Table of contents

1. Introduction

IV stands for "human immunodeficiency virus":"human" because the virus causes diseases only in people; "immunodeficiency" because the immune system, which normally protects a person from disease, becomes weak; "virus" because like all viruses, HIV is a small organism that infects living things and uses them to make copies of itself. HIV causes AIDS (acquired immune deficiency syndrome). AIDS is a group of diseases that occur when a person's immune system is damaged by HIV. When HIV is in the body, it start to destroy CD4+ cells which are white blood cells (WBC) that help the body to fight infections and diseases. HIV is spread when blood, semen or vaginal fluids from an infected person enters another person's body, usually through sexual contact, sharing of needles, injection of drugs or from mother to child during birth.

HIV makes it difficult for the body to fight off infections I.e. when a person is infected with HIV, the person may get some infections, otherwise known as opportunistic infections (O.I), that the body can no longer fight off. The HIV attacks the immune system, and if the immune system is damaged, it increases the risk of developing a serious infection or disease.

The question people often ask is where did HIV come from? The origin of HIV/AIDS has been a puzzle to the whole world. Scientists have professed many theories about the origin of HIV/AIDS but none has proven conclusively. According to Children's Aid Fund, the actual region of the virus origin may never be known (CAF2006).

The illness first came to light in the late 1970s in the USA. From 1979-1981, Doctors in Los Angeles and New York began to report rare types of pneumonia, cancer and other illnesses among a number of gay male patients that seemed stubbornly resistant to any treatment. These were conditions not usually found in people with healthy immune system but it was quickly noticed that all the men were suffering from a common syndrome.

In 1982, public health officials began to use the term "Acquired Immune Deficiency Syndrome" or AIDS to describe the occurrences or opportunistic infections. Kaposi Sarcoma and Pneumocystis Carini Pneumonia in previously healthy men (CAF, 2006). Final tracking (surveillance) of AIDS cases began in the same 1982 in the United States.

In 1983, Scientists isolated the virus that causes AIDS. The virus was at first named HTLV-111 (Human Tcell Lymph tropic Virus-Type 111; Lymphadenopathy-Associated Virus (LAV) by an international Scientific Committee (Children's Aids Fund). It was also called AIDS Related Retrovirus (ARV). Later, this name was changed to HIV (Human Immune Deficiency Virus) probably to depict its mode of infection in man.

After the recognition of this disease, there were many arguments as to the relationship between HIV and AIDS and how it began to cause disease in humans. Scientists began to seek evidence of its origin to better understand its mode of transmission, as well as gain insight into potential treatments and control measures.

As information came in increasing quantum to the United State Centres for Disease Control and Prevention (CDC) in Atlanta, it became clear that the United States was not the only country experiencing this epidemic. Cases in Europe were soon identified and traced to Central Africa.

But the question is; did the disease really originate from Africa? This gave too many theories on the origin of HIV.

The first two causes of HIV/AIDs in Nigeria were identified in 1985 and were reported at an international AIDS conference in 1986. In 1987, the Nigerian health sector established the national AIDs advisory committee, which was shortly followed by the establishment of the National AIDS Advisory Committee on AIDs (NEACA).

At first, the Nigerian government was slow to respond to the increasing rate of HIV transmission and it was only in 1991that the federal ministry of health made the first attempt to asses Nigeria AIDS situation. The result showed that around 1.8 percent of the populations of Nigeria were infected with HIV.

Subsequent results revealed that during the 1990's, HIV prevalence rose from 3.8 percent to 4.5 percent in 1998.

When Olusegun Obasanjo became president in 1999, HIV prevention, treatment and care became one of the Government's primary concern. The presidents committee on AIDS and the national action committee on AIDS (AIDS) were created, and in 2001, the government set up a three year HIV/AIDS Emergency Action Plan (HEAP).

In 2005, a new framework was developed covering the period from 2005 to 2009 despite increased effort to control the epidemic by 2006, it was estimate that just 10percent of HIV infected woman and men were receiving antiretroviral therapy and only 7 percent of pregnant woman were receiving treatment to reduce the risks of mother to child transmission of HIV.

In 2010, NACA launched its comprehensive National Strategic framework to cover2010 to 2015, which required an estimated 756 billion naira to implement. Some of the main aims included in the framework are to reach 80 percent of sexually active adults and 80percent of most at risk populations with HIV counseling and testing by 2015; sand to improve access to quality care support service to at least 50 percent of people living with HIV by 2015.

Of all the people living with HIV globally, 90% of them live in Nigeria. This shows that the prevalence of HIV among Nigerians is very large. This infection cuts across different age groups including adults, youths and children. Remarkably, the most highly affected population are the young people. Chiefly among the young people with the highest risk of HIV infection are students of higher learning across the country including but not limited to universities, polytechnics, colleges of health etc. This is not only the case in our country, Nigeria. It is global. Around 2,100 young people and adolescents are infected with HIV everyday. In 2013, four million young people aged 15-24 were living with HIV, with 29% aged under 19.AIDS remains the number one killer of adolescents in Africa and the second leading cause of death among adolescents worldwide. The majority of young people living with HIV are in low and middle -income countries, with 85% in sub-saharan Africa of which Nigeria is one of the countries in this region already have a youthful populations and this trend is expected to increase until 2050. The number of AIDS -related deaths among youths and adolescents rose by 50% between 2005 and 2015. This is in comparison to a 30% fall among people of all ages living with HIV.

The question begging for answer is why are young people vulnerable to HIV? Young people are vulnerable to HIV at two stages of their lives; the first decade of life when HIV can be transmitted from mother to child, and the second decade of life when adolescence brings new vulnerability to HIV. This second stage is where interest lies as far as this research work is concerned.

In HIV transmission in the second decade of life and into the third decade, unprotected sex is the most common cause of HIV among students and young people in general. The second of this cause of HIV is sharing of infected needles, youth and adolescence associated with experimentation of risky sexual and drug related behaviors, increasing a young person's vulnerability to HIV.

For some, this is a result of not having the correct knowledge about HIV and how to prevent it, highlighting the need for HIV and sexual and reproductive health education. For others, it is the result of being forced to have unprotected sex, or to inject drugs.

Whilst programs to prevent mother to child transmission of HIV (PMTCT) have been hugely successful in recent years, reducing new infections among adolescent, youths and students is more difficult. There are many factors that can put young people at an elevated risk of HIV, chief among this is the fact that they are excluded from national plans. They are often forgotten in national HIV and AIDS plans which typically focus on adults and children. Consequently, there are lack of youth friendly health sciences.

Vulnerability via unprotected sex is also a risk factor. Also the age of sexual debut is reducing, showing a negative change in attitudes among young people with regards to sexual behavior. The use of condoms among young people is usually low. The number of sexual partners young people have is rising with many young people engaging in multiple relationships.

Also, young people are usually part of key populations such as sex workers, men who have sex with men, people who inject drugs or transgender people. Young people with HIV fall under at least one of these groups.

In view of the above stand points, the issues and risk factors that predispose young people to HIV infection should be taken into heart and tackled squarely by government and the general populace especially parents, school heads, leaders of religious groups and Non -Governmental organizations (NGO's)

2. a) Backgrounds of study

According to centers for disease control and prevention, AIDS was first discovered in early 1980 and HIV was identified as the cause. A few years later, the infection has become a worldwide epidemic.

HIV infection and spread has taken a geometric increase among the youths in the last few years. Its prevalence has been an alarming increase. National data on HIV infection in Nigeria suggest that 1.3% of young women (15-24 year old) are living with HIV and 0.7% of young men. Only 25% of young people in 2012 could currently identify ways to prevent sexual transmission of HIV and reject common myth.

Early sexual abuse is common in Nigeria which begins at less than 15years for 15% of Nigeria youth. This is one fact that increases HIV vulnerability among young people, alongside very low HIV testing rate. Only 17% of young people known their HIV status.

The current trend of moral decadence and deterioration among student and Nigeria youths in general has become so rampant that the society is lost of where it all went wrong form. There is a growing public concern and findings from the governmental agencies e.g. National Agency for the control of AIDS (NACA) and other bodies have shown that explosion in population of youths living with HIV and AIDS are not unconnected with the risky behaviors and moral bankruptcy that have greeted the Nigeria youthful population in recent years.

What has helped matters is also the fact the youthful age is the age of self-exploration. It's also the stage of life of sexual activeness. Also, a higher percentage of the populations live below the poverty line and there are students and youths from families in this category of the population. Problems associated with these self-exploration, sexual activeness and poverty have presented a huge threat to the fight against HIV and AIDS pandemic among the youths and the country in general. This is because a significant number of infections and death as far HIV and AIDS is concerned have been traced to one or more of the above factors.

Treatment facilities nationwide are now gradually being over burdened with HIV related problems and cases. The need to prevent HIV infection among the general population and specifically, the youthful population thus becomes imperative. The problem of HIV infection poses a far greater health hazard and economic implication that most imagine.

