Non-disclosure of Human Immunodeficiency Virus (HIV) has been linked to medical (e.g. infection/t... more Non-disclosure of Human Immunodeficiency Virus (HIV) has been linked to medical (e.g. infection/treatment recuperation rate) and social (e.g. social support) related problems, and there is paucity of literature addressing the role of behavioral intervention in improving selfdisclosure. This study examined the efficacy of Psychological Inoculation (PI) in enhancing self-disclosure. A randomized-clinical-trial design was adopted. Fifty-five respondents (39.5 ± 10.5 years) who scored below the mean (X ¼ 45.30) on HIV-Self-disclosure Index were purposively assigned to study groups. The PI was effective in enhancing self-disclosure (effect size (n p 2) ¼ 0.35). However, individuals who received the refutation preemption variant (X ¼ 78.18) and the supportive variant of PI (X ¼ 75.18) reported higher disclosure than those who did not (X ¼ 72.39). Psychological Inoculation was reported effective in enhancing self-disclosure. Psychological Inoculation should be incorporated into the existing treatment for HIV/AIDS. AIDS in the world, such that in 2018, over a million new cases were recorded in the African continent, which was considered high when compared to the reported cases in other continents (UNAIDS, 2020). Recent statistics revealed the prevalence of 25.8 million PLWHA were Africans and a prevalence of 730,000 newly infected cases were reported in 2019. In the most famous black nation, i.e., Nigeria, an HIV prevalence of 1.4% was reported, indicating over 1.9 million Nigerians are functioning with HIV/AIDS (UNAIDS, 2020). The prevalence of HIV/AIDS is alarming, especially in Nigeria because many people living with HIV in Nigeria are unaware of their status and the majority who are aware fail to disclose their positive status to the appropriate audiences (Olaseni, 2020). The prevalence of HIV-positive disclosure behavior among PLWHA in Nigeria was below the recommended disclosure rate by the World Health Organization ([WHO]; Olley et al., 2011; WHO, 2004). The recommended disclosure rate for developing countries, such as Nigeria is 79% benchmark (WHO, 2004). The study conducted by Olaseni et al. (2020) reported a 64.6% non-disclosure prevalence among people living with HIV (PLHIV). Some of the PLHIV who disclosed their HIV-positive status opted
Background and Objectives: Depression as major psychological sequelea of the HIV/AIDS infection h... more Background and Objectives: Depression as major psychological sequelea of the HIV/AIDS infection has continued to attract investigation. With few studies in Nigeria, it is unclear whether levels of perceived stigma, sexual risk behaviors, and anticipated discrimination are differentially associated with severity of depression. Materials and Methods: The present study using a multivariate design investigated the role of stigma, anticipated discrimination, self-esteem, HIV-related factors (e.g., drug use combination, knowledge of duration of HIV diagnosis) and socio demographic factors (e.g., multiple spouse, age, gender, and ethnicity) in depression among people living with HIV/AIDS (PLWHA) on follow-up management in three tertiary hospitals in Nigeria. Five hundred and two (187 [37.3%] males and 315 [62.7%] females) HIV/AIDS patients participated in the study. Results: Mean age and mean time in months since diagnosis were 36.73 ± 9.38 and 19.42 ± 23.12, respectively. Three variables: Ethnicity, anticipated discrimination, and HIV-related stigma were related to severity of depression at (P < 0.05). Multinomial logistic regression analyses showed that being from Yoruba (odds ratio [OR] = 0.25; 95% confidence interval [CI] = 0.145-0.441), or Igbo extraction (OR = 0.43; 95% CI = 0.214-0.873) reduces the risk of reporting severity of depression by 25% and 43%, respectively. Moreover, low perceived HIV-related stigma (OR = 0.59; 95% CI = 0.355-0.966) and low anticipated discrimination (OR = 0.54; 95% CI = 0.319-0.914) reduced the risk of reporting symptoms of severe depression by 59% and 54%, respectively. Conclusion: Intervention to reduce the severity of depression should consider cultural specificity in its design and also evolve educational programs that incorporate discrimination and stigma in managing depression among PLWHAs.
