CHAPTER ONE

 INTRODUCTION

• Introduction

This chapter comprises of background of the study, statement of the problem, purpose of the study, research questions, general and specific objectives, rational, formulation of research hypotheses, significance of study, scope of the study, definition of variables and operational definition of terms.

• Background of the study.

Adolescents are human beings between the ages of 10 and 19 WHO, 2019. In 2015, this age group accounted for 16% of the world’s population, or 1.2 billion people UNAIDS 2016. Adolescence is a stage of life during which individuals have unique psychological, social, and health needs Adejumo O. A., et al 2015. The rapid physical and hormonal development of this period is sometimes accompanied by a desire for self-discovery, an emerging sense of autonomy, separation from caregivers, and assertion of independence, as well as a search for recognition and acceptance, which can lead to risk behaviors Gardner M., and Steinberg L. 2005. Adolescent sexual risk behavior is a global public health problem Kirby D., et al 2005. Unprotected sex exposes the adolescent to intentional or unintentional trauma, unwanted pregnancy, and sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV) infection WHO, 2019. With regard to HIV infection, UNICEF estimates that approximately 700 adolescents aged 10-19 years are infected with HIV every day, or one infected adolescent every two minutes. Some 360,000 adolescents will die of HIV/AIDS-related illnesses between 2018 and 2030 UNICEF 2019. According to global data, 5.1 million adolescents and the youth lived with HIV worldwide in 2019. In the last 10 years, despite the 46% decline in new infections among adolescents and the youth, per seven new HIV infections, two were among individuals aged 15 to 24 years UNAIDS 2021. The countries which Global AIDS Monitoring accompanied indicated greater vulnerability of this population to infection in sex workers, gays and other men who have sex with men, injectable drug users, transsexual people, and persons deprived of liberty UNAIDS 2021.

HIV (Human Immunodeficiency Virus) is believed to have originated from the Simian Immunodeficiency Virus (SIV) in chimpanzees and other non-human primates in Central Africa Hoang C. L., et al. 2020. The exact timing and mechanism of transmission from animals to humans is unclear, but it’s thought to have occurred through hunting and handling of infected animals. The first reported cases of AIDS (Acquired Immune Deficiency Syndrome) occurred in the early 1980s in the United States, primarily among gay men and injection drug users Hoang C. L., et al. 2020.

HIV is a retrovirus that attacks the body’s immune system, specifically the CD4 cells (T cells). HIV infects and destroys these cells, weakening the immune system and making the body more susceptible to infections and diseases. AIDS is the most advanced stage of HIV infection Judd A., et al 2016. It occurs when the HIV virus has severely damaged the immune system, leading to the development of opportunistic infections and cancers that take advantage of a weakened immune system. It’s essential to note that HIV and AIDS is not the same thing. HIV is the virus that causes AIDS Judd A., et al 2016, and not everyone with HIV will develop AIDS. With proper treatment and care, individuals with HIV can manage their condition and prevent the progression to AIDS. HIV can be transmitted through: Unprotected sex (vaginal, anal, or oral) with an infected person Judd A., et al 2016, Sharing needles or syringes contaminated with infected blood, Mother-to-child transmission during pregnancy, childbirth, or breastfeeding, Blood transfusions from an infected donor (rare in developed countries due to screening) and Occupational exposure (e.g., healthcare workers through needle sticks) Judd A., et al 2016.

Risk Factors for HIV/AIDS include; Unprotected sex engaging in unprotected sex, especially with multiple partners or those with unknown HIV status, Injection drug use: Bryan A. D., et al 2012 sharing needles or syringes contaminated with infected blood, multiple sexual partners: having multiple sexual partners increases the risk of exposure to HIV, STIs: Having other sexually transmitted infections (STIs) can increase the risk of HIV transmission, Blood transfusions: Bryan A. D., et al 2012 receiving blood transfusions from an infected donor (rare in developed countries), and Mother-to-child transmission: Pregnant women with HIV can transmit the virus to their child during pregnancy, childbirth, or breastfeeding Bryan A. D., et al 2012.

They exist four stages of HIV/AIDS with Acute HIV infection Maskew M., et al 2016: The initial stage of HIV infection, characterized by flu-like symptoms followed by Clinical latency: A period of time (often years) during which the virus is present but not causing symptoms next by Symptomatic HIV Maskew M., et al 2016: As the virus progresses, symptoms such as fever, fatigue, and weight loss may occur and lastly by AIDS: The most advanced stage of HIV infection, characterized by severe damage to the immune system and increased susceptibility to opportunistic infection Maskew M., et al 2016. Prevention of HIV/AIDS includes; avoiding unprotected sex or delaying sexual debut, using condoms consistently and correctly during sex, Pre-exposure prophylaxis (PrEP) by taking antiretroviral medication daily to prevent HIV infection Tran B. X., et al 2020, Post-exposure prophylaxis (PEP) by taking antiretroviral medication after potential exposure to HIV to prevent infection Tran B. X., et al 2020, providing access to clean needles and syringes to reduce transmission through injection drug use, encouraging regular HIV testing and providing counseling to those infected, and providing ART to those infected to suppress the virus and prevent transmission Tran B. X., et al 2020.

• Statement of the problem

HIV/AIDS remains a significant public health concern among adolescents in Cameroon, particularly in high-risk areas. Despite efforts to prevent the spread of HIV/AIDS, adolescents continue to be vulnerable to infection due to limited knowledge on the causes, risk factors, and prevention methods. The lack of knowledge on HIV/AIDS among adolescents is a critical issue that requires immediate attention. If left unaddressed, this knowledge gap can lead to increased risk of HIV/AIDS transmission, perpetuating the cycle of infection and affecting the overall health and well-being of adolescents in the community. Therefore, this study aims to assess the knowledge of adolescents on the causes, risk factors, and prevention of HIV/AIDS in fiango, new-lay out community, with the ultimate goal of informing the development of effective interventions to prevent HIV/AIDS transmission among this vulnerable population.

• Research questions

Generally, what are the Knowledge of adolescents on the Causes, Risk Factors, and Prevention of HIV/AIDS in the fiango, new-lay out community? Specifically;

1. What is the level of knowledge on the causes of HIV/AIDS among adolescents in the fiango, new-lay out community?
2. What are the risk factors associated with HIV/AIDS that adolescents in the fiango, new-lay out community are aware of?
3. What is the level of knowledge on the prevention of HIV/AIDS among adolescents in the fiango, new-lay out community?
   • Research objectives

1.5.1General objective

Assessing adolescence knowledge on the causes, risk factors, and prevention of HIV/AIDS in the fiango, new-lay out community.

1.5.2Specific objectives

1. To assess the level of knowledge on the causes of HIV/AIDS among adolescents in the fiango, new-lay out community; the study aims to evaluate the adolescents’ understanding of the modes of HIV transmission and the factors that contribute to the spread of the disease.
2. To identify the risk factors associated with HIV/AIDS that adolescents in the fiango, new-lay out community are aware of; the study seeks to determine the risk factors that adolescents in the fiango, new-lay out community are aware of, including behavioral, biological, and socio-economic factors.
3. To evaluate the knowledge of adolescents in the fiango, new-lay out community on the prevention of HIV/AIDS; the study aims to assess the adolescents’ understanding of the preventive measures against HIV/AIDS, including abstinence, condom use, and voluntary counseling and testing.