMed
Asefa, A and Mitike, G (2014) Prevention of mother-to-child transmission of HIV services in Adama town, Ethiopia: clients’ satisfaction and challenges experienced by service providers. BMC Pregnancy and Childbirth 14(1), 57.CrossRefGoogle ScholarPubMed
Beegle, K, Poulin, M and Shapira, G (2015) HIV testing, behaviour change, and the transition to adulthood in Malawi. Economic Development and Cultural Change 63(4), 665684.CrossRefGoogle Scholar
Berhan, Y and Berhan, AA (2015) Meta-analysis of risky sexual behaviour among male youth in developing countries. AIDS Research and Treatment 2015, 580961.CrossRefGoogle ScholarPubMed
Bwambale, FM, Ssali, SN, Byaruhanga, S, Kalyango, JN and Karamagi, CA (2008) Voluntary HIV counselling and testing among men in rural western Uganda: implications for HIV prevention. BMC Public Health 30(8), 2638.Google Scholar
Cohen, MS, Chen, YQ and McCauley, M (2011) Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine 365(6), 493505.CrossRefGoogle ScholarPubMed
Delavande, A, Gine, X and McKenzie, D (2012) Measuring subjective expectations in developing countries: a critical review and new evidence. Journal of Development Economics 94(2), 151163.CrossRefGoogle Scholar
Delavande, A and Kohler, H (2012) The impact of HIV testing on subjective expectations and risky behaviour in Malawi. Demography 49(3), 10111036.CrossRefGoogle ScholarPubMed
Donnell, D, Baeten, JM, Kiarie, J, Thomas, KK, Stevens, W, Cohen, CRet al. (2010) Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet 375(9731), 20922098.CrossRefGoogle ScholarPubMed
Dupas, P (2010) Do teenagers respond to HIV risk information? Evidence from a field experiment in Kenya. American Economic Journal of Applied Economics 3(1), 134.Google Scholar
Edin, K, Nilsson, B, Ivarsson, A, Kinsman, J, Norris, SA and Kahn, K (2016) Perspectives on intimate relationships among young people in rural South Africa: the logic of risk. Culture Health & Sexuality 18(9), 10101024CrossRefGoogle ScholarPubMed
Emeka-Nwabunnia, I, Ibeh, O and Ogbulie, T (2014) High HIV sero-prevalence among students of institutions of higher education in southeast Nigeria. Asian Pacific Journal of Tropical Disease 4(2), 159168.CrossRefGoogle Scholar
Federal Ministry of Health (2013) National HIV & AIDS and Reproductive Health Survey, 2012. NARHS Plus, Abuja.Google Scholar
Fonner, VA, Denison, J, Kennedy, CE, O’Reilly, K and Sweat, M (2012) Voluntary counselling and testing (VCT) for changing HIV-related risk behaviour in developing countries. Cochrane Database of Systematic Reviews 12(9), doi: 10.1002/14651858Google Scholar
Gersovitz, M (2010) HIV testing: principles and practice. World Bank Research Observer 26(1), 141.CrossRefGoogle Scholar
Gong, E (2015) HIV testing and risky sexual behaviour. Economic Journal 125(582), 3260.CrossRefGoogle Scholar
Green, EC, Daniel, T, Halperin, VN and Hogle, JA (2006) Uganda’s HIV prevention success: the role of sexual behaviour change and the national response. AIDS and Behaviour 10(4), 335350.CrossRefGoogle ScholarPubMed
Hargreaves, J and Howe, L (2010) Changes in HIV prevalence among differently educated groups in Tanzania between 2003 and 2007. AIDS 24(5), 755761.CrossRefGoogle ScholarPubMed
Hutchinson, PL and Mahlalela, X (2006) Utilization of voluntary counselling and testing services in the Eastern Cape, South Africa. AIDS Care 18(5), 446455.CrossRefGoogle ScholarPubMed
Ibrahim, M, Ipadeola, O, Adebayo, S and Fatusi, A (2013) Socio-demographic determinants of HIV counselling and testing uptake among young people in Nigeria. International Journal of Prevention and Treatment 2(3), 2331.Google Scholar