Long Distance Truck Drivers (LDTDs) have been found to be a high risk group in the spread of HIV/... more Long Distance Truck Drivers (LDTDs) have been found to be a high risk group in the spread of HIV/AIDS globally; perhaps, due to their high Sexual Risk Behaviours (SRBs). Interventions for reducing SRBs in trucking population have not been fully exploited. A quasi-experimental control group pretest-posttest design was used to assess the efficacy of psycho-education and behavioural skills training in reducing SRBs among LDTDs. Sixteen drivers rivers were randomly assigned into either experimental or control groups using balloting technique. Questionnaire was used as an instrument for data collection. Repeated measures t-test and independent t-test were used to test hypotheses. Intervention had significant effect on the SRBs among LDTDs at post-test (t{7}= 6.01, p<.01) and at follow up (t{7} = 6.42, p<.01). No significant difference in sexual risk behaviour of LDTDs at post-test and at follow-up stage. Similarly, intervention had significant effects on sexual risk behaviour at po...
Child Abuse Neglect the International Journal, Mar 1, 2006
Objectives: This study documents the extent and impact of perceived patterns of behavior in a sam... more Objectives: This study documents the extent and impact of perceived patterns of behavior in a sample of youths of the streets of Ibadan, Nigeria, with the purpose of implementing a Life Skills Educational (LSE) intervention. Method: The study uses both qualitative and quantitative methods of data collection. Qualitatively, two Focus Group Discussions (FGD) and two in-depth interviews (IDI) with 20 boys and 2 community leaders were conducted on separate occasions for the purpose of eliciting commonly exhibited behaviors and patterns of street youth. Quantitatively, 169 youths (89.3% male) were consecutively interviewed from five subcultural areas in Ibadan, Nigeria. Street youths were accessed through a snowballing technique made possible by "Area boys" (AB, adults, who serve as a symbol of authority for street children). Results: The mean age of participants was 18.4 years. The majority was on the street for financial reasons, had been on the street for more than 1 year, and had not completed their primary schooling. While youths of the street were economically viable, 69% had a history of alcohol abuse, 14% of drug abuse, and 24% operated as drug couriers; 46% reported school refusal, 27% school suspension, and 47% school truancy. Forty-nine percent admitted to being sex workers and 11% had been raped and were, therefore, at risk of contacting sexually transmitted diseases (STD). One-third of youths had been arrested for various offenses, including street fighting and drug use. While females were in the minority, they were more likely to engage in antisocial behaviors compared with boys. Conclusions: Although many youths of the street display antisocial behaviors, they also are an economically viable group. Some of their antisocial behaviors may have been exhibited within the context of economic survival.
Http Dx Doi Org 10 1080 17450120802385737, Dec 17, 2008
... To Sylvester Okhakhume; Ibukun Opaleye and Jenny-Uguru-Okorie-my post graduate students who a... more ... To Sylvester Okhakhume; Ibukun Opaleye and Jenny-Uguru-Okorie-my post graduate students who assisted in data collection. References. ... BMC Public Health, 6: 310 [CrossRef], [PubMed], [Web of Science ®]; 2. Ajuwon, AJ, Olley, BO, Akin-Jimoh, I. and Akintola, O. 2001. ...
African Journal of Medicine and Medical Sciences, Sep 1, 2008
Background-Little is known about factors that determine the QoL of elderly persons living in deve... more Background-Little is known about factors that determine the QoL of elderly persons living in developing societies undergoing rapid social changes.
World psychiatry : official journal of the World Psychiatric Association (WPA), 2006
Studies indicate that stigmatizing attitudes to mental illness are rampant in the community world... more Studies indicate that stigmatizing attitudes to mental illness are rampant in the community worldwide. It is unclear whether views about the causation of mental disorders identify persons with more negative attitudes. Using data collected as part of a community study of knowledge of and attitudes to mental illness in Nigeria, we examined the relationships between views about causation and attitudes. Persons holding exclusively biopsychosocial views of causation were not different from those holding exclusively religious-magical views in regard to socio-demographic attributes, and the two groups were not very dissimilar when general knowledge of the nature of mental illness was compared. However, religious-magical views of causation were more associated with negative and stigmatizing attitudes to the mentally ill. Findings demonstrate the challenge of developing and delivering an educational program to change public attitudes to mental illness.
SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance / SAHARA , Human Sciences Research Council, 2011
Past studies have shown that in attempts to prevent HIV, health education yields little change in... more Past studies have shown that in attempts to prevent HIV, health education yields little change in condom use. The reason may be that education fails to target barriers for changing behaviour. The present controlled pilot study tested whether psychological inoculation (PI) reduces such barriers for using male condoms. Twenty-two Nigerian women with HIV were randomly assigned to receive PI or health education (control). In the PI condition, women learned to refute sentences reflecting barriers against condom use, while controls learned how to use condoms and the consequences of their non-use. Barriers for condom use, self-efficacy to negotiate condom use with partners and actual condom use were self-reported before and one week after interventions. Results revealed that only in the PI group were there statistically significant increases in condom use negotiating self-efficacy and reductions in barriers concerning motivation, sexual satisfaction and partners. Controls reported no stati...
