Profiling HIV/AIDS Risk Perception, Safety and Marital Adjustment in Southwest Nigeria
Profiling HIV/AIDS Risk Perception, Safety and Marital Adjustment in Southwest Nigeria
Profiling HIV/AIDS Risk Perception, Safety and Marital Adjustment in Southwest Nigeria
https://orcid.org/0000-0002-1985-3455
Abstract
This study examined the relationship between HIV/AIDS risk perception, safe behaviour
and marital adjustment among Federal Public officials in Ibadan. It explored how the risk of
HIV/AIDS affected the sexual behaviour of federal workers who are transferred away from
their families. The study sample was chosen based on the perceived implications of the constant
posting of the Federal Government official to locations far away from their families. Both
primary and secondary data were utilized in the study. Quantitative data was collected through
a questionnaire survey conducted with 200 respondents. qualitative data was collected from
official records and previous empirical studies. The qualitative data was content analyzed,
while the quantitative data was analyzed using percentage and chi-square. Results reveal that
measures taken by respondents when they feel the urge for sex include travelling back home to
meet their spouses, reading scriptures, fasting and prayer, taking sleeping pills, while some male
respondents move along with their wives and children while on transfer. The study concludes on
the need for increased awareness about HIV/AIDS as well as counselling and family support
services for federal civil service workers.
Keywords: Risk perception to safe behaviour, Marital Adjustment, HIV/AIDS,
Sexual Behaviour
Introduction
The global HIV/AIDS scourge is at epidemic proportions, particularly in Sub-
Saharan Africa (Tanser et al., 2018, McGillen et al., 2016). It is estimated that by
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2020, between 10.6 and 20.9 million children under the age of 18 would have
lost one or both parents due to AIDS-related causes (Awofala and Ogundele,
2018, Osasona 2006). Millions more have been impacted by the epidemic,
which has increased the likelihood of poverty, homelessness, discrimination and
lost opportunities (UNAIDS, 2020), in addition to contracting COVID-19
(Perri et al., 2020). Furthermore, seven out of every 10 HIV-positive people live
in Sub-Saharan Africa, which includes Nigeria. AIDS is currently the largest
cause of death in Sub-Saharan Africa, while prevalence rates vary greatly
between nations. In Africa, unprotected heterosexual sex remains the most
common means of transmission, but acute poverty in many parts of the
continent has aided the disease's spread among economically vulnerable groups
(Osasona, 2006).
Recent statistics (Hlongwa et al., 2019, Kharsany and Karim, 2016, UNAIDS,
2013) show that HIV/AIDS continues to destroy humanity, with Sub-Saharan
Africa bearing the brunt of the disease. UNAIDS estimates for Sub-Saharan
Africa, which accounts for just over 10% of the world's population, show that
the continent had more than 60% of all HIV/AIDS patients globally in 2004,
with numbers ranging from 23.4 million to 28.4 million (UNAIDS, 2008).
Similarly, according to Kalipeni and Zulu (2008), the nine countries of southern
Africa account for only 2% of the worldwide population, but 30 percent of
persons living with HIV/AIDS in the world are concentrated in these countries.
This is especially true in developing countries like Nigeria, where various factors
such as low levels of education, poverty, a lack of information (Nweze et al.,
2017, Frohlich, 1999, Oladepo et al., 1998, and Orubuloye et al., 1993), and other
factors stifle the acceptance of new ideas and behaviors (Nweze et al., 2017,
UNAIDS, 2008). In Nigeria, the six states of Kaduna, Akwa Ibom, Benue,
Lagos, Oyo, and Kano, account for 41% of HIV-positive people in the country
(NACA, 2017). HIV prevalence is highest (5.5 percent) in Nigeria's southern
states (known as the South South Zone). The frequency according to NACA
(2015) is lowest in the southeast (South East Zone), where it is 1.8 percent. In
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rural areas, HIV prevalence is higher (4%) than in urban areas (3%). In 2017,
over 150,000 people in Nigeria died as a result of AIDS-related illnesses. From
2005 to the present, the number of annual AIDS-related deaths has decreased
very slightly, indicating that only 33% of people in Nigeria with a positive
diagnosis are receiving antiretroviral treatment (ART) across the country (Avert,
2020).
The impact on individuals, families, and communities that these numbers have
at the micro-level of society is an issue that cannot be overstated. People
become unwell, are unable to work, and lose income as their families spend
money on care and treatment while also losing time caring for them. As people
continue to die, specialized workers, skilled artisans, and educated officials go
without successors. Firms close, crops sit fallow, current profits are lost, future
earnings are postponed, and time and money are spent on funerals and grieving.
