HIV Epidemiology in Urban and Rural Regions of Nigeria

 Association between Attitudes, Religious Beliefs, Knowledge of HIV, Sexual Risk Behaviors and its effect on HIV Epidemiology in Urban and Rural Regions of Nigeria

1.0  Introduction

Over the last few years, over 25 million individuals lived with HIV/AIDS. 75% of these people were living within the sub-Saharan Africa region. Typically, HIV infection incidents and high-risk behavior prevalence among the population in Nigeria, specifically, continue to rise. This paper uses data from 2013 Demographic and Health Survey (DHS 2013). The DHS 2013 entails a cross-sectional and multistage stratified survey based on systematic sampling. The survey was meant to obtain information about key indicators regarding the Nigerian population and health. Such indicators include sexual activities, knowledge about AIDS among other STDs, as well as the associated behavior. The study, in this case, focuses on the relationships between attitudes, religious beliefs, and knowledge of HIV, and the sexual risk behaviors of people living in urban versus rural regions in Nigeria.

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1.1  Background

Human Immunodeficiency Virus infection is one of the most highlighting and significant public health consequence and challenges in the Federal Republic of Nigeria (Adebayo, et al., 2002). The ailment has common outcomes all over the globe and is known to influence a major portion of the population over the course of time. Nigeria, with the consideration of the HIV infection, is considered to be the country that is affected second-most in all of the international countries, exhibiting the 14% of the cases and symptoms that are associated with the ailment. As official statistics and arguments have provided, the epidemic condition of HIV has been relatively slow in influencing the conditions of Nigeria in terms of economic and social tendencies (Bogart, et al., 2005).

In contrast to Africa, research evidence collected from Nigeria represents that the epidemiology and occurrence of HIV as a condition is considerably high; the geographic and social contribution of the disease is immense as well (Adebayo, et al., 2002). According to Esu-Williams et al., for instance, there were 2300 individuals reported along from five Nigerian states, HIV virus 1 was exhibited in about 60% of those individuals working as commercial sex workers (CSW), 8% in blood donors considering fewer number of states, with male clients involved with sex workers, truck drivers, patients going through any sexually transmitted disorders having approximations of 8%, 9% and 10% respectively (Bogart, et al., 2005).

In a recent consideration of outlining a study conducted by the United States Naval Health Research Center, it was estimated that there was a 15% serum prevalence rate of HIV among those personnel that was associated with Nigerian militant forces. As the most heavily populated country in African region (with the population being over 130 million) and one of the most crowded countries internationally, even the slightest form of increase in the AIDS/ HIV intervention rate in Nigeria is going to bring about the representation of a significant prospect; the global burden of HIV/ AIDS as a disorder is going to decrease (Bogart, et al., 2005).

1.2  Problem Statement

In the year 2007, women were held responsible for about 58% of all the adults between the ages of 15 and 45 living with HIV infection. Some of the contributing factors for the expanding epidemic conditions among women in Nigeria involve multiple cultural implications such as polygamy and a restriction of emotional exhibition of thoughts over matters such as sexuality issues; the increasingly popular nature of mating with multiple partners among urban-based women in the age group of 15-29 years has also seemed to contribute in the process. Lack of sexual education and aspects of education in schools such as religious teachers has resulted in astigmatic growth of the issue (Bing, 2008). There are no empowering and support mechanisms formulated to bring about for the prevention of the ailment; the educational factors lead to non-substantial support of women and an unwillingness of most men to use sexual protection during sexual intercourse practice. In addition to that, social values and ethical considerations that do not promote the use of protective measures have been well understood to also provide a significant contribution to the efficacy of HIV transmission among Nigerian population (Bogart, et al., 2005).

There is a significant amount of literature present on the topic of HIV risk phenomenon, there is information needed still of the involvement of military individuals within the progressive stages of this ailment. The current research and mediation of information on the topic is going to address the issues by observing the association of HIV knowledge and risk tendencies among Nigerian social and cultural sectors (Bryan, et al., 1997).

1.3  Purpose of the Study

The research is focused on providing a significant amount of information and insight for the association between attitudes, religious beliefs, knowledge of HIV infection, sexual risk behaviors and its outcome on the HIV epidemiology and occurrence in rural and urban region of Nigeria. The paper is going to provide a substantial amount of information on the knowledge which results in behavioral changes and risk influence with the perception of sexually transmitted infections; such ailments that are coordinated with the sexual risk of a partner are also mediated on a functional basis.