This study explored the problem of sexual coercion from the perspectives of 77 young people aged ... more This study explored the problem of sexual coercion from the perspectives of 77 young people aged 14-21 in Ibadan, Nigeria, the behaviours they perceive to be sexually coercive and the contexts in which these occur through four narrative workshops. Participants were drawn from two secondary schools and 15 apprentice workshops. All four groups identified similar coercive behaviours and developed narratives of the events that typically lead up to them. Behaviours included rape, unwanted touching, incest, assault, verbal abuse, threats, unwanted kissing; forced exposure to pornographic films, use of drugs for sedation and traditional charms for seduction, and insistence on abortion if unwanted pregnancy occurs. Men were typically the perpetrators and young women the victims. Perpetrators included acquaintances, boyfriends, neighbours, parents and relatives. All the narratives revealed the inability of young people to communicate effectively with each other and resolve differences. The results suggest the need for life-skills training that facilitates communication, seeks to redress gender power imbalances, teaches alternatives to coercion as a means of resolving conflict over sexual relations and respect for sexual and reproductive rights, and provides victims with information on appropriate services, support and referral.
Objective: Even though depression and chronic physical conditions are common causes of disability... more Objective: Even though depression and chronic physical conditions are common causes of disability in the elderly, their relative impact is unknown among elderly Africans.
Background: Psychiatric disorders in HIV/AIDS are common, emerging soon after diagnosis or during... more Background: Psychiatric disorders in HIV/AIDS are common, emerging soon after diagnosis or during the subsequent course of illness. However, there are few prospective studies on the rates of psychiatric disorders in HIV/AIDS, particularly in the context of the developing world. Methods: Sixty-five patients with recently diagnosed HIV were interviewed on presentation to a hospital-based HIV clinic and then 6 months later. On both interviews, the patients were assessed using the MINI International Neuropsychiatric Interview, the Carver Brief COPE, and the Sheehan Disability Scale. Exposure to negative life events and risk behaviors was also evaluated. Results: The overall prevalence of psychiatric disorders in the follow-up period remained high (56% of patients had at least one psychiatric disorder at baseline, and 48% of patients had at least one psychiatric disorder at 6 months). Depression and posttraumatic stress disorder (PTSD) were the most prevalent disorders at both baseline (34.9% and 14.8%) and follow-up (26% and 20%), respectively. More than half of all patients with depression at baseline improved (16 of 29; 55.1%). However, there was a new onset of both depression (4 of 49; 8.1%) and PTSD (12 of 17; 70.5%) on follow-up. In univariate analysis, depression on follow-up was significantly associated with: (a) disability in work/social/family functioning, (b) greater number of negative life events, and (c) a decline in CD4 lymphocyte count. Univariate analysis also revealed that a diagnosis of PTSD on follow-up was significantly associated with (a) a longer duration of infection and (b) baseline disability in work/social/family functioning. However, in multivariate analysis, only disability scores predicted the diagnoses of major depression and PTSD on follow-up assessment. Persistence of risky sexual behaviour was also noted, with a significantly higher number of participants reporting nonuse of condom on follow-up. There appeared to be a shift from maladaptive coping behaviors to more adaptive coping behaviors over the 6-month period. Conclusion: The rate of psychiatric disorders in HIV/AIDS patients was consistent over time. These findings emphasize the importance of regular evaluation for psychiatric disorders in HIV/AIDS patients, not only at the commencement of treatment but also during subsequent follow-up visits. D
International Journal of Geriatric Psychiatry, 2009
Objective-To provide information on the profile, comorbidity and impact of insomnia among an unde... more Objective-To provide information on the profile, comorbidity and impact of insomnia among an understudied group of elderly Africans.
... Olagoke Akintola, Doctoral student, MPH Centre for Gender Studies, Faculty of Human Sciences,... more ... Olagoke Akintola, Doctoral student, MPH Centre for Gender Studies, Faculty of Human Sciences, University of Natal, Durban, South Africa. ... Adekunle, AO, Ladipo, OA (1992), "Reproductive tract infections in Nigeria: challenges for a fragile health infrastructure", in Germain, K ...
