Assessment Of Knowledge On HIV Screening Among Students In Girls' Secondary School Abayi, Aba, Abia State, Nigeria

BACKGROUND: Voluntary counseling and testing is a vital element of Human Immunodeficiency Virus (HIV) prevention and care strategies worldwide. It is a test carried out to determine the HIV status of a person. HIV screening enables early detection and initiation of treatment which improves the quality, and life expectancy of a HIV positive individual.

between the ages of 10 and 19 were living with HIV worldwide. 4 Nigeria follows South Africa as having the second largest HIV burden in the world with a prevalence of 4.2%. 5 This prevalence rate differs by region. In the South-South region, the prevalence stands at 5.5% which is the highest compared to other regions, while the South-East region has the lowest with a prevalence of 1.8% 6

IJCRT2308739
International Journal of Creative Research Thoughts (IJCRT) www.ijcrt.org g712 A study among junior secondary school students in the country showed that 21% of them had ever been tested for HIV. 7 The 2008 National demographic Health Survey reported that only seven percent of women and seven percent men had themselves tested and obtained results, in the six geo-political zones of the country, in the twelve months preceding the survey. 8 Some studies have linked HCT (HIV counseling and testing) uptake with people's knowledge of HIV/AIDS transmission and prevention. 7,9 WHO defined an adolescent as a person between ages of 10 and 19. Adolescence is a period of vulnerability with onset of multiple risky behavior with the consequences of an increased risk of engaging in unprotected, multiple sexual experiences and this further exposes the adolescents to HIV/AIDs and other STDs. 7,8,9 The testing rates in West/Central Africa and South Asia were even lower. 10  In a study carried out in Osun State it was found out 67.8% of the respondents correctly reported that HCT was used to screen for HIV/AIDS. 20 This study is intended to provide information for future researchers and also for policy makers who will use it for intervention strategies. Hence this study will be on assessment of adolescents' knowledge on HIV screening among students in Girls' Secondary School Abayi, Aba.

Study Location
This study was conducted in Girls' Secondary School, Abayi. Ossisioma-Ngwa Local Government Area Nigeria is 41,050,000 and 22% of total population. 24 There are 10,648 female adolescents in public secondary

Study Population
The study population was 848 students which was 8% of 10,648 female adolescent students in the LGA. There are 440 students in the Junior secondary School and 408 students in the Senior Secondary School. 24

Inclusion criteria
This included adolescent students in Girls' Secondary School Abayi, OsisiomaNgwa who gave consent for the study.

Exclusion Criteria
This included those students of Girls' secondary Abayi, OsisiomaNgwa, who were not adolescent

Study Design
This was a descriptive cross-sectional study carried out among adolescents in Girls' Secondary School Abayi, OsisiomaNgwa. An interviewer administered questionnaire was used to obtain information from the respondents.

Sample Size Determination
The sample size was determined using the formula 26 With sampling interval of 2, 424 students were selected between 001 and 848.

Data Collection Method
Data was collected in July 2020 by using semi-structured self -administered questionnaires on the participants who had given consent by the research team.

Data Analysis
Data collected were entered into and analyzed using percentage of respondents who scored ≥50% of the knowledge questions of the questionnaire, Poor knowledge signifies number and percentage of respondents who scored <50% of the knowledge questions of the respondents. Chi-Square test was used to test the association between sociodemographic variables and level of knowledge of the participant at statistically significant level of p-value of < 0.05

Ethical approval
Ethical approval for this work was sought for and obtained from the ethics and research committee of Abia State University Teaching Hospital, Aba. Permission was obtained from the school authority of Girls' Secondary School Abayi, Aba and informed consent was obtained from the participants. All information received from our respondents was handled with utmost confidentiality.

RESULTS
A total of 424 students was the sample size in the study with non-response rate of 20 (4.7%) leaving 404 students being the only participants.        Table 4 showed that there was uptake of HIV screening among 57 (14.1%) respondents and these range from those who had once, twice, thrice, equal and more than four time while 347 (85.9%) did not have any uptake of HIV screening. The table 5 shows reasons why most adolescents did not do HIV screening as 178 (44.1%) respondents said that lack of proper awareness was their reason, One hundred and fifty-one (37.4%) respondents thought it was unnecessary, One hundred and twenty five (30.9%) felt that unawareness of screening centre, seventy three (18.0%) said lack of confidentiality, sixty six (16.3%) felt being judged by HIV screening provider, Sixty-two (15.3) respondents accepted that ignorance about HIV screening, fifty-seven (14.1%) said it was health workers' attitude, fifty-six (13.9%) said cost of screening, forty (9.9%) said distance of screening centre.  Table 6 showed the importance of going for HIV screening, three hundred and thirty-two (82.2%) agreed, thirty-seven (9.2%) disagreed while thirty-five respondents (8.6%) were indifferent.  Table 7 shows the association of socio-demographic characteristics and knowledge of HCT: Association of class of the respondents and knowledge HCT was found to be statistically significant with p-values of 0.006 respectively while association of age group, tribe and religion and HCT was not statistically significant with p-values of .237, .599, .180 respectively.

DISCUSSION
The age of the adolescents in this study ranged from 10-  30 National Survey of Adolescents (NSO) 29 and Orlu, Imo State. 28 Similarly, a study conducted in Addis Ababa among high school student stated that 75.7% of the students were aware about voluntary HIV testing and counseling service. 31 However, the level of knowledge in our study was lower than those of USA, Malawi and Addis Ababa This may be due to differences in the level of ignorance and lack of awareness among the respondents in the study groups. There was a high level of awareness of HIV/AIDS (96.9%) in a study in Nasarawa State 37 Nigeria. Previous researches conducted within the country also corroborated this finding. In two national studies, HIV/AIDS awareness was 94 and 91% (nationally) 38,39 and 97 and 95% (in the South West). 40 the fact that people were aware of HIV/AIDS did not translate into correct knowledge of transmission and prevention of the disease.
The above findings and that of our study were inconsistent with the study conducted in Bahir Dar University 29 with 45.7%, Plateau 41 Nigeria with 41.0%, Akwa-Ibom 42 with 9.4%, of the respondents were knowledgeable about HIV/AIDS. 41 The possible reasons for these levels of knowledge may be due to ignorance and lack of awareness.
In this study, 178 (44.1%) of the respondents stated that lack of proper awareness the major reason why adolescent didn't do HIV screening, this finding was different among youths in Kwara state 43 where the cost of VCT was the major reason for hindering factors for VCT. This was also different in Ethiopia 44,45 where AIDS-related stigma and discrimination where the major factors affecting the utilization of HCT services. In a similar study carried out in Osun state, 35.6% of the respondents pointed that the most important reason for not accessing HIV counseling and testing were the perception of being in good health. 41 Also in a study carried out in South Africa in 2012, results showed that respondents aged 16 and older had fear of HIV testing. 33 while in a study carried out in Sydney sexual health clinics, the most commonly reportedly barriers to testing were annoyance at having to return for results (30.2%), not having done anything risky [29.6%], the stress in waiting for results (28.4%), being afraid of testing positive (27.5%), and having tested recently (23.2%). 40,41 In this study association of sex and class of the respondents and knowledge HCT were found to be statistically significant with p-values of 0.008 and 0.006 respect

CONCLUSION
There was a good knowledge of HIV screening among adolescents with a poor uptake of HIV screening among the respondents. The reasons for poor screening uptake among adolescents were lack of awareness on HIV screening and inadequate provision of screening opportunities.
Proper awareness of HIV screening in secondary schools, churches and mosques. and through