Social Determinants of Health and Knowledge About Hiv/Aids Transmission Among Adolescents

By Godwin C. Osakwe MBA MPH PhD

Godwin C. Osakwe draws on his academic knowledge and painstaking research to determine if there’s a link between knowledge and transmission of HIV/AIDS among youths in this important study. The author, who holds a doctorate degree in public health and a business management degree, shares broad information and engages in a comprehensive review of the origin of the disease. Focusing on Nigeria, he examines a multitude of factors that may play a role in the transmission of HIV, such as adolescent health care, demographics, social factors, and more.

The goal of the study is to lessen HIV transmission by increasing knowledge about the disease. Governmental and nongovernmental organizations can use its findings to influence childhood health-care improvements and advance education to help reduce or eradicate HIV/AIDS transmission.

With adolescents making up 23 percent of Nigeria’s population—and given this group is likely to engage in risky behavior—there’s never been a more critical time to strive to prevent the transmission of this devastating and, still, deadly virus.

• Language: English
• Publisher: iUniverse
• Release date: Jan 10, 2019
• ISBN: 9781532065644

Godwin C. Osakwe MBA MPH PhD

Godwin C. Osakwe, MBA, MPH, PhD, earned a master of business administration from Schiller International University and a PhD in public health from Walden University. He is an adjunct professor online, teaches courses in health sciences, and also works at UNC-REX hospital as a patient safety associate. He lives in North Carolina.

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Copyright © 2017 Godwin C. Osakwe,MBA, MPH, PhD .

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ISBN: 978-1-5320-6565-1 (sc)

ISBN: 978-1-5320-6564-4 (e)

Library of Congress Control Number: 2019900086

iUniverse rev. date:   01/09/2018

Contents

Synopsis of the Research

Acknowledgments

Preface

Chapter One

Introduction to the Study

Introduction

Background of Study

Problem Statement

Purpose of the Study

Research Questions

Chapter Two

The Theoretical Framework

Nature of Study

Definition of Terms

Assumptions

Scope and Delimitations

Limitations

Significance of the Study and Social Change Effect

Summary

Chapter Three

Literature Review

Introduction

Literature Summary

Literature Search Strategy

HIV/AIDS Situation in Nigeria

Conceptual Framework: Theoretical Foundation of Diseases

Chapter Four

Health Belief Model Theory

AIDS Risk-Reduction Model (ARRM)

Literature-Related Key Variables

Childhood Health Care and HIV/AIDS

Demographic Characteristics: Age, Sex, Place of Residence, Education, and HIV/AIDS

Behavior Variables: Religion, Culture, and HIV/AIDS

Wealth Index Variable

Disease Management and HIV/AIDS

Summary

Chapter Five

Research Method

Introduction

The Research Design and Rationale

Methodology

The Target Population

The Sampling and Sampling Procedure

Power-Analysis Plan

Chapter Six

Data Collection

Instrumentation and Materials

Reliability

Validity

Threats to Validity and Reliability

Data-Analysis Plan

Ethical Considerations

Summary

Chapter Seven

Results

Research Questions and Hypotheses

Data Collection

Descriptive Statistics

Verifying the Assumptions of the Regression Analysis

Conclusion

Chapter Eight: Discussion

A Brief Overview of the Study

Theoretical Basis of Research

Significant Social Determinants of HIV Transmission

Limitations

Chapter Nine

Conclusions, and Recommendations

Implication for Social Change

Recommendation for Practice

Recommendation for Future Study

Conclusion

References

Tables

Table 1.   List of Variables and How They Were Measured

Table 2.   Demographic Frequencies and Means

Table 3.   Incidence of Vaccinations

Table 4.   Health Care Affordability and Accessibility

Table 5.   Knowledge of HIV/AIDS among Nigerian Adolescents

Table 6.   Results of Hypothesis Tests

Table 7.   Correlation Matrix Vaccines and AIDS Knowledge

Table 8.   Multiple-Regression Model Vaccinations as Predictors of AIDS Knowledge

Table 9.   Descriptive statistics of the variables gender, age and location

Table 10.   Correlation Matrix: Gender, Age, Location, and AIDS Knowledge

Table 11.   Multiple-Regression Model: Gender, Age, and Location as Predictors of AIDS Knowledge

Table 12.   Descriptive statistics for education, religion, culture, and AIDS knowledge

Table 13.   Correlation Matrix: Education, Religion, Culture, and AIDS Knowledge

Table 14.   Multiple-Regression Model: Education, Religion, and Culture as Predictors of AIDS Knowledge

Table 15.   Descriptive statistics for accessibility, affordability and AIDS Knowledge

Table 16.   Correlation Matrix: Health Care Accessibility and Affordability and AIDS Knowledge

Table 17.   Multiple-Regression Model: Health Care Accessibility and Affordability as Predictors of AIDS Knowledge

Table 18.   Descriptive Statistics for wealth

Table 19.   Linear-Regression Model: Wealth Index Scale as a Predictor of AIDS Knowledge

Figures

Figures 1.   Diagram of the Socioenviromental Factors, as Illustrated by Locker (2005

Figures 2.   Figure 2. The Interaction between Social Determinants of Health and ARRM.

