Abstract
The study focused on the knowledge, attitude and practice of premarital screening of HIV/AIDS among rural area of Itas Gadau local government area of Bauchi state. This study is therefore tailored towards assessing the awareness, attitude and practice of HIV premarital screening among rural duelers in Itas Gadau LGA of Bauchi state, Nigeria. This study adopt a descriptive survey design. A total of 300 community’s leaders were used. Simple random sampling technique was used to select participants. The research instrument was structured questionnaire. Results obtained from the questionnaire were analysed using percentage and graphical method and hypotheses was tested using Chi-square statistics with the aid of SPSS 21. Result showed that the knowledge, attitude of community leaders on HIV/AIDS, premarital HIV screening and Voluntary Confidential Counselling and Testing (VCCT) was high. Most of the premarital HIV screening was initiated by the religious and community leaders in the LGA. Also, majority of leaders made premarital HIV screening compulsory which is against the right of the members. In as much as premarital HIV screening is good; members should be convinced to do this screening and not to be coerced by these religious leaders, thus, stepping on one of their human right.
CHAPTER ONE
INTRODUCTION
- Background of the study
One of the biggest health challenges threatening the human race in recent times is the HIV/AIDS pandemic. To know one’s HIV status is a part of the human right to health, it should not be a duty imposed on individuals by the state. For example, it is widely acknowledged that governments cannot oblige people to undertake genetic testing to determine if they are carriers of haemophilia or impose mandatory testing for genital herpes or hepatitis (World Bank. 2017). Today, however, some governments and international agencies, religious leaders are pressing for changes to HIV testing strategies that can severely erode the rights of individuals to make informed choices about HIV testing and place control over these decisions in the hands of the state, religion institution and the health care system (Nigeria Demographic and Health Survey 2015). The disease has continued to be in the front burner for many years now, despite initial denials and cover-ups by some countries. UNAIDS estimated that globally, there were 33 million [30 million–36 million] people living with HIV in 2007 (UNAIDS, 2018). Overall, 2.0 million [1.8 million– 2.3 million] people died due to AIDS in 2007, compared with an estimated 1.7 million [1.5 million–2.3 million] in 2001. Sub-Saharan Africa with just over 10 percent of the world’s population has the greatest burden of this disease. It is estimated that close to two thirds of all people living with HIV are in sub Saharan Africa with South Africa having about 5.3m million people living with HIV/AIDS-the largest in Africa. The HIV/AIDS pandemic has significantly interfered with the gains which has been made in the area of health and development in many African countries over the years and has also reduced the quality of life. According to (UNAIDS 2018) with AIDS claiming so many people’s lives, Nigeria’s life expectancy has declined. In 1991, the average life expectancy was 53.8 years for women and 52.6 years for men (Spink, G. 2019). In 2007, these figures had fallen to 46 for women and 47 for men. There is therefore a disparity between what ought to be and what is happening presently as regards the situation of HIV/AIDS in Nigeria. The disparity between what should have been and what will exist will worsen further if the HIV prevalence is allowed to rise further and the epidemic is not adequately controlled (FMOH, 2016). The response to the HIV/AIDS epidemic which was initially characterized by denial and inaction has gained greater recognition in Nigeria. The high point of the response was the establishment of the National Committee for the Control of AIDS (NACA) which has now become a full-fledged agency. The response to HIV/AIDS in Nigeria has not been limited to the government or government agencies alone. Other sectors and non-governmental agencies including religious bodies are also involved. In the early early days of the epidemic, the prevailing view among religious leaders was that God had sent AIDS as a punishment for sexual sins and other moral failings (Adeokun, L. 2016). This view has changed as many religious bodies in Nigeria are now playing key roles in the fight against HIV/AIDS. As far back as 2012, the inter-faith HIV/AIDS Council was inaugurated with five trustees each from the Christian and Muslim faiths. Many religious organizations, in recognition of the fact that HIV/AIDS knows no religious boundaries have also developed policies to combat the spread of HIV/AIDS in their congregations. According to (McCain 2013), AIDS is affecting the religious community, as many of the people suffering from AIDS are religious people, members of churches and mosques. Controversies have however trailed the response to combat HIV/AIDS put in place by some religious organizations. A particular response which has attracted a lot of controversies is mandatory pre-marital HIV testing. Mandatory premarital HIV testing refers to the requirement of an HIV test as a condition for entering into marriage. The practice of mandatory pre-marital HIV testing which originated from the states of Louisiana and Illinois in the United States has also been documented in Nigeria, Democratic Republic of Congo (DRC), Ghana, Burundi and Uganda (Open Society Institute, 2008). The Open Society Institute (2008) stated that in Nigeria in the late 1990s, Orthodox and Pentecostal churches began to require a mandatory premarital HIV test for those who wish to marry in the church. Mandatory premarital HIV testing, in spite of the opposition has continued to gain ground among intending couples. The 2005 National HIV/AIDS and Reproductive Health Survey showed that the number of people who desired HIV testing to fulfill mandatory marriage requirement rose to 3.0%7 from 2.4% in the 2003 survey. Furthermore, a study conducted among health care workers in North-central Nigeria revealed the support for the enforcement of pre-marital HIV testing for intending couples (Musa, O. I. 2015). Orthodox churches such as The Anglican and the Baptist Churches as well as Pentecostal Churches such as Deeper Life Bible Church and Assemblies of God Church are some of the churches in Nigeria that have instituted Baptist Church stated that the intention is to prevent HIV infection, rather than punish those living with the virus, the Anglican Church instituted the test to