Background: In Nigeria ACT use at the community level has not been evaluated and the use of antim... more Background: In Nigeria ACT use at the community level has not been evaluated and the use of antimalarial drugs (commonly chloroquine (CQ)) at home has been shown to be largely incorrect. The treatment regimen of ACT is however more complicated than that of CQ. There is thus a need to determine the feasibility of using ACT at the home level and determine community perception on its use.
This study examined the prevalence of unprotected sex, other sexual risk behaviours, and factors ... more This study examined the prevalence of unprotected sex, other sexual risk behaviours, and factors associated with unprotected sex among men and women recently diagnosed with HIV in South Africa. One hundred and forty-nine outpatients (44 males and 105 females) were assessed, of whom 101 were sexually active at least 6 months prior to study entry. Subjects were asked about sexual risk behaviours with reference to their most recent sexual encounter. Logistic regression analysis was employed to determine the predictors of condom use, with independent variables selected from five general categories: (1) sociodemographic characteristics; (2) situational characteristics regarding sexual intercourse (i.e. alcohol or drugs used before intercourse); (3) clinical diagnoses; (4) negative life events; and (5) coping styles. Fifty-five patients (19 males and 36 females), representing 54.4% of those sexually active in the 6 months preceding the study, had not used a condom during the most recent intercourse. Compared with those who used condoms, participants who did not significantly reported shorter duration of HIV infection (t = -2.7, p &amp;amp;amp;amp;lt; 0.001), have a current partner (chi2 = 3.98, p = 0.005), and lack knowledge of their partner&amp;amp;amp;amp;#39;s HIV status (chi2 = 4.78, p = 0.004). Also they were significantly more likely to engage in denial (t = 3.2, p &amp;amp;amp;amp;lt; 0.002) and to use substances (t = 1.98, p &amp;amp;amp;amp;lt; 0.05) as a means of coping. Logistic regression showed that shorter duration of illness (odds ratio (OR) = 1.2, 95% confidence interval (CI) = 1.01-1.41) and coping styles characterized by denial (OR = 0.6, 95% CI = 0.45-0.96) were significantly associated with unprotected sex. These data suggest the need for interventions to further reduce sexual risk behaviours in HIV-positive patients in South Africa.
This study surveyed 1,025 adolescent students and apprentices in Ibadan, Nigeria, to document the... more This study surveyed 1,025 adolescent students and apprentices in Ibadan, Nigeria, to document their sexual behaviour and experience of sexual coercion including verbal threats, unwanted touch, unwanted kiss, assault, deception, drugging, attempted rape, and rape. Sixty five per cent of male and 48% of female apprentices were sexually experienced, compared to 32% of male and 24% of female students. More males than females reported sex with multiple partners and contact with a sex worker while females had exchanged sex for money and gifts. Fifty five per cent of all the subjects had been victims of at least one type of sexual coercion, the commonest being unwanted kiss and touch of breasts (47%). Although both males and females were victims of coercion, females were disproportionately affected--68% of female students and 70% of apprentices had experienced one coercive behaviour, compared to 42% of male students and 40% of apprentices. Female apprentices fared worst, with 19% of them raped. The main perpetrators of the coercion were persons well known to the victims including neighbours, peers and boy/girlfriends. We recommend multiple intervention programs including skills training for young persons, sensitisation workshop for training health workers, and media advocacy for the public to challenge stereotypes that favour sexual coercion of adolescents.
A stress-coping model was tested to examine the role that negative life events, coping methods, a... more A stress-coping model was tested to examine the role that negative life events, coping methods, and depression might play in moderating the associations between HIV-related factors (ARV drug regimen, HIV staging and CD4 count) and higher-risk sexual behaviours of people living with HIV/AIDS. The model depicted hypothesised relationships among several characteristics of HIV-related variables, negative life events, coping behaviours and depression. One hundred and fifty-four HIV patients who were receiving antiretroviral therapy through the PEPFAR programme in Ibadan, Nigeria, responded to a questionnaire. In a hierarchical multiple regression analysis, variables were entered into the equation in the order specified a priori by the model. The results show that: (a) patients on the combined 3-drug ARV regimen were more likely to have engaged in higher-risk sexual behaviours as compared to those on a regimen of two or one ARV drugs; (b) negative life events and (c) a coping method characterised by HIV-status denial both predicted increased higher-risk-sexual-behaviour practice among the patients. The study underscores the need for continuous evaluation of the level of higher-risk-sexual-behaviour practice and associated factors, particularly among HIV/AIDS patients receiving ARV treatment.
