Prevention of HIV/AIDS is fundamentally dependant on sexual behaviour. There is substantial experience internationally that this is the best opportunity to impact positively on adolescents. Sexual behaviour is prior to the onset of sexual activity. The key to success, international experience shows is an open communication about sex and early sex education. In Uganda and Senegal, open communication about sex has been at the heart of those countries largely effective HIV/AIDS prevention efforts.
The average age of onset of sexual activity among Nigerian teenagers is 14 years, thus sexually transmitted infections such as gonorrhea and syphilis are common place among sexually active teenagers. And despite substantial public education efforts over the past years, the use of condoms among young people remains below expectation. To positively influence adolescent sexual behaviour, there is need to advocate for a new lifestyle for young people based on informed choice, shared responsibility and positive sexuality. A strategy to get all Nigerians particularly 12-19 years old to talk about sex more openly must involve a combination of high powered media with nation wide adolescent sexual health services and outreach programmes.
The conclusion are clear; open communication about sex and early sex education is essential to delaying the onset of sexual activity, reducing teenage pregnancy, increasing the use of condoms and reducing the spread of HIV/AIDS and other STDs. It is equally essential to back up open communication and sex education with adolescent friendly sexual health services, outreach and support programmes.
Despite considerate efforts at public education about the risks of HIV/AIDS, high-risk sexual behaviour remains the norm. However, there is a weak relationship between perceived risk of infection and actual infection. Though a less percentage of those who thought that they were at low risk were already infected with HIV. The greatest barriers to achieving HIV prevention are; fear, denial and ignorance. HIV prevention efforts have been plagued, above all by silence, resulting from the stigma associated with the disease.
Traditionally behaviour change models focused on individual behaviour and were based on the assumption of a direct correlation between knowledge and action. The theory is that preventative behaviour is the result of rational decision making informed by the seriousness of the threat, perceptions of the effectiveness of risk reducing measures (such as condoms, the value individuals put a good health, as well as the self confidence and communication skills of the individual. The problem with this model is that is assumes a logical pattern of decision-making and a degree of personal control that is unrealistic in the complex web of sexual relations. There is growing recognition that individual risk reduction and behaviour change require changes in the attitude, values and norms of society generally.
Forced sex is also a reality for many young people. For young women in Nigeria coercion or enticement is pervasive while for young men, the hiatus in employment, lack of education, recreation and other opportunities, create an environment where recreational sex is a major preoccupation. It is also necessary to investigate the sexual ideologies of adolescents. Young men say they are often consumed by impulses beyond their control and young women often buy into this notion by acquiescing to sexual advances.
Cultural scripts that capture the imagination such as “skin to skin” (unprotected sex) can strongly influence sexual decision making. However, achieving sexual behavioral change is a complex task requiring integrated approaches implemented at all levels of society and sustained over a considerate number of years. Prevention initiatives need to succeed in creating a social consciousness and environment that facilitate appropriate personal action.
Although projections for the HIV epidemic in Nigerian are bleak, it is still possible through converted prevention efforts to curtail the scale of the epidemic and to turn the tide over the next few years. The primary reasons for hope are that HIV/AIDS is eminently preventable and that approximately 20 percent of the Nigerian population is less than 14 years of age. Prevention initiatives, especially if packaged as part of life skills can contribute to creating hope for the future and building respectful relationships among young people. Your guess is as good as mine.
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