Women get sick and die at a much earlier age than men. Female survivors are
forced to rely on relatives for land, shelter, and inheritance because of their
reproductive roles in the family, farm, and the informal economy, or relocate to
cities and join the underclass of commercial sex workers and street children.
Religion, social life, mutual friends, in-laws, money, and sex are the six domains
of marital adjustment identified by psychologists (Lazarus and Delingis, 1983).
According to several scholars (Hashmi et al., 2007, Parron, 1982, Margolin,
1980), marital satisfaction, coherence, agreement, affection, and conflict are
other elements that contribute to levels of marital adjustment. Couples that are
well adjusted are more likely to have long-lasting, stable marriages, whereas
those who are poorly adjusted are more likely to experience instability and/or
divorce. Social and personal resources, lifestyle satisfaction, and benefits from
spousal connection are all predictors of marriage satisfaction, which is a
component of marital adjustment. Age differences between spouses, length of
marriage, and number of children are other determinants of marital adjustment.
Working married women, according to studies, have greater challenges in their
marriages than non-working married women. Hashmi et al. (2007) found that
highly educated working and non-working married women can do well in their
married lives and are less depressed than little educated working and non-
working married women.
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Risk perception is a subjective assessment of a risk's features and severity. Risk
perceptions are also influenced by the perceiver's emotional state (Kummeneje
and Rundmo, 2020, Arshad et al., 2014, Bodenhausen, 1993). Several ideas have
been offered to explain why different people evaluate the severity of dangers
differently (Girlando et al., 2021). The valence theory of risk perception
distinguishes between positive and negative emotions like happiness and
optimism, as well as fear and wrath. Positive emotions, according to valence
theory, lead to optimistic risk perceptions, whereas negative emotions effect a
more pessimistic risk perception (Lerner and Keltner, 2000). Risk and benefit
are positively connected across all hazardous activities in the world, yet research
reveals they are inversely correlated in people's brains and judgments (Slovic,
2006). Using these concepts of risk perception, safe behaviour and marital
adjustment as a foundation, this study aims to assess the ability of Federal Civil
Servants to sense or have the feeling that they are likely to contract or have
contracted HIV/AIDS as a result of their sexual behaviour when they are away
from their families due to their jobs. Hypotheses generated here include:
Methodology
The study examined the relationship between HIV/AIDS risk perception, safe
behaviour and marital adjustment among Federal Public officials in Ibadan
southwest Nigeria. It investigated the risk of HIV/AIDS affected the sexual
behaviour of federal workers who are transferred away from their families. The
data was collected primarily through the use of questionnaire survey. According
to Olorunlana et al (2018), survey questionnaire is part of qualitative tools and
strategies. We administered both open and close-ended questionnaire. A total
of 200 respondents participated in the survey (100 hundred males and 100
hundred females). All of the participants have been married for at least 5 years.
The respondents were randomly selected from the Federal Civil Servants
working at the Federal Secretariat in Ikolaba, Ibadan, Nigeria. Given the study's
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objective, 159 respondents initially agreed to participate in the study while 41
declined. A second round of random selection was conducted to give room for
inclusion of others in order to meet up with projected number of respondents.
The questionnaire took the respondents an average of two weeks to complete.
Every copy of the questionnaire that was distributed was duly filled out,
returned, and was useable. The Federal Civil Service (FCS) employees of the
Federal Secretariat in Ibadan were picked to represent a diverse ethnic group.
This is achievable due to the FCS's Federal Character policy for employee
recruiting. The policy states that civil service and political appointments should
reflect the country's broad ethnic character. In analyzing the data collected, the
t-Test of independent variables and the Pearson Product Movement Correlation
were used to test the hypotheses at 0.05 level of significance.
Results
Majority of the respondents were female (58%); while males constituted the
remaining 42%. All the respondents were married. This is not surprising since
marital status was an important criterion for selection of the study population.
Their age range were: 31 to 40 years (44%). 41 to 50 years (38%) and those
above 50 years (18%). The Christians were in majority (54%). followed by the
Muslims (30%) and the remaining 16% that did not signify their religious
inclination. The academic qualification showed that 18% had Masters Degree,
42% had Bachelor Degree and Higher National Diploma certificate, 16% had
National Diploma certificate, 14% had Secondary School certificate while the
remaining 10% had professional certificates in Accounting/Computer operation
and word processing as well as Typing and Shorthand.