The relationship between attitudes, religious beliefs and knowledge of HIV with the sexual risk behaviors of people living in rural and urban Nigerian regions are to be examined using the NDHS 2013 survey.

1.4  Research Objective

For the purpose of fulfillment of the topic, the research objective is to test the association between attitudes, religious beliefs, knowledge of HIV, sexual risk behaviors and the effect of these variables on the HIV risk-related sexual behavior in urban and rural areas of Nigeria. Identify effective ways on how to prevent the spread of HIV through an effective campaign

1.5  Research Question and Hypothesis

  1. What are the relationships between attitudes, religious beliefs, and knowledge of HIV, and the sexual risk behaviors of people living in urban versus rural regions in Nigeria?

H101: Attitudes towards sex are not related to sexual risk behavior (unprotected sexual intercourse) of urban versus rural people in Nigeria.

H1a1: Attitudes towards sex are significantly related to sexual risk behaviors of urban versus rural people in Nigeria.

H102: Religious beliefs are not significantly related to the sexual risk behavior of urban versus rural people in Nigeria.

H1a2: Religious beliefs are significantly related to the sexual risk behavior of urban versus rural people in Nigeria.

H103: Knowledge of HIV, religious beliefs, and attitudes toward sex are significantly related to the sexual risk behavior of urban versus rural people in Nigeria.

H1a3: Knowledge of HIV, religious beliefs, and attitudes toward sex are significantly related to the sexual risk behavior of urban versus rural people in Nigeria.

  1. What are the relationships between attitudes, religious beliefs, and knowledge of HIV, and the sexual risk behaviors of people living in urban regions in Nigeria?

H201: Attitudes towards sex are not significantly related to the sexual risk behaviors of people living in urban regions in Nigeria.

H2a1: Attitudes towards sex are significantly related to the sexual risk behaviors of people living in urban regions in Nigeria

H202: Religious beliefs are not significantly related to the sexual risk behaviors of people living in urban regions in Nigeria.

H2a2: Religious beliefs are significantly related to the sexual risk behaviors of people living in urban regions in Nigeria.

H203: Knowledge of HIV is not significantly related to the sexual risk behaviors of people living in urban regions in Nigeria.

H2a3: Knowledge of HIV is significantly related to the sexual risk behaviors of people living in urban regions in Nigeria.

  1. What are the relationships between attitudes, religious beliefs, and knowledge of HIV, and the sexual risk behaviors of people living in rural regions in Nigeria?

H301: Attitudes towards sex are not significantly related to the sexual risk behaviors of people living in rural regions in Nigeria.

H3a1: Attitudes towards sex are significantly related to the sexual risk behaviors of people living in rural regions in Nigeria.

H302: Religious beliefs are not significantly related to the sexual risk behaviors of people living in rural regions in Nigeria.

H3a2: Religious beliefs are significantly related to the sexual risk behaviors of people living in rural regions in Nigeria.

H303: Knowledge of HIV is not significantly related to the sexual risk behaviors of people living in rural regions in Nigeria.

H3a3: Knowledge of HIV is significantly related to the sexual risk behaviors of people living in rural regions in Nigeria.

1.6  Theoretical Framework of Study

HIV epidemiology is also transactional and can be shared in different forms. HIV epidemiology involves having knowledge and information with command over things that a person is working within and when it comes to talking about the trading industry, this is something which can be moved and transferred in a positive manner to multiple other associations that require and add such capabilities with greater achievements. This transfer actually doesn’t affect or prevent the use of such information from the original user but it associates multiple benefits of other individuals which can use professional and educational aspects on their background information in an effectual manner. Most of the times, HIV epidemiology is only included and talked about in terms of skills and knowledge when it is actually more than just that; it is about human intelligence and in a way, accomplishing things in an appropriate manner with artistic abilities and conformational objectives. HIV epidemiology relates to capital human formation in capabilities form more than any other phenomenon.

The concept of HIV awareness theory is of a basic individual and therefore it corresponds with the smaller and fractions of things that are numbered for an individual to perform that are not just important but are extremely essential in the being and formation of a personality and overall mindset of an individual.  The philosophical assumptions of this theory is a curiosity of an individual towards how they want things to be in the present, how they already are and what can they do to make things right and in the same manner, how can they contribute not to repeat the same mistakes and loses they have been experiencing all this time. This is something which is accountable and responsible for the benefits of a person and counteracting for the betterment of an individual on consistent terms. The envisioning process of the therapy and counseling makes sure that the individual has in mind the preferred and required tasks in the mind and thinking about them, he or she is making a positive approach towards life and its benefits and offerings. Together, the therapist and the person both are moving towards betterment and means through which a smaller or larger increment in the personality traits and individual capacities can be encountered. When these smaller changes tend to be focusing on the larger ones that is when the successful achievements of a particular theory come into being.