3. b) Statement of problem

The population of student in Nigerian's tertiary institutions has increased tremendously in recent times. Statistically data shows that about one million, five hundred thousand students are enrolled in more than 344 institutions in the country. Survey has revealed that Nigeria has about 63 colleges of education, 50 polytechnics, 61 monotechnics, 70 professional institutions including school of nursing, colleges of health technology, vocational institutes etc. Figures in the last few years show that Nigeria has over 100 universities altogether. In this figure, 33% accounts for federal university while 44% account for the state university and 23% account for the private university. The number of higher learning continue to increase.

The Nigerian youths constitutes 70% of the entire population which is 124.95 million out of 178.5 million of the general population. A very high percentage of this population of youths are students of higher institutions. Recent trends indicate that the spread of HIV has dramatically increased particularly to claim the lives of millions of people annually. In recent years, the federal government has approved billions to AIDS agencies National action committee on AIDS (NACA); state Action committee on AIDS (SACA) and local Action committee on their global AIDS control and prevention programs to establish and maintain research and counseling centers for risk and infected persons and also for widespread media sensitization on the causes, risk, prevention, infection, and as well, counseling services.

Statistical and demographical analysis by the W.H.O showa that a total of 90% of people living with HIV globally live in Nigeria, that is to say HIV infection has become a major problem nationally. Evidence as earlier stated showa that the people who can contribute effectively to the economy of the country, there is therefore no gain saying that increasing youth's infection of HIV is a major threat to national development of the country.

As already established, the youth's are the most at risk of HIV infection, the reasons are not far-fetched. Youths are the ones that are majorly engaged in taking illicit substances such as drugs thereby injecting them into the body through the use of needles, mostly youths are present in higher institutions some of them are from a poor family background which led to their finding any means to cater for themselves and sustain hardship living thereby engaging in risk factors such as premarital sexual activities that can pose their lives to HIV infection. The students age most times is seen as the age of sexual and sex exploration by youths. Incidents of forced sex or rape are rampant on campuses.

Sex workers, men who sleep with men and people who inject drugs makeup only 10% of Nigeria population, yet account for around 23% of new HIV infection every year. In response to this, the Nigeria National HIV/AIDS strategic plan (NSP) 2010-2015 calls for enhanced behavioral change communication for key affected population. This key affected population are the sex workers which as data have it 19% of male sex workers and 25% of female sex workers in Nigeria living with HIV; men who sleep with men which as data as have it have 17% of men who do this living with HIV infection in Nigeria are among people who inject drugs. This is not to mention rape cases and unprotected sex, these key population are common among students.

It has been observed that despite many programs organized by governments to inform people about the problems of HIV/AIDS, the rate of infection continues to be on the increase. Moreover, the incidence of these problems has been attributed to some factors, parts of which are listed below:

1) Lack of knowledge of HIV/AIDS: this might be as a result of un-evenly spread of government organized programs on HIV/AIDS. 2) Educational background : this may be as a result of being illiterate of basic health education 3) Ignorance: this may be in the aspect of protection and abstinence of sex or making use of unsterilized sharp objects out of ignorance To this end judging from the problems and data outlined above, this research aims at assessing the risk factors that can predispose students to HIV infection in college of health sciences and technology Ijero Ekiti.

4. c) Justification of the study

The importance of this study is to provide resource materials for as many individuals, groups, organizations and even the government of the causes, prevention and most importantly, the risk factors that predispose youths and students to HIV infection as well as the prevalence of HIV. This project research will serve as encouragement to organizations like National Action Committee on Aids (NACA), global health organizations like world health organizations (WHO), other nongovernmental parastasals and ministries to establish more HIV/AIDS counseling centers, epidemiological centers, develop workable policies and framework and generate evidence-based prevention programs for HIV and AIDS pandemic.

Recent studies show that the rate of HIV infection has drastically increased among youths, especially among students of higher learning across the country, this problem has a unique slant because Nigeria tertiary institution admit students in their mid adolescence, the minimum age requirement is 16 years, misconduct appears or even escalates in adolescence. It is at this stage that juvenile deliquesces like rape, unprotected sex, multiple sexual partners, use of drugs etc. become pronounced. These deliquesces all have links to HIV infections which is a great public health concern.

College of Health sciences and Technology Ijero Ekiti is an institution with students from diverse ethnicities, cultures and climes and has championed the chunning out of highly qualified workers for the country's health sector. Therefore, this research work will be of immense help to youth's and the general populace.

5. d) Objective of the study i. Main objectives

The main objective of this study is to assess the prevalence of HIV and risk factors that can predispose students to HIV infection in College of Health Sciences and Technology Ijero Ekiti, Ekiti State.

ii. Specific objectives 1. To assess the knowledge of students about HIV infection, causes and prevention.

2. To find out the risk factors of infection among students. 3. To establish the degree of exposure to these risk by students. 4. To assess the consequences of HIV infection among students.

6. e) Method of research

The study included both qualitative research methods, questionnaire was distributed among students in the college. Multistage sampling method and random sampling method was applied for each department. The questionnaire explored the risk that can predispose students in the college to HIV.

7. f) Structure of the study

Chapter 2 provides an overview of relevant literature, it firstly explores various factors that might predispose students to HIV, it then took a general look on that are mostly vulnerable to HIV infection. Chapter 3 outlines the research methodology used in the study, chapter 4 presents findings on research project, in chapter 5 the findings are discussed and interpreted while chapter 6 concludes the findings and outlines recommendation.

8. g) Scope of study

The scope was conducted among students of College of Health Sciences and Technology in Ijero Ekiti.

9. h) The significance of the study

Findings of this study if communicated will help to; 1. Enlighten students and the public in the risk factors that can lead to HIV infection. 2. Enlighten students and the public on the consequences and ways of escape of these risk factors. Immune System: A system of biological structures and processes within an organism that protects against disease. I.e. it is a system that defends the body against infections and diseases.

10. MTCT (Vertical Transmission):

Mother-to-Child Transmission. Haemophiliacs: People with genetic deficiency which prevent their blood from clotting in cases of cuts and injuries. Factor 8: Substance that is made from blood. It is given to hemophiliacs to aid blood clotting.

11. II.

12. Literature Review a) Overview of risk factor

The purpose of this report is to discuss the factors and prevalence of HIV as well as identify the most significant demographic, socio-economic, biomedical and behavioral determinants of HIV risk in college of health sciences and technology Ijero Ekiti, The first major risk factor to be identified is sexually transmitted diseases (STDs) and treatment seeking behaviors in respect of these infections. STDs increase the risk of HIV transmission. Rates of STDs are particularly high among ladies, and ladies also appear to be more likely to delay or avoid seeking treatment. Asymptomatic STDs are particularly common among ladies, and this is a further reason for women not receiving treatment. A second risk factor is knowledge and beliefs about HIV/AIDS. Most students know of HIV/AIDS, and know that it is spread sexually. However, there are many misconceptions regarding other forms of transmission and cures for HIV/AIDS. Evidence suggests, though, that knowledge by itself does not provide much protection against HIV infection. A number of sexual behavior factors affect the risk of HIV infection. Young ladies are particularly vulnerable to rape and violence in sexual relationships, and in many cases they have limited control over their sexual relationships. It is also clear that many ladies depend on sex as a source of income or support, and these women are vulnerable because they have limited power in negotiating safe sex practices workers and other unsafe sex behaviors. While promiscuity is also a risk factor, it is clear that many individuals are at risk because of whom they have sex with, rather than how many people they have sex with. Certain forms of sexual intercourse are also associated with higher risks of HIV transmission. Sex without a condom is the most common form of high-risk sexual intercourse among students in the college. Anal sex also significantly increases the risk of transmission, and has been one of the reasons for the high levels of HIV prevalence among men who have sex with men. Dry sex and sex during menses are suspected to increase the risk of HIV transmission, although much of the evidence suggests that their effect is not significant, and there is little to suggest that their practice is common. Other predisposing factors are that many are accommodated in single sex hostels, and many engage in casual sexual relationships as a result of being separated from their regular partners. Their regular partners are also not necessarily faithful to them in their absence, often for economic reasons

For biological and socio-economic reasons, females are in general at a higher risk of HIV infection than males. Male and female prevalence patterns also differ substantially with respect to age.

A variety of other factors has been identified, but have not been discussed in much detail due to a lack of information on these factors. These factors include the use of hormonal contraceptives; modes of transmission other than heterosexual intercourse; and psychological factors. The most important conclusion to be drawn from this study is the importance of distinguishing between risk factors that determine the individual's own sexual behavior patterns, and risk factors that determine the level of infection in the group of people from which the individual is likely to choose a sexual partner. Into the first group can be placed factors such as age, gender, knowledge of HIV, and STD treatment seeking behavior.

