FACULTY OF PUBLIC HEALTH
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Item An assessment of the nutritional status of ART receiving HIV-orphaned and vulnerable children in South-West Nigeria(Elsevier Ltd, 2019) Fagbamigbe, A. F.; Adebowale, A. S.; Ajayi, I.Introduction: Good nutritional status is pertinent to the optimal outcome of effective ART among children. Against this backdrop, the objective of the current study is to assess the nutritional indices of children receiving ART in South-West Nigeria. Methods: The study was cross-sectional in design. We randomly selected three urban and six rural ART sites from the ones offering ART services in Oyo state. All consented children receiving ART treatments in the aforementioned sites participated in the study. A total of 390 HIV-positive children and adolescents aged 6–18 years were interviewed using a semi-structured interviewer-administered questionnaire. Children were assessed and growth curves were constructed using the 2007 World Health Organisation (WHO) growth reference standard for children as well as adolescents. Data were presented using descriptive statistics. Results: About 52% of the children are male, 136 (34.9%) have lost at least one parent, 52 (13.3%) have lost either parent to HIV/AIDS. Among the males, 19%, 27%, and 27% were underweight, stunted and thin, respectively when compared with 17%, 23% and 23%, respectively, among females. The male and female weight-for-age average z-score were (-0.98 vs -1.04), height-for-age (-1.12 vs -1.07), and BMI-for-age (-1.19 vs -1.18). Irrespective of age, sex, parental survival, and residence, weight-for-age and BMI-for-age analysis revealed substantial underweight, with the worst outcomes being among those orphaned by HIV/AIDS. Conclusion: All nutritional indices considered in this study fell short of the WHO standard. HIV positive children in the ART sites included in this study are faced with a high burden of undernourishment despite been placed on daily ART regimens. In addition to efficient ART, interventions to ameliorate poor nutritional status is needed.Item Bayesian geo-additive spatial modelling of HIV prevalence using data from population-based surveys(Polish AIDS Research Society, 2019) Adebayo, S. B.; Gayawan, E.; Fagbamigbe, A. F.; Bello, F. W.Introduction: Estimates of human immunodeficiency virus (HIV) prevalence in Nigeria have been based on the data from HIV surveillance and sentinel studies among pregnant women attending antenatal clinics at some selected sentinel sites. However, such data overestimate HIV prevalence. This paper explores possible geographical variations in HIV prevalence among the general population of males and females based on two waves of the National HIV/acquired immune deficiency syndrome (AIDS) and Reproductive Health Surveys. Material and methods: Data were extracted from the cross-sectional 2007 and 2012 National HIV/ AIDS and Reproductive Health Serological Surveys of men (15-64 years) and women (15-49 years) covering all states of Nigeria. Bayesian geo-additive modelling technique was employed for analysis. Appropriate prior distributions were assigned to the different types of variables in the models and inference was based on the Markov Chain Monte Carlo (MCMC) technique. Models of different specifications were considered. Results: The findings reveal significant spatial variations at a highly disaggregated level of states in Nigeria. The nonlinear effects of respondents’ age show a similar pattern of HIV prevalence for male, female and the combined respondents, implying that HIV prevalence is peak among middle-age individuals, from where it declines with age. Also, the results reveal a downward change in HIV prevalence in Nigeria between 2007 and 2012. Conclusions: When these findings are taken into consideration in designing intervention strategies, it is believed that each state can be targeted with the right intervention(s). This can also lead to efficient utilization of the scarce resources witnessed globally and more importantly with the economic recession in Nigeria.Item Influence of spousal communication about Family Planning and HIV/AIDS related issues on modern contraceptive use in Nigeria(Sage Publishing, 2017) Fagbamigbe, A. F.; Ojebuyi, B. R.Contraceptive use in Nigeria at 15 per cent is low, despite a high human immunodeficiency virus (HIV) prevalence of 3.4 per cent and fertility rate of 5.7 per cent. We assessed the levels of spousal communication on family planning and contraception (FPC) and HIV/acquired immune deficiency syndrome (HIV/AIDS), influence of demographic characteristics on this communication and association between this communication and the respondents’ health behaviours. We used a cross-sectional and nationally representative data on reproductive health and HIV/AIDS-related issues from randomly selected 30,752 men and women of reproductive age. Descriptive statistics, Pearson chi-square (c2 ) and logistic regression were used to analyze the data at 5 per cent significance level. About 61 per cent of the respondents were 25–49 years old and mostly from rural areas (65 per cent). Only 20 per cent of the respondents discussed HIV/AIDS with their spouses within 12 months preceding the survey while 15 per cent discussed FPC. A discussion of both HIV/AIDS and FPC among spouses was reported among 9 per cent compared to 26 per cent who reported discussing either. Respondents aged 35–39 years had higher odds of discussing HIV/AIDS (Odds Ratios [OR] = 7.06:6.16–8.09) than those aged 15–19 years. Urban dwellers also had higher odds (OR = 1.24:1.16–1.31) of HIV/AIDS discussions than rural respondents. Modern contraceptive use was 35 per cent and 23 per cent among respondents who discussed FPC and HIV/AIDS compared to 8 per cent and 9 per cent, respectively, among those who did not. Spousal