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By Asekun-Olarinmoye IO, *Asekun-Olarinmoye EO, Fatiregun AA and Fawole IO.

Assessment of the Role of Religious Leaders in the Management of HIV/AIDS in Ibadan, Southwestern Nigeria. By Asekun-Olarinmoye IO, *Asekun-Olarinmoye EO, Fatiregun AA and Fawole IO.

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By Asekun-Olarinmoye IO, *Asekun-Olarinmoye EO, Fatiregun AA and Fawole IO.

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  1. Assessment of the Role of Religious Leaders in the Management of HIV/AIDS in Ibadan, Southwestern Nigeria. By Asekun-Olarinmoye IO, *Asekun-Olarinmoye EO, Fatiregun AA and Fawole IO. Department of Epidemiology, Medical Statistics, and Environmental Health, College of Medicine, University of Ibadan, Oyo State, Nigeria *Department of Community Medicine, College of Health Sciences, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State, Nigeria

  2. Background • The HIV/AIDS pandemic is without doubt, one of the greatest health problems challenging science and man and may remain so for a long time (Salako, 2003).] • HIV is the fourth (4th) leading cause of death globally and the leading cause of death in Africa (WHO, 1999) • Worldwide, people aged 15-24 account for about 30% of the total HIV/AIDS count (UNAIDS/WHO, 2001)

  3. Statement of the Problem • The epidemic of HIV continues at alarming rates in Nigeria despite efforts to control it. • Meaningful efforts aimed at combating the scourge must be multi-sectoral. • Despite the high influence religious leaders have in our society, their roles in prevention and care of HIV/AIDS have not been well studied.

  4. Study Justification • Religion is one of the world’s largest institutions • Probably the only institution which bridges the gap of race, class, occupation and nationality. • Dispersed throughout the country, and thereby have the capacity to reach a much larger number of people.

  5. Study Justification 2 Therefore, religious leaders and their institutions can and do provide a good medium of communication to an audience, which is generally respectful and receptive to the teachings/preaching of such leaders.

  6. Objectives: • To assess knowledge, attitudes, perceptions and role of conventional religious leaders in the management and control of HIV/AIDS in Ibadan, Nigeria.

  7. MATERIALS AND METHODS • Study Area: Ibadan, Southwest Nigeria • Study Design: Descriptive, Cross-sectional . • Study tool: Self-administered, semi-structured, pre-tested questionnaire

  8. Sample Size: 336 leaders of eight (8) different religious denominations • Sampling technique: multi-stage, cluster random sampling technique • Inclusion criterion: All adult members of the selected FBOs aged 15 years and above holding any leadership position

  9. RESULTS SOCIO-DEMOGRAPHIC CHARACTERISTICS • The mean age of respondents was 37.9 years + 13.5 • male/female ratio of 2.3:1. • Majority fell into the age group 25-34yrs and >45yrs (30.1% and 30.7%) respectively • Were males (69.9%), married (61.6%), • Had at least post-secondary education (84.6%) and were Christians (72.6%).

  10. Table 1. Respondents’ knowledge, attitude and practice scores about HIV/AIDS.

  11. Respondents’ knowledge score, attitudinal score and practice score about HIV/AIDS • Almost all,(97.6%) were aware of the HIV/AIDS scourge. Most respondents had good knowledge of routes of transmission and modes of prevention (85.7%), good attitude (84.2%) and good practice of preventive measures (94.9%).

  12. A few respondents had misconceptions that kissing, hugging, handshake, mosquito bites, and using the same toilet are routes of transmission of HIV infection.

  13. Table 2: Distribution of Respondents by attitude towards HIV

  14. Table 3: Distribution of Respondents by perception of HIV

  15. Only 10.4% of respondents thought PLWHAs should be isolated from the general congregation of worshippers.

  16. Only 95 (28.3%) respondents had a correct perception of their vulnerability to HIV infection while about half (50.3%) thought that they do not risk ever contracting HIV/AIDS; another 53.6% of respondents believe that HIV/AIDS is a curable disease.

  17. Table 4: Distribution of Respondents according to response on stigmatizing behavior towards PLWHAs

  18. A little over half (56.5%) of the respondents ever preached about health issues relating to HIV/AIDS transmission and treatment to their congregations while 76.5% used their position as a medium of educating their congregation about the dangers of HIV/AIDS. Role played respondents in control of HIV/AIDS amongst congregation

  19. Role played respondents in control of HIV/AIDS amongst congregation contd. • Preventive means mostly advocated include marital faithfulness (95.7%), abstinence for the unmarried (77.8%) and monogamy (61.5%).

  20. Role played respondents in control of HIV/AIDS amongst congregation contd. • 58.3% of respondents’ organizations have programmes currently being run aimed at educating their members on preventive measures against HIV/AIDS. The most commonly used measures are health education talks/seminars, youth forums, and volunteer counseling units by 91.3%, 88.3% and 71.9% respectively.

  21. Measures of dealing with stigmatizing issues in the congregation • Measures of dealing with stigmatizing issues in the congregation included Counseling, visitation and involvement in church activities by 57.2%, 6.3% and 7.2% of respondents while 35.4% of respondents did not have any measures put in place for dealing with such issues.