HIV/AIDS has become a global epidemic. It has awakened the consciousness of governments, organizations and individuals with fear and anxiety. Every day on television screen, radio, in the newspapers, here and there, people talk about HIV/AIDS amidst fear, confusion and a lot of unanswered questions.

HIV/AIDS is one of the most challenging health problems of this area of study, since the first reported case of HIV/AIDS in Nigeria, the Federal Government as continued to respond to epidemic through the implementation of various awareness programs aimed at preventing, controlling and mitigating its impact. One of such programs the National Anti-Retroviral Drug (ARV) Access Programs. This was initiated in the year 2001 to provide affordable ARV's to the many Nigerians living with HIV/AIDS. The private sectors, non-governmental organizations, faith-based organizations, and international bodies have also been on immense assistance in the provision of ARV's.

John Hubley (2002): The most common screening test for HIV is the Enzyme-Linked Immunosorbent-Assay (ELISA) test.

Florence Uchendu (2008): Enzyme-Linked Immunosorbent-Assay (ELISA) is a screening test which identifies antibodies to HIV. It is very sensitive and so may show false-positive result. False-positive result might be as a result of serious connective tissue disease or influenza vaccination.

Adeoye (2002): Research has shown that it is possible for some people infected with HIV to live for many years without developing symptoms of AIDS. These groups of people are called Long Term Non-Progressor (LTNPs). They have immune system containing a particular gene called "HLA5701" which those who easily manifest AIDS symptoms do not have.

There is no cure for HIV/AIDS. However, there are treatments that can slow down its progression. All the people living with HIV/AIDS have to make do with the anti-retroviral drugs and treatments around. With anti-retroviral drugs, the viral load is reduced and the people living with HIV/AIDS can still live longer than they should. According to centers for disease control and prevention, AIDS was first discovered in early 1980 and HIV was identified as the cause. A few years later, the infection has become worldwide epidemic.

The first case of AIDS was identified in Nigeria in 1986. Since then, HIV prevalence has witnessed an increase from 1.8% in1991 to 5.8% in 2001. However in 2003 and 2005 the national prevalence dropped to 5% and 4.4% respectively.

The rate of HIV infection among young people is growing rapidly with about 67% of newly infected individual in the developing world being young age between 15 and 24 years, especially young women and young girls who constitute 64% of the youth in the developing countries. About 2.5million children under 15years are living with HIV (UNAID, 2007).

The International Labor Organization (ILO) estimates that 6,000 youths become infected with HIV an The first case of AIDS was reported in Nigeria in 1986. Since then, the HIV prevalence has witnessed an increase from 1.8% in 1991 to 5.8% in 2001. However, in 2003 and 2005, the national prevalence dropped to 5% and 4.4% respectively.

Vos et'al (2005): AIDS affect the body's immune system reducing its defense against attacks, so the patient develop and often die of usual infection or tumor within few years.

Dr. Robert Gallon (an American) and Dr. Luck Mantayner) a French man, who called their discoveries HIV-1 and HIV-2 respectively.

The first official report on AIDS appeared in June, 1981 in the United State of America (USA), when some gay men in New York California suddenly began to develop some opportunistic infections and cancer that seemed stubbornly resistant to any treatment.

Dr. Anthony Franci, Director of the National of Allergy and Infectious Disease wrote thus, HIV infection is rising more rapidly among women than men in many parts of the world. Half of all adults living with HIV/AIDS worldwide are females, compared with 41% in 1997, according to Joint United Nation.

Not only has scientists isolated the responsible agents, which is Human Immune Deficiency Virus (HIV), this weakens the immune system, making people vulnerable to infection and illness they normally would have been able to resist.

Gray et'al (2000): these opportunistic infection and malignancies are the major clinical manifestation of HIV infection and indeed defile the illness. Grant et'al (2000): also stressed that the pattern of opportunistic infection associated with HIV varies from one country to another, even within the developing world.

In developed countries, pneumocystis carinni (pneumonia) is the most prevalent opportunistic infection with about 64% of HIV/AIDS patients in United State infected. Tuberculosis is the most prevalent opportunistic infection in Brazil, Congo and Ivory Coast affecting more than 40% of all people living with HIV/AIDS. The window period of HIV is the period between potential exposure to HIV infection and the point when the test will give an accurate result.

During the window period, a person can be infected with HIV but have a negative HIV test. This period is known to be highly dangerous as any test conducted which depends on the presence of antibodies will be negative.

The window period for a 4 th generation antigen/antibody is four weeks. At this time, this test will detect 95% of infections. After three months window period after exposure, the confirmatory test will detect 99.97% of infections.

The first HIV protein (antigen) that can be measured is p24 (from 1 to 8 weeks after exposure). Viral load and p24 tests are not accurate for diagnosing early if the results are negative.

An HIV antibody response can be detected as early as two weeks. In a few people and in more than 99.9% of people by 12 weeks. An antibody test at 4 weeks will detect 95% of infections. Antibody testing at 4 weeks can give you a good medication of your HIV status, but you need a test at 12 weeks after the exposure to be considered HIV negative.

During the window period, the infected person can still look and feel healthy in spite of the vast amount of HIV present in the body fluids; these are fluids such as semen, vaginal secretion and blood.

The incubation period is the period between the times an individual got infected with HIV and clinical manifestation of AIDS. The period from infection to development of anti-HIV antibodies is usually less than a month, but may be up to 3 months; newer tests have a shorter window period, where a false negative result may be obtained early in infection.

The interval from HIV infection to the diagnosis of AIDS ranges from about 9 months to 20 years or longer with a median of 12 years. There is a group of people with a more rapid onset of disease who develop AIDS within 3-5 years of infection, and another smaller group who do not seem to progress to AIDS.

HIV/AIDS has become a major global public health issues especially in Sub-Saharan Africa. However, in 2007, 33.2 million (30.6-36.1 million) people were estimated to be living with HIV, 2.5 million (1.8-4.1million) people became newly infected and 2.1 million (1.9-2.4 million) people died of AIDS (UNAIDS, 2007).There were estimated 1.7million (1.4-2.4million) new HIV infections in Sub-Saharan Africa in 2007, a significant reduction since 2001. However, the region remains most severely affected. An estimated 22.5million (20.9-24.3million) people living with HIV, or 68% of the global total are in Sub-Saharan Africa. Eight countries in this region now account for almost one-third of all new HIV infections and AIDS death globally.

Since 2001, when the United Nations Declaration of Commitment on HIV/AIDS was signed, the number of people living with HIV in Eastern Europe and Central Asia has increased from 630,000 (490,000-1.1million) to 1.6million (1.2-2.1million) in 2007. In Asia, the estimated number of people living with HIV in Viet Nam has more than doubled between 2000 and 2005 and Indonesia has the fastest growing epidemic.

HIV/AIDS in Africa in 2007 is 1.7million new infections, 2.4million death, 22.5million victims and life expectancy with HIV in 47 years, 62 years without AIDS. UNAIDS report shows that for every ten young men (15-24 years) infected with HIV in Kenya and Mali, there are as many as forty-five infected women (UNAIDS, 2007).

It is unfortunate that South Africa has the highest number of infected people of any country in the world, estimated at 4.7 million. In South Africa, about 5000 babies are born HIV positive every month.

The first case of AIDS was identified in Nigeria in 1986. Since then, the HIV prevalence has witnessed an increase from 1.8% in 1991 to 5.8% in 2001. However in 2003 and 2005, the National prevalence dropped to 5% and 4.4% respectively. In addition, state prevalence rates varied from as low as 1.0% in Kebbi State to as high as 12% in Benue State.

The rate of HIV infection among youths is growing rapidly with about 67% of newly infected individuals in the developing world being young women aged between 15 and 24 years especially young women and girls who constitute 64% of the youths in the developing countries. About 2.5 million children under 15 years are living with HIV (UNAIDS, 2007).

Florence Uchendu et'al (2008): It is pathetic to note that states like Cross River, Edo, Kano and Osun that were not affected (0.0% prevalence) as at 1991/ 1992, became heavily affected by 2003 especially Cross River state (12%) and was the highest of all the 36 states of the Federation.

Since 1999, Nigeria has adopted a multisectoral approach in fighting the HIV/AIDS epidemics. HIV/AIDS scourge is on the increase in some states in Nigeria. The 2005 National HIV prevalence survey conducted among pregnant women attending antenatal clinic in Nigeria revealed that HIV/AIDS is still on the increase in some States.

However, the collective effort of the Federal Government of Nigeria foreign aids, Non-Governmental Organization (NGOs), Community Based Organizations (CBOs), Faith Based Organizations (FBOs) and other stakeholders are yielding more fruits.

Many Government Organizations and Non-Governmental Organization (NGOs) have come out to fight the dreaded HIV/AIDS. In the four-front of this fight is the former president of Federal Republic of Nigeria, President Olusegun Obasanjo.