Johnston, L, O’Bra, H, Chopra, M, Mathews, C, Townsend, L, Sabin, K, Tomlinson, M and Kendall, C (2010) The associations of voluntary counselling and testing acceptance and the perceived likelihood of being HIV infected among men with multiple sex partners in a South African township. AIDS and Behaviour 14(4), 922931.CrossRefGoogle Scholar
Johnson, LF, Rehle, TM, Jooste, S and Bekker, LG (2015) Rates of HIV testing and diagnosis in South Africa: successes and challenges. AIDS 29(11), 14011409.CrossRefGoogle ScholarPubMed
Kalichman, SC and Simbayi, LC (2003) HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sexually Transmitted Infections 79(6), 442447.CrossRefGoogle Scholar
Kennedy, CE, Medley, AM, Sweat, MD and O’Reilly, KR (2010) Behavioural interventions for HIV positive prevention in developing countries: a systematic review and meta-analysis. Buletin of the World Health Organisation 88(8), 615623CrossRefGoogle ScholarPubMed
Khan, MA (2002) Knowledge on AIDS among female adolescents in Bangladesh: evidence from the Bangladesh Demographic and Health Survey data. Journal of Health, Population and Nutrition 20(2), 130137.Google ScholarPubMed
Kibombo, R, Neema, S and Ahmed, HF (2007) Perceptions of risk to HIV infection in Uganda: are they related to sexual behaviour? African Journal of Reproductive Health 11(3), 168181.CrossRefGoogle ScholarPubMed
Kiene, SM, Bateganya, M, Wanyenze, R, Lule, H, Nantaba, H and Stein, MD (2010) Initial outcomes of provider-initiated routine HIV testing and counselling during outpatient care at a rural Ugandan hospital: risky sexual behaviour, partner HIV testing, disclosure, and HIV care seeking. AIDS Patient Care and STDS 24(2), 117126.CrossRefGoogle Scholar
Lacroix, JM, Pellowski, JA, Lennon, CA and Johnson, BT (2013) Behavioural interventions to reduce sexual risk for HIV in heterosexual couples: a meta-analysis. Sexually Transmitted Infections 89, 620627.CrossRefGoogle ScholarPubMed
Lehrer, EL (2004) Religion as a determinant of economic and demographic behaviour in the USA. Population and Development Review 30(4), 707726.CrossRefGoogle Scholar
Leta, TH, Sandoy, IF and Fylkesnes, K (2012) Factors affecting voluntary HIV counselling and testing among men in Ethiopia: a cross-sectional survey. BMC Public Health 12, 438.CrossRefGoogle ScholarPubMed
Liu, G, Hariri, S, Bradley, H, Gottlieb, SL, Leichliter, JS and Markowitz, LE (2015) Trends and patterns of sexual behaviours among adolescents and adults aged 14 to 59 years, United States. Sexually Transmitted Diseases 42(1), 2026.CrossRefGoogle ScholarPubMed
Mah, TL and Halperin, DT (2010) Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS and Behaviour 14(1), 11–6.CrossRefGoogle ScholarPubMed
Maina, AN, Kimani, J and Anzala, O (2016) Prevalence and risk factors of three curable sexually transmitted infections among women in Nairobi, Kenya. BMC Research Notes 9, 193.CrossRefGoogle ScholarPubMed
Mall, S, Middelkoop, K, Mark, D, Wood, R and Bekker, LG (2013) Changing patterns in HIV/AIDS stigma and uptake of voluntary counselling and testing services: the results of two consecutive community surveys conducted in the Western Cape, South Africa. AIDS Care 25(2), 194201.CrossRefGoogle ScholarPubMed
May, AL and Parrott, AC (2015) Greater sexual risk-taking in female and male recreational MDMA/ecstasy users compared with alcohol drinkers: a questionnaire study. Human Psychopharmacology 30(4), 272275CrossRefGoogle ScholarPubMed
Mola, OD, Mercer, MA, Asghar, RJ, Gimbel-Sherr, KH, GimbelSherr, S and Micek, MA (2006) Condom use after voluntary counselling and testing in central Mozambique. Tropical Medicine & International Health 11(2), 176181.CrossRefGoogle ScholarPubMed
