KNOWLEDGE AND PRACTICE OF POSITIVE LIVING BY PERSONS LIVING WITH HIV IN IBADAN AND LAGOS NIGERIA.

Abstract

Care and support for people living with HIV (PLWH), their families and communities were until recently neglected components of most HIV/AIDS programmes in Nigeria. Lack of positive living practices aggravates existing problems of inadequate social protection resulting in adverse social and economic consequences. The available treatments are expensive and inaccessible to the vast majority of PLWH, hence the need to be informed of simple but effective positive behaviour to be practised to remain healthy. The objective of the study was to determine the knowledge of PLWH on positive living practices, current healthy practices, factors affecting them and to determine social support. The study was descriptive and cross-sectional in design. Respondents were recruited from PLWH from HIV Government Clinics, Antiretroviral (ARV) Clinics and Non-Governmental Organisations in Ibadan and Lagos. The study instrument was a semi-structured pretested questionnaire. Scales constructed from the questionnaire included an 88-point knowledge score from responses on understanding of positive living with HIV and the importance of its component to the health of PLWH. The researcher with a team of trained interviewers conducted all interviews. Respondents consisted of 103 females and 97 males (51.5% and 48.5% respectively), whose ages ranged from 18 and 53 years (mean-33.58, S .D ±6.907), 50.5% understood positive living to be ability to manage and improve body immunity, followed by having positive attitude (47%), taking balanced nutrition (40.5%), taking ARV drugs (36%) and being hygienic (12%). Knowledge mean score on positive living was significantly higher (p<0.05) among males (29.4) than females (27. 9), among youth (18-24years) (30.9) than older respondents (25-34/35-44years) (28.0) and among educated (29.0) than non-educated (25.0). In respect to current healthy daily practices, 13.5% reported taking balanced diet, (54.5%) 2-4 hours rest, (77.5%) taking ARV drugs and (92.5%) engage in daily hygienic practices (such as hand washing and environmental cleaning). Gender differences in the performance of these activities was significant (p<0 05) only for taking 2-4hours rest, while age was significant (p<0 05) for taking ARV drugs and hygiene practice. Level of education was only significant (p<0.05) for taking balanced diet. Conversely, smoking and alcohol consumption were significantly higher (p<0.05) among males (85.7%) than females (14.3%), and the educated than non-educated. Motivating factors associated with these practices include inner will to survive and improve immunity (34.9%), trainings from PLWH associations (20.5%) and counselors' encouragement (15.6%). Restraining factors were mainly financial problems (47.5%), lack of social supports (11.3%) and negative attitude of health workers (9.7%). As regards social support, only (25%) received emotional support from spouse, (22.9%) socioeconomic support from government and (17%) received care from their communities. In conclusion knowledge of positive living was lower among older PLWH and the women, and healthy practices lower among the youth, while risky practices in respect of smoking and alcohol consumption were higher among males and the educated respondents. Lack of financial and social support seems to hinder effective performance of healthy practices. A health education approach that facilitates resource mobilization and social support is important for improving positive practices of PLWH.