Figure 1: Conceptual Structure of Behavioral Concept (Ogbuji, 2005)

1.7  Nature of the Study

The purpose of this dissertation is to, first of all, create a sense of balance and integration within general readers and individuals about HIV epidemiology and its association between attitudes, religious beliefs and sexual risk behaviors and how clinical knowledge brings about a routine of consistent knowledge and conceptual information about human development and reformations. For the purpose of carrying out quantitative research, a survey questionnaire was distributed among the target population by Measure DHS/ICF Macro of Calverton, Maryland. In this study, I will conduct a secondary analysis from these previously collected data. The independent variables in this study were attitude (which was measured by the NDHS [2013] attitude subscale that was used to evaluate attitudes towards sexually transmitted infections [STIs]), religious beliefs (which were evaluated by the NDHS sexual risk behavior subscale), and knowledge of HIV (which was evaluated by the NDHS knowledge subscale about HIV). The dependent variable was sexual risk behavior (measured by the NDHS sexual risk behavior scale). Covariates that will be identify and properly adjust in the statistical analysis are socioeconomic status, number of sex partners, wealth index, type of place of residence, age, gender, marital status, place of residence (urban or rural), religion, and educational level (also from the NDHS). In this study, I will use a national representative sample of the Nigerian population from the NDHS (2013) in which the researchers assessed religious beliefs, attitudes, and knowledge of the participants including their behavioral choices with regards sexual practices. The sample was selected using a stratified, two stage cluster design. Three different questionnaires were used. They were the men’s questionnaire, the women’s questionnaire, and the household questionnaire. I will employ a quantitative research method that included testing of hypotheses based on data from the survey. A quantitative method is best for this type of research because I will compare three different groups to explore the relationship between the independent variables (attitudes, religious beliefs, knowledge of HIV) to search for associations. Other assessment dimensions included participants’ demographic characteristics such as marital status, sex, age, educational status, wealth index, and history of sexually transmitted infections which will be adjusted for in the statistical analysis.


1.8  Definition of Terms

1.8.1        HIV Infection

HIV can be abbreviated as Human Immunodeficiency Virus. The disease is basically known and identified as that of a life-threatening one since it breaks down the immune system which is responsible for all of the possible protective mechanisms of the body. HIV causes people to get sick with different ailments, infections mostly and they are normally the ones which wouldn’t affect them in a significant manner (Carey, et al., 1997).

AIDS is an abbreviation for acquired immune deficiency syndrome. It is the most advanced form of HIV as a disease.

1.8.2        Sexual Risk Behaviors

Sexual risk behaviors are identified by the increased risk of a negative outcome or a consequence which can be provided with the help of two methods; risky sexual behaviors are those which can enhance the chance of sexual disease contraction and transmission or increase the occurrence of unwanted pregnancy chances with the help of different procedures and understanding phenomenon. Sexual risk behaviors comprise of having one or more than one sexual partner, alterations of sexual partners in a much frequent manner, having vaginal, oral or anal sexual contact without using proper protective measures and using inconsistent and improper birth control methods or a non-mediated use of birth control (Diclemente, 1991).

1.8.3        HIV Related Knowledge

The literature brings about an insight that the knowledge does not always have outcomes in behavioral mechanisms within an individual, nor does it provide an influence in the risk management and observing capabilities of sexually transmitted infections. Some of those individuals who contact infections of sexual transmittance often overlook the sexual partner risk. Additional findings represent that sexual education and awareness tends to be restricted, enhancing delayed sexual initiation and less number of partners instead of protected sex (Ekong, 2006).

1.8.4        Perceived Risk

Perceived risk can be defined as a process of being personally influenced by AIDS/HIV in some manner, such as observing a close person die due to the disease. Personal exposure perception results in the adaptation of secured behavior and analytical calculation of thoughts. Therefore, having knowledge of someone dying due to the HIV infection is expected to induce practices such as the use of condoms as a protective measure against the ailment overall (Essien, et al., 2006).

1.8.5        AIDS

AIDS abbreviated as acquired immunodeficiency syndrome represents the multiple ranges of diseases as a result of human immunodeficiency virus from an initiating infection to later serious symptoms and consequences. It is consistent damage to the organ systems, in particular, the immune system. Being followed by a prolonged period of illness without symptoms, the side effects can ultimately result in central nervous system damage as well.