After National Agency for the Control of AIDS (NACA) is a very important agency on AIDS under Federal Ministry of Health. NACA has published so many books on HIV/AIDS which are distributed freely to secondary and primary schools in the country. The committee also facilitates the formation of the Nigeria Business Coalition against HIV/AIDS (NIBUCAA). Seventy-four antiretroviral sites have been created across the country.

Gill Gordon, Tony Klouda et'al (1988): Our blood contains White and Red Blood Cells. Normally, the White Blood Cells fight off and kill any germs which enter the body. They do this by eating up the germs and producing chemicals called antibodies which kill them. In this way, the body fights off many different germs and stays healthy. Sometimes, there are symptoms of illness when the White Blood Cells win and we get better.

HIV weakens this immune system by entering and finally destroying the white cells. As more and more white cells are killed, the body becomes less able to fight off many different germs which live around and in the body all the time. Finally, people living with AIDS die from one of a number of serious and rare diseases which their bodies cannot resist.

HIV can also attack the brain cells and various system directly causing mental and co-ordination problems.

Test Done For HIV/AIDS (Florence UCHENDU, 2008) Human Immune Deficiency Virus (HIV) can be found in blood or blood clotting products, semen, breast milk, vaginal fluid, sweat, saliva, tears and body organs such as liver, kidney, brain of an infected person (NWOKEDI, 2013). HIV can only pass from an infected person to an uninfected person when the blood and blood products, semen, vaginal fluid, breast milk or body organs (kidney) of an infected person enters the body of an uninfected person. HIV virus can enter the body through the lining of the anus or rectum, lining of the body of the vaginal and of cervix, the opening of the penis, the mouth, other mucus membrane (e.g. eyes, or inside of the nose), cuts or open sores.

13. b) Analysis of risk factors

A large number of factors affect the risk of HIV infection, and interactions between these factors can be complex. Although the major factors are analyzed separately below, and attempts have been made to control for variations in other factors as far as possible, it needs to be emphasized that these risk factors are highly inter-linked. The purpose of the discussion that follows is both to identify the effects that the various factors have on HIV risk (independently of associations with other risk factors) and to describe how each factor relates to other risk factors.

14. i. STDs and treatment seeking behaviors

There is a large body of evidence that suggests that STIs play a role in increasing the infectiousness of HIV-positive individuals and the susceptibility of HIV-negative individuals. However, the relationship between STIs and HIV is complex, and the evidence is at times contradictory or difficult to interpret due to the presence of confounders. The sections below discuss the impact of STIs on HIV transmission and some of the challenges in determining the relationship between the two and STD such as herpes, chlamydia, syphilis, or gonorrhea may cause changes in the tissue of the vagina or penis that make it easier for HIV to pass to you while having sex.

One of the most significant bio-medical factors driving the epidemic in Ijerois the high prevalence of sexually transmitted diseases (STDs). STDs greatly increase the risk of HIV transmission, and there is thus a significant correlation between STD and HIV prevalence. A second problem is that even when symptoms occur, individuals will often not seek treatment, either because treatment is inaccessible or because the infection is not regarded as being serious. Wilkinson et al (1997) estimate the average time before treatment for STD symptoms is sought to be 10 days for men and 18 days for women. The increased risk of transmission of HIV when one sexual partner is infected with an STD has been reported in numerous studies. Rehle et al (1999), for example, estimate the probability of HIV transmission per sexual contact to be 6% if either partner is experiencing genital sores or ulcers. This compares with HIV transmission rates in the absence of STD infection of 0.2% (for the probability of an infected male infecting an uninfected female) and 0.1% (for the probability of an infected female infecting an uninfected male). Many individuals do not cease to have sex when experiencing STD symptoms. O'Farrell et some ladies continue to have sex despite experiencing genital ulcers, and Williams et al (2000) have found that only 24% of men and 19% of women seek to protect their partner by abstaining from sex or using a condom if they have an STD. Individuals who frequently experience STDs and who do not receive prompt treatment for their STDs are thus more likely to be HIV positive. In the Carletonville study (Williams et al, 2000), it was found that there was a strong positive correlation between HIV prevalence, syphilis prevalence and prevalence of gonorrhea. The correlation between STD prevalence and HIV prevalence is also evident from a comparison of STD and HIV prevalence data at a provincial level of STD prevalence and HIV prevalence in Northwest.

15. ii. Knowledge and belief about HIV/AIDS

A number of studies show that there is good knowledge of the basic facts surrounding HIV/AIDS: that it is spread sexually, and that the risk of infection can be reduced by using condoms (Van der Ryst et al (2001), KFF (2001), Williams et al (2000), DOH (1999(b))). However, there are many misconceptions about other forms of transmission. An extremely common belief, for example, is that HIV can be spread by blood-sucking insects, and there are also substantial numbers who believe that sharing food with an HIV positive person, using public toilets, and touching HIV positive people can lead to transmission (Williams et al (2000), DOH (1999(b)). There are also many misconceptions about cures for HIV/AIDS. A national survey of teenagers (KFF, 2001) suggested that 7% of teenagers believed that a person could be cured of AIDS by having sex with a virgin, 13% believed that traditional African medicine had a cure for AIDS, and 15% believed that Western medicine had a cure. Equally concerning is the belief that HIV positive individuals can always be identified by their symptoms; over 30% of those sampled in the Carletonville study expressed this view (Williams et al, 2000). Beliefs such as these can give individuals a very false sense of their risk of infection. It may therefore be hypothesized that higher HIV prevalence is associated with poor knowledge of HIV, if this false sense of risk results in risk-taking behavior. Williams et al (2000), however, found no such association, although it was found that substantial proportions of those who did not regard themselves as being at risk of infection were in fact HIV positive. High levels of awareness are not necessarily indicative of a low risk of infection. Some individuals may have actively sought knowledge because of their high-risk status, and others may not act on the knowledge they have. Levels of knowledge and awareness of HIV/AIDS are typically substantially lower among students.

16. iii. Sexual behavioral pattern

The CDC has identified sexual abuse as one of the key risk factors for HIV among ladies (CDC, 2007). Sexual victimization is a serious issue for college students. Ladies have been found to be at a slightly greater risk for certain types of sexual abuse, including being called derogatory names, threats to leave a relationship if the woman does not agree to have sex, or forced sex without protection. Furthermore, ladies who had been abused had low self esteem, were insecure, and lacked the skills to leave such a relationship (Berkel et al., 2005).

Firstly, violence can increase the risk of HIV infection where a lady is forced to have sexual intercourse. Secondly, violence may mean that a lady is less able to negotiate the use of preventive measures such as a condom. Thirdly, links have been found between physical and sexual abuse during childhood and high levels of risk-taking behavior in adolescence and adulthood. Ladies who are infected and disclose their HIV status may be at increased risks of violence. Violence is thus both a determinant and a potential consequence of HIV infection. The effect of having sex while experiencing STD symptoms, for example, has already been described. Further forms of high-risk sexual behaviour are discussed below. Anal inter course A large number of studies demonstrate a significantly increased risk of male-to-female transmission from anal intercourse relative to vaginal intercourse (Douglas, 2001). This association may be due to the higher trauma associated with anal sex relative to vaginal sex. Although it is commonly hypothesized that the risk of HIV transmission is much greater when ladies use drying agents, most African studies do not show any significant relationship between use of drying agents and HIV prevalence. Sex during menses It is hypothesized that the bleeding that occurs during menstruation may allow a more direct route of transmission of HIV, and that ladies who have sex during menses are thus more likely to pass the virus on to their partners. Some studies find that sex during menses results in a significantly increased risk of female-to-male transmission and others have found that sex during menses has no significant effect on the risk of transmission (Douglas, 2001). Being sexually active, rather than being promiscuous, is the major determinant of HIV risk. This is perplexing, as one would expect the HIV prevalence to continue to rise with the increasing number of partners. It has been suggested that it is possible for certain individuals to develop a resistance to infection with HIV (O'Farrell, 2001), and this is one possible explanation for the prevalence patterns observed. However, it should also be recognized that significant confounding with age is likely in this analysis.

17. iv. Sharing needles

The other big risk is reusing needles, syringes, or other equipment an HIV-positive person used to inject drugs, whether they were prescribed by a doctor or illegal. HIV can be transmitted from a needle used for piercing or tattooing if it wasn't sterilized after piercing or tattooing someone with HIV.

However, there are a number of studies that have examined the risk to those sharing needles and syringes relative to those who do not share, and where the HIV status of the injecting partner was unknown. Despite inconsistencies in how sharing needles and syringes was measured, the epidemiological studies that investigated the risk of HIV transmission associated with needle and syringe sharing have all found a positive relationship An accidental stick from a contaminated needle or medical device could cause HIV, but that's very rare.

