Background: Globally, an estimated 4 million of the 35 million people living with HIV are between the ages of 15 and 24. Nigeria has the second largest burden of HIV worldwide with an estimated 3.2 million individuals living with HIV/AIDS. The prevalence of HIV among adolescents in Nigeria is 3.5%, which is the highest among countries in West and Central Africa. Although insufficient or a complete lack of knowledge about HIV has been identified as a major barrier to HIV prevention efforts, no study has been conducted to evaluate HIV knowledge, identify deficiencies in knowledge, or examine the relationship between HIV knowledge and risky sexual behaviors (RSB) among adolescents in senior secondary school (high school) in Nigeria. Objectives: The purpose of this study was to evaluate HIV knowledge, identify deficiencies in knowledge, and examine the relationship between HIV knowledge and RSB among adolescents in senior secondary schools (high schools) in Nigeria. Patients and Methods: We conducted a cross-sectional survey with a stratified random sample of 361 adolescents from nine senior secondary schools (SS) in Jos Plateau state Nigeria. We used the HIV-KQ-18 survey questionnaire to assess HIV related knowledge and RSB was assessed using the Brief HIV Screener (BHS) questionnaire. Descriptive statistics including mean and standard deviation and multiple linear regression were performed using the SPSS 21. Significance for the statistical test was set at P < 0.05. Results: Overall, 361 participants completed the survey. Forty-seven percent were males and 53% were females with a mean age of 16.9. HIV knowledge (t = -3.3, P < 0.01), age (t = 3.4, P < 0.01) and gender (t = -2.3, P < 0.01) were identified as significant predictors of RSB with female participants having lower RSB scores. An inverse relationship was identified between HIV knowledge and RSB, while a positive relationship existed between RSB and age. Deficiencies in HIV knowledge and misconception about HIV transmission were identified. Conclusions: Adolescents in this study with higher HIV knowledge had low RSB, indicating the importance of including interventions to increase HIV knowledge in HIV prevention programs. Misconceptions about casual means of HIV transmission need to be clarified, and culturally stigmatizing myths about HIV transmission need to be debunked among adolescents in Nigeria.

Background This study examines the factors associated with skilled birth attendants at delivery among married adolescent girls in Nigeria. Methods The study was a secondary data analysis of the fifth round of the Multiple Indicator Cluster Survey conducted between September 2016 and January 2017. Married adolescent girls aged 15–19 y who had live births in the last 2 y preceding the survey were included in the analysis. We performed univariate and multivariate logistic regression analyses with a skilled birth attendant (doctor, nurse or midwife) at delivery as the outcome variable and sociodemographic, male partner- and maternal health-related factors as explanatory variables. Results Of the 789 married adolescent girls, 387 (27% [95% CI=22.8–30.7]) had a skilled birth attendant at delivery. In the adjusted model, adolescent girls who were aged ≥18 y (ref: &lt;18 y), primiparous (ref: multiparous), had antenatal care (ANC) provided by skilled healthcare providers (ref: no ANC), belonged to at least the poor and middle wealth index quintiles (ref: poorest), and resided in the south west zone (ref: north central), independently had a significantly higher likelihood of having a skilled birth attendant at delivery. Conclusions Interventions that will reduce pregnancy in younger adolescent girls, poverty, and increase ANC provided by skilled attendants, are likely to improve deliveries assisted by skilled birth attendants among married adolescent girls in Nigeria.

HIV/AIDS remains a major public health problem despite the efforts to prevent and decrease its spread. Sub-Saharan Africa (SSA) represents 70% of the global number of people living with HIV and 73% of all HIV/AIDS-related deaths. Young adults age 15-24 years are disproportionately impacted by HIV/AIDS in SSA with 34% of people living with HIV (PLWHIV) and 37% of newly diagnosed individuals being in this age group. It is important that PLWHIV be linked to care to facilitate antiretroviral therapy (ART) initiation and limit the spread of infection. We conducted a systematic literature review to identify effective interventions designed to improve linkage to care among HIV-infected young adults in SSA. One hundred and forty-six titles and abstracts were screened, 28 full-texts were reviewed, and 6 articles met the inclusion and exclusion criteria. Home-based HIV counseling and testing, home-based HIV self-testing, and mobile HIV counseling and testing followed by proper referral of HIV-positive patients to HIV care were effective for improving linkage of young adults to care. Other factors such as referral forms, transportation allowance, home initiation of HIV care, and volunteer escort to the HIV treatment clinic were effective in reducing time to linkage to care. There is a vast need for research and interventions that target HIV-positive young adults in SSA which aim to improve their linkage and access to HIV care. The results of this study illustrate effective interventions in improving linkage to care and reducing time to linkage to care of young adults in SSA.

Although improved knowledge is often the first approach in HIV prevention for adolescents, studies have shown that despite being well informed, adolescents still engage in risky sexual behavior (RSB). Low self-esteem has been considered to be a psychological explanation for behavioral problems, but little is known about the impact of self-esteem on RSB among adolescents in Nigeria. The purpose of this study was to determine whether adolescents with high self-esteem demonstrate lower RSB compared to those with low self-esteem. We conducted a cross-sectional survey of 361 adolescents in nine secondary schools in Jos Plateau, Nigeria. The Rosenberg Self Esteem Scale was used to measure self-esteem and the Brief HIV Screener (BHS) was used to measure RSB. All data were analyzed using SPSS 21. Chi square and odds ratios (ORs) were calculated to determine differences in BHS questions based on predetermined low or high self-esteem categories. Independent t-test were utilized to determine difference in mean BHS scores based on self-esteem categories. Participants were 169 male (46.8%) and 192 female (53.2%) with a mean age of 16.9. Mean self-esteem score was 27.6 with no significant difference in self-esteem scores by gender. Adolescents with low self-esteem were 1.7 times more likely to be sexually active and had a higher mean BHS scores compared to adolescents with high self-esteem. Programs aimed at reducing RSB and in-turn HIV/AIDS should consider interventions to raise adolescents’ self-esteem.

HIV/AIDS knowledge has been rated as the most important factor for HIV prevention. However, studies have also shown that knowledge alone does not always translate into reduced risky sexual behavior (RSB). Health locus of control (HLC) categorized as perceived control over health status (internal locus of control) or attribution of health status to chance or fate (external health locus of control) is a psychological construct that has been shown to impact health outcomes including RSB. This study thus investigated the relationship between HLC and RSB among Nigerian adolescents.A cross-sectional survey design was employed among 361 adolescents from nine senior secondary schools selected through stratified random sampling from Jos, Plateau State Nigeria. Data were collected between August and October of 2008. Health Locus of Control Scale was used to categorize individuals into having either an internal or external HLC. RSB was assessed using the Brief HIV Screener (BHS). Descriptive statistics were computed and Mann-Whitney U test was used to determine differences in BHS scores by HLC categories. Odds ratios and adjusted odds ratios were calculated for individual BHS question responses based on HLC.Participants were 169 males (46.8%) and 192 females (53.2%) with a mean age of 16.9. When grouped into HLC categories, 141 were internal and 220 were external. The mean score on the BHS showed statistically significant difference based on HLC (p=0.01). Odds for using a condom during sexual intercourse were higher for adolescents with an internal HLC while adolescents with an external HLC had significantly higher RSB scores. Prevention programs targeted at adolescents should also aim to internalize their HLC.