1.8.6        Attitude

An expression of favor or belief towards individuals related to a sexual encounter. In the study, attitudes were measured with the help of study researches and the scale of magnitudes the variable was recorded on.

1.8.7        Knowledge

Knowledge in this particular case involves the awareness and information about HIV/ AIDS before there is a sexual interaction for an individual. The population samples from the researches that were studied provided an insight on the particular variable.

1.8.8        Religious Beliefs

A particular set of applications, values, symbols and services estimated to provide the sacred entities through promoting an awareness of an individual’s accountability and association to others at a social platform in the community settings.

1.9  Assumptions

The mechanisms and information developments of sexual risk behaviors and how they influence different individuals living in rural and urban regions of Nigeria involved were quite a difficult and sensitive issue to discuss. There were assumptions presented that the studies reviewed for the sampling and estimating information were accurate and comprehensive enough to have outlined the mentioned topic effectively. The information and knowledge provided by those studies were checked using the PICO scale regarding the attitudes and sexual risk behaviors. It is also considered that there was an effectual mediation of search strategy within the studies that were selected primarily for similar functions. An assumption was formed that the survey and literature search was managed and observed in an appropriate manner, and the information was availed in quality terms. It was also assumed that the reliability and validity statement of research was followed before the conduction of the literature search.

Without the formulation of suitable assumptions, it was not considered possible for me to derive suitable and accurate response regarding this research on a particular search strategy function because the process not only allowed me to outline suitable data, but it also cleared the methods through which reliable and valid information can be utilized. These mentioned assumptions were significant also in a way that this form of qualitative research can outline constructive concepts and theory building regarding the HIV infection and other associated ailments that are produced as a result. The cause of a phenomenon and the subjective materials related to the situation of individuals is also outlined for the purpose. For the awareness of HIV infection and its effects on the epidemiology in rural and urban Nigeria, the assumptions are crucial and significant enough.

1.10          Scope and Delimitations

Research has helped so many individuals get what they want and also be on places where they have always wanted to be doing things that are beneficial and resulting for them in all of the cases. Research is a means of communication and relation of different human being to a person that can listen to them and undermine the issues they are going through and not just that, devising a plan to what could be done about several things in the future. This helps several individuals on levels that they hadn’t thought will work out on and the results which will be derived. Research can reveal the basic purpose and developmental aspects about life and there can be different talking session and things like contribution and enhancement followed up with the process but then again, transformation and rehabilitation are some procedures which don’t occur without the wellbeing of an individual. If a person is willing to know all of the aspects about knowing what he or she is supposed to do then probably that is the most effective thing that will ever happen. A therapy session can induce feelings and thoughts in an individual that were never there and the realization of truth becomes fairly easier as well.

With the help of research, people can actually determine what their future holds for them and how well off they are on their way to achieving it. It gives them a chance to explore their future requirements and known facts; only in an improvised and thoughtful manner to gain knowledge and information on their own. If there are any flaws and hindrances in the middle of doing so, there can be different means of communicating and problem-solving induced in the routine as well. Research in terms of focus theory gives individuals a chance to know where, how and what is occurring in bits and pieces around them for their preferred future already and how well off they only have to become a part of it. The approach is highly practical and it can be well off to arranging different equipment and material on consistent terms. Questions can be asked in the sessions to wonder if the particular individual has what it takes to become a changed personality and overcome the gaps and flaws that were there before. Mistakes and avoidance which occurs shouldn’t also prevail in such matters.

Solution-focused counseling; consulting and therapies will induce the personality, health and psychological tendencies of an individual in a classic conditional manner. There are different reasons to which it can be performed and carried out but the different personalities and their resource outcomes derive several possible results on a routine basis. The models have been referred to and talked about in brief details for a long time that is to be included with the time being and different individuals but there are always outcomes and the ones that are constructive and much more advanced. If there are any negative outcomes, the mode and change in the therapy lessons or the kind of it is changed to something which is better suited and appropriate for the individual to take in and derivations are made for future references. The integration of different sessions and their results depend on how well a person is doing in participation and taking interest towards making life a better phenomenon. If there is an ultimate interest, there are outcomes adjusted and sought after and if it is something which is being forcefully implied, the mind or body of the individual is not going to have any effects.

These aspects of a man’s life are about organizational management and availability as well because there are various kinds of issues going around and there has to be a solution for each one of them. This not only links different individuals to their true self but also guides them to the path of proper management and dealing with abilities which they probably weren’t aware of for some time. It is about having a responsibility and practices in separate walks of life.