18. v. Having unsafe sex

One of the most common ways one can get HIV is by having vaginal or anal sex with someone who has HIV. It could pass HIV during oral sex, too, but that's less common. It's also risky when one doesn't know whether or not the partner is HIV-positive, because they could be. The more sexual partners one has, the more your odds of catching HIV go up.

Using condoms, barriers, and dental dams will help a lot to keep safe, but they're not perfect.

The choice of partner also matters. Having sex with someone who has a higher chance of getting (and therefore having) HIV, a sex worker or an IV drug user, for example --raises chances of contacting HIV as well.

19. a. Anal intercourse

Anal intercourse carries a higher risk of HIV transmission for both receptive and insertive partners when compared with vaginal intercourse. This is because rectal mucosa differs from vaginal mucosa. There is a higher density of lymphoid follicles (i.e., HIV target cells) in rectal mucosa and it is more susceptible to abrasions than vaginal mucosa. The risk of transmission to the receptive partner resulting from receptive anal intercourse has been estimated to be between 5 and 18 times higher than the risk from receptive vaginal intercourse.

20. b. Vaginal intercourse

Several studies have examined the risk of sexual transmission among heterosexual populations, without specifying the nature of the sex acts (i.e., vaginal versus anal intercourse). However, it is likely that the majority of the sex acts were penile-vaginal. However, as in the case of risk estimates for anal intercourse, the summary risk estimates should be interpreted with caution due to the significant heterogeneity in (a) the infectiousness of HIV-positive individuals and (b) the susceptibility of their partners. Higher rates have been reported for male-to-female sexual transmission compared with female-to-male sexual transmission. This may be due to biological mechanisms, such as a larger anatomical surface and/or higher numbers of vulnerable cell types in the vagina compared with the penis. However, at present it is not clear whether ladies are at higher risk than males in a discordant relationship.

21. c. Oral intercourse

The risk of HIV transmission through oral intercourse has been difficult to quantify, in part because many individuals do not practice oral intercourse to the exclusion of other sex acts. However, it is clear that the risk of transmission by oral intercourse (whether penile-oral or vaginal-oral) is markedly lower than for anal or vaginal intercourse. The oral cavity has a thick epithelial layer, a low number of CD4 target cells, and antiviral antibodies, all of which make it relatively resistant to HIV transmission. In a meta-analysis of 10 studies, only four studies reported a non-zero estimate of risk from unprotected oral intercourse. While a pooled estimate of risk was not produced due to small sample sizes, their review suggested a low but not a zero probability of transmission. While precise measures of risk have been difficult to develop, it is likely that ejaculation and the presence of oral ulcers or oropharyngeal inflammation or STIs increase the risk of HIV transmission to the receptive partner during oral intercourse. There is a concern that while the risk of HIV transmission from oral intercourse is assumed to be low, this sex act may contribute to HIV transmission if there is a high frequency of unprotected oral intercourse in relation to higher risk practices, which are more likely to be protected. Unprotected oral intercourse has been identified as a significant route of transmission in the recent resurgence in syphilis cases among students.

vi.

22. Risk of transmission among people who use noninjection drugs

Use of some non-injection drugs has been reported as independent risk factors for HIV transmission. Crack smoking alone and amphetamines have been found to be independent risk factors for HIV seropositivity, increasing the risk. Important limitations with these studies include their dependence on self reported data and the difficulty of properly adjusting the analyses for confounding factors. Non-identified confounding factors outside of the knowledge of the investigating team could be at play, and answers to some questions have the potential to be biased. Information on the mechanisms of HIV transmitssion solely through smoking or snorting is limited. Sharing drug paraphernalia like straws, banknotes and crack pipes or stems has been proposed as a transmission route.

However, transmission of HIV through nasal secretion is low unless there is blood in the secretions. Blisters, sores, and cuts on the lips and in the mouths of crack smokers may facilitate oral transmission of HIV, with the evidence supporting this causal relationship building but still sparse HIV transmission among people who use drugs through non-injecting routes may also be due to sexual contact. Studies have found that the exchange of sex for drugs and drugs for sex is pervasive in this group. It has also been suggested that high rates of HIV in people who use non-injection drugs may be the result, in part, of the effects of "bridging", due to overlapping social and sexual networks. Ladies are especially vulnerable due to a greater likelihood of overlap between their drug and sexual networks. Drug use can alter sexual behaviours by increasing risk taking. Research that has investigated this issue has focused mainly on crack cocaine and amphetamine use. Crack smoking has been associated with increased numbers of sex partners, exchanging sex for drugs or money, and unprotected sex. Amphetamines have also been associated with the risk of HIV transmission because they are often used to enhance and prolong sexual pleasure and to reduce sexual inhibitions. Use of marijuana, ecstasy, poppers, cocaine, opiates, alcohol and erectile dysfunction medications has also been linked to risk taking behaviours during sexual encounters, those who did reported risky sexual behaviours similar to those of younger drug users. Among the older drug users, those who smoked crack were at especially high risk of engaging in risky sexual behaviours. Overall, the risk of HIV per sexual act in non-injection drug users is comparable to that of the rest of the population Drug users higher risk of contracting HIV stems predominantly from an increased frequency of risk-taking behaviours during sexual encounters and prolonged intercourse before orgasm due to difficulties associated with ejaculation.

23. vii. Other risk factors

These factors include the use of hormonal contraceptives; modes of transmission other than heterosexual intercourse; and psychological factors.

24. III.

25. Methodology

This chapter discussed the method adopted by researcher, area of study, Advocacy penetration, study population, inclusion criteria, exclusion criteria, study consent, research design, sample size technique/ determination, validity of the research instrument, sampling technique, data collection, data processing and analysis.

Validity of research instrument: the first draft of the questionnaire was given to the project supervisor for correction before final typing and distribution to make sure that the instrument measures what it is supposed to measure.

26. a) Description of the study area

College Moreover the long awaited Bill for the establishment of the college was assented to on the 21 st of January, 2011. It was a profound experience in the annals of history of the institution that its status by this development, metamorphosed from school to College.

27. b) Advocacy/Community penetrarion c) Study population

The study population included all students of College of Health Science and Technology, Ijero Ekiti, whom by the virtue of their provisional admission letter, are students of the College.

28. d) Inclusion criteria

All the students of the College who agree to participate in the study were eligible for inclusion in the study.

29. e) Exclusion criteria

All students of the College who are not willing to participate in the study were excluded. Students not physically present, or visitors during the data collection process were also excluded.

30. f) Study consent

Verbal consent was obtained from the respondents after detailed explanation of the objectives, scope, and benefits of the study had been made known to them.

31. g) Study design

A descriptive cross-sectional study design was used for the study.

32. h) Simple size determination

The fisher formula for sample size determination was used to calculate the sample size from the population of student in the college thus:

33. ?108

The minimum sampling required for the study was estimated at 108. However a total of 125 questionnaires were distributed. A total of 120 Respondents successfully filled and returned their questionnaires.

Multistage sampling method was used in the selection of the participants for the study using self administered questionnaire.

34. i. First stage

The first step was selection of two third of the twenty one departments in the college of health sciences and technology, Ijero Ekiti which is 14 departments by using simple random sampling by balloting. The selected 14 departments are; The second step is the proportional allocation of the sample size across the 14 selected department within the college thus: Number of students in each level x sample size Total number of students in the 14 selected departments At health information management department: The three existing levels or arms in health information management department were randomly picked.

35. ii. Second stage

The first step at this stage was the use of a systemic random sampling in each of the department thus:

Total number of students in each level = The sampling interval Proportion allocated to each level At Health Information management sampling interval is: Thus, 17 was used as sampling interval for 100 level, 19 for 200 level, while 28 was used as sampling interval for 300 level students of X-RAY Technician department. 20 7 200 level = 120 = 20 8 300 level= 130 = 19 7 Thus, 20 was used as sampling interval for both 100 level and 200 level while 19 was used as sampling interval for 300 level students of Medical Laboratory Technician department. Thus 20 was used as sampling interval for 100 level and 400 level students, 19 was used as sampling interval for 200 level, while 16 was used as sampling interval for 300 level students of Environmental Health Technology department. Thus, 17 was used as sampling interval for 100 level, 28 was used as sampling interval for 200 level while 21 was used as sampling interval for 300 level students of Environmental Health Technician department.

100 level = 180 =

36. At Medical Laboratory Technician department sampling interval is:

100 level = 138 =

37. At Health Technician department sampling interval is:

38. At Junior Community Health Extension workers department sampling interval is:

At Human Nutrition department sampling interval is: Thus, 10 was used as sampling interval for 100 level, 17 was used as sampling interval for 200 level while 27 was used as sampling interval for 300 level students of Human Nutrition and Dietetics department.