communication on FP and HIV/AIDS was low and has influenced contraceptive use and HIV positivity in Nigeria. There is a need to encourage spousal discussion on FP and HIV/AIDS, especially among the rural dwellers and the poor and uneducated as a strategy for improving modern contraceptive use.Item Marital status and HIV prevalence among women in Nigeria: Ingredients for evidence-based programming(International Society for Infectious Diseases, 2016) Fagbamigbe, A. F.; Adebayo, S. B.; Idemudia, E.Objective: To assess the influence of marital status and other correlates on HIV infection among women in Nigeria. Methods: Data were extracted from the 2012 Nigerian population-based HIV/AIDS and reproductive health survey. The survey determined the HIV status of consenting women using standard procedures. Data were weighted and analyzed using descriptive statistics and logistic regression at the 5% significance level. Results: HIV prevalence among currently married and never married women was 3.4%, but was 5.9% among formerly married women. The odds of HIV infection were found to be 1.8 times higher among formerly married women compared with currently married women (odds ratio (OR) 1.8, 95% confidence interval (CI) 1.3–2.5) and never married women (OR 1.8, 95% CI 1.2–2.6). Also, the odds of HIV infection were 1.5 times higher among women who had made their sexual debut before the age of 15 years (adjusted OR 1.5, 95% CI 1.1–2.1) compared with women who delayed it. The odds of HIV infection were 1.4 times higher among women who had recently had transactional sex (adjusted OR 1.4, 95% CI 1.1–2.0) compared with others. Conclusion: Being formerly married, under 15 years of age at first sex, and having engaged in transactional sex were found to be the strongest HIV risk factors among women. Besides empowering formerly married women and providing better social security, these women should be targeted in HIV programming and policies.Item A comparative analysis of condom use among unmarried youths in rural community in Nigeria(Scientific & Academic Publishing, 2011) Fagbamigbe, A. F.; Adebowale, A. S.; Olaniyan, F. A.Globally, youths are more sexually active than any subgroup of the population. In Nigeria, the prevalence of condom use among youths is low. This study explored and compared condom use among in-school youths and out-of-school youths in south western Nigeria. This population based study used multistage random sampling technique to select eligible 600 youths aged 15-24 years which included 300 high school students and 300 out-of-school youths in Ekiti West Local Government area of Ekiti state, Nigeria. Descriptive statistics, t-test, chi square test and logistic regression were used for analysis. The mean age of in-school youths and out of school youths were 18.1±2.2 years and 19.0±2.7 years respectively. Overall, 35.5% of all sexually active respondents, 29.8% in-school and 40.8% out-of-school youths reported to have ever used condom during sexual intercourse (p<0.05) The study concluded that although, condom use is low across the study population, but higher among out-of-school youths. Youths aged 15-24 should be given free access to condom particularly the in-school youths.Item Gender variation in self-reported likelihood of HIV infection in comparison with HIV test results in rural and urban Nigeria(Biomed Central, 2011) Fagbamigbe, A. F.; Akinyemi, J. O.; Adedokun, B. O.; Bamgboye, E. A.Background: Behaviour change which is highly influenced by risk perception is a major challenge that HIV prevention efforts need to confront. In this study, we examined the validity of self-reported likelihood of HIV infection among rural and urban reproductive age group Nigerians. Methods: This is a cross-sectional study of a nationally representative sample of Nigerians. We investigated the concordance between self-reported likelihood of HIV and actual results of HIV test. Multivariate logistic regression analysis was used to assess whether selected respondents’ characteristics affect the validity of self-reports. Results: The HIV prevalence in the urban population was 3.8% (3.1% among males and 4.6% among females) and 3.5% in the rural areas (3.4% among males and 3.7% among females). Almost all the respondents who claimed they have high chances of being infected with HIV actually tested negative (91.6% in urban and 97.9% in rural areas). In contrast, only 8.5% in urban areas and 2.1% in rural areas, of those who claimed high chances of been HIV infected were actually HIV positive. About 2.9% and 4.3% from urban and rural areas respectively tested positive although they claimed very low chances of HIV infection. Age, gender, education and residence are factors associated with validity of respondents’ self-perceived risk of HIV infection. Conclusion: Self-perceived HIV risk is poorly sensitive and moderately specific in the prediction of HIV status. There are differences in the validity of self-perceived risk of HIV across rural and urban populations.Item Perceptions about sexual abstinence and knowledge of HIV/AIDS prevention among in school adolescents in a western Nigerian city(BMC Public Health, 2011) Oladepo, O.; Fayemi, M. M.Background: Young people are becoming increasingly exposed to the risk of HIV infection. According to the 2008 HIV/Syphilis sentinel survey in Nigeria, 3.3% of young people aged 15-19 years are infected. Primary prevention especially abstinence, remains one of the most realistic interventions for reducing further spread of the virus. However, the adoption of sexual abstinence as a prevention strategy among adolescents remains low and factors influencing its practice among urban young people in Nigeria are relatively unknown. The aim of the study was to document the sexual abstinence behaviour of in-school adolescents, the factors influencing or obstructing