Non-disclosure of Human Immunodeficiency Virus (HIV) has been linked to medical (e.g. infection/t... more Non-disclosure of Human Immunodeficiency Virus (HIV) has been linked to medical (e.g. infection/treatment recuperation rate) and social (e.g. social support) related problems, and there is paucity of literature addressing the role of behavioral intervention in improving selfdisclosure. This study examined the efficacy of Psychological Inoculation (PI) in enhancing self-disclosure. A randomized-clinical-trial design was adopted. Fifty-five respondents (39.5 ± 10.5 years) who scored below the mean (X ¼ 45.30) on HIV-Self-disclosure Index were purposively assigned to study groups. The PI was effective in enhancing self-disclosure (effect size (n p 2) ¼ 0.35). However, individuals who received the refutation preemption variant (X ¼ 78.18) and the supportive variant of PI (X ¼ 75.18) reported higher disclosure than those who did not (X ¼ 72.39). Psychological Inoculation was reported effective in enhancing self-disclosure. Psychological Inoculation should be incorporated into the existing treatment for HIV/AIDS. AIDS in the world, such that in 2018, over a million new cases were recorded in the African continent, which was considered high when compared to the reported cases in other continents (UNAIDS, 2020). Recent statistics revealed the prevalence of 25.8 million PLWHA were Africans and a prevalence of 730,000 newly infected cases were reported in 2019. In the most famous black nation, i.e., Nigeria, an HIV prevalence of 1.4% was reported, indicating over 1.9 million Nigerians are functioning with HIV/AIDS (UNAIDS, 2020). The prevalence of HIV/AIDS is alarming, especially in Nigeria because many people living with HIV in Nigeria are unaware of their status and the majority who are aware fail to disclose their positive status to the appropriate audiences (Olaseni, 2020). The prevalence of HIV-positive disclosure behavior among PLWHA in Nigeria was below the recommended disclosure rate by the World Health Organization ([WHO]; Olley et al., 2011; WHO, 2004). The recommended disclosure rate for developing countries, such as Nigeria is 79% benchmark (WHO, 2004). The study conducted by Olaseni et al. (2020) reported a 64.6% non-disclosure prevalence among people living with HIV (PLHIV). Some of the PLHIV who disclosed their HIV-positive status opted
Background and Objectives: Depression as major psychological sequelea of the HIV/AIDS infection h... more Background and Objectives: Depression as major psychological sequelea of the HIV/AIDS infection has continued to attract investigation. With few studies in Nigeria, it is unclear whether levels of perceived stigma, sexual risk behaviors, and anticipated discrimination are differentially associated with severity of depression. Materials and Methods: The present study using a multivariate design investigated the role of stigma, anticipated discrimination, self-esteem, HIV-related factors (e.g., drug use combination, knowledge of duration of HIV diagnosis) and socio demographic factors (e.g., multiple spouse, age, gender, and ethnicity) in depression among people living with HIV/AIDS (PLWHA) on follow-up management in three tertiary hospitals in Nigeria. Five hundred and two (187 [37.3%] males and 315 [62.7%] females) HIV/AIDS patients participated in the study. Results: Mean age and mean time in months since diagnosis were 36.73 ± 9.38 and 19.42 ± 23.12, respectively. Three variables: Ethnicity, anticipated discrimination, and HIV-related stigma were related to severity of depression at (P < 0.05). Multinomial logistic regression analyses showed that being from Yoruba (odds ratio [OR] = 0.25; 95% confidence interval [CI] = 0.145-0.441), or Igbo extraction (OR = 0.43; 95% CI = 0.214-0.873) reduces the risk of reporting severity of depression by 25% and 43%, respectively. Moreover, low perceived HIV-related stigma (OR = 0.59; 95% CI = 0.355-0.966) and low anticipated discrimination (OR = 0.54; 95% CI = 0.319-0.914) reduced the risk of reporting symptoms of severe depression by 59% and 54%, respectively. Conclusion: Intervention to reduce the severity of depression should consider cultural specificity in its design and also evolve educational programs that incorporate discrimination and stigma in managing depression among PLWHAs.
