UGWUANYI, JOSEPH NWACHUKWU

PG/Ph.D/09/50584

EFFECT
EFFECTS OF PEER EDUCATION ON AWARENESS AND ATTITUDE
TOWARDS HIV AND AIDS AMONG
IN-SCHOOL
SCHOOL ADOLESCENTS IN NSUKKA

FACULTY OF RDUCATION

DEPARTMENT OF EDUCATIONAL FOUNDATIONS

Digitally Signed by: Content manager’s Name

DN : CN = Webmaster’s name
Fred Attah O= University of Nigeria, Nsukka
OU = Innovation Centre
EFFECTS OF PEER EDUCATION ON AWARENESS
AND ATTITUDE TOWARDS HIV AND AIDS AMONG
IN-SCHOOL ADOLESCENTS IN NSUKKA
EDUCATION ZONE OF ENUGU STATE

BY

UGWUANYI, JOSEPH NWACHUKWU

PG/Ph.D/09/50584

DEPARTMENT OF EDUCATIONAL FOUNDATIONS

(GUIDANCE AND COUNSELLING UNIT)
FACULTY OF EDUCATION
UNIVERSITY OF NIGERIA, NSUKKA

MARCH, 2015
 1

TITLE PAGE

EFFECTS OF PEER EDUCATION ON AWARENESS AND

ATTITUDE TOWARDS HIV AND AIDS AMONG IN-
SCHOOL ADOLESCENTS IN NSUKKA EDUCATION
ZONE OF ENUGU STATE

BY

UGWUANYI, JOSEPH NWACHUKWU

PG/Ph.D/09/50584

A Ph.D THESIS SUBMITTED TO THE DEPARTMENT OF

EDUCATIONAL FOUNDATIONS, UNIVERSITY OF NIGERIA
NSUKKA IN FULFILMENT OF THE REQUIREMENT FOR THE
AWARD OF DOCTOR OF PHILOSOPHY IN EDUCATION
(GUIDANCE AND COUNSELLING)

MARCH, 2015
 2

CERTIFICATION

Ugwuanyi, Joseph Nwachukwu, a postgraduate student in the Department of

Educational Foundations, with registration number PG/Ph.D/09/50584 has

satisfactorily completed the requirements for the award of the Degree of Doctor

of Philosophy in Guidance and Counselling. The work embodied in this thesis

is original and has not been submitted in part or full for any other diploma or

degree of this or any other university.

--------------------------------------- ---------------------------------
Ugwuanyi, J.N. Assoc. Prof. J.C. Omeje
Student Supervisor
 3

APPROVAL PAGE

This thesis has been approved for the Department of Educational

Foundations, Faculty of Education, University of Nigeria, Nsukka.

BY

------------------------------ -------------------------------
Assoc. Prof. J.C. Omeje Prof. C.J.A. Onwuka
Supervisor Head of Department

------------------------------ -------------------------------
Internal Examiner External Examiner

------------------------------
Prof. Uju Umo
Dean of Faculty
 4

DEDICATION

This work is dedicated to my late parents, Mr. Bernard Ugwuanyi and

Mrs Regina Ugwuanyi who nurtured me.

 5

ACKNOWLEDGMENTS

The researcher wishes to acknowledge with unquantifiable gratitude, the

invaluable contributions of the following personalities in making this research

project worthy and meaningful. Research of this magnitude could not have been

possible but for the great assistance received from many sources and experts at

various stages of this work. The researcher’s indebtedness goes primarily to the

project Supervisor, Assoc. Prof. J.C. Omeje for the constructive guidance,

criticisms and thorough supervision towards bringing this work to a successful

completion Assoc. Prof. Omeje is not just a supervisor but a mentor and

motivator whose humble disposition and open door are beyond human

imagination. Infact his encouragement and prodding sustained the tempo in

bringing this work to its logical conclusion. The researcher will ever remain

grateful to him.

The researcher’s immense gratitude also goes to the following experts

that embellished the work in terms of face validation of: Prof. I.C.S, Ifelunni,

Prof. A. Ali, and Prof. U.N. Eze. The researcher highly appreciates Dr. V.

Nwachukwu for his input as the design reader during the proposal stage of the

work. Also worthy of appreciation are Prof. P.N. Onwuasoanya, Prof. (Mrs)

J.O. Chukwu, Dr. A.U.. Okere, Dr. A.N. Okolo Dr. D.U. Ngwoke, and Dr.

M.A. Obidoa who are lecturers in the Department of Educational Foundations,

University of Nigeria Nsukka for the invaluable contributions in terms of

editorial work. The researcher appreciates Rev. Dr. Lambert Ejionueme for his

constant advice and useful suggestions during this work and Prof. D.N. Eze for
 6

putting his resources and facilities at the researcher’s disposal at the stages of

literature review and data collection.

Furthermore, the researcher is highly grateful to Bishop Emeritus Most

Rev. Dr. F.E.O. Okobo who initiated this study and the New Bishop of Nsukka

Catholic Diocese Most Rev. Prof. G. I. Onah for their care and fatherly concern

in the researcher’s educational journey up to this level. Special gratitude goes

next to the researcher’s family whose prayerful support to the success has been

a great source of encouragement and strength to reach this level. The family

members are brother A. Azegba and Rev. Fr. C.Y Okpe and Sr. N. Omeje for

providing him with comfort during this highly stressful and strainous academic

journey. The researcher’s immense gratitude goes to E. Ugwu, for the pains

taken in typing and retyping this work.

Finally, the researcher is aware of the omission of the names of several

individuals who have contributed to the success of this work. So, to all who has

been quite sincerely involved in my life, hopes and aspirations and who make

this work a success I say thank you immensely.