100 level =10 =

A semi structured self-administered questionnaire was used to collect qualitative data. Questions were specific, brief and polite. The questionnaire has four sections with section A relating to the socio-demographic characteristics of respondents, Section B deals with the knowledge that the respondents have about HIV infection, section C is about the level of predisposure of students to HIV infection and section D is concerned with the awareness and consequences of HIV infection among students.

39. k) Data processing and analysis

The questionnaires were retrieved, sorted, cleared, checked properly and code entering using SPSS software package. Frequently distribution table and simple percentages were used to present data, cross tabulation of important variables was also done. Thr indices of measurement included students awareness about HIV infection.

Chi square test was used to determine the statistical significance of differences in variables observed and p-value was set at p ? 0.050. From table 4.1 above, the total number of respondents was 120. Most respondents 63 (52.5%) were between the age of 21-25 years with the least being those that were 30 years and above 7(5.8%). Minimum age category was 16-20 while maximum age category was 30 years and above.

40. IV.

41. Results

42. Section A: SOCIO -Demographic Characteristics

There were 41 (34.2%) respondents from 100 level, 38 (31.6%) from 200 level, 37 (30.8%) respondents from 300 level and 4 (3.3%) respondents from 400 level. There were more females respondents 75 (62.5%) than the males 45 (37.5%) out of the total 120 correspondents. 70 (58.3%) were single, 18 (15%) were married, 24 (20%) were engaged and 8 (6.7%) accounts for divorced couple. 71 (59.2%) accounts for respondents from polygamous family background while 49 (40.8%) accounts for those from monogamous family background, 38. (31.6%) lives with their parents, 12 (10%) lives with their father, 14 (11.7%) lives with their mother, 17 (14.1%) lives with their friends, 13(10.8%) lives with their guardian while 26(21.7%) lives alone. Table 4.2 shows that 16 (15.2%) of respondents heard of HIV infection from hospital, 8 (71.6%) heard about it from radio, 10 (9.5%) heard about it from television, 9 (8.6%) heard about it from poster, 10 (9.5%) heard of HIV infection from friends, 19 (18.1%) heard about it from school, 11 (10.5%) heard about it from workshop, 15 (14.3%) heard about it from seminar, while 7 (6.7%) heard from more than one source. Also, 105 (87.5%) respondents have knowledge of HIV infection while 15 (12.5%) does not have the knowledge of HIV infection. However, 50 (41.7%) respondents are of the opinion that Ekiti state is one of the states in Nigeria with alarming rate of HIV infections while 70 (58.3%) respondents does not support the opinion that Ekiti state has alarming rate of HIV infection in Nigeria. 37 (30.8%) respondents believe that males are at higher risk of contacting HIV infection, 63 (52.5%) believes females are more at risk of contacting HIV infection, 15 (12.5%) are of the opinion that both male and females are at risk of contacting HIV infection while 5 (4.2%) believes children are at risk of contacting HIV infection.

43. Section B: Knowledge of HIV Infection

88 (73.3%) respondents believed that having sex without the use of condom can predispose them to contacting HIV while 32 (26.7%) believe that having sex with the use of condom can still predispose them to contacting HIV. 35(29.2%) respondents believed that illiteracy is a factor that can contribute to having HIV infection, 26 (21.6%) also believed that poverty is the factor contributing to spread of HIV infection, 29 (24.2%) as well believed sexual urge is a major factor contributing to spread of HIV, 25 (20.8%) are of the opinion that ignorance is a factor that can contribute to the spread of HIV infection among students, 5 ( Table 4.5 shows that more females have more knowledge of HIV infection than their male counterparts. The findings was however not statistically significant because its p-value of 0.831 is greater than the 0.050 alpha level of significance. 4.9 shows that the respondents from monogamous family background have more knowledge of HIV infection than respondents from polygamous family background, this findings is statistically significant because its p-value of 0.029 is less than the 0.050 alpha level of significance. Table 4.10 shows that the respondents who lived their parents have more knowledge of HIV infection than other categories, this findings is however not statistically significant because its p-value of 0.787 is greater than the 0.050 alpha level of significance.

V.

44. Discussion

The aims and objective of this research work has been clearly stated in chapter one, chapter two which is the literature review discuss the following, meaning of HIV /AIDS, origin of HIV/AIDS, HIV/AIDS in Nigeria, global prevalence of HIV/AIDS in Africa, HIV/AIDS in Nigeria as well as risk factors that can predispose students in the college to HIV.

HIV is either of the two retrovirus that infect and destroy helper T cells of the immune system causing the marked reduction in numbers that is diagnostic of AIDS, it makes it difficult for the body to fight off infections i.e. when a person is infected with HIV, the person may get some infections otherwise known as opportunistic infections (OI) that the body can no longer fight off.

HIV is a microscopic organism, it survives only in human being and it lowered the bodys ability to fight infections. HIV enters into the body through blood semen, vagina fluid or breast milk of an infected person.

AIDS is an advanced form of HIV infection the first cause of AIDS was reported in Nigeria in 1986, since then, the HIV prevalence has witnessed an increase.

For the research on the prevalence of HIV and risk factors that can predispose students of college of health sciences and technology Ijero Ekiti to HIV infection, 125 questionnaires were distributed among students of the 14 selected departments. However a total of 120 (96%) questionnaires were retrieved.

The total number of respondents was 120. Most respondents 63 (52.5%) were between the age of 21-25 years with the least being those that were 30 years and above 7 (5.8%). Minimum age category was 16-20 while maximum age category was 30 years and above. There were 41 (34.2%) respondents from 100 level, 38 (31.6%) from 200 level, 37 (30.8%) respondents from 300 level and 4 (3.3%) respondents from 400 level. There were more females respondents 75 (62.5%) than the males 45 (37.5%) out of the total 120 correspondents, 70 (58.3%) were single, 18 (15%) were married, 24 (20%) were engaged and 8 (6.7%) accounts for divorced couple. 71 (59.2%) accounts for respondents from polygamous family background while 49 (40.8%) accounts for those from monogamous family background, 38.(31.6%) lives with their parents, 12 (10%) lives with their father, 14 (11.7%) lives with their mother, 17 (14.1%) lives with their friends, 13 (10.8%) lives with their guardian while 26 (21.7%) lives alone.

Further analysis shows that 16 (15.2%) of respondents heard of HIV infection from hospital, 8 (71.6%) heard about it from radio, 10 (9.5%) heard about it from television, 9 (8.6%) heard about it from poster, 10 (9.5%) heard of HIV infection from friends, 19 (18.1%) heard about it from school, 11 (10.5%) heard about it from workshop, 15 (14.3%) heard about it from seminar, while 7 (6.7%) heard from more than one source. Also, 105 (87.5%) respondents have the knowledge of HIV infection while 15 (12.5%) does not have the knowledge of HIV infection. However, 50 (41.7%) respondents are of the opinion that Ekiti state is one of the states in Nigeria with alarming rate of HIV infections while 70 (58.3%) respondents does not support the opinion that Ekiti state has alarming rate of HIV infection in Nigeria. Furthermore, 37(30.8%) respondents believe that males are at higher risk of contacting HIV infection, 63 (52.5%) believes females are more at risk of contacting HIV infection, 15 (12.5%) are of the opinion that both male and females are at risk of contacting HIV infection while 5 (4.2%) believes children are at risk of contacting HIV infection. 88 (73.3%) respondents believed that having sex with the use of condom cannot predispose them to contacting HIV while 32 (26.7%) believe that having sex with the use of condom can still predispose them to contacting HIV. 35 (29.2%) respondents believed that illiteracy is a factor that can contribute to having HIV infection, 26 (21.6%) also believed that poverty is the factor contributing to spread of HIV infection, 29 (24.2%) as well believed sexual urge is a major factor contributing to spread of HIV, 25 (20 Out of 71 (59.2%) believed that the level of HIV infection can be reduced in the college while 49 (40.8%) are of the opinion that HIV level in the college cannot be reduced. The analysis further reveals that 68 (56.2%) are aware of the consequences of HIV infection while 52 (43.3%) are not aware of the consequences of HIV infection.

Further analysis shows that out of 105 respondents that have the knowledge of HIV infection more females have more knowledge than males, the difference was however not statistically significant as its p-value of 0.831 is greater than the 0.050 alpha level of significance.

Respondents between the ages of 21-25 years have more knowledge about HIV infection than those from other age groups, this findings is not statistically significant because its p-value 0.456 is greater than the 0.050 alpha level of significance.

Respondents with marital status of single have more knowledge about HIV infection than those from other categories, this is because most respondents in the college and that filled the questionnaire are single, this findings is not statistically significant because its pvalue 0.423 is greater than the 0.050 alpha level of significance.

Respondents from 100 levels have more knowledge about HIV infection than those from other level; the table revealed that the observation is statistically significant because its p-value 0.106 is greater than the 0.050 alpha level of significance.