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This corroborates the position of Xu et al. (2015) that children play an
important role in stabilizing marriage and resolving conflicts in marriage. The
couple especially the wife most often, uses the presence of children to console
themselves at the time of disagreement and conflict. Omobowale et al. (2019)
stressed that the survival of many marriages among the Yorùbá in Nigeria was
largely due to the existence of children. He asserted further that most couple
tolerate one another basically for the sake of the children in such marriages. It is
in view of this that the Yorùbá in Nigeria likened marriage to a business
transaction which becomes less attractive to prospective buyers once a child is
involved. As a result, African couples exercise more patience and endurance in
their marriages because of their children who may also suffer if the marriage is
allowed to fail.
The reality of this is equally manifested in the responses of the majority of the
study population (76%) that they sometimes considered the possibility of
divorce, however other respondents (24%) have never considered the divorce
option. It implies that these people considered the idea of divorcing their
spouses but jettisoned the idea because of other intervening factors. Some
respondents (46%) reported further that marriage did not have much impact on
their career. On the other hand, 28% said since they got married, their job
performance improved, 16% of them said the job was worse than before
marriage, while the remaining 10% could not comment on this. Life after office
work was a hell of sort to some respondents (6%) hence they never look
forward to it. To 34%, this was a period of the day they always look forward to;
52% of the respondents frequently looked forward to it, while 12% occasionally
looked forward to it. Only 18% affirmed that in-laws did interfere in matters
concerning their marital lives, while the rest said such a thing was never allowed
in their marriage. All of the respondents reported satisfaction with the way their
spouses handled their children.
The respondents were of the view that couples have differing sexual interests
which should be respected. Most of them also believed that sexual compatibility
was very important toward marital harmony. Sexual intercourse was mostly
seen as an act that should be regular but with the use of contraceptives except
when decision is made to make new baby. Few disagreed with the idea that sex
should occur only when there is need for new baby. The respondents saw sex as
necessary in marriage. They further asserted that couple should make love
regularly to prevent unfaithfulness and extramarital affairs.
Most of the respondents agreed that Jobs that involved transfer away from
home make couples vulnerable to HIV/AIDS contract. The idea that most
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people living with HIV/AIDS contracted it sexually was not accepted by the
respondents. However, they revealed that couples should go for HIV/AIDS
test on regular basis since the disease is not contracted through sexual
intercourse alone. Drinking and taking of drugs was seen as capable of exposing
one to high-risk sexual behaviour. At the same time, lack of adequate emotional
supports from one’s partners according to the respondents could make one to
look elsewhere for support. Quite importantly, only few of the respondents
agreed that having more than one sexual partner was dangerous, and that every
sexually active person should undergo STD test every six months. To most of
the respondents, the use of condoms and similar contraceptives in a marital
relationship suggest mistrust. They further agreed that some couples engage in
extramarital affairs in order to make ends meet. However, respondents
disagreed with the position that only promiscuous couples contracted STD and
HIV/AIDS. They believed that most people living with HIV/AIDS did not
contract it through sexual intercourse.
Since the calculated value (0.1688) is less than the critical value (0.1946). the
hypothesis stated is hereby retained. Therefore, there is no significant
relationship between HIV/AIDS risk perception and marital adjustment among
workers of federal civil service.
From the above table, t–calculated (1.25) is less than t-critical (1.98). Therefore,
since t-calculated is less than t-critical, the hypothesis stated is hereby retained.
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This however implies that sex will have no significant effect on couples’
HIV/AIDS risk perception and marital adjustment.
The above table revealed that calculated ‘r’ (0.2177) is higher than the critical ‘r’.
In light of the fact that calculated value is higher than the critical value, the
hypothesis stated is hereby rejected. By implication therefore, risk perception
will be significantly related to mutual agreement on reproductive decision as an
adjustment strategy in the context of HIV/AIDS.
Above table showed that calculated value is 0.2072 while the critical value is
0.1946. Since the calculated value is less than the critical value, the hypothesis
stated is hereby rejected. This implies that the religion of couples will have
significant relationship with HIV/AIDS risk perception and marital adjustment.
Discussion
In reference to the data obtained for this study, sex was revealed as necessary in
every marriage as sexual compatibility was asserted as crucial to marital
harmony. However, the need for appreciation of differing individual sexual
interests was also emphasized. It was also noted that couples need regular sexual
intercourse in order to prevent unfaithfulness and extra marital affairs.