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TABLE OF CONTENTS
CONTENT PAGES
TITLE PAGE I
CERTIFICATION II
APPROVAL PAGE III
DEDICATION IV
ACKNOWLEDGMENT V
TABLE OF CONTENTS VII
LIST OF TABLES X
LIST OF FIGURES XI
ABSTRACT XII

CHAPTER ONE: INTRODUCTION

Background of the Study 1
Statement of the Problem 11
Purpose of the Study 12
Significance of the Study 13
Scope of the Study 15
Research Questions 15
Hypotheses 16
CHAPTER TWO: REVIEW OF LITERATURE
Conceptual Framework 18
Concept of peer education 18
Concept of awareness 20
Concept of attitude 20
Concept of HIV and AIDS 22
Concept of adolescence 24
Concept of gender 26
Conceptual relationship 27
 8

Theoretical Framework 28
The social cognitive theory by Bandura 1977 28
Health belief model by Rosenstock et al 1950 30
Aids risk reduction model by Catania 1990 31
Theory of reasoned action by Fishbein and Ajzen 1975 32
Self perception theory of attitude by Bem 1967 34
Review of empirical studies 35
Studies on HIV and AIDS 35
Studies on awareness and attitude towards HIV/AIDS 38
Summary of Literature Reviewed 40

CHAPTER THREE: RESEARCH METHOD

Design of the study 42
Area of the Study 43
Population of the study 43
Sample and sampling techniques 43
Instrument for data collection 44
Validation of the instrument 45
Reliability of the instrument 45
Experimental Procedure 46
Treatment Procedure 47
Developing the instructional programme 48
Control of extraneous variable 49
Method of data collection 50
Method of data analysis 50
CHAPTER FOUR: RESULTS
Data analysis and presentation of data 52
Summary of findings 61
 9

CHAPTER FIVE: DISCUSSION OF RESULTS, CONCLUSION,

IMPLICATIONS, RECOMMENDATIONS AND
SUMMARY OF THE STUDY
Discussion of results 62
Conclusion 69
Educational implications of the findings 69
Recommendations 71
Limitations of the study 72
Suggestions for further studies 72
Summary of the study 73
REFERENCES 75
APPENDICES
Appendix A The Detail of Treatment Packages 79
Appendix B: Instrument 82
Appendix D: Reliability 85
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LIST OF TABLES
Table Page

1 Mean scores and standard deviation of students in the experimental

and control groups in pre-test and post-test (Awareness) ---- 52

2 Two-way ANCOVA result on students’ post mean score in

awareness of HIV and AIDS ------------------------------------ 54

3 Pre-test post-test mean scores and standard deviation

of gender differences on students’ awareness towards
HIV and AIDS ----------------------------------------------------- 55

4 Two-way ANCOVA Result on students’ post-awareness scores

towards HIV and AIDS -------------------------------------------- 56

5 Pretest-posttest means scores and standard deviation of

the effect of peer education on students’ attitude towards
HIV and AIDS ----------------------------------------------------- 57

6 Summary of analysis of covariance (ANCOVA) on students

post-test mean score on attitude towards HIV and AIDS --- 58

7 Pretest post-test mean scores and standard deviation

of gender differences on students’ attitude towards HIV and AIDS
when exposed to peer education --------------------------------- 58

8 Two-way ANCOVA Result on influence of gender on

students’ attitude towards HIV and AIDS ------------------- 59

9 Posttest awareness Mean achievement scores and standard

deviation of the interaction effect of gender and peer education
on students’ awareness towards HIV and AIDS ------------- 59

10 Posttest Attitude Mean achievement score and standard deviation

of the interaction effect of gender and peer education on
students’ attitude towards HIV and AIDS ------------------ 59
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LIST OF FIGURES
Figure Page

1 Conceptual Relationship of the Variables ------------------------- 27

(Cognitive, affective, and biological events)

2 Reciprocal relationships as proposed by ------------------------- 29

Bandura (1977) (http:llwww.let.uu.nl.)
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ABSTRACT

This study was designed to determine the effects of peer education on

awareness and attitude towards HIV and AIDs among in- school adolescents in
Enugu State. To guide this study, six research questions were posed and six null
hypotheses formulated and tested at 0.05 level of significance. The research
design used in this study was non-equivalent control group Quasi-Experimental
involving experimental treatment group and a control group. The sample for the
study was made up of 231 students in SSII. A random sampling technique was
used to draw two co-educational schools from each of the local government
areas and they were randomly assigned to both experimental and control
groups. Three trained research assistants were used for the experiment while the
control group was not exposed to any treatment. A 20-item researcher designed
questionnaire titled HIV and AIDS Awareness and Attitude Questionnaire
(HAAAQ) was used for the study. The reliability of the instrument was
determined using Cronbach Alpha statistic which yielded Alpha co-efficient
values of 0.80 and 0.79 for the two clusters. Measures were taken to control the
extraneous variables. A pretest of the questionnaire was administered before the
treatment on peer education that lasted for six weeks. The data collected were
analysed using Mean, and Analysis of Covariance.(ANCOVA) The Results
revealed that: students exposed to treatment on peer education have higher
awareness of HIV and AIDS when compared to those of the control group;
gender is not a significant factor influencing students awareness towards HIV
and AIDS, students exposed to treatment on peer education have a higher
positive attitude towards HIV and AIDS compared to those of the control.
Furthermore, gender does not significantly influence students’ attitude towards
HIV and AIDS. Also, there is no interaction effect of gender and peer education
on students’ awareness as well as attitude towards HIV and AIDS. It was
recommended among others that school authorities should integrate play
method in the teaching of sexuality issues as this will create room for students
to utilize peer approach in learning; while federal and state ministries of
Education should organize and sponsor workshops and seminars for school
guidance counselors on how to implement peer education on awareness and
attitude towards HIV and AIDS among in-school adolescents.
 1

CHAPTER ONE

INTRODUCTION

Background of the Study

Adolescence period is characterized by emotional, intellectual,

physical, social and sexual changes and the individual is faced with various

challenges. Adolescence according to Conger, Kegan and Mussen (2004) is a

period of transition between childhood and adulthood. It is considered to last

from ages 10 to 19 and from puberty to full biological /physiological

maturation. Within this time frame, adolescents are affected by various

developmental transformations including physical, emotional, and social

changes. With these changes come many responsibilities and privileges that are

different from those of childhood or full adulthood, and these aspects ultimately

define the period of adolescence.

The word adolescence has it’s origin and meaning from Latin

perspective. In Latin, it implies “to grow into maturity” (Eke, 1989). The author

further noted that the common denominator in all adolescents experiences,

irrespective of cultural variations, is the biological change from childhood into

mature adult status capable of reproduction. According to Eke, during this

period, remarkable physical changes take place. Boys and girls experience a

spurt in growth. A sharp increase in height for girls at the ages of 11 and 13 and

in boys between 13 and 15. There is the presence of growth spurt which leads to

the development of primary and secondary sex characteristics. Nworah, (2004)

has it that adolescence is a period of rapid transitional or developmental

1
 2

changes from childhood to adulthood. It is a period when the physical and

physiological change that accompany the transition from childhood to

adulthood become manifest and continues into adulthood. Adolescence as noted

by Unachukwu and Ebenebe (2009) cover the age of 12 or 13 till the early

twenties. They pointed out that in Nigeria, variations exist which may be longer

or shorter than the above stipulated age range depending on the tradition or the

modern outlook of those involved. In the view of Eze (2005), adolescence is a

period or stage of life when an individual gradually moves from childhood to

adulthood. It is a period of muratorium when the individual is in a state of

abeyance, and so requires proper handling to avoid creating conflict since the

individual is no longer regarded as a child, yet the individual is not accepted

into full adult life. This is a period when individuals tend to adapt themselves to

changing influences in their environment.