Moshoeu, PM, Desmond, K, Nonjabulo, G and Tivani, PM (2019) The use of home-based HIV testing and counselling in low-and-middle income countries: a scoping review. BMC Public Health 19, 132.CrossRefGoogle ScholarPubMed
Mshana, G, Wamoyi, J and Plummer, ML (2002) Sexual negotiation and decision making among young people in rural northern Tanzania. Paper presented at the 14th International AIDS Conference, Barcelona, Spain, 7–12th July 2002. Abstract No. E11595.Google Scholar
Mudau, M, Peters, RP, De Vos, L, Olivier, DH, Davey, D, Mkwanazi, ESet al. (2018) High prevalence of asymptomatic sexually transmitted infections among human immunodeficiency virus-infected pregnant women in a low-income South African community. International Journal of STD and AIDS 29(4), 324333.CrossRefGoogle Scholar
Nachega, JB, Uthman, OA, del Rio, C, Mugavero, MJ, Rees, H and Mills, EJ (2014) Addressing the Achilles’ heel in the HIV care continuum for the success of a test-and-treat strategy to achieve an AIDS-free generation. Clinical Infectious Diseases 59 (Supplement 1), 2127.CrossRefGoogle ScholarPubMed
Nasidi, A and Harry, TO (2006) The epidemiology of HIV/AIDS in Nigeria. In Adeyi, Oet al. (eds) AIDS in Nigeria: A Nation on the Threshold. Harvard Centre for Population and Development Studies, Cambridge, MA.Google Scholar
Nemoto, T, Bodeker, B, Iwamoto, M and Sakata, M (2014) Practices of receptive and insertive anal sex among transgender women in relation to partner types, socio cultural factors and background variables. AIDS Care 26(4), 434440.CrossRefGoogle Scholar
Nwachukwu, CE and Odimegwu, C (2011) Regional patterns and correlates of HIV voluntary counselling and testing among youths in Nigeria. African Journal of Reproductive Health 15(2), 131146.Google ScholarPubMed
Obidoa, CA, M’Lan, CE and Schensul, SL (2012) Factors associated with HIV/AIDS sexual risk among young women aged 15–24 years in Nigeria. Journal of Public Health in Africa 3(1), e15.CrossRefGoogle ScholarPubMed
Odimegwu, CO (2004) Correlates of sexual behaviour among Nigerian students. Journal of Adolescent and Child Mental Health 17(1), 3538.CrossRefGoogle Scholar
Odimegwu, CO (2005) Influence of religion on adolescent sexual attitude and behaviour among Nigerian university students: affiliation or commitment? African Journal of Reproductive Health 9(2), 125140.CrossRefGoogle ScholarPubMed
Odimegwu, C, Adedini, SA and Ononokpono, DN (2013) HIV/AIDS stigma and utilization of voluntary counselling and testing in Nigeria. BMC Public Health 13, 465.CrossRefGoogle ScholarPubMed
Odimegwu, C and Somefun, OD (2017) Ethnicity, gender and risky sexual behaviour among Nigerian youth: an alternative explanation. Reproductive Health 14, 16.CrossRefGoogle Scholar
Odimegwu, O, Somefun, OD and Chisumpa, VH (2019) Regional differentials in positive sexual behaviour among youths in sub-Saharan Africa. Journal of Biosocial Science 51(2), 254272.CrossRefGoogle Scholar
Osborn, M and Obermeyer, CM (2016) Understanding client satisfaction with HIV testing and counselling services: a mixed-methods study in four African countries. AIDS Care 28(6), 689694.CrossRefGoogle ScholarPubMed
Oshi, SN, Ezugwu, FO, Oshi, DC, Dimkpa, U, Korie, FC and Okperi, BO (2007) Does self-perception of risk of HIV infection make the youth to reduce risky behaviour and seek voluntary counselling and testing service? A case study of Nigerian youth. Journal of Social Sciences 14(2), 199203.CrossRefGoogle Scholar
Ostermann, J, Reddy, EA, Shorter, MM, Muiruri, C, Mtalo, A and Itemba, DK (2011) Who tests, who doesn’t, and why? Uptake of mobile HIV counselling and testing in the Kilimanjaro Region of Tanzania. PLoS One, 6(1), e16488.CrossRefGoogle ScholarPubMed
