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YOUNG PEOPLE AT RISK OF HIV/AIDS IN EDO STATE: WHAT SHOULD WE DO?. BY. Professor Emeritus Andrew G. Onokerhoraye , Executive Director: Centre For Population and Environmental Development (CPED)Benin City. Outline of the presentation. Introduction
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Andrew G. Onokerhoraye,
Executive Director: Centre For Population and Environmental Development (CPED)Benin City
Sub-Saharan Africa still bears the greatest share of the global HIV burden.
In recent years, promising developments have taken place in global efforts to address the AIDS epidemic such as increased access to effective treatment and increased preventive programmes
It has been estimated that 80% of the infected group are aged 20-29 years.
Young people are more likely to experiment with dangerous behaviours that favour HIV/AIDS transmission.
However, in spite of recent calls for increased attention to the high levels of HIV transmission to youth, little scientific consensus exists about how best to prevent HIV infection among them.
This entails encouraging young people to form positive relationships between themselves and their peers, parents, teachers, religious groups and health services that will contribute to the prevention of the spread of HIV among the youth.
The first focuses on schools which are regarded as the most appropriate setting for targeted HIV prevention intervention in young people.
The second type of intervention to prevent HIV among youth focuses on improving health services which play a vital role in the prevention, care and treatment of HIV/AIDS in young people.
The most common type of interventions reported in the literature focus on training service providers, including taking actions to make the improved health facility more youth-friendly as well as activities in the community to link or refer young people to health services.
Community level interventions have the potential to change established norms, values and traditions that may impede HIV prevention and care.
Those that focus on providing information, skills building and behavior change targeting young people; and
country fall in this category of people that need
to be reached.
It is only when concerted efforts are directed towards increasing the knowledge base of youth on sexual and reproductive health (SRH) issues that the rapid spread of HIV can be reversed.
Evidence of unmet need is reflected in research that confirms that some young people have a poor understanding of the reproductive process, others harbour misconceptions.
The data from the National HIV/AIDS and Reproductive Health Survey (NARHS) reveals that among the sexually active 15 to 19 year olds only 34.4% used condoms at their most recent sexual encounter.
The explanation for these behaviors includes earlier sexual maturity, the effect of media that glamorize sex, and an increasing weakness of traditional control of the family system in Nigeria
Therefore, sexuality education during adolescence is likely to foster positive attitudes and healthy behaviors in adult years
In the first place, sex is traditionally a very private subject in Nigeria and the discussion of sex with teenagers is often seen as inappropriate.
Secondly, there is the difficulty of coping with the large population of young people in Nigeria.
In some localities in Nigeria girls marry relatively young, often to much older men. It has been found that those who are married at a younger age have less knowledge about HIV and AIDS and are more likely to believe they are low-risk for becoming infected with HIV.
Consequently, youth in rural areas are particularly disadvantaged since educational and prevention programming does not reach them, leaving them more vulnerable to infection than their urban peers.
Whereas out-of-school adolescents are generally less informed about reproductive health and participate more in risky sexual activity than students, virtually all sexuality education programmes for young persons are school-based.
This indicated then that something urgent needed to be done to address young people’s vulnerability.
It was within this context that an action research programme titled “HIV Prevention for Rural Youth” was conceived and implemented in Edo State.
“HIV Prevention for Rural Youth” was a 4-year programme funded by a grant from the Global Health Research Initiative, Canada to a team of Canadians and Nigerians from the following institutions participated in the project:
iv Centre for Population and Environmental Development (CPED), Nigeria
v Women’s Health and Action Research Centre (WHARC), Nigeria
vi Action Health Incorporated, Nigeria
The goal of HIV Prevention for Rural Youth (HP4RY) was to develop and use research evidence to build and evaluate HIV prevention for youth delivered through schools and communities.
Thirty rural communities and thirty junior secondary schools located in them constituted the locus of the research with results were used in consultation with communities to establish strategies to reduce youth vulnerability to HIV infection.
The research and evaluation of the school and community programming tried to answer two questions:
To what degree can school- and community-based interventions separately, and in combination, contribute to reducing youth risk and vulnerability?
They were used to improve the Family Life and HIV Education (FLHE) programme of Edo State, teacher training, and community programming, insuring that their content addresses locally relevant issues and vulnerabilities.
Thus after baseline data collection, teachers as well as Guidance Counselors were trained in FLHE to teach students in 20 of the 30 schools participating in the project.
Subsequent waves of data collection were carried out to track the outcomes of the intervention in FLHE and Youth Corpers programming in the schools and communities.
Out-of-school youth became conscious of the presence of AIDS in their community and now take some precautions including:
In terms of specific results, there was evidence that in response to the school and/or community programming at least some students:
rights of girls to refuse sex;
vi Attitudes became more accepting of
vii Students reported fewer sources of pressure
to engage in sex;
Viii Greater Knowledge in HIV/AIDS related
ix Sexual debut was delayed;
x Those who were sexually experienced
reduced recent sexual activity.
With respect to the trained teachers, a variety of gains from their FLHE training were noted.
texts and schemes of work for teaching
iv Increased use of classroom instruction,
school assemblies and school displays for
teaching about HIV and AIDS;
v Increased discussion of FLHE teaching
strategies in staff meetings;
vi Teachers’ desires to teach about HIV and
AIDS and talking about sexuality grew after
their training in FLHE.
Continue expanding delivery of the FLHE programme to all secondary schools in Edo State including those in rural areas.
Public-private partnerships are essential to bring HIV/AIDS interventions to more young people in rural communities
All teachers should be made to mainstream HIV/AIDS teaching into all subjects in all primary and secondary schools in Edo State.
Although young people are major victims of the HIV epidemic, they have not, over the years, been given the required attention in actions designed to control its spread.
Both the Millennium Development Goals and the global goals endorsed by the UN General Assembly’s Special Session on HIV/AIDS have explicitly focused on the unique vulnerability of young people.
The action research findings reported in this address reflect the concern for the challenges facing young people in rural communities in Nigeria with respect to combating the HIV epidemic in the country.