The adolescent’s environment constitutes to a large extent certain

behavioural and health challenges. For instance, adolescents who live in

densely populated areas are more prone to risky behavior as a result of exposure

to a wide range different characters and backgrounds of the peer group.

Besides, the presence of rapid hormonal development put them into a lot of

exuberant behaviours. The period is characterized by sexual experimentation

which is as a result of their physical changes or sexual maturation. Ngwoke and

Eze (2004) pointed out that sexual experimentation, which is the physical

readiness, is widely distanced from psychological readiness. In other words, the

ability to copulate may not mean knowledge of sexual functions and

 3

reproduction. The upsurge of hormones during adolescents and its effect on

their sexuality makes the adolescent easily sexually aroused, and being young,

some of them get involved in sexual activities without taking necessary

precautions. This may be the reason why there has been a consistent increase in

prevalence of Human Immunodeficiency Virus (HIV) and Acquired Immune-

Deficiency Syndrome (AIDS) (Akanwa 2008). Generally, the adolescents’

sexual behaviour increases their vulnerability to sexual infections and diseases

including HIV and AIDS.

HIV stands for Human Immunodeficiency Virus and it affects only

human beings. It attacks the human immune system, the body’s defence against

invading diseases. It damages the immune system by systematically destroying

an important type of white blood cell, CD4 cells or T4 cells (Williams, 2000).

On the other hand, AIDS (Acquired Immune Deficiency Syndrome) is a term

not often used by doctors today. They rather prefer to talk of advance or late

HIV infection based on the outcome of damage to the immune system by HIV.

When the body is severely weakened by HIV, it can be attacked by a number of

serious conditions which is then referred to as AIDS (Kawanza, 1999).

The Human Immunodeficiency Virus and Acquired Immune-deficiency

Syndrome (HIV and AIDS) pandemic is one of the greatest humanitarian and

developmental challenges facing the global community in recent times (Lloyd,

2004; MAP Report, 2004;& Osagbemi, Joseph, Adepetu, Nyong and Jegede,

2007). HIV and AIDS have brought unquantifiable suffering, confusion,

dejection, uncertainty and hopelessness to humanity (Adekeye, 2005, 2009).

 4

The epidemiological survey of 2003 showed that an estimate of 3, 300, 000

adults were living with HIV and AIDS in Nigeria and 57% of this were women

(Avert, 2007). The prevalence rates among the young people between the ages

of 20 and 24 were 5.6%. In 2005, there were about 220, 000 deaths from AIDS

and 930, 000 orphans living in Nigeria (Avert, 2007). Over 60% new infections

with HIV are within the 15-25 year old age group or adolescents (Gunfire,

2005). In recent years, there had been an alarming increase in the number of

HIV positive children and 90% of these children contracted the virus from their

mothers. Apart from mother- child transmission, most of HIV and AIDS

patients contact the disease though sexual intercourse, and may be other

sexually related behaviours.

Sexual behaviour among youths has over the years become an issue of

great concern particularly with the upsurge of the HIV and AIDS Pandemics.

According to UNAID (2003), an increasing number of youths within the age of

15-25 years have continued to be infected with HIV. As reported by National

AIDs Reproductive Health Survey (NARHS) (2003), youths are more

vulnerable to sexual infection because of their age, gender and sexual

orientations. UNAID (2003) reported that half of the entire world population

whose ages are between 15-25 years are among the most vulnerable to HIV and

AIDS infections. Awareness campaigns, lectures, seminars, rallies in schools

have been organized to attract the attention of youths. In some States, teachers

have been trained to carry out HIV and AIDS programmes. Civil society

organizations and the private sector organizations have directly or indirectly

 5

contributed to the overall attempt to reduce the spread of HIV and AIDS. The

process and aim of provision of information and education is to make youths

perceive issues relating to HIV and AIDS, adopting the perception of their

vulnerability to HIV and AIDS and develop positive attitude to sex. However,

inspite of current efforts by governmental non-governmental organizations, and

educational institutions, it seems that youths have not developed positive

attitude to sex because many youths still express sexual intimacy which could

carry the risk of transmission of HIV. Such may be in areas of casual sex,

multiple sex, anal sex, covert and open prostitution. In other words, the attitudes

of adolescents toward the dreaded HIV and AIDS is unencouraging. This

implies that they may not be aware of the implication of their sexual behavior

especially in relation to the contact of HIV and AIDS.

The inability of youths to control their sexual appetite, and the negative

comments made by them about HIV and AIDS have been the major source of

concern to the researcher. Youths have been reported in studies Kemiodu and

Akanle (2006) and Olawale (2001) to express negative belief and knowledge

which reflect on their attitude towards HIV and AIDS. Attitude is seen as a

mental predisposition held towards ideas, objects or person. It is a combination

of beliefs, feelings and evaluation and some predisposition to act in one way or

the other. As noted by Agbaegbu (1997), attitudes are hypothetical constructs

used in explaining consistencies in affective reaction. The scholar opined that

the zeal or enthusiasm to move into science and succeed creditably in science

subjects is dependent on the attitude of the person towards science. This implies
 6

that an attitude is a mental predisposition held towards ideas, objects or persons.

Rosenberg and Hovland in Omeje (2007) defined attitude as a predisposition to

respond in a particular way towards a specific class of objects. The scholars

maintained that attitude is made up of three components-affective, cognition

and behaviour. Affective is a component of attitude used to refer to emotion and

feeling. Cognition refers to mental processes by which information is acquired,

analyzed and synthesized while behaviour refers to any response or action of an

organism to its feelings. Operationally, attitude is a favourable or unfavourable

evaluation of something which generally in the positive or negative views of a

person about place, a thing or an event. In the context of this study, it is

adolescents relatively enduring way of thinking, feeling or behaving towards

HIV and AIDS.