Long Distance Truck Drivers (LDTDs) have been found to be a high risk group in the spread of HIV/... more Long Distance Truck Drivers (LDTDs) have been found to be a high risk group in the spread of HIV/AIDS globally; perhaps, due to their high Sexual Risk Behaviours (SRBs). Interventions for reducing SRBs in trucking population have not been fully exploited. A quasi-experimental control group pretest-posttest design was used to assess the efficacy of psycho-education and behavioural skills training in reducing SRBs among LDTDs. Sixteen drivers rivers were randomly assigned into either experimental or control groups using balloting technique. Questionnaire was used as an instrument for data collection. Repeated measures t-test and independent t-test were used to test hypotheses. Intervention had significant effect on the SRBs among LDTDs at post-test (t{7}= 6.01, p<.01) and at follow up (t{7} = 6.42, p<.01). No significant difference in sexual risk behaviour of LDTDs at post-test and at follow-up stage. Similarly, intervention had significant effects on sexual risk behaviour at po...
Child Abuse Neglect the International Journal, Mar 1, 2006
Objectives: This study documents the extent and impact of perceived patterns of behavior in a sam... more Objectives: This study documents the extent and impact of perceived patterns of behavior in a sample of youths of the streets of Ibadan, Nigeria, with the purpose of implementing a Life Skills Educational (LSE) intervention. Method: The study uses both qualitative and quantitative methods of data collection. Qualitatively, two Focus Group Discussions (FGD) and two in-depth interviews (IDI) with 20 boys and 2 community leaders were conducted on separate occasions for the purpose of eliciting commonly exhibited behaviors and patterns of street youth. Quantitatively, 169 youths (89.3% male) were consecutively interviewed from five subcultural areas in Ibadan, Nigeria. Street youths were accessed through a snowballing technique made possible by "Area boys" (AB, adults, who serve as a symbol of authority for street children). Results: The mean age of participants was 18.4 years. The majority was on the street for financial reasons, had been on the street for more than 1 year, and had not completed their primary schooling. While youths of the street were economically viable, 69% had a history of alcohol abuse, 14% of drug abuse, and 24% operated as drug couriers; 46% reported school refusal, 27% school suspension, and 47% school truancy. Forty-nine percent admitted to being sex workers and 11% had been raped and were, therefore, at risk of contacting sexually transmitted diseases (STD). One-third of youths had been arrested for various offenses, including street fighting and drug use. While females were in the minority, they were more likely to engage in antisocial behaviors compared with boys. Conclusions: Although many youths of the street display antisocial behaviors, they also are an economically viable group. Some of their antisocial behaviors may have been exhibited within the context of economic survival.
Http Dx Doi Org 10 1080 17450120802385737, Dec 17, 2008
... To Sylvester Okhakhume; Ibukun Opaleye and Jenny-Uguru-Okorie-my post graduate students who a... more ... To Sylvester Okhakhume; Ibukun Opaleye and Jenny-Uguru-Okorie-my post graduate students who assisted in data collection. References. ... BMC Public Health, 6: 310 [CrossRef], [PubMed], [Web of Science ®]; 2. Ajuwon, AJ, Olley, BO, Akin-Jimoh, I. and Akintola, O. 2001. ...
African Journal of Medicine and Medical Sciences, Sep 1, 2008
Background-Little is known about factors that determine the QoL of elderly persons living in deve... more Background-Little is known about factors that determine the QoL of elderly persons living in developing societies undergoing rapid social changes.
World psychiatry : official journal of the World Psychiatric Association (WPA), 2006
Studies indicate that stigmatizing attitudes to mental illness are rampant in the community world... more Studies indicate that stigmatizing attitudes to mental illness are rampant in the community worldwide. It is unclear whether views about the causation of mental disorders identify persons with more negative attitudes. Using data collected as part of a community study of knowledge of and attitudes to mental illness in Nigeria, we examined the relationships between views about causation and attitudes. Persons holding exclusively biopsychosocial views of causation were not different from those holding exclusively religious-magical views in regard to socio-demographic attributes, and the two groups were not very dissimilar when general knowledge of the nature of mental illness was compared. However, religious-magical views of causation were more associated with negative and stigmatizing attitudes to the mentally ill. Findings demonstrate the challenge of developing and delivering an educational program to change public attitudes to mental illness.
SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance / SAHARA , Human Sciences Research Council, 2011
Past studies have shown that in attempts to prevent HIV, health education yields little change in... more Past studies have shown that in attempts to prevent HIV, health education yields little change in condom use. The reason may be that education fails to target barriers for changing behaviour. The present controlled pilot study tested whether psychological inoculation (PI) reduces such barriers for using male condoms. Twenty-two Nigerian women with HIV were randomly assigned to receive PI or health education (control). In the PI condition, women learned to refute sentences reflecting barriers against condom use, while controls learned how to use condoms and the consequences of their non-use. Barriers for condom use, self-efficacy to negotiate condom use with partners and actual condom use were self-reported before and one week after interventions. Results revealed that only in the PI group were there statistically significant increases in condom use negotiating self-efficacy and reductions in barriers concerning motivation, sexual satisfaction and partners. Controls reported no stati...