abstinence, and knowledge of HIV and AIDS in Ibadan, South-West Nigeria. Methods: The study was a descriptive cross-sectional survey of students in Ibadan South-West Local Government Area. A total of 420 respondents (52% males and 48% females), selected through a multistage sampling technique, completed a semi-structured questionnaire. This was supplemented with eight focus group discussions (FGDs) which had an average of 9 respondents within the 10 and 19 years age group. The data from the FGDs were transcribed and summarized manually while the quantitative data was analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables and logistic regression analysis. Results: Twelve percent of the entire sample had ever had sex. Overall, knowledge of HIV transmission and prevention was high and most respondents favoured the promotion of abstinence as an HIV prevention strategy. A smaller proportion of male respondents (79%) abstained compared with the females (98%). Major predictors of sexual abstinence were being a female, not having a boyfriend or girl friend, not using alcohol and having a positive attitude towards abstinence (P < 0.05). Sexual abstinence was also significantly associated with perceived self efficacy to refuse sex and negative perception of peers who engage in sexual behaviours (P < 0.05). Majority of the FGD discussants suggested the involvement of parents, media, schools, faith-based institutions and non governmental organizations in promoting the adoption of abstinence. Conclusions: The sexual abstinence behaviour of young persons is influenced by multiple factors and should be considered in determining the effectiveness of interventions targeting this behaviour. Coherent sexuality education interventions to promote the adoption of abstinence among young people are urgently needed.Item Correlates of the quality of life of adolescents in families affected by HIV/AIDS in Benue State, Nigeria.(Routledge Taylor & Francis Group, 2015) Akpa, O. M.; Bamgboye, E. A.It was estimated that over 260,000 children are living with Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) while close to 2 million are directly or indirectly affected by the disease in Nigeria. Improvements in treatments for infected children have been documented in the literature but there is gross knowledge gap on the impact of HIV/AIDS on the quality of life and psychosocial functioning (PSF) of affected children in Nigeria. We comparatively explored the association of quality of life with PSF and other factors among adolescents in families affected by HIV/AIDS (FAHA) and in families not affected by HIV/AIDS (FNAHA). Data were extracted for 960 adolescents from a State wide cross-sectional study in which participants were selected through multistage sampling techniques. Data were collected using question naires consisting of demographic information, adapted World Health Organization Quality of Life-BREF and the strength & difficulty questionnaire (SDQ). The quality of life scores were categorized into poor, moderate, and high based on the amount of standard deviation away from the mean while the SDQ scores were categorized into normal, borderline, and abnormal based on the SDQ scoring systems. The chi-square test and the independent t-test were used for bivariate analyses while the logistic regression was used for multivariate analyses at the 5% level of significance. The proportion with poor quality of life (27.0%) was significantly higher among adolescents in FAHA than in FNAHA (p = 0.0001). Adolescents in FAHA (OR:2.32; 95%CI: 1.67—4.09) were twice more likely to have poor quality of life than those in FNAHA. In FAHA, adolescents on the borderline of PSF (OR:2.19; 95%CI: 1.23-3.89) were twice more likely to have poor quality of life than those with normal PSF. Adolescents in FAHA have poor quality of life than those in FNAHA and also face additional burden of psychosocial dysfunctions. Interventions focusing on functional social support and economic empowerment will benefit adolescents in FAHA in the studied location.Item Analysis of trends and projections of the emergence, impact and the epidemiology of HIV/AIDS in Nigeria(Nigerian Statistical Association, 2010) Akpa, O. M.; Oyejola, B. A.The first case of AIDS was reported in Nigeria-(Lagos) in 1986. Since then, both the incidence and the prevalence of the epidemic has grown steadily, particularly during the military regimes. In this study, We used the UNAIDS softwares: Estimation and Projection Package-(EPP) and AIDS Impact Mode/-(AIM), to present models, trends analysis and projections/or the incidence a/HIVIAIDS in the six geopolitical zones in Nigeria. 0111' results show that the peak incidence 0/HIVIAIDS epidemics in the zones was during the Military rule in Nigeria. We also projected that by year 2010, the incidence are expected to be stable.Item Statistical modelling of HIV/AIDS epidemics; Nigeria’s most needful statistical support for meeting the MDGs in HIV/AIDS intervention initiatives.(Nigerian Statistical Association, 2006) Akpa, O. M.; Oyejola, B. A.Since the first cases of AIDS were identified in the United State of America nearly two decades ago, researchers have made significant progress in understanding the epidemiology of HIV/AIDS Pandemic worldwide, with special attention to Sub-Saharan Africa. However, no particular attempt has been made to Model either the transmission dynamics or the trajectory of HIV/AIDS infection in Nigeria. In this paper, we review various methods adopted by Mathematicians and statisticians to Model HIV/AIDS epidemics. Their peculiar applicability and limitations with reference to Nigeria are discussed. We also discuss why Statistical Modeling of HIV/AIDS Epidemics is one of the most needed Statistical support for meeting the Millennium Development Goals (MDGs), particularly in Nigeria.