Presently, the attitude of adolescents towards HIV and AIDS is that of “it

doesn’t concern me” or “man must die of something someday”. Many studies

had been carried out in Nigeria on the knowledge of adolescents about HIV and

AIDS. For instance, Odujinrin and Akinkuade (1999) found that the adolescents

have poor knowledge of HIV and AIDS, while Harding, Anadu, Gray and

Champeau (1999) indicated that their respondents were knowledgeable about

transmission of HIV but had some misconceptions about the mode of

transmission which affect their attitude. There are no consensuses on the group

of adolescents whether male or female that have favourable or unfavourable

attitude towards HIV and AIDS. Onoja (2004) studied gender influence on the

level of awareness of HIV and AIDS among adolescents in Otukpo, Benue

 7

State, and came up with the conclusion that the females’ level of awareness is

more than that of the males. This, according to the author, may be due to time

given to them in enlightening them on safe health method. Eze (2006) revealed

in her study on strategies for empowering in school female adolescents against

sexual behaviour related to HIV and AIDS Transmission in Enugu State that

male adolescents are more aware of the existing phenomena than the females.

This present study will try to clarify the controversy of issue of gender on

awareness and attitude.

In Nigeria, there is no formal HIV and AIDS education in the school

curriculum; the main strategies for empowerment used are mass media

campaigns and condom promotion. More often than not these are merely

superficial panaceas that have little effect on the infection prevalence. In the

same vein, in Enugu State, there is no strategy that is exclusively directed

towards HIV and AIDS prevention among secondary school students. Whatever

awareness or skill they have, they acquired through televisions and radios for

those who have access to them. With the epileptic power supply, the maximum

benefits from the use of mass media, as a medium for HIV educational

prevention strategy is greatly hampered. As a result of the above, the

adolescents might be depending greatly on the views of their peers. Their

knowledge level and awareness are would be enhanced through peer education.

Education generally gives the beneficiary opportunity for informed or

reasoned actions and the upliftment of personal welfare. Therefore, by

educating an individual, one acquires desirable knowledge, understanding,

 8

skills, interest, attitude and critical thinking. In any case, education seeks to

develop the innate capacities of man. Peer education means “to lead forth” or

“to come out” and take decisions about themselves being free from bias,

prejudices, superstitions and blind beliefs. Thus, they have to learn all the

qualities of complex human relations, the cause and effect relationships as

equipment for survival strategy (Onoja, 2004).

Essentially, peer education provides veritable intervention strategy

through which members of peer group positively or negatively influence the

thoughts, actions, inclinations and aspirations of individuals of close age group.

In many cases, peer education may be used to effect positive changes at the

group level for social transformation through modifying behaviours, norms and

stimulating collective actions to improve welfare and health conditions of peer

group. Green (2001) perceived peer education as an approach to health

promotion in which community members are supported to encourage health

enhancing changes among peers. Cornish and Campbell (2009) posited that

peer education is a voluntary counseling and information support service

rendered by one or a group towards helping another to imbibe positive attitude

and behaviour over an issue of collective concern . In a similar vein, Boyle

(2011) sees peer education as an encouragement or advice from members of a

peer group to effect positive behavioural outcome on issues of common interest

or threats by doing or not doing a particular thing even if one personally wants

it. In essence, peer education approach to health matters is the teaching or

sharing health information, values and behaviour among members of a peer

 9

group who may share similar views, social backgrounds or life experiences.

The idea is that, rather than health professionals educating members of the

public, peer educators are in the best position to encourage healthy behaviour of

one another.

Peer education has become very popular in the broad field of HIV

prevention. It appears to be a potent mechanism for HIV and AIDs prevention

and control among vulnerable groups including adolescents, sex workers,

people who often use intravenous drugs and men who have unprotected sex

with men and all those involved in unsafe casual sex. In secondary schools,

peer educators are role models of young adolescents leading healthy behaviours

and helping to create and reinforce social norms that support safer behaviours

inside and outside classrooms (Mattern, 2010). Peer educators are typically the

same age or slightly older than the group with whom they are working with.

Peer education gives adolescents legitimacy to talk about sex without the risk of

being stigmatized as sexually promiscuous which the adolescents are mostly

characterized with doing this developmental period.

Adolescents can learn a great deal through joint effort and

communication with peers. However, little is known about how peer education

affects their awareness and attitudes most especially as they relate to HIV and

AIDS. Peer education is a situation whereby pupils learn from each other as

they act as teachers and co-learners. In peer education, a pair of relatively

novices work together to solve task that neither of them could do previously. In

this approach, they begin at roughly the same level of competence and learn
 10

from each other (Ames & Murray, 2012). Peer education can be seen as a

developmental process occurring in social activities through interaction. It

stimulates the challenges of discovery learning by placing these challenges in a

context of peer assistance and support (Obah 1992).

In a survey of peer effects on adolescent girls’ sexual debut and

pregnancy risk among 3015 sexual active girls in America, Bearman and

Bruckner (2008) found that peer education among adolescents is a significant

factor that influence their sexual behavour and that peer influence operates at

multiple level of peer context and the level of social scientists have spent the

most time on-best friends-is the least important. Much more important

influences arise from the network of close friends and the larger group in which

adolescents are embedded. Liu, Kilmarx, Jenkins, Manopiabon, Mock,

Jeeyapunt, Uthaivrauit and Van Griensven (2006) found that peer education

was a significant factor for males for whom the presence of a close friend as a

confidant was associated with earlier sexual initiation. They concluded that peer

group exerts a great deal of influence over the young male’s sexual experience

and exploration. The question now is whether peer education has any effect on

adolescents awareness and attitude towards HIV and AIDS. Based on the fact

that adolescents learn a lot from their peers as they discuss their romantic

interest and experiences with friends, consider and construct sexual roles,

interpret the meaning of the roles and make decisions regarding their

acceptability, could their awareness and attitude to HIV and AIDS be affected

by peer education in Enugu State.

 11

In Enugu State, most adolescents behaviour increases their vulnerability

to HIV and AIDS. Lacking the judgment that comes with experience,

adolescents often cannot appreciate the adverse consequence of their actions.

The risks of HIV and AIDS may be particularly hard for them to grasp. Hence,

the need to determine the effect of peer education on adolescents awareness and

attitude towards HIV and AIDS.

Statement of the Problem

Adolescence is a period when individuals become socially responsible

for themselves and for their actions. At this stage, they are affected by various

developmental transformations including physical, emotional and social

changes. With these changes come many responsibilities and privileges that are

different from those of childhood or adulthood as they try to discovery by

themselves against the wish of the adult. This experimentation subjects them to

risky sexual behaviour that may expose them to HIV and AIDS. Generally their

risky behaviour increases their vulnerability to HIV and AIDS. Lacking the

judgment that comes with experience, adolescents often cannot appreciate the

adverse consequences of their actions. The risks of HIV and AIDS may be

particularly hard for them to grasp.