Respondents from monogamous family background have more knowledge of HIV infection than those from polygamous family background, this findings is statistically significant because its p-value 0.029 is greater than the 0.050 alpha level of significance.

Respondents who live with their parents have more knowledge about HIV infection than those from other categories, this findings is not statistically significant because its p-value 0.787 is greater than the 0.050 alpha level of significance.

45. VI.

46. Conclusion

HIV is a problem that is of great concern to the society and the country at large, it is a retrovirus transmitted by sexual contact, blood products, through the use of contaminated needles, or vertically from mother to fetus. Two subtypes of HIV has been identified, the most common is HIV-1 which occurs worldwide, HIV -2 id found mainly in west Africa and is associated with a slower progression to AIDs than HIV-1. HIV uses the CD4 receptor and the CCR5 or CXCR4 co receptors to enter T lymphocytes and monocytes/macrophages where viral RNA is reverse transcribed into DNA and inserted into the host genome, viral replication results in immune activation and progressive depletion of CD4+ T lymphocyte.

Based on the findings previously reported in this study, the following conclusion was drawn:

? HIV infection is a life threatening disease ? Most students in the college have the knowledge of HIV infection ? Females are more at risk of contacting the infection ? Lack of diligence can contribute to having HIV infection ? Majority of the students in the college have not gotten tested for HIV infection recently.

Finally, many students are of the opinion that the level of HIV infection in the college can be reduced through the following suggestions: a) Introduction of HIV related courses and workshops to educate staff and students in the college on HIV infection b) Organizing seminars and workshops to educate staff and students c) Creating awareness through posters, billboard, etc to disseminate related vital information on HIV infection d) Lastly, organizing HIV test for members of staff and students occasionally so they can know their status.

VII.

47. Recommendations

Analysis with the major findings of the survey and interpretation of the qualitative data with the help of qualitative data collected from focus group sessions (students of college of health sciences and technology Ijero Ekiti) have been done. By so doing, the objectives of the studies have been fulfilled which are: 1. To assess the knowledge of HIV infection, causes and prevention. F 2. To find out the risk factors of infection among students 3. To establish the degree of exposure to these risk by students 4. To assess the consequences of HIV infection among students.

Final task is to make some broad recommendations on the basis of findings and related services for the students to be aware of HIV infection prevalence as well as predisposure risk factors.

In view of the highlights of this study, the following recommendations are suggested to reduce HIV infection level among students.

? Designing a curricula on HIV infection, ministry of Education at all level (federal, state, local) should as a matter of urgency add the curricula of HIV to all level of education. ? Providing educative posters and advertisements on every medical journal platform to constantly remind people on the negative effects of HIV ? Establishment of counseling centres for HIV ? Establishment of programs those are highly effective by both federal and state governments that will be made available and easily accessible to all citizens. ? Voluntary organizations like NGO's should be encouraged in the society to render useful services where necessary so as to divert peoples mind from unhealthy practices that can predispose people to contacting HIV infection e.g. Having unprotected sexual intercourse, sharing sharps and unsterilized sharp objects e.t.c. ? Parents should try to take proper care of their children so as to prevent them from bring lured into immoral acts which contributed high rate of HIV/AIDS infection such as commercial sex workers, all in the name of money and other materials. ? Health providers should be careful in delegating their duties to patients in the hospital. ? Individuals (both infected and non infected) should support and contribute to fighting in the reduction and prevalence of HIV infection. ? People who are already infected should be faithful to others especially their sexual partners about their status. ? Individuals should try not to keep not more than one sexual partner and practice safe sex if they cannot abstain. ? Some professionals whose jobs put them at risk of contacting the infection such as Medical Doctors, Nurses, Medical laboratory staff etc should be extraordinarily careful so as to keep them safe from being infected.

VIII.

48. Further Recommendation

Further recommendations that can help to reduce the spread of HIV infection include:

Figure 1.
Volume XIX Issue III Version I
D D D D )
(
Medical Research
Global Journal of
Note: F
Figure 2.
Various commercial enterprises such as
Telecommunication Center, Mobile Network Station,
Power Holding Company of Nigeria (PHCN), Police
Command, Specialist Hospital, Factories, Sawmill,
Bakeries, Filling Station, Banks, e.t.c. operate in
Ijero Ekiti.
The Ijero local government has a largely
agrarian population producing cash crops such as
cocoa, kola Ekiti state.
Academic programs commenced formally in
January 1999 with two courses. They were Community
Health Extension Workers (C.H.E.W.) in training
and Junior Community Health Extension Workers
(J.C.H.E.W.) in training. On 2 nd January 2000, the
Institution introduced four additional courses. They were
Medical Laboratory Assistants (M.L.A.) in training,
Pharmacy Technician (P.H.T.) in training, Medical
Records Technician (M.R.T.) in training, and
Environmental Health Assistant (E.H.A.) in training
programmes.
Figure 3. Table 1
1
S/N. Departments Number of Level Total
1 Health Information 3 466
2 Pharmacy Technician 3 65
3 Orthopeadic Technician 2 71
4 Community Health Extension Worker 3 173
5 X-ray Technician 3 97
6 Medical Laboratory 3 388
7 Health technician 3 334
8 Food Hygiene 3 63
Figure 4. Table 4 . 1 :
41
Variable Frequency Percentage (%)
Age Group (In Years)(N=220)
16-20 31 25.8
21-25 63 52.5
26-30 19 15.8
Above 30 7 5.8
Total 120 100
Gender
Male 45 37.5
Female 75 62.5
Total 120 100
Marital status (N=120)
Single 70 58.3
Married 18 15
Engaged 24 20
Divorced 8 6.7
Total 120 100
Level (N=120)
100 41 34.2
200 38 31.6
300 37 30.8
400 4 3.3
Total 120 100
Family Background (N=120)
Polygamous 49 40.8
Monogamous 71 59.2
Total 120 100
Who they presently live with (N=120)
Parents 38 31.6
Father 12 10
Mother 14 11.7
Friend 17 14.1
Guardian 13 10.8
Alone 26 21.7
Total 120 100
Figure 5. Table 4 . 2 :
42
Variable Frequency Percentage (%)
Source of Information about HIV Infection (N=120)
Hospital 16 15.2
Radio 8 7.6
Television 10 9.5
Poster 9 8.6
Friends 10 9.5
School 19 18.1
Workshop 11 10.5
Seminar 15 14.3
Others (multiple choice) 7 6.7
Total 105 100
Knowledge of HIV Infection (N =120)
Yes 105 87.5
No 15 12.5
Total 120 100
Opinions if Ekiti state is one of the states in nigeria with
alarming rate of HIV infection (N=120)
Yes 50 41.7
No 70 58.3
Total 120 100
Individuals at higher risk of contacting HIV infection
(N=120)
Both male and female 15 12.5
Male 37 30.8
Female 63 52.5
Children 5 4.2
Total 120 100
Opinions if HIV infection can be spread without thr use of
condom (N=120)
Yes 88 73.3
No 32 26.7
Factors contributing to spread of HIV infection (N=120) 120 100
Poverty 26 21.6
Illiteracy 35 29.2
Sexual urge 29 24.2
Ignorance 25 20.8
Others (multiple choice) 5 4.2
Total 120 100
Increasing rate of contacting HIV infection due to lack of
diligence (N=120)
Yes 90 75
No 30 25
Total 120 100
Contribution to fighting HIV infection (N=120)
Yes 80 66.7
No 40 33.3
Total 120 100
Ways of contribution to fighting HIV infection (N=120)
Practicing safe sex 13 16.2
Abstinence 25 31.2
Staying away from non-sterilized sharp objects 15 18.8
Being faithful to partner 22 27.5
Others 5 6.3
Total 80 100
Figure 6. Table 4 . 3 :
43
4.2%)
Figure 7. Table 4 . 4 :
44
Variable Frequency Percentage (%)
Possibility of reduction of HIV level in the college ( N=120)
Yes 71 59.2
No 49 40.8
Total 120 100
Awareness of consequences of HIV infection (N=120)
Yes 68 56.7
No 52 43.3
Total 120 100
Figure 8. Table 4 .
4
Section E: Cross Tabulation
Figure 9. Table 4 . 5 :
45
Gender Knowledge of HIV Infection Chi -Square Degree of Fredom P-Value
Yes No
Male 39 (86.7%) 6 (13.3%) 0.046 1 0.831
Female 66 (88%) 9 (12%)
Figure 10. Table 4 . 6 :
46
Age Group Knowledge of HIV Infection Chi -Square Degree of Fredom P-Value
Yes No
16 -20 26 (83.9%) 5 (16.1%)
21 -25 57 (90.5%) 6 (9.5%) 2.608 3 0.456
26 -30 17 (89.5%) 2 (10.5%)
30 and above 5 (71.4%) 2 (28.6%)
Figure 11. Table 4 .
4
Figure 12. Table 4 . 7 :
47
Marital Status Knowledge of HIV Infection Chi -Square Degree of Fredom P-Value
Yes No
Single 64 (91.4%) 6 (8.6%)
Married 15 (83.3%) 3 (16.7%) 2.797 3 0.423
Engaged 20 (83.3%) 4 (16.7%)
Divorced 6 (75%) 2 (25%)
Figure 13. Table 4 .
4
7 shows that the respondents with finding is not statistically significant because its p-value
marital status of single have more knowledge of HIV of 0.423 is greater than the 0.050 alpha level of
infection than respondents from other categories, this significance.
Figure 14. Table 4 . 8 :
48
Level Knowledge of HIV Infection Chi -Square Degree of Fredom P-Value
Yes No
100 35 (85.4%) 6 (14.6%)
200 34 (89.5%) 4 (10.5%) 6.102 3 0.106
300 34 (91.9%) 3 (8.1%)
400 4 (66.7%) 2 (33.3%)
Figure 15. Table 4
4
.8 shows that the respondents from 100 is not statistically significant because its p-value of 0.106
level have more knowledge of HIV infection than is greater than the 0.050 alpha level of significance.
respondents from other departmental level, This findings
Figure 16. Table 4 . 9 :
49
Family Background Knowledge of HIV Infection Chi -Square Degree of Fredom P-Value
Yes No
Monogamous 66 (93%) 5 (7%) 4.736 1 0.029
Polygamous 39(79.6%) 10 (20.4%)
Note: FTable
Figure 17. Table 4 .
4
Who they presently live with Knowledge of HIV Infection Chi -Square Degree of Fredom P-Value
Yes No
Parents 35 (92.1%) 3 (7.9%)
Father 10 (90.9%) 1 (9.1%)
Mother 10 (76.9%) 3 (23.1%) 2.248 5 0.787
Friend 15 (88.2%) 2 (11.8%)
Guardian 10 (83.3%) 2 (16.7%)
Alone 25 (86.2%) 4 (13.8%)
Figure 18.
ignorance is a factor that can contribute to the spread of
HIV infection among students, 5 (4.2%) have multiple
choices. 90 (75%) respondents believed in the
increasing rate of HIV infection spread due to lack of
diligence while 30 (25%) doesn't support the opinion of
contacting HIV infection due to lack of diligence.
40 (33.3%)respondents does not contribute to fighting
HIV infection, 80 (66.7%) respondents contributes to
fighting HIV infection. 13 (16.2%) contributes through
practicing safe sex, 25 (31.2%) contributes through
abstinence, 15 (18.8%) contributes by staying away from
non sterilized sharp object, 22 (27.5%) contributes by
being faithful to their partner, 5 (6.3%) have multiple
choices.
Findings revealed that 36 (30%) had sex or
used a non sterilized sharp recently while 84 (70%)
didn't have sex or used a non -sterilized sharps
Volume XIX Issue III Version I recently. 40 (33.3%) have gotten tested for HIV infection recently while 80 (66.7%) have not gone for HIV test recently.
D D D D ) F
(
Medical Research
Global Journal of
© 2019 Global Journals 1
Figure 19.
5) Consider male circumcision: there's evidence that
male circumcision can reduce a man's risk of
acquiring HIV. In sub-saharan Africa, circumcision
has been found to reduce HIV infection in
heterosexual men by 38-66% over two years
(Siegfried 2009). The world health organization and
UNAIDS have both recommended male
circumcision method of preventing female -to-male
transmission (WHO 2007). At present it is unclear
whether circumcision is of benefit among man who
have sex.
6)
1

