Impact of Comprehensive HIV/AIDS Prevention Program on Reduction of Risky Sexual Behaviors in an African Rural Community

Abstract

Aims: This study compares the sexual behaviour of the residents of Bonny kingdom, Rivers State in pre-intervention and post-intervention periods of a comprehensive HIV/AIDS prevention program carried out by the African Health Project in collaboration with independent research consultants and members of the Ibanise HIV/AIDS initiative in the community for three years from 2009-2012.
 Methodology: This is a quantitative survey that used a structured questionnaire among a representative sample of the general population aged 15 – 49 years. Post-intervention survey was conducted three years after the pre-intervention survey. The data obtained include the demographics; age, sex, education, occupation, marital status and sexual related information. Data were analyzed using SPSS version 25.0.
 Results: This study comprised 1021 (53.3%) males and 895 females (46.7%) in the pre-intervention survey and 659 (54.2%) males and 556 (45.7%) in the post-intervention survey, mostly aged 15-34 years and had secondary education. More females have ever had sex in both surveys but there was a significant reduction in the percentage of males who have ever had sex from 70.8% to 42.0% in pre-intervention and post-intervention surveys respectively. The rate of sexual activities was very high before intervention among unmarried males (51.6%), age 15-24 years (69.6%), secondary education (50.7%) and graduates (65.9%). However, there was a drastic reduction in these values after the interventions. During pre-intervention survey, 9.4% of females and 13% of males had ever accepted or given gifts exchange for sex while the post-intervention survey showed a decrease into 8.0% among females and 5.5% among males. This proportion was 13.0% among adolescents 15-24 years in the pre-intervention survey and 4.7% in the post-intervention survey. Also, there was 65.0% decrease in the proportion of singles who had ever received gifts in exchange for sexual intercourse after the intervention. A high proportion of the males had multiple sexual partners during the pre-intervention survey (34.6%) but the value reduced to 3.2% after the intervention. Similarly, the percentage of the adolescent who had multiple sexual partners reduce from 22.2% to 2.5% due to the intervention. The pre-intervention survey showed that about 56.0% of males and 81.0% of females had sex with non-marital partners while the post-intervention survey showed that about 71.0% of males and 76.0% of females did same.
 Conclusion: The study has shown a significant positive impact of health interventions in improving the sexual behaviour of Bonny residents. However, more and regular interventions are needed in this environment to further prevent the spread of HIV and STIs due to the vulnerability of the residents, especially the adolescents to sexually transmitted infection.There is also need for more study to evaluate the impact of sexual and reproductive health programs for adolescence and adult that already exist in Nigeria in comparison with the HIV intervention outcome.