Intervention programmes for HIV and AIDS prevention: a study of in- school adolescents in Orlu Senatorial Zone of Imo State, Nigeria


  • Ezeama M. C. Department of Nursing, Imo State University, Owerri, Nigeria
  • Enwereji E. E. Department of Public Health, Abia State University, Uturu, Nigeria
  • Onyekwere I. A. Department of Sociology, Imo State University, Owerri, Nigeria



HIV, AIDS, School-based intervention, Knowledge, Attitudinal change, Adolescents


Background: Helpful strategies to prevent human immuno-deficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among adolescents remain the greatest challenge in developing countries including Nigeria. In Nigeria, interventions for preventing HIV and AIDS for in-school adolescents are limited. This study used class-room instruction (CI) and drama (DR) for HIV and AIDS prevention among in-school adolescents in Orlu Senatorial Zone.

Methods: A quasi-experimental design using 165 students from three randomly selected co-educational secondary schools was adopted. Two experimental groups (CI and DR) and a control group were used for the study. Baseline data were collected using a semi-structured questionnaire with 29-point knowledge and 9-point attitudinal scales. Knowledge was analysed using the scores <15 and ≥15 for low and high knowledge respectively. For attitude, scores of <5 and ≥5 were categorised as negative and positive respectively. The results for baseline studies were used to design interventions that were implemented for 8 weeks. Also, mid-term and follow-up evaluations were conducted during the study. Data were analysed using descriptive statistics, t-test and ANOVA at p=0.05.

Results: The mean ages of the respondents in CI, DR and control groups were 13.4±1.2, 13.9±1.5 and 13.8±1.2 years respectively. Knowledge scores on HIV and AIDS at baseline were 20.5±2.7, 20.4±2.6 and 21.1±2.7 for CI, DR and Control groups respectively. These scores increased to 22.7±2.7, 22.6±1.8 and 21.2±0.3 at mid-term for CI, DR and control, respectively. At follow-up, scores for CI and DR increased to 23.9±1.8 and 24.5±1.4 respectively while the score for the control dropped to 20.0±2.8. Scores for attitude for CI, DR and control groups during baseline study were 5.3±1.4, 4.9±1.5 and 5.3±1.0 respectively. For mid-term, attitude scores were 5.1±1.2, 5.0±0.9 and 4.7±1.5 for CI, DR and control respectively while scores for follow-up were 5.3±1.2, 5.6±0.7 and 4.5±1.2, indicating greater increase among the intervention groups than that of control.

Conclusions: Based on the results of the study, drama yielded more positive outcomes in both knowledge gained and in attitudinal change among in-school adolescents than classroom instruction. Drama intervention is therefore, an important HIV and AIDS prevention strategy for in- school adolescents.


Loutfy MR, Blitz S, Zhang Y. Self-Reported Preconception Care of HIV-Positive Women of Reproductive Potential: A Retrospective Study. J Int Assoc Provid AIDS Care, 2013. Available at

Federal Ministry of Health (FMOH). Technical Report: National HIV Sero-prevalence Sentinel Survey among pregnant Women attending Antenatal Clinics in Nigeria. Federal Ministry of Health, Department of Public Health National AIDS/STI Control Programme, Abuja, Nigeria; 2010.

Federal Ministry of Health (Nigeria). National human immunodeficiency virus and acquired immunodeficiency syndrome and Reproductive Health Survey 2012 (plus II): Human Immunodeficiency virus Testing. J HIV Hum Reprod. 2014;2:15-29.

Paul-Ebhohimhen VA, Poobalan A, van Teijlingen ER. A systematic review of school-based sexual health interventions to prevent STI/HIV in sub-Saharan Africa. BMC Public Health; 2008:8:4.

Singhal A, Rogers EM. Combating AIDS: Communication strategies in action. New Delhi India: Sage Publication Ltd; 2003.

Stover J, Walker N, Garnett GP, Salomon JA, Stanecki A, Ghys PD, et al. Can we reverse the HIV/AIDS pandemic with an expanded response? The Lancet. 2002;360:73-7.

UNAIDS/WHO. Report on the global AIDS epidemic. WHO Library Cataloguing-in-Publication Data, Geneva, Switzerland New Delhi India: Sage Publication Ltd; 2010.

World Health Organization Social determinants of health and well-being among the young people. Health Behaviours in school aged children (HBSC). International report from the 2009/2010 survey; 2012.

Orji EO, Esimai OA. Sexual behaviour contraceptive use among secondary school students in Ilesha South West Nigeria. J Obstet Gynaecol. 2005;25(3):269-72.

Ijioma BC, Kalu IG, Nwachukwu CU, Nwachukwu IG. Incidence Cases of HIV/AIDS Infection in Owerri West Local Government Area of Imo State, Nigeria. Res J Biol Sci. 2010;5(4):304-9.

Ajuwon AJ, Titiloye M, Oshiname F, Oyediran O. Knowledge and use of HIV counselling and testing services among young persons in Ibadan, Nigeria. Int Quart Com Health Educat. 2011;31(1):33-50.

Helleve A, Flisher AJ, Onya H, Mathews C, Aarø LE, Klepp KI. The association between students’ perceptions of a caring teacher and sexual initiation. A study among South African high school students. Health Educat Res. 2011;26(5):847-58.

Fisher JC, Bang H, Kapiga SH. The association between HIV infection and alcohol use: a systematic review and meta-analysis of African studies. Sexually transmitted diseases. 2007;34(11):856-63.

Rogers RW. A protection motivation theory of fear appeals and attitude change. J Psychol. 1975;91:93-114.

Michie S, Abraham C. Interventions to change health behaviours: Evidence- based or evidence-inspired? Psychol Health. 2004;19:29-49.

Gebhardt WA, Maes S. Integrating social-psychological frameworks for health behaviour research. Am J Health Beh. 2001;25:528-36.

Cohen J. AIDS origins. Disputed AIDS theory dies its final death. Science. 2001;292(5517):615a-15.

Johnson LF, Lewis DA. The effect of genital tract infections on HIV-1 shedding in the genital tract: a systematic review and meta-analysis. Sex Transm Dis. 2008;35(11):946-59.

Anderson BL, Firnhaber C, Liu T. Effect of trichomoniasis therapy on genital HIV viral burden among African women. Sex Transm Dis. 2012;39(8):638-42.

Blish CA, McClelland RS, Richardson BA. Genital inflammation predicts HIV-1 shedding independent of plasma viral load and systemic inflammation. j acquir immune Defic Syndr. 2012;61(4):436-40.

Homans J, Christensen S, Stiller T. Permissive and protective factors associated with presence, level, and longitudinal pattern of cervicovaginal HIV shedding. J Acquir Immune Defic Syndr. 2012;60(1):99-110.

Donnell D, Baeten JM, Kiarie J. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375(9731):2092-8.

Del Romero J, Castilla J, Hernando V, Rodriguez C, Garcia S. Combined antiretroviral treatment and heterosexual transmission of HIV-1: cross sectional and prospective cohort study. BMJ. 2010; 340:c2205.






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