HIV is the kind of ailment which prevails in all of the world’s population these days according to the statistical analysis, there are things which can cause a couple of complications with the routine and general behavior of the individual. Being obese and overweighed doesn’t ask for something which is normally irregular and a person can surely live with it but the consequences are affiliated for a longer amount of time. Factors that are causing adolescent HIV and several other elements along with it adding motivation, the intervention of goal setting theory and self-determination theory in relation to the motivation theory in both manners. HIV concerns are rising by the days and they are said to have more and more complications along with time because of the genetic factors and things such as the promotion of fast foods and junk items which contain lots of calories within them and less appreciation, rejection of physical activities and things that are related of such sort. If HIV remains a leading cause of issues within an individuals’ personality, it can create more problems as well and ultimately lead to cancer forms which is unhealthy for the routine by all means. Depression induced by HIV is highly objectionable and disadvantageous as well due to the fact. The appreciation of physical activity in such regards is extremely important and for those that are carrying it out, it is essential for the consistent efforts to be taking place as well.

1.11          Limitations of the Study

As the study brings about an understanding for the HIV ailment, the reported data and knowledge from different databases was ruled out regarding the particular topic only. The information of historic nature, sexual risk behavior, religious considerations regarding sexual behavior of individuals and their concepts was outlined. In addition to that, regardless of the participants revealing their sexual attitudes, responses towards activities of such nature, prospects and social or religious thoughts regarding sexual functions and their HIV knowledge might be difficult to know of.

Another limitation provided by this study method was the incapability of maintaining a consistent result because of with the systemic review of literature being employed in the study routine, the findings being of multiple nature and categories. The language was another limitation for this research particularly with the information available in local Nigerian language that was difficult to comprehend and translate. The external validity of the research was limited according to the statistics provided since the information derived for analysis was vulnerable to inaccuracy and inconsistent results.

1.12          Significance of the Study

Knowledge of HIV is associated and deeply inherited with the HIV epidemiology levels of different kinds and they are relatable in plentiful manner because of things which are coordinated and altered within the same manner. HIV epidemiology is basically the significant element of clinical knowledge and it has unique formations which can be concluded successfully in implementing economic considerations and methods within public and social sectors. Instead of the applications of elementary efficacy, the significance of the problem relies and adventures on the HIV epidemiology and sexual behavior statements which are expandable and self-prospective with application. As a patient is performing his usual routine activities, he gets to experience more and his HIV epidemiology base increases so does the endowment of the knowledge of HIV. This decreases all of the possible scarcity elements because they are replaced with the procedures of self-motivation and self-generation.

To support this idea and concept of therapy and counseling, there are a number of key concepts and things which are considered and kept into account. One of such major things is the fact that questions have a major role in the build-up of a person’s needs and wants. A counselor will ask the individual how they want life to be like and how they actually want things to turn out and what are they doing to achieve so. The strengths are discussed and their weaknesses as well as to where they are lagging and going in the right direction and the best means to do so is one on one question-answer sessions and several other means of communication and answer recordings. The resources through which they can carry out the means and measurements of success and end outcomes are also discussed in the theory sections.  If there are any exceptions to the problems, they are discussed as well.

Man is the creation to which there are several flaws and detailing done and there are different concepts to what the realizations are to be made and thought on.  There are several abilities that he or she can perform and there are instances where they can go wrong as well and it is all about how it works out with their limitations and parameters in a suitable and appropriate manner. The cognitive abilities and things a man can do are endless and even if to think of a little thing can be performed in the easiest and feasible manner but when it comes to talking about the issues and personality traits, there could be different scenarios and conditions that are implied differently in multiple cases. The emotions, feelings, and thoughts that are processed within the human mind can be accessed and promoted but if they are going in a negative manner, there has to be consultation and rehabilitation done in a similar pattern as well. Man develops with the mistakes and perception that it holds within and there are focusing abilities which make it even improvised and enhanced for the cause of betterment. Human personality is based on different categorization and those too on different levels of judgment and impairments and figuring them out is the basic and fundamental notions everyone follows.

