This quasi-experimental, proof-of-concept study evaluated the effects of an intervention designed to help Nigerian men decrease risk for HIV/sexually transmitted infections and unintended pregnancy. The intervention was delivered in groups during two 5-hour workshops, with a monthly 2-hour check-in session. A comparison condition consisted of a group-based half-day didactic workshop. Based on recruitment area, 149 men were assigned to the intervention and 132 to the comparison. Men were evaluated at baseline and 3-month post-intervention. At follow-up, men assigned to the intervention were almost four times more likely than comparison men to report condom use at last intercourse (P < 0.001) and to report fewer unprotected vaginal sex occasions, greater self-efficacy for negotiation, a more egalitarian power dynamic in their primary relationship, more positive expectations for condom use and greater intention for future consistent condom use (all P values < 0.05). Findings suggest that this intervention is both feasible and effective.
HIV prevalence in the Niger Delta of Nigeria is generally attributed to concurrent sexual partnerships and weak public sector health care and education systems. This paper examines the likelihood of additional factors, such as the intersection of widespread poverty, migration, and sex work, as contributory channels of HIV transmission in the region. To explore this issue, we conducted a Delphi survey with 27 experts to formulate consensus about the impact of poverty, migration, and commercial sex on AIDS in the Niger Delta. Results suggest that these factors and others have exacerbated the epidemic in the region. To stop the further spread of HIV in the region, efforts to address poverty, sex work, and multiple sexual partnerships require building a public-private partnership which involves participatory action strategies among key stakeholders.
The Niger Delta, according to the Nigerian Ministry of Health, has a disproportionately high HIV infection rate, which is double the national average. The United Nations Development Program attributes the spiraling HIV infection rate in the region to poverty, migration and gender inequality. This paper examines two complementary suppositions: Is the high prevalence of HIV in the Niger Delta related to incompetent leadership and corruption? Is it related to the negative effects of oil exploration in the region? Currently, there is a dearth of research on the effectiveness of government programs or the role of the oil industry on the impact of AIDS in Nigeria. To address this gap, we conducted a survey with 27 internationally renowned experts from diverse disciplines using a three-round modified Delphi to formulate consensus about the impact of weak governance and oil corruption on AIDS in the Niger Delta. Results from the Delphi suggest that these factors and others have exacerbated the transmission of HIV in the region. To mitigate the impact of AIDS in the region, efforts to engage oil companies in implementing HIV prevention programs as part of their corporate environmental responsibility to the community are urgently needed.
In most of sub-Saharan Africa, HIV/AIDS is driven by endemic structural problems such as unemployment, poverty, forced migration, sexual exploitation, and concurrent sexual partnerships. In the Niger Delta of Nigeria, the epidemic is exacerbated by recurring regional conflict and negative environmental externalities resulting from 50 years of oil exploration. This article seeks to identify and analyze potential barriers to HIV/AIDS prevention and treatment from oil pollution and other environmental stressors in Nigeria's Niger Delta. We develop a conceptual framework to understand how oil politics and economic systems affect HIV risks in Nigeria. We then evaluate evidence of how environmental exposures can amplify risks. Using 10 semi-structured interviews, with 85 focus group participants, we test the argument that HIV transmission in the Niger Delta is related to a manipulative "divide and rule" power dynamic that characterizes multinational oil companies' role in shaping conflict contours in oil communities. Oil exploration destroys livelihoods, institutions, and values and forces impoverished and illiterate girls and women to migrate or be trafficked to urban centers as child laborers and sex workers. The elevated HIV/AIDS risk in the Niger Delta brings into focus the political economy of resource extraction, globalization, and indigenous, minority rights and struggles.
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