SCHOOL–BASED HIV/AIDS RISK-REDUCTION INTERVENTION PROGRAMMES AMONG ADOLESCENTS IN ORLU SENATORIAL ZONE, IMO STATE, NIGERIA

Abstract

Human Immuno-deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) constitute a major public health challenge in Imo State and adolescents are increasingly becoming vulnerable. It is necessary to target adolescents with risk-reduction educational interventions because they can be effectively reached through schools. However, effective interventions for doing this are limited in Nigeria. This study was, therefore, conducted to investigate the relative effectiveness of Class-room Instruction (CI) and Drama (DR) on HIV/AIDS knowledge, attitudes, perception and risk-reduction practices among adolescents in Orlu Senatorial Zone. A quasi-experimental design was adopted which involved 165 students from three randomly selected co-educational secondary schools assigned to two experimental groups (CI and DR) and control. Baseline data were collected using a semi-structured questionnaire which included 29-point knowledge, 9-point attitude, 15-point Self-Efficacy (SE) scales and 27- point risk reduction practices scales. Knowledge scores <15 and ≥15 were classified as poor and good respectively; attitude scores <5 and ≥5 were respectively categorised as negative and positive; SE scores <7 and ≥7 were grouped as low and high respectively ,while risk reduction practices scores <13 and ≥13 were categorised as positive and negative respectively. Results were used to design interventions that were implemented for 8 weeks. Mid-term and follow-up evaluations were conducted using the same instrument. Data were analysed using descriptive statistics, t-test and ANOVA at p=0.05. Ages of the respondents in CI, DR and control groups were 13.4 ± 1.2, 13.9 ± 1.5 and 13.8 ± 1.2 years respectively. Knowledge scores on HIV/AIDS at baseline were 20.5±2.7, 20.4 ± 2.6 and 21.1 ± 2.7 for CI, DR and Control groups respectively. These increased to 22.7 ± 2.7, 22.61.8 and 21.2 ± 0.3 at mid-term among CI, DR and control, respectively. At follow-up, scores among CI and DR increased to 23.9 ± 1.8 and 24.5 ± 1.4 respectively while the control’s score dropped to 20.0 ± 2.8. At baseline, respondents’ with high SE among CI, DR and control were 87.3%, 81.8% and 70.9% respectively; at mid-term scores were 96.2%, 96.3%, 85.5% while scores at follow-up were 98.1%, 100.0%, 84.9% respectively. Attitude scores among CI, DR and control groups at baseline were 5.3 ± 1.4, 4.9 ± 1.5 and 5.3 ± 1.0 respectively. At mid-term attitude scores were 5.1 ± 1.2, 5.0 ± 0.9 and 4.7 ± 1.5 for CI, DR and control respectively while scores at follow-up were 5.3 ± 1.2, 5.6 ± 0.7 and 4.5 ± 1.2. HIV risk reduction practice among the respondents in CI, DR and control at baseline were 18.5±4.6, 19.8 ± 5.8 and 17.0 ± 4.8, at mid-term scores were 23.8 ± 3.4, 23.6 ± 3.4 and 17.7 ± 5.1, while scores at follow-up were 24.9 ± 2.6, 26.7 ± 1.1 and 17.0 ± 5.3 respectively, indicating significant increase among the intervention arms than control. Prevalence rates of non-sharing skin-piercing objects at baseline among CI (38.2%), DR (40.0%) and control (23.6%) were low compared to 94.2% and 96.3% at mid-term and 90.4% and 94.3% at follow-up for CI and DR, respectively. Drama intervention yielded more positive outcomes in knowledge gained, self-efficacy and risk-reduction practices than classroom instruction. Drama is therefore recommended for use as school-based HIV/AIDS risk-reduction intervention in Orlu Senatorial Zone, Imo State, Nigeria.