This study explored the problem of sexual coercion from the perspectives of 77 young people aged ... more This study explored the problem of sexual coercion from the perspectives of 77 young people aged 14-21 in Ibadan, Nigeria, the behaviours they perceive to be sexually coercive and the contexts in which these occur through four narrative workshops. Participants were drawn from two secondary schools and 15 apprentice workshops. All four groups identified similar coercive behaviours and developed narratives of the events that typically lead up to them. Behaviours included rape, unwanted touching, incest, assault, verbal abuse, threats, unwanted kissing; forced exposure to pornographic films, use of drugs for sedation and traditional charms for seduction, and insistence on abortion if unwanted pregnancy occurs. Men were typically the perpetrators and young women the victims. Perpetrators included acquaintances, boyfriends, neighbours, parents and relatives. All the narratives revealed the inability of young people to communicate effectively with each other and resolve differences. The results suggest the need for life-skills training that facilitates communication, seeks to redress gender power imbalances, teaches alternatives to coercion as a means of resolving conflict over sexual relations and respect for sexual and reproductive rights, and provides victims with information on appropriate services, support and referral.
Objective: Even though depression and chronic physical conditions are common causes of disability... more Objective: Even though depression and chronic physical conditions are common causes of disability in the elderly, their relative impact is unknown among elderly Africans.
Background: Psychiatric disorders in HIV/AIDS are common, emerging soon after diagnosis or during... more Background: Psychiatric disorders in HIV/AIDS are common, emerging soon after diagnosis or during the subsequent course of illness. However, there are few prospective studies on the rates of psychiatric disorders in HIV/AIDS, particularly in the context of the developing world. Methods: Sixty-five patients with recently diagnosed HIV were interviewed on presentation to a hospital-based HIV clinic and then 6 months later. On both interviews, the patients were assessed using the MINI International Neuropsychiatric Interview, the Carver Brief COPE, and the Sheehan Disability Scale. Exposure to negative life events and risk behaviors was also evaluated. Results: The overall prevalence of psychiatric disorders in the follow-up period remained high (56% of patients had at least one psychiatric disorder at baseline, and 48% of patients had at least one psychiatric disorder at 6 months). Depression and posttraumatic stress disorder (PTSD) were the most prevalent disorders at both baseline (34.9% and 14.8%) and follow-up (26% and 20%), respectively. More than half of all patients with depression at baseline improved (16 of 29; 55.1%). However, there was a new onset of both depression (4 of 49; 8.1%) and PTSD (12 of 17; 70.5%) on follow-up. In univariate analysis, depression on follow-up was significantly associated with: (a) disability in work/social/family functioning, (b) greater number of negative life events, and (c) a decline in CD4 lymphocyte count. Univariate analysis also revealed that a diagnosis of PTSD on follow-up was significantly associated with (a) a longer duration of infection and (b) baseline disability in work/social/family functioning. However, in multivariate analysis, only disability scores predicted the diagnoses of major depression and PTSD on follow-up assessment. Persistence of risky sexual behaviour was also noted, with a significantly higher number of participants reporting nonuse of condom on follow-up. There appeared to be a shift from maladaptive coping behaviors to more adaptive coping behaviors over the 6-month period. Conclusion: The rate of psychiatric disorders in HIV/AIDS patients was consistent over time. These findings emphasize the importance of regular evaluation for psychiatric disorders in HIV/AIDS patients, not only at the commencement of treatment but also during subsequent follow-up visits. D
International Journal of Geriatric Psychiatry, 2009
Objective-To provide information on the profile, comorbidity and impact of insomnia among an unde... more Objective-To provide information on the profile, comorbidity and impact of insomnia among an understudied group of elderly Africans.
... Olagoke Akintola, Doctoral student, MPH Centre for Gender Studies, Faculty of Human Sciences,... more ... Olagoke Akintola, Doctoral student, MPH Centre for Gender Studies, Faculty of Human Sciences, University of Natal, Durban, South Africa. ... Adekunle, AO, Ladipo, OA (1992), "Reproductive tract infections in Nigeria: challenges for a fragile health infrastructure", in Germain, K ...
