Disabled Adolescents’ Access to HIV/AIDS Education in Nigeria TAIWO Modupe, (MPH) Obafemi Awolowo University, Ile-Ife Nigeria

Background Prevalence of HIV/AIDS is highest among young people in Sub-Sahara Africa. Nigeria HIV/AIDS Sero-Prevalence rate is 4.1% in 2010 ( NDHS, 2010 ) and 3.9% ( NACA, 2011 ) Same prevalence figure for Young people including those with disabilities Disabled adolescents are faced with numerous forms of discriminations, exclusion and neglect particularly in provision of HIV/AIDS education, care and support services both in schools and within the communities. Over 12 million people with disabilities in Nigeria, with a large population of young persons ( JONAPWD, 2010)

Background Contd. National HIV/AIDS education curriculum does not take cognizance of information needs of the blind, deaf, mentally Retarded and the physically challenged students either in special or integrated schools.

Study Objective To determine the accessibility of adolescents with physical disability to HIV/AIDS education in view of their exposure to the risks of HIV/AIDS in Southwest, Nigeria.

Methodology 100 physically impaired students from five schools for the handicapped in Osun state, Nigeria surveyed in a cross sectional design in item questionnaire adapted from WHO question bank measured sexual and reproductive knowledge, attitude and practices as determinants of risks of HIV/AIDS. Sample size was determined using z-score calculation from previous similar study from a neighbouring state Simple random sampling technique was used for sample selection SPSS was used for analysis.

Results 1 Mean age of respondents is 16 years, highest class is primary 6. Knowledge of Sexual health and HIV/AIDS prevention and management is very low Less than 40% discuss sexual issues with parents, although 67% discuss other matters with parents Sexual practices vary, 35% engage in unprotected sex 21.2% satisfy sexual desire with any available persons 13.1% engage in masturbation 45% had boy/girl friend with sexual relationship 21.5% has more than one sexual partner at a time

Results 2 Sexual assault by strangers and sometimes carers is common, 45% reported forced sex. Low contraceptive use- 61.9% have never used any contraceptive, only 9.5% have ever used condom Teenage pregnancy is common- 11.9% had been pregnant before with various outcomes Sexual risk reduction is poor, 40% are aware of STI/HIV/AIDS but are less concerned about the infection 92.3% males and 87.6% females exchange sex for gifts

Attendance at classes on Sexuality/ HIV/AIDS Education

Results 3 HIV/AIDS risk reduction behaviour is poor. No access to HIV counseling and testing Positive cases are neglected Never heard about HCT or ART/HAART Sexuality education not thought in school National FLHE curriculum not user friendly for adolescent with disabilities Teachers lack knowledge and skills in providing sexual and HIV/AIDS education sexual health/HIV/AIDS information is mostly sourced from friends

Case study A community man in one of the host communities for the handicapped schools consistently engaged in forced sex with 5 adolescent girls who are mentally retarded and got all of them pregnant at the same time KII from the school head teacher

Conclusion Adolescents with physical disabilities are faced with numerous sexual health challenges without required knowledge and skills to handle the challenges. Teachers and parents are not sufficiently informed to provide required sexuality education to disabled adolescents. No structure/facilities in place for prevention and management of HIV/AIDS despite their vulnerability. Adolescents with disabilities are potential risks for the spread of new HIV infections with the current state of neglect

Recommendation Urgent need to develop disability friendly Sexuality and HIV/AIDS education curriculum and integrate into scheme of work in the schools for the handicapped in Nigeria Parents and teachers require education and training to become resourceful in HIV/AIDS education to students and wards. Peer education is essential to facilitate peer-led HIV/AIDS education Legislations and prosecution against sexual assaults on adolescents with disabilities is crucial Provision of access to HCT and ART for disabled adolescents is important for effective prevention and management of HIV/AIDS

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