“Growth in the understanding of the realities and the words [of revelation] which have been handed down”

This scripture references to the developmental aspects of the human basis and the purpose of it being alive and philosophically well and being.  Though there is a less identification to what a man realizes and implements on a consistent term but there are more and more developments about this with time. If an individual has known the change in their life and they want to get along with it then he or she must know the costs of life and how it should be lived. There are different paths that a man can choose but to set the right one and to do so in a constructive and appealing manner should be the cause and methodology of life.  Change is constant but to deal with it in a manner which is fruitful and even benefitting can become a really motivating and relative thing to perform within a short amount of time. Though there are a lot of hindrances but development can always be achieved.

“Spend your time and energy in training yourself for spiritual fitness. Physical exercise has some value, but spiritual exercise is much more important for it promises a reward in both this life and the next.  This is true and everyone should accept it.” 1, Timothy 4:7-9

Health is the most important aspect about human life and that is something which keeps a differentiation and a fact of appreciation in human life as well. If there are a lot of things for a person to do and if there is no time for things like health and prosperity then it is most likely for the person to get caught up in the routine and do things which are unhealthy by all means. The prosperity of the body is an essential thing to happen and there are several signs of it. A health person is always contented and satisfied with what the life has to offer and its benefits and influences. The surrounding elements don’t tend to bother or specify his or her needs and requirements and there are always things which can improvise on this.

Signs of health also include the routine life of an individual and how much time he or she has to give what the support and organization of the body is like and the extent to which it can be deliberated. The health standards that are not achieved in an appropriate manner should be done so in an effectual manner and it is not difficult to do so. Health improvisation can be carried out if one is taking care of the basic needs and requirements of the body such as eating well and not consuming harmful reagents and components that can cause complications within the body. It also comprises of the balance and exercise routine; if the body that you are provided with is not being worked upon and left to nothing, it will get all sorts of immunity destroying agents and processes which will be consequential. To deal with such things, there should always be a plan out and schedule to which anyone can act at any instance. Using better products and life term things such as oil, synthetic substances and even things of necessities like oil, herbs, creams, shampoo and things as such should be selected by proper means and considerations before even one starts to use them appropriately on a daily basis.

Abnormality is something which can occur to anyone and there can be numerous causes that can be implied to the situation. It is a procedure which is out of the ordinary and there can be reasons and factors to judge so. Abnormality occurs when there is a notion of senselessness in the body and when things are not functioning the way they are supposed to and there could be many causes as to which that can be happening for. There are different ailments as to which consequences and effects prevail and there are the ones that can’t be solved with normal conditions and sequential measures but then again, if a person is taking proper measurements and known precautions to live life the way they are supposed to. If an abnormality has to occur, there are going to be things that will trigger such events in the first place such as bad eating habits or things like ignorance or lack of complete sleep and several other factors. To know about such things, a person should keep a record of things that he or she has been doing for a considerable amount of time and how everything is going to turn out a lot different if things were changed or altered.

Probably causes of abnormality can also be the fact that the person is addicted to different things that cannot be healed or dealt with unless there are extreme measures of rehabilitation and consequential therapies designed. Lack of focus, for instance, can be a result of some trauma or life accidents that happened and affected everything that a person has which is why there are no more outcomes left to be judged or considered. If there are any psychological needs and requirements to build a relationship with counselor or other affectionate personalities, it could be carried out in a positive manner more than anything else. There are several nervous problems occurring in the brain or some social rejection that can cause abnormalities on focal and apparent abilities of an individual and they can be dealt with in a time frame with suitable medications or things like therapies and discussion sessions that turn out to be constructive and appealing. If there are any hindrances in the middle of therapy success, those can be identified and dealt with in a consistent manner as well for the betterment and positive approach of an individual.

1.13          Summary

HIV in Nigeria, according to the deliberations, was identified in the 80s. At present, it has the third-ranking on an international scale with appropriate number of people infected and suffering from the viral conditions; these patients are not only going through medical consequences, but they also have social, medical and economic stressors. The contribution of this situation in Nigeria was provided by the encouragement of multiple sexual partners, denial of AIDS as an epidemic and less awareness regarding condoms and additional sexual protection methods.

At present stage, though different countries and regions are working in an appropriate manner to cultivate and particularly stabilize the conditions of HIV in the past couple of years, the overall HIV incidence is still greater than it was before, the registered cases and deaths every year are an indication to that. There are some Nigerian regions where the HIV pandemic is functionally controlled with the help of intravenous drug use fundamentally, a process which needs to be configured with the help of theoretical approaches. Theories such as Anderson’s behavioral health service, Kuhn’s paradigm shift and Roemer’s health care systems are definitive to examine different variables and their outcomes with the purpose of reducing the possible spread of HIV and its linked stressors in the urban and rural Nigerian regions.



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