عنوان

By Her Own Hands: Combination Income-Generating HIV Prevention Intervention to Promote HIV Risk-Reduction among In-School Adolescent Girls in Nigeria

Number

TL53388

.Language of Text, Soundtrack etc

انگلیسی

Title Proper

By Her Own Hands: Combination Income-Generating HIV Prevention Intervention to Promote HIV Risk-Reduction among In-School Adolescent Girls in Nigeria

General Material Designation

[Thesis]

First Statement of Responsibility

Nwaozuru, Ucheoma C.

Subsequent Statement of Responsibility

Iwelunmor, Juliet

Name of Publisher, Distributor, etc.

Saint Louis University

Date of Publication, Distribution, etc.

2020

Text of Note

202 p.

Dissertation or thesis details and type of degree

Ph.D.

Body granting the degree

Saint Louis University

Text preceding or following the note

2020

Text of Note

Adolescent girls and young women (AGYW) between the ages of 15-24 years in Nigeria disproportionately carry the burden of HIV among young people in the country. AGYW in this age group are over three times more likely to be living with HIV than young men within the same age group. A multitude of factors including biological, behavioral, socioeconomic, cultural, and structural risks increase AGYW's vulnerability to HIV acquisition, therefore suggesting the need for a multi-risk HIV preventive approach. A growing body of literature suggests that addressing structural factors such as economic resources in addition to behavioral level factors can alter AGYW's likelihood of engaging in risky sexual behaviors that increase their vulnerabilities to HIV infections. Combination income-generating HIV prevention interventions offer many benefits for HIV prevention, yet little is known as to how it works among AGYW in Nigeria. To address this gap, this dissertation examined, 1) preliminary efficacy of a combination income-generating intervention on HIV preventive indicators among in-school adolescent girls in Nigeria; 2) the acceptability, feasibility, and efficacy of combination income-generation HIV risk-reduction intervention among in-school adolescent girls in Nigeria; and 3) perceived barriers and facilitators to participating in a school-based combination income-generating HIV prevention intervention in Nigeria. The combination income-generating intervention was guided by the asset, social cognitive, and empowerment theories. In a quasi-experimental design, participants who received a combination HIV prevention intervention (4 sessions of HIV education + jewelry micro-enterprise training + youth development micro-credit for jewelry micro-enterprise) (n = 142) were compared to participants who received HIV risk-reduction education only (n = 177). Data was collected using a self-administered questionnaire at baseline, immediately after intervention completion, and 6 months. Changes in means scores between intervention and control groups were compared using t-tests on each outcome. A multi-level regression was conducted to examine the intervention effect on study primary outcomes (HIV prevention attitude, safe sex self-efficacy, and attitude towards toward income generation). The mean age of study participants was 15.0 (±0.9) years. The majority of the participants (93.2%) lived with their parents and had never had sex (97%). Results revealed a significant increase in safe sex self-efficacy (t = 2.4, df = 125, p < 0.01), self-esteem (t = 8.4, df = 125, p < 0.001), and decision-making skills (t = 1.8, df = 125, p = 0.07) among participants in the intervention group immediately after intervention completion. Compared to the control group, participants in the intervention group demonstrated an increased HIV prevention attitude (B = 0.08, 95% CI 0.03-0.15), p < 0.01, and safe sex self-efficacy (B = 0.04, 95% CI 0.02-0.10), p < 0.05 immediately after intervention completion. Participants in the intervention group showed a significant increase in safe sex efficacy and reductions in sexual risk-taking intentions (both P < 0.05) over time compared to the control group. Feedback from focus group discussions suggested that the intervention was acceptable and appropriate to address HIV risk-reduction among adolescent girls in Nigeria. Results from this research expand our understanding of the impact of combination economic strengthening HIV prevention on reducing HIV risk among AGYW. These findings can inform the development of large-scale combination income-generation HIV prevention intervention among adolescent girls and young women in Nigeria. Promoting combination income-generating HIV prevention intervention among adolescent girls in Nigeria may help promote HIV risk reduction by increasing safe sex self-efficacy and reducing sexual risk-taking intentions.

Subject Term

Behavioral psychology

Subject Term

Health sciences

Subject Term

Sub Saharan Africa studies

Nwaozuru, Ucheoma C.

Iwelunmor, Juliet

Saint Louis University

Electronic name

p

[Thesis]

276903

a

Y