The adolescents are usually in different levels of schools such as

secondary schools and tertiary institution. However in Nigeria, there is no

formal HIV and AIDS education in the school curriculum. The main strategies

for creating awareness about the dreaded disease are mass media campaigns

and condom promotion. In Enugu State, there is no strategy also that is

 12

exclusively directed towards HIV and AIDS prevention among secondary

school adolescents. This therefore makes them to rely on peer education

information as a source of empowerment.

Although adolescents learn a lot through peer group influence their

awareness level as well as their attitude to HIV and AIDS is influence by their

relationship with peers but is not yet known. It is on this background that the

present study is focused on determining what is the effect of peer education on

awareness and attitude of adolescents towards HIV and AIDS in Enugu State,

Nigeria.

Purpose of the Study

The major purpose of the study is to determine the effect of peer

education on awareness and attitude towards HIV and AIDS among adolescents

in Enugu State. Specifically, the study sought to:

1. Find out the effect of peer education on in-school adolescents’ awareness

of HIV and AIDS in Enugu State.

2. Determine gender differences in the effect of peer education on the

adolescents’ awareness towards HIV and AIDS.

3. Determine the effect of peer education on in-school adolescents’ attitude

towards HIV and AIDS

4. Find out the gender differences in the effect of peer education on the

attitudes of adolescents towards HIV and AIDS

5. Determine the interaction effect of gender and peer education on in-

school adolescents’ awareness of HIV and AIDS in Enugu State.

 13

6. Determine the interaction effect of gender and peer education on

students’ attitude towards HIV and AIDS in Enugu State.

Significance of the Study

This study hopefully would be significant both theoretically and

practically. Theoretically, the study is hinged on Health Belief model which

hypothesizes that an individual will not make the decision to undertake a health

action aimed at avoiding a specific disease threat unless he or she is

psychologically ready to act. Readiness to act is brought about by the person’s

perception of his or her susceptibility to the health threat, and the perceived

severity of the threat among others. The findings would help to explicate the

functionality of the theory on adolescents’ awareness and attitudes towards HIV

and AIDS through peer education.

Practically, the findings of this study would be useful to policy makers,

counsellors, adolescents, curriculum planners, researchers and the society at

large. This study will furnish counsellors as well as adolescent psychologists

with essential information on the effect of peer education on adolescent

awareness and attitudes towards HIV and AIDS. It will also make available to

them empirical information on interaction effect of gender and peer education

on adolescent awareness and attitude towards HIV and AIDS. These data

provided will enable counselors and psychologists to carry out more research

that will help in better understanding of adolescents’ awareness and attitudes

toward HIV and AIDS. An understanding of the finding would further assist

the counselors on how to guide adolescent to get aware of HIV and AIDS
 14

towards the virus and disease. The study would help policy makers to see the

need for fashioning out a means of empowering the adolescent with the

knowledge of HIV and AIDS as they are at the risk of being infected with the

dreaded disease if not well informed. The Government will be aptly armed with

the useful information from this research to form more effective broad-based

HIV and AIDS policies that will impact positively on the HIV and AIDS

awareness programmes. This would help in making the adolescents to acquire a

positive attitude towards HIV and AIDS. Through the policies, government

would assist school to manage adolescent to gain from peer education and

influence.

The adolescents themselves harnessing the findings of this study will

deepen their appreciation of the need for self awareness, self-confidence,

strengths and weakness in the face of HIV and AIDS. Based on this they will be

in a position to fashion positive attitudes toward HIV and AIDS.

The findings will enable curriculum planners to perceive the need to

integrate HIV and AIDS awareness programme on school curriculum. This

equally will enhance the use of peer education to increase the awareness level

of adolescents and appropriate attitudes towards HIV and AIDS. Finally, the

findings of this study will be of help to prospective researchers in the field of

education and sexuality education, they will become aware of adolescents

awareness level as well as attitudes towards HIV and AIDS and can get more

facts that will help them in developing their research works.

 15

Scope of the Study

This study is delimited to in-school adolescents in state owned co-

educational secondary schools in Nsukka Education Zone of Enugu State.

Specifically, the study covered students in senior secondary II (SS II) to

determine the effect of peer education on their awareness and attitude towards

HIV and AIDS. The study was finally looked at the interaction effect of gender

and peer education on awareness and attitude of adolescents towards HIV and

AIDS education.

Research Question

The following research questions guided the study.

1. What is the effect of peer education on in-school adolescents’ awareness

towards HIV and AIDS in Enugu State when compared with the

control?

2. What is gender differences in the effect of peer education on the

adolescents’ awareness towards HIV and AIDS?

3. What is the effect of peer education on in-school adolescents’ attitude

towards HIV and AIDS in Enugu State when compared with the

control?

4. What is the gender difference in the effect of peer education on the

attitudes of adolescents towards HIV and AIDS?

 16

Hypotheses

The following null hypotheses were postulated and tested at p<0.05 level

of significance

Ho1: There is no significant difference in the mean scores of in-school

adolescents exposed to peer education and those exposed to conventional

counseling on their awareness towards HIV and AIDS.

Ho2: There is significant difference in the scores of male and female

adolescents exposed to peer education on their awareness towards HIV

and AIDS.

Ho3: There is no significant difference in the mean scores of in–school

adolescent exposed to peer education and those exposed to conventional

counseling on their attitudes towards HIV and AIDS.

Ho4: There is no significant difference in the mean scores of male and female

adolescents exposed to peer education on their attitude towards HIV and

AIDS

Ho5: There is no significant interaction effect between gender and peer

education on adolescent awareness towards HIV and AIDS.

Ho6: There is no significant interaction effect between gender and peer

education on adolescents’ attitude towards HIV and AIDS.

 17

CHAPTER TWO

REVIEW OF LITERATURE

This chapter deals with the review of literature related to the present

study. The review is presented under the following sub-headings:-

Conceptual Framework

- Concept of Peer Education

- Concept of Awareness

- Concept of Attitude

- Concept of HIV and AIDS

- Concept of Adolescent

- Concept of Gender

Theoretical Framework

- Social cognitive learning theory by Bandura (1977)

- Health Belief model by Rosenstock et al (1950)

- AIDS Risk Reduction Model by Catania (1990)

- Theory of Reasoned Action by Fishbein and Ajzen (1975)

- Self perception theory of Attitude – Bem (1967)

Review of Empirical Studies

- Gender and attitude towards HIV/AIDS

- Awareness and attitude towards HIV/AIDS

- Peer Education and Sexual Behaviour

Summary of Literature Review

17
 18

Conceptual Framework

This section will review concepts of adolescence, HIV, AIDS, Peer

education, awareness and attitude.