help couples make more informed choices when choosing marriage partners (Eyoboka, S. 2014). Similarly, a report by the Center for the Right to Health indicated the position of one the Pentecostal churches where this policy is in place that there was no need to continue marriage with somebody who already has a death sentence. In this case, the HIV infection is the death sentence. The human rights violation inherent in the practice, the limited population it targets as well as the belief that it is not a cost-effective HIV prevention and control measure has generated a lot of concerns particularly among human rights groups, government and nongovernmental organizations who are into HIV/AIDS-related issues.. According to (Gruskin, Roseman and Ferguson 2017) requiring individuals to submit to a pre-marital HIV test before being allowed to marry raises many of the human rights concerns such as voluntariness, privacy and confidentiality as well as appropriate counseling. Similarly, (Uneke et al 2017) stated that mandatory pre-marital HIV screening could generate social stigmatization and infringement of the fundamental human rights of infected individuals
- STATEMENT OF THE PROBLEM
HIV premarital screening is one of the practices that is prevalent and compulsory in religious communities of many African countries and it is a major health issue that constitute a threat to the fundamental human right (Segun Odukomaiya 2014). The scientific approved screening should be voluntary after adequate counselling of an individual. It is contrary to premarital screening in religious institution especially in rural area of Itas LGA. This negates the principle of informed voluntary screening testing and human right to health. The immediate and long term health consequences have been observed in various communities in Itas LGA of Bauchi state. There are few systematically documented studies that enable care providers to bring out the direction association or linkage between observed problem in HIV premarital screening in religious institutions enforcing by religious leaders and ideal HIV voluntary counselling and testing. This has undermine the fact that not all couple are member of the two dominant religion in the state as the marriage of a traditionalist is not subject to medical screening in Nigeria. It is in view of this that this study becomes pertinent to examine the knowledge, attitude and practice of premarital screening of HIV/AIDS among rural areas of Itas Gadau LGA of Bauchi state.
- OBJECTIVE OF THE STUDY
The study has one main objective which is subdivided into general and specific objective. The general objective is to examine the knowledge, attitude and practice of premarital screening of HIV/AIDS among rural area of Itas Gadau LGA of Bauchi state. The specific objectives are;
- To examine the effect of mandatory premarital screening on the health of rural duelers in Itas Gadau LGA of Bauchi state
- To examine the impact of knowledge premarital screening on HIV/AIDS on the infection rate of Itas Gadau LGA of Bauchi state
- To examine the relationship between premarital screaning practice of HIV/AIDS and the health of the couple
- To proffer suggested solution to the identified problem
- RESEARCH QUESTIONS
The following research questions were formulated by the researcher to aid the completion of the study;
- Is there any effect of mandatory premarital screening on the health of rural duelers in Itas Gadau LGA of Bauchi state?
- Does knowledge premarital screening on HIV/AIDS play any role in the reduction in infection rate of HIV/AIDS in Itas Gadau LGA of Bauchi state?
- Is there any significant relationship between premarital screening practice of HIV/AIDS and the health of the couple?
- RESEARCH HYPOTHESES
The following research hypotheses were formulated by the researcher to aid the completion of the study;
H0: knowledge premarital screening on HIV/AIDS does not play any role in the reduction in infection rate of HIV/AIDS in Itas Gadau LGA of Bauchi state
H1: knowledge premarital screening on HIV/AIDS does play a role in the reduction in infection rate of HIV/AIDS in Itas Gadau LGA of Bauchi state
SIGNIFICANCE OF THE STUDY
It is believed that at the completion of the study, the findings of this study will be of great importance to religious leaders as the study seek to enlighten the leaders and the populace on the need for voluntary premarital screening for HIV/AIDs in the study area, the study will also be of great importance to marriage counselor in the study area as the study reveals the need for more enlightenment program for young and soon to be couples. The study will also useful to researchers who intend to embark on a study in a similar topic as the study will serve as a reference point to further research. Finally, the study will be useful to student, teachers, lecturers, academia’s, and the general public as the study will contribute to the pool of existing literature on the subject matter and also contribute to knowledge.
SCOPE AND LIMITATION OF THE STUDY
The scope of the study covers the knowledge, attitude and practice of premarital screening of HIV/AIDs among rural areas of Itas Gadau of Bauchi state. In the course of the study, there are some factors that limit the scope of the study;
a) AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study
b) TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.
c) Organizational privacy: Limited Access to the selected auditing firm makes it difficult to get all the necessary and required information concerning the activities.
1.8 OPERATIONAL DEFINITION OF TERMS
Knowledge
Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts, skills, or objects
Attitude
In psychology, attitude is a psychological construct, a mental and emotional entity that inheres in, or characterizes a person.
Practice
Practice is the act of rehearsing a behaviour over and over, or engaging in an activity again and again, for the purpose of improving or mastering it, as in the phrase ‘practice makes perfect'.
HIV
HIV (human immunodeficiency virus) is a virus that attacks the body's immune system.
AIDS
Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight infection and disease
1.9 ORGANIZATION OF THE STUDY
This research work is organized in five chapters, for easy understanding, as follows
Chapter one is concern with the introduction, which consist of the (overview, of the study), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study. Chapter two highlight the theoretical framework on which the study its based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding. Chapter five gives summary, conclusion, and recommendations made of the study.