  22. Distribution of respondents based on scope of their efforts in the control of HIV/AIDS

  23. Scope of respondents activities in HIV prevention and control • The scope/reach of efforts/programmes by the respondents and their organizations:- The programme is limited to local congregation in 145 (43.2%), extended to local community in 70 (20.8%) and interstate in 26 (7.7%) while 94 (28.0%) of respondents and their organizations have no programmes in place.

  24. limited scope of reach • This result shows limited scope of reach. • This may be due to the fact that, as results further revealed, only: • Only 12.5% of the organizations have partnerships with other organizations such as SACA, NACA, ADRA (Adventist Development and Relief Agency), UNICEF, UNAIDS, WHO etc, limited capacity. • Only 102 (30.4%) respondents have programmes running to take care of PLWHAs in their congregations.

  25. Table 5: Distribution of Respondents by type of programmes being run for PLWHAs in congregations

  26. Bivariate analysis showed statistically significant relationship between good attitudinal score and individual role (p<0.05). Multivariate analysis revealed attitude (p=0.000, OR=3.013; p=0.038, OR=1.872) as predictors of both individual and organizational roles.

  27. Relationship between Individual Role (Ever Preach) and Variable Scores • Respondents who have good attitudes are more likely to ever preach about HIV/AIDS issues than those with poor attitudes. This is statistically significant at p = 0.000. Furthermore, respondents with good practice of preventive measures are more likely to preach than those with bad practice, though this is not statistically significant (p= 0.418).

  28. Relationship between Individual Role (Ever Preach) and Variable Scores S – Significant, NS – Not Significant

  29. Logistic Regression Model to test the relationship between Individual Role ‘Ever Preach’ and Attitude Score Logistic Regression Model to test the relationship between Organizational Role and Attitude Score

  30. Respondents with good attitudes were three times more likely to have ever preached about HIV/AIDS/health-related issues from their pulpits. (p = 0.000, OR = 3.013). • Respondents with good attitudes were about two times more likely to have programs aimed at educating their congregations running in their organizations (p = 0.038, OR = 1.872).

  31. Table 22: Logistic Regression Model to assess the relationship between Individual Role ‘Ever preach’ and Socio-demographic variables S – Significant, NS – Not Significant S – Significant, NS – Not Significant

  32. Relationship between Individual Role (Ever Preach) and Socio-demographic variables • The study showed that respondents who were Christians (p = 0.026), had ever married (p = 0.004), and were males (p = 0.002) were more likely to have ever preached about health issues to their congregations.

  33. The study also showed that respondents who had tertiary education were more likely to have ever preached compared to those with primary and secondary education, though this was found not to be statistically significant at p = 0.057. In addition, it shows that respondents within the age group 35-44yrs were more likely to have ever preached. This is statistically significant (p = 0.016).

  34. Predictors of individual role (ever- preached) • After adjusting for the effects of other variables, only gender (p = 0.001, OR = 2.260) and marital status (p = 0.026, OR = 0.495) were found to be statistically significant predictors of individual role in a multiple logistic regression analysis.

  35. This study also found out that respondents who were Christians (p = 0.001), had ever married (p = 0.021), and were males (p = 0.008) were more likely to belong to organizations who had programs running aimed at educating and informing their members on preventive measures against HIV/AIDS.

  36. Logistic Regression Model to examine the relationship between Organizational Role and Socio-demographic variables • Using logistic regression analysis, after adjusting for the effects of other variables, only religion and gender were found to be statistically significant predictors of the organizational role with the role being twice more likely to occur in Christians than Moslems, and in males than in females (p = 0.004, OR = 2.086; p = 0.007, OR = 1.951 respectively).

  37. Logistic Regression Model to examine the relationship between Organizational Role and Socio-demographic variables

  38. Relationship between Organizational Role (Have programs) and Socio-demographic variables

  39. The study found out that Age is a positive predictor of the organizational role (have infrastructure or means to care for PLWHAs), where as the organization grows in age, it is more likely to have infrastructure or means of taking care of PLWHAs (p = 0.113, OR = 1.223).

  40. Conclusions: • The study shows that the religious leaders have high and good knowledge of routes of transmission and mode of prevention of HIV accompanied by good/positive attitudes.

  41. They also performed roles in educating, informing and raising the awareness of their congregations on HIV preventive measures and practices • They can, thus, be used as vital instruments to occupy a pivotal role in the war against the HIV/AIDS scourge in Nigeria.

  42. However, their current role and scope of activities are limited and/or inadequate.

  43. Recommendations • Seminars and workshops should be organized for this target group (Religious leaders) to address areas of misconceptions, inadequate knowledge and lack of skill to handle issues relating to HIV/AIDS among the members of their congregations, if and when affected.

  44. Partnerships should be encouraged between FBOs, governmental and non-governmental agencies to increase capacity building, sustainability and funding to enable FBOs play an even greater and more active role in fight against HIV/AIDS.

  45. Efforts should be made by the government/policy makers to involve more FBOs in the on-going HIV prevention programmes as results from this study show that 28% of the respondents, and their organizations by extension, currently do not have any programmes (educative/preventive) in place for their congregations.

  46. Finally, I recommend that FBOs, on the other hand, develop strong and sound policy statements on HIV/AIDS and that they work increasingly in collaboration with other advocates to bring greater moral urgency to the fight against HIV/AIDS

  47. Thank you for listening!!!

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