Concept of Peer Education

Peer education is a popular concept that implies an approach, a

communication channel, a methodology, a philosophy, and a strategy. The

English term ‘peer’ refers to “one that is equal standing with another; one

belonging to the same societal group especially based on age grade or status”,

“training”, or “persuasion” of a given person or thing, or the “knowledge”

resulting from the educational process (Webster, 1985)

In practice, peer education has taken on a range of definitions and

interpretations concerning who is a peer and what is education example

advocacy, counseling facilitating discussions, drama. Lecturing, distributing

materials, making referrals to services, providing support etc (Flanagan &

Mahler 1996, Shoe maker, Gordon, Hutchins & Rom 1998;). Peer education

typically involves the use of members of a given group to effect change among

other members of the same group. Peer education is often used to effect change

at the individual level by attempting to modify a person’s knowledge, attitudes,

beliefs, or behaviours. However, peer education may also effect change at the

group or societal level by modifying norms and stimulating collective action

that leads to changes in programmes and policies.

Peer education typically involves training and supporting members of a

given group to effect change among members of the same group. Peer
 19

education is often used to effect changes in knowledge, attitudes, beliefs and

behaviours at the individual level. Odeh and Dayo (2006) perceived peer

education as a voluntary programme where young people are trained as

volunteers to provide information, education services and help the young

people with the view to influence them to imbibe positive sexual and sexual

behaviour. This implies there shall abound two parties the teacher and the

taught that will be of the same age. Teachers amongst peers are referred to as

peer educators. The authors further noted that peer educator is a trained

adolescent or young person who has successfully completed the peer education

training programme and has developed the necessary skills to lead his or her

peers.

During adolescence, teens desire to belong to the peer groups. Some

youth willingly conform to the ways of a specific peer group while others are

pressured into the group norm through peer education. Peer education can be

defined as when people of your own age encourage you to do something or to

keep from doing something else, no matter if you personally want to or not

(Santor 2000). Whereas, conformity is defined as changing one’s behaviour to

fit into a group or develop popularity.

In the context of this study peer education will be taken to be a process

where students of equal standing volunteers to provide information or education

to themselves with a view to influence them be aware and have positive

attitudes towards HIV and AIDS.

 20

Concept of Awareness

Awareness is an attribute of action. Doing one thing while taking heed of

other relevant occurrences are not two parallel lines of action but a specific way

of pursuing a line of action, namely to do it competently, mindfully,

accountably (Schmidt, 2002). The author further note that “awareness” does not

refer to some special category of mental state existing independently of action

but to a person’s being aware of something. According to Schmidt, (1998)

awareness is an integrated aspect of practice and must be investigated as such.

As noted by Heath, Vomlehn, Hindmarsh, Svensson, Sanchez and Luff

(2002) awareness a feature of practical action which is systematically

accomplished within developing course of everyday activities. They further

note that awareness is not the same as cognizance; awareness is an automatic

response to environment, which could be directed when needed. Heath et al

further opined that awareness is a social activity, in that we take cues from

those around us which can influence our awareness and lead to a greater shared

awareness. Awareness is ‘ongoing’ achieved in collaboration with others

(Heath et al 2002). Operationally, awareness in the context of this study has to

do with automatic response to issue of HIV and AIDS when reference is made

towards such within the environment.

Concept of Attitude

An attitude is a favourable or unfavourable evaluation of something.

Attitudes are generally positive or negative views of a person, place, thing or

event – this is often referred to as the attitude object. People can also be
 21

conflicted or ambivalent toward an object, meaning that they simultaneously

possess both positive and negative attitudes toward the item in question

(Mattern 2010). An attitude can be defined as a positive or negative evaluation

of people, objects, event, activities, ideas, or just about anything in your

environment (Zimbardo 1999)

Attitude is a relatively enduring way of thinking, feeling and behaving

toward an object, person, group or idea. Attitudes almost always involve a

certain amount of bias or prejudging on our part. When we apply a label such as

“stingy” or “psychotic” to a person, we both state an attitude and reveal the way

in which we perceive the person. In a sense, then attitudes are perception that

involves emotional feeling or biases and they predispose us to act in a certain

way (McConnell 1984).

Attitudes are generally concerned with activities. Hornby (2007)

identified attitudes as the way that one thinks, and feel about somebody,

something, the way one behaves towards somebody/something that shows how

one thinks and feels. It is therefore a person’s tendency to react towards another

person, object or institution in a favourable or unfavourable manner. Attitude is

either positive or negative.

In the view of National Teachers Institute (NTI) (2000), attitude

indicates depth of feeling that is degree to which a person, idea or institution are

rather inferred either through what the individual does or says. The institute

further added that individual display one attitude or another and attitude takes

time to develop and it is often difficult to alter the feeling. The institute asserted
 22

that it is more difficult to get adolescent change his attitude than an adult. In the

opinion of Bain (http:llen,Wikipedia.org/wiki/Attitude - % 28 psychology %

29) an attitude is the relatively stable overt behaviour of a person which affects

his status. Attitudes which are different to a group are those social attitudes or

values. The attitude is the status that manifest as behaviour. This differentiates

it from habit and vegetative processes as such and totally ignores the

hypothetical ‘subjective states’ which have formerly been emphasized.

Operationally, attitude in the context of this study has to do with positive or

negative evaluation of HIV and AIDS in our environment. That is an enduring

way of thinking, feeling and behaving towards the issue of HIV and AIDS.

Concept of HIV and AIDS

HIV as defined by the World Health Organisation (WHO, 1995) stands

for Human Immunodeficiency Virus that affects only human beings. As noted

by Williams, (2000) HIV attacks the human immune system, the body’s

defence against invading disease. It damages the immune system by

systematically destroying an important type of white blood cell, CD4 cells or

T4 cells. As noted by Muriel and Sylvia (2001) HIV is the Virus that causes

AIDS. It is a virus that affects human beings and causes a lowering of the

body’s immune system. This situation makes it impossible for the body to fight

certain infections. HIV destroys certain white blood cells. These cells are

critical to the normal functioning of the human immune system, which defends

the body against illness. When HIV weakens the immune system, a person is
 23

more susceptible to developing a variety of cancers and becoming infected with

viruses, bacteria and parasites (WHO, 2006).

On the other hand, AIDS which is Acquired Immune Deficiency

Syndrome is a term not often used by doctors today as they prefer to talk of

advanced or late HIV infection. It is the outcome of damage to the immune

system by HIV. When the body is severely weakened by HIV, it can be

attacked by a number of serious disease conditions like Pneumocystio Carinni

Pneumonia (PCP) and Tuberculosis (TB). Such conditions are referred to as

AIDS (Kawonza, 1999). The UNAIDS (2002) Opined that AIDS exerts a heavy

toll on its victims and it compromised people’s way of life and dramatically

increased the risk of death. As noted by WHO, (2006) a person who is tested

positive for HIV is considered to have progressed to AIDS when a laboratory

test shows that his or her immune system is severely weakened by the virus or

when he or she develops at least one of about 25 different opportunistic

infections, diseases that might not affect a person with a normal immune system

but that take advantage of damaged immune systems.