Appendix A

Appendix A.1

Appendix B

  1. , http://www.aidsmap.org.za/hiv-aids-basics/ AIDS Foundation S A
  2. , Martindale the complete drug Reference 1. (35 th edition)
  3. Global Epidemiology fact on HIV/AIDS and sexually transmitted diseases, 2001.
  4. , Children AID FUND (CAF) 2006.
  5. Adengbo Adeyemo . Epidemiology of HIV in, (Nigeria
    ) 2006.
  6. Analysis of HIV risky behaviors of college students in Malawi. A case study of Bunda and the polytechnic by Robert Aguga, Cara E. Rice, Carissa I Balchelder, Fally masambuca, Sarah Chilungo, Charles Bunda.
  7. HIV infection in a South African mining town is associated with herpes simplex virus-2 seropositivity and sexual behaviour. Auvert B , R Ballard , C Campbell , M Carael , M Carton , G Fehler , E Gouws , C Macphail , D Taljaard , J Van Dam , B Williams . AIDS 2001. 15 p. .
  8. Identifying 'high risk situations' for preventing AIDS. A Zwi , A Cabral . British Medical Journal 1991. 303 p. .
  9. Being faithful to your partner ( ), if others please specify_______________________ Section C. what way, practicing safe sex, 17. (Staying away from non -sterilized sharp objects (. Level of Predisposure to Factors that can Cause HIV Infection)
  10. To Access the Knowledge of HIV), B Section .
  11. , Department____________________________________________________________ .
  12. Risk factors associated with HIV prevalence. Honours research project, D Kirk . 2001. Department of Actuarial Science, University of Cape Town
  13. Do you agree with the fact that lack of diligence among students can contribute to getting HIV infection? yes (,
  14. Do you think Ekiti is one of the states with alarming rate of HIV infection in Nigeria? yes (,
  15. EMDEX, the complete Drug Formulary, 2012. 2013 Edition.
  16. father ( ), mother (, (Who do you presently live with? Parents (. friend (. guardian(. Alone ()
  17. Florence Uchendu . HIV all you must know, 2008.
  18. Literature review to investigate the assumptions of HIV-positive fertility, heterosexual transmission and HIV-positive survival in the ASSA2000 models. Honours research project, G Douglas . 2001. Department of Actuarial Science, University of Cape Town
  19. Have you ever been tested for HIV infection? yes (,
  20. Have you ever had sex or used a non -sterilized sharps recently? Yes (,
  21. HIV Risk Factors: A review of demographic, socioeconomic, biomedical and behavioral determinants of HIV prevalence in south Africa, Hiv . http://www.cdc.gov>hiv>risk15 Leigh Johnson and Debbie Budlender (ed.) January 2002.
  22. HIV / AIDS Prevention -Mayo Clinic,
  23. , Hiv I-Base . http://i-base.info/guides/testing/what-is-the-window-period
  24. Hiv Wikipedia . http://en.m.wikipedia.org17 Taking AIDS. A guide for community work, 1988.
  25. If no to question 21 above, why ___________________________________________________ Section D (Awareness and Condequences of HIV Infection),
  26. If yes to question 15, in what aspect? Using an infected syringe ( ), using sharps and other non sterilized materials ( ), if others please specify,
  27. If yes to question 19 above,
  28. If yes to question 21 above,
  29. If yes to question 24 above,
  30. If yes to question 8 above, from which source? Hospital( ),radio (, (Television( ) Poster ( ),friends ( ), school ( ), workshop (. others specify_____________________________________________)
  31. If yes to question 8 above, what are your views about HIV?,
  32. The AIDS handbook, a guide to the prevention of AIDS and HIV, John Hubley . 2002.
  33. Enhanced efficiency of female-tomale HIV transmission in core groups in developing countries. O'farrell . Sexually Transmitted Diseases 2000. 2001. 28 p. . (Quoted in Douglas)
  34. Poverty and HIV infection. CDC report 1998.
  35. , P Piot , J Goeman , M Laga . AIDS in Africa Essex M., Mboup S., Kanki P., Kalengayi M. (ed.) 1994. Raven Press.
  36. Seventh national HIV survey of women attending antenatal clinics of the public health services in the Republic of South Africa. Epidemiological comments 1997. Oct /Nov 1996. 23 (2) p. . Department of National Health and Population Development (DNHPD
  37. Sex : male ( ), female (,
  38. Statistical analysis with world Health Organization,
  39. The Jaipur paradigm -a conceptual framework for understanding social susceptibility and vulnerability to HIV. T Barnett , A Whiteside , J Decosas . South African Medical Journal 2000. 90 p. .
  40. AIDS epidermic update), Unaids , Who . 2007.
  41. Unaids/Who . Epidemiological fact sheet on HIV/AIDS and sexually transmitted infections, 2002.
  42. United Nations Joint programme on AIDS and World Health Organization. UNAIDS 2002.
  43. Who do you think is at higher risk of contacting HIV infection? Children ( ), male ( ), female (, (both male and female ()
  44. Studies of fact surrounding HIV/AIDS by, Williams et al (ed.) 2001. 2001. 2000. 1999. KFf; DOh.
  45. Essentials of Community/Primary Health Care Health Management Medisuccess Publications, Wole Alakija . Benin31.www.cdc.gov/mmwr/preview/mmwrhtml/00023587.htm
Notes
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© 2019 Global Journals
Date: 2019 2019-01-15