Oladunni, TM and Osezua, C (2013) Acceptance and uptake of HIV counselling and testing by youth corp members in Osun State, Nigeria. International Journal of Asian Social Science 3(6), 13811388.Google Scholar
Perkins, JM, Nyakato, VN, Kakuhikire, B, Mbabazi, PK, Perkins, HW, Tsai, ACet al. (2018) Actual vs. perceived HIV testing norms, and personal HIV testing uptake: A cross-sectional, population-based study in rural Uganda. AIDS and Behaviour 22(2), 616628.CrossRefGoogle Scholar
Prata, N, Weidert, K and Sreenivas, A (2013) Meeting the need: youth and family planning in sub-Saharan Africa. Contraception 88(1), 8390.CrossRefGoogle ScholarPubMed
Sam-Agudu, NA, Folayan, MO and Ezeanolue, EE (2016) Seeking wider access to HIV testing for adolescents in sub-Saharan Africa. Paediatric Research 79(6), 838845.CrossRefGoogle ScholarPubMed
Sewell, J, Miltz, A, Lampe, FC, Cambiano, V, Speakman, A, Phillips, ANet al. (2017) Attitudes to and understanding of risk of acquisition of HIV (AURAH) Study Group. Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics. International Journal of Drug Policy 43, 3343.CrossRefGoogle Scholar
Suthar, AB, Ford, N, Bachanas, PJ, Wong, VJ and Rajan, JS (2013) Towards universal voluntary HIV testing and counselling: a systematic review and meta-analysis of community based approaches. PLoS Medicine 10(8), e1001496.CrossRefGoogle ScholarPubMed
Teva, I, Bermúdez, MP, Ramiro, MT and Ramiro-Sánchez, T (2013) Sexual behaviour and adolescents. Current HIV Research 11(2), 512519CrossRefGoogle Scholar
Trinitapoli, J and Regnerus, MD (2007) Religion and HIV risk behaviours among married men: initial results from a study in rural sub-Saharan Africa. Journal for the Scientific Study of Religion 45(4), 505528.CrossRefGoogle Scholar
UNAIDS (2014) Ambitious Treatment Targets: Writing the Final Chapter of the AIDS Epidemic. UNAIDS, Geneva. URL: 2014. http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2014/JC2670_UNAIDS_Treatment_Targets_en.pdf (accessed 12 November 2018).Google Scholar
UN (2013) Global Report: UNAIDS Report on the Global AIDS Epidemic. United Nations Programme on HIV/AIDS. URL: http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Global_Report_2013_en_1.pdf (accessed 8 November 2018).Google Scholar
van Rooyen, H, Essack, Z, Rochat, T, Wight, D, Knight, L, Bland, R and Celum, C (2016) Taking HIV testing to families: designing a family-based intervention to facilitate HIV testing, disclosure, and intergenerational communication. Frontiers in Public Health 4, 154.CrossRefGoogle ScholarPubMed
Voluntary Counselling Efficacy Group (2000) Efficacy of VCT in individuals and couples in Kenya, Tanzania and Trinidad: a randomized trial. Lancet 356(9224), 103112.CrossRefGoogle Scholar
Witte, SS, El-Bassel, N, Gilbert, L, Wu, E and Chang, M (2010) Lack of awareness of partner STD risk among heterosexual couples. Perspectives on Sexual and Reproductive Health 42(1), 4955.CrossRefGoogle ScholarPubMed
World Health Organization (2010) Delivering HIV Test Results and Messages for Re-Testing and Counselling in Adults. WHO, Geneva. URL: http://www.who.int/hiv/pub/vct/hiv_re_testing/en/index.html (accessed 10 December 2018).Google Scholar
Young, SD, Hlavka, Z, Modiba, P, Gray, G, Van Rooyen, H and Richter, L (2010) HIV-related stigma, social norms, and HIV testing in Soweto and Vulindlela, South Africa: National Institutes of Mental Health Project Accept (HPTN 043). Journal of Acquired Immune Deficiency Syndromes 55(5), 620624.CrossRefGoogle Scholar
Zembe, YZ, Townsend, L, Thorson, A and Ekström, AM (2012) Predictors of inconsistent condom use among a hard to reach population of young women with multiple sexual partners in peri-urban South Africa. PLoS One 7(12), e51998.CrossRefGoogle ScholarPubMed