AIDS manifest after about 10 years of HIV infection an indication that it

is a condition that brought about by the HIV Virus according to United State on

AIDS (USAID, 2008). A person gets infected and experiences the AIDS signs

and symptoms like rapid weight loss, persistent fever or profuse, night sweats,

dry cough, swollen lymph glands in the armpits or neck, diarrhea that last for

more than a week, pneumonia, white spots or unusual blemishes on the tongue,

depression and other neurological disorders (United State on AIDS, (USAIDS,

 24

2008). In the views of Ogunyombo (1999), there are white blood cells in the

body which are very useful for fighting against the infection but HIV destroys

the cells. When the blood cells fall to unsafe levels, it is said that the person is

having AIDS.

The centre for Disease Control and Prevention (CDCP) according to

WHO (2006) defines AIDS to mean that a person has had either a positive test

for HIV antibodies along with the occurrence of infections that take advantage

of an impaired immune system or CD4 lymphocytes count of 200 or less. CD4

lymphocytes are those white blood cells that are in charge of immune system

function.

Concept of Adolescence

The concept adolescence has been variously defined by scholars based

on their perceptions and culture. Conger, Kegan and Mussen in Ani (2004)

opined that adolescence is a period of transition between childhood and

adulthood. It is a period that varies from culture to culture and is a time when

individuals learn to be socially responsible for themselves and for their actions.

It is considered to last from ages 10 to 19 and from puberty to full biological/

physiological maturation. They further opined that within this time frame,

females in particular are affected by various developmental transformations

including physical, emotional, and social changes. With these changes come

many responsibilities and privileges that are different from those of childhood

or full adulthood, aspects that ultimately define the period of “adolescence”.

 25

Adolescence is a period of rapid transitional developmental changes

from children to adulthood (Nworah, 2004). It is a period when the physical and

physiological change that accompanies the transition from childhood to

adulthood becomes manifest and continues into adulthood. The author further

remarked that it is a period usually between the ages of 10 to 21 years, marked

by the development of the child to adult, extending from puberty to

independence. This implies that it is a period of great energy and changes of

mood, which can come in form of cheerfulness, anger and other times

withdrawal. Adolescence period is characterized by maturity of reproductive

organs and behavioural changes, with corresponding interest in sexuality and

desire for sexual expression. There is usually a tendency for the adolescents to

express themselves sexually (Samuel, 2010).

In the view of Eze (2005) adolescence is defined as a period or state of

life when an individual gradually moves from childhood to adulthood. It is a

period of moratorium when the individual is in a state of abeyance and so

requires proper handling to avoid creating conflict, he/she is no longer regarded

as a child, yet he/she is not accepted into full adult life. This is a period when

individuals tend to adapt themselves to changing influences in their

environment as well as changes taking place within them. The author noted that

adolescence starts from about the eleventh or twelfth (11th – 12th) year to about

the nineteenth (19th) year of life, though this may vary among different cultures

and even between different individuals within the same culture. It coincides
 26

with the senior primary and secondary school days in developing countries like

Nigeria or higher school days in developed countries.

Oladepo (1999) assert that an adolescent is a young person who is

developing from a child into an adult the age bracket of adolescent is 10 and 25

years and these years are full of activities that turns the adolescents into a rather

problematic person, as he tends to behave like an adult. The author further

noted that this age bracket involve a period of sexual aggression, exploitation of

physiological make-up, search for sociable friends and rapid discussions of

child’s growth rate and development. Operationally, adolescent is seen as a

period of transaction from childhood to adulthood which last from 10-19years.

Concept of Gender

Gender has been seen and described variously by scholars. According to

Nwagbara, (1998); and Okeke, (2000) gender refers to socially constructed

roles and socially learned behaviours and expectations associated with males

and females. Also, Berk (1998) affirmed that gender is a social construction that

has to do with behaving according to type. In other words gender issue is a

broad categorically characteristics attributes of a person based on his/her

belonging to one of the two sexes. This gender issue limits one from benefiting

from one’s area of interest. Schooling adolescents are not left out in this issue.

Gender issue has continued to reduce productivity and thereby development of

young people in all spheres of life, for instance, it affects the level of aspiration,

self-concepts, goal setting and career choice of adolescent boys and girls

(Maduewesi 2005).
 27

Wikipedia (2003) added that gender refers to the sum of cultural values,

attitudes, roles, practices and characteristics based on sex. It means that gender

is a condition of being masculine or feminine through one’s behaviour. Thus,

this is the gender issue that is seen in every aspect of family and school

organisation Action Health Incorporated (AHI) (2003) added that gender refers

to the sum of cultural values attitude, roles, practices and characteristics based

on sex. It means that gender is the condition of being masculine or famine

through one’s behaviour. Man and woman are biologically different but all

cultures especially in Nigeria interpret these inherent biological differences into

a set of social expectations about what behaviors and actions appropriate for

them and what rights, resources and even power they posses. This is what

gender implies (Nworan, 2004).

Conceptual Relationship

Independent Intervening Dependent Effect

Variables Variables Variables

Peer Gender Awareness Positive

Education Awareness

Attitude Positive
Attitude

Fig 1: Conceptual Relationship of the Variables

 28

The diagram above illustrates the network of the conceptual relationship of the

variables. The independent variable, the peer education is an approach that was

employed in the study as treatment to determine its effectiveness on awareness

and attitude among in-school adolescents. Gender and location as the

intervening variables were introduced as moderating variables to establish their

influence over the treatment outcomes.

The dependent variables, awareness and attitudes were predicated on the

outcome of the programme at the end of the research. Treatment that is peer

education was deemed to be effective when there was a mean gain in terms of

awareness and positive attitude.

Theoretical Framework

The theoretical framework of this review will focus on social cognitive

theory, Health belief model, AIDS Risk Reduction Model and Theory of

Reasoned Action, respectively.

Social Cognitive Learning Theory by Bandura (1977)

The leading proponent of the Social Cognitive learning theory is Albert

Bandura in 1977. The social learning theory focuses on the learning which

occurs within a social environment. The theory argues that individuals

according to the social learning model live and interact together in the social

environment and their behaviour depends on the influence of the environment.