Figures 3.   Figure 3. Multiple-Regression Model: Vaccinations as Predictors of AIDS Knowledge

Figures 4.   Figure 4. Multiple-Regression Model: Gender, Age, and Location as Predictors of AIDS Knowledge

Figures 5.   Figure 5. Multiple-Regression Model: Education, Religion, and Culture as Predictors of AIDS Knowledge

Figures 6.   Figure 6. Multiple-Regression Model: Health Care Accessibility and Affordability as Predictors of AIDS Knowledge

Figures 7.   Figure 7. Linear-Regression Model: Wealth Index Scale as a Predictor of AIDS Knowledge

Synopsis of the Research

HIV is a virus that leads to AIDS. Millions of people are living with HIV. Globally, there is an increased incidence of this disease among adolescents. In literature, there is a gap regarding how social determinants of health have jointly or singly contributed to HIV/AIDS transmission. With the application of the AIDS risk-reduction model (ARRM) to the secondary analysis of survey data, the purpose of this research was to determine whether any significant relationships existed between adolescents’ childhood health care factors, demographic factors, social-level factors, structural-level factors, aspects of disease-management factors, and knowledge about HIV/AIDS transmission among Nigerian adolescents.

Survey data were used from MEASURE (Monitoring and Evaluation to Assess and Use Results) Demographic and Health Survey (MDHS) in Nigeria for 2008. Multiple linear regressions revealed that childhood vaccinations were a weak predictor for HIV transmission risk (R² = 0.020). Gender, age, place of residence, education, religion and culture, some disease-management aspects (e.g., accessibility and affordability of care), and wealth index were all significant but weak predictors of knowledge of HIV/AIDS (R² = 0.016, R² = 0.019, R² = 0.003 and R² = 0.015).

The potential positive social change effect of the study would be HIV transmission reduction through increasing knowledge of HIV/AIDS among adolescents in Nigeria. The results could be used by both governmental and nongovernmental organizations to influence childhood health care improvements and advance education to help reduce or eradicate HIV/AIDS transmission among the adolescent population.

Acknowledgments

My heartfelt gratitude goes first to the Most High God, who, by His grace, made it possible in every way for me to meet my aspiration. My unreserved gratitude also goes to my wife, Rosemary Osakwe, who relentlessly encouraged me throughout this process. You are truly a great companion and a blessing. To all my children, I am grateful for your prayers and your technical support.

My special thanks to Dr. Tolulope Osoba for her guide during this journey. You will always be close to my heart for your assistance. I am also very grateful to Dr. Cheri Langley for her assistance in the review of my work while at Walden University. Thanks to you both for your honest feedback.

To all the names mentioned here, I ask God to bless every one of you because I may not have been able to achieve this feat without your support.

Preface

According to the World Health Organization, individuals between the ages of ten and nineteen years are referred to as adolescents. In Nigeria, this significant group, according to the 1991 census, makes up 23 percent of the population. As an adjunct online professor in health science field, and a patient-safety associate at the UNC-REX hospital, I am privileged to understand that in addressing the health context of the adolescents, the dimension transcends beyond the traditional physical, social, spiritual, and mental challenges. In Nigeria, the focus is often on the areas of sexual and reproductive health, accidents, violence, nutrition, and substance abuse (Federal Ministry of Health 2007). Unfortunately, adolescent health challenges are not limited only to the above mentioned.

One of the hallmarks of the adolescent group is their preparedness to venture into the unknown, especially in health-risky behaviors. Irrespective of the quality of relationship that may exist between an adolescent individual and their parents (whether single or both parents), individuals in this group attempt to take risky adventures that affect their health conditions. Many of the underlying factors that contribute to unhealthy adolescent developments in Nigeria have affected their health and development challenges because of their ignorance in the knowledge, and lack of understanding, of the forces of social determinants of health that shape their lives.

Health knowledge is primarily based on science and uncertified orthodox methods of medicine. The science aspect encompasses six areas that include but are not limited to epidemiology and statistics and the collection, analysis, and determination of essential related information. Availability and adequate management of knowledge of the factors that affect this group are critical to changing the future health conditions of adolescents.

While various authors may have touched on the issues of social determinants of health among this target population, the author draws particular attention to the crucial role knowledge of the social determinants of health could play in the transmission of such diseases as HIV/AIDS among adolescents, particularly among Nigerian adolescents. The author also highlights the impact an existing significant relationship between management of disease and knowledge of such disease has in the target population.

The thought and eventual production of this book is my effort to help readers, students and nonstudents alike, extend their boundaries of knowledge about the power of knowledge in disease transmission vis-à-vis some factors of social determinants of health among adolescents in a particular geographic region.

Reference

Federal Ministry of Health, Nigeria. 2007. National Policy on the Health and Development