Background: In Nigeria ACT use at the community level has not been evaluated and the use of antim... more Background: In Nigeria ACT use at the community level has not been evaluated and the use of antimalarial drugs (commonly chloroquine (CQ)) at home has been shown to be largely incorrect. The treatment regimen of ACT is however more complicated than that of CQ. There is thus a need to determine the feasibility of using ACT at the home level and determine community perception on its use.
This study examined the prevalence of unprotected sex, other sexual risk behaviours, and factors ... more This study examined the prevalence of unprotected sex, other sexual risk behaviours, and factors associated with unprotected sex among men and women recently diagnosed with HIV in South Africa. One hundred and forty-nine outpatients (44 males and 105 females) were assessed, of whom 101 were sexually active at least 6 months prior to study entry. Subjects were asked about sexual risk behaviours with reference to their most recent sexual encounter. Logistic regression analysis was employed to determine the predictors of condom use, with independent variables selected from five general categories: (1) sociodemographic characteristics; (2) situational characteristics regarding sexual intercourse (i.e. alcohol or drugs used before intercourse); (3) clinical diagnoses; (4) negative life events; and (5) coping styles. Fifty-five patients (19 males and 36 females), representing 54.4% of those sexually active in the 6 months preceding the study, had not used a condom during the most recent intercourse. Compared with those who used condoms, participants who did not significantly reported shorter duration of HIV infection (t = -2.7, p &amp;amp;amp;amp;lt; 0.001), have a current partner (chi2 = 3.98, p = 0.005), and lack knowledge of their partner&amp;amp;amp;amp;#39;s HIV status (chi2 = 4.78, p = 0.004). Also they were significantly more likely to engage in denial (t = 3.2, p &amp;amp;amp;amp;lt; 0.002) and to use substances (t = 1.98, p &amp;amp;amp;amp;lt; 0.05) as a means of coping. Logistic regression showed that shorter duration of illness (odds ratio (OR) = 1.2, 95% confidence interval (CI) = 1.01-1.41) and coping styles characterized by denial (OR = 0.6, 95% CI = 0.45-0.96) were significantly associated with unprotected sex. These data suggest the need for interventions to further reduce sexual risk behaviours in HIV-positive patients in South Africa.
This study surveyed 1,025 adolescent students and apprentices in Ibadan, Nigeria, to document the... more This study surveyed 1,025 adolescent students and apprentices in Ibadan, Nigeria, to document their sexual behaviour and experience of sexual coercion including verbal threats, unwanted touch, unwanted kiss, assault, deception, drugging, attempted rape, and rape. Sixty five per cent of male and 48% of female apprentices were sexually experienced, compared to 32% of male and 24% of female students. More males than females reported sex with multiple partners and contact with a sex worker while females had exchanged sex for money and gifts. Fifty five per cent of all the subjects had been victims of at least one type of sexual coercion, the commonest being unwanted kiss and touch of breasts (47%). Although both males and females were victims of coercion, females were disproportionately affected--68% of female students and 70% of apprentices had experienced one coercive behaviour, compared to 42% of male students and 40% of apprentices. Female apprentices fared worst, with 19% of them raped. The main perpetrators of the coercion were persons well known to the victims including neighbours, peers and boy/girlfriends. We recommend multiple intervention programs including skills training for young persons, sensitisation workshop for training health workers, and media advocacy for the public to challenge stereotypes that favour sexual coercion of adolescents.
A stress-coping model was tested to examine the role that negative life events, coping methods, a... more A stress-coping model was tested to examine the role that negative life events, coping methods, and depression might play in moderating the associations between HIV-related factors (ARV drug regimen, HIV staging and CD4 count) and higher-risk sexual behaviours of people living with HIV/AIDS. The model depicted hypothesised relationships among several characteristics of HIV-related variables, negative life events, coping behaviours and depression. One hundred and fifty-four HIV patients who were receiving antiretroviral therapy through the PEPFAR programme in Ibadan, Nigeria, responded to a questionnaire. In a hierarchical multiple regression analysis, variables were entered into the equation in the order specified a priori by the model. The results show that: (a) patients on the combined 3-drug ARV regimen were more likely to have engaged in higher-risk sexual behaviours as compared to those on a regimen of two or one ARV drugs; (b) negative life events and (c) a coping method characterised by HIV-status denial both predicted increased higher-risk-sexual-behaviour practice among the patients. The study underscores the need for continuous evaluation of the level of higher-risk-sexual-behaviour practice and associated factors, particularly among HIV/AIDS patients receiving ARV treatment.
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