Contraceptives such as male condom are believed to be necessary in order to
prevent unwanted pregnancy. Issues like inadequate emotional support from
one’s partner and the need to make ends meet were identified as capable of
leading to extramarital affairs. Living away from home as a result of transfers at
work make couples susceptible to high-risk sexual behaviour and vulnerable to
HIV/AIDS. Alcohol consumption and hard drugs were also seen as exposing
people to high-risk behaviour. While some people believe that most people
living with HIV/AIDS contracted it through sexual intercourse, the view of
other people is that contraction of HIV/AIDS is not limited to sexual
intercourse and that people should go for test on regular basis, this is similar to
the findings of Okoror et al. (2016) on heterosexual men. Others believed that
only promiscuous couples contacted STD and HIV/AIDS hence the negative
view of the practice of having multiple sexual partners.
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The above points at respondents’ acceptance of sexual intercourse as a necessity
in marriage and their perception of the risk of HIV/AIDS. It is clear that most
matured humans experience and respond to the need for sex. The measures
taken by respondents when this happens include travelling home to meet their
spouses, taking to scriptural reading, subjecting oneself to fasting and prayer to
take one’s mind away from sex and taking sleeping tablets, while some male
respondents move along with their wives while on transfer. This would imply
that such spouses were not formally employed. While such movement with
wives is taking care of emotional and domestic needs of the husbands, this
affects the stability and education of the children as they change school, friends
and neighborhoods frequently.
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6) Full use must be made of legislation to promote the protection of couples
living with the HIV especially in the work place. Most work places have
negative attitude towards people living with HIV/AIDS and stigmatized
them. They subsequently they lay them off or make the work environment
most unfriendly which forces such people to drop off. An enabling law will
solve help to solve this problem.
7) Policy makers must ensure that couples are empowered to make choices
regarding sexual and reproductive health matters. This includes making
contraceptive service available and affordable (including emergency
contraceptive). Other measures such as forced sterilization or abortion and
ensuring that access to post-abortion facilities is easy where such abortions
are permitted by law.
8) Owing to the dynamic nature of HIV/AIDS pandemic, the role of religions
such as Christianity and Islam in achieving attitudinal and behavioural
change cannot be overemphasised. Therefore, such religions should rise
and embrace the challenge posed by HIV/AIDS pandemic. The religious
organizations, more than ever before should be aggressive in the campaigns
against HIV/AIDS. The religious organizations need to continually train
and re-train religious leaders such as pastors and Imams on the latest facts
about HIV/AIDS.
9) Government through its agencies such as National Agency for Control of
AIDS (NACA). State Agency for Control of AIDS (SACA) and Local
Agency for Control AIDS (LACA) should fund and support the
establishment of HIV/AIDS counselling centres targeted at itinerant
federal workers. This provides affective avenue for reaching sexually
vulnerable staff who are living away from their families.
Given the current and projected levels of HIV infection especially in sub-
Saharan Africa, new approaches and strategies to prevent transmission will be
needed. There is also a need to investigate its impact because sexual
transmission is still the predominant mode of its spread. Preventing the
epidemic’s further spread requires fundamental changes in individual and
community sexual attitudes and practices.
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List of Tables
Table 1: Reproductive Decision, Sexual behaviour and HIV/AIDS Risk
Perception
Statement Mean
We have sex only when we want to have another child 2.82
Sexual intercourse should be regular with the use of contraceptives 3.24
especially condoms except we want another child
Sex is necessary in every marriage 4.06
Couple should make love regularly to prevent unfaithfulness and 3.92
extramarital affairs
The use of condoms and other contraceptives in a marital 3.14
relationship suggest marital mistrust
To make ends meet, some couples engage in extramarital affairs. 3.94
The first law to marital harmony is sexual compatibility 4.22
Couples have differing sexual interests and should respect them 3.58
Not having adequate emotional support from one’s partner could 3.82
make one to look elsewhere for support
Jobs that involved transfer away from home make couples 4.02
vulnerable to HIV/AIDS.
Most people living with HIV/AIDS contract it sexually 2.94
Only promiscuous couples contact STD and HIV/AIDS 2.56
Since HIV/AIDS is not contracted through sexual intercourse 3.42
alone, couple should go for test on regular basis
Having more than one sexual partner is dangerous 3.74
Every sexually active person should undergo STD test every six 3.62
months
Drinking/drugs use exposes one to high-risk behaviours 3.22
Source: Field Survey, 2021
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Table 3: Sex of Subjects and HIV/AIDS Risk Perception
Variables N X SD R Df Crit. t P
Male 100 45.7 5.1 1.25 198 1.98 0.05
Female 100 46.7 6.2
Source: Field Survey, 2021
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