The theory further believes that man lives symbiotically in the environment. In

other words, individual interact with the environment and allows the

environment to interact with him thus generating behaviour.

 29

In the social cognitive learning theory, human behaviour is explained

using a three way reciprocal theory in which personal factors (one’s cognitive

processes) behaviour and environmental influences continually interact in a

process of reciprocal causality. These are very dynamic relationships where the

person can use to shape the environment as well as environment shaping the

person. Bandura is of the assumption that cognition plays a role in learning.

Human functioning hinges on cognitive, vicarious, self-regulatory and self-

reflective processes in human adoption and change. The theory maintains that

people are viewed as self-organizing, proactive, self-reflecting, self-regulating

rather than as reactive organisms shaped and shepherded by environmental

forces or driven by concealed inner impulses. In line with the present study, this

theory implies that adolescent may through interaction with one another and

through peer education be exposed to acquire positive attitude and increases

their awareness towards HIV and AIDS .

BEHAVIOUR

PERSONAL ENVIRONMENTAL
FACTOR FACTOR

(Cognitive, affective, and biological events)

Figure 2: Reciprocal relationships as proposed by Bandura (1977)
(http:llwww.let.uu.nl.)
 30

Health Belief Model by Rosenstack et al (1950)

The propounders of Health Belief Model were a group of psychologists

Rosenstock, Becker, Fishben and Ajzen in 1950s. The rationale for this was to

help explain people’s health behaviours. The Health Belief Model focuses on

individual belief and knowledge of factors related to health problems. How

individuals perceive the threat to their own health, how they judge severity and

how they evaluate the cost and benefits of health services.

Furthermore, Health Belief Model attempts to explain health behaviour

in terms of individual decision making and proposes that the likelihood of a

person adopting a given sexual or health related behaviour is a function of that

individual’s perception of a threat to his personal health, and his belief that the

recommended behaviour will reduce this threat. What this implies is that a

person would be more likely to adopt a given attitude and behaviour in a

situation where non-adoption of such is perceived as a health threat and

adoption is seen as reducing threat.

In the view of Becker the HBM can be outlined using four constructs

which represent the perceived threat and net benefits of a particular behaviour.

- Perceived susceptibility, a person’s opinion of the chances of getting

certain condition.

- Perceived severity, a person’s opinion of how serious the condition is.

- Perceived benefits, a person’s opinion of the effectiveness of some

advised action to reduce the risk or seriousness of the impact, and

 31

- Perceived barriers, a person’s opinion of the concrete and

psychological cost of this advised action. Another concept in the

Health Belief Model is known as cues to action. These are events

(internal and external) which can activate a person’s readiness to act

and stimulate an observable behaviour.

Another factor seen as vital is the concept of self-efficacy in relation to

performing the behaviour. Self-efficacy a concept originally developed by

Albert Bandura in social cognitive theory is simply a person’s confidence in his

or her ability to successfully perform an action. Even though the HBM was

originally developed to help explain certain health related behaviours, it has

also helped to guide the search for ‘why’ these behaviours occur and to identify

points for possible change. When HBM is applied to the issue of peer education

on awareness and attitude towards HIV and AIDS one could see that awareness

and attitude could be attributed to these factors of Health Belief Model that is,

the individual’s perception, the modifying factor and the likelihood of the

action. Hence, the appropriateness of the theory to the present study.

AIDS Risk Reduction Model (Catania, 1990)

This theory was specifically developed by Catania, (1990) for

understanding risk behaviour to a healthy one related to AIDS transmission. It

recognizes that changing high-risk behaviour is the only means of preventing

transmission of HIV and AIDS. Three stages are identified as necessary; an

individual must traverse themselves to reduce or change sexual activities that

place him/her at risk of acquiring HIV and AIDS. This requires the individual
 32

identifying and labeling activities as risky. This has three components: first,

knowledge of Modes of transmission and Personal appraisal of the risk of

acquiring it. unless one judges oneself as personally vulnerable to contracting

AIDS, the individual will not label their behaviour as risky and an individual’s

reference group opinion of what constitutes risky sexual practices could affect

that person’s view of his/her behaviour.

The second stage of AIDS Risk Reduction Model, States that

commitment to engaging in low risk activities will be enhanced by the potential

threat to social norms governing the health promoting behaviours. These

considerations span through a wide spectrum of non health related realities.

The final stage hypothesizes that the enactment of the behaviour depends

on one sexual communication abilities with ones sexual partner(s).Unless an

individual is able to communicate convincingly to his/her partner the choice he

/she has made for low-risk behaviour, such a one will not be able to act on her

intentions and commitments (Catania, 1990). The use of peer education as

advocated in the present study would make the adolescent to be more aware of

consequences attached to HIV and AIDS and thereby be in a position to

communicate convincingly.

Theory of Reasoned Action (TRA) by Fishbein and Ajzen (1975)

The theory was propounded by Fishbein and Ajzen (1975). The theory

was designed to explain not just health behaviour but all volitional behaviours.

TRA hypothesizes that two key components influences ones intention to

 33

undertake health-promoting action. First is the person’s attitude towards the

suggested behaviour. Second is the health – related cost and benefits perceived

as necessary in averting the threat, the degree of the threat and other social

expectations and non-health-related considerations.

The theory is designed to predict individual behaviour by focusing on

four dimensions: affect, cognitive, intention, behaviours and the relationship

among them. The TRA according to Stetson and Davis asserts that there is a

close relationship between attitudes, beliefs, intentions and behaviour and that

change in attitudes and beliefs will engender changes in intentions and

behaviour. In this model, behaviour is seen as a function of a person’s

intentions, which in turn is comprised of the individual’s attitude towards

performing the behaviour and the influence of perceived social norms

concerning the performance of the behaviour. Attitudes are affected by the

person’s beliefs about the perceived consequences of performing a given action

and his or her subjective evaluation of each of the consequences. The theory

asserts that a person’s intention to perform a specific behaviour is a function of

two factors.

- attitude (positive or negative) towards the behaviour, and

- the influence of the social environment (general subjective norms) on

the behaviour.

In line with the present study on HIV and AIDS, the attitude towards the

behaviour is determined by the person’s belief that a given outcome will occur

if he or she performs the behaviour and by an evaluation of the outcome. The

 34

social and subjective norms are determined by a person’s informative

motivation to comply with those other people-wishes or desires.

With regard to the awareness and attitude of the adolescents towards

HIV and AIDS, the additional influence from societal group expectations on

them could explain the relevance of the theory to the present study as this

would make them to be aware of what they are all about which in turn influence

their attitudes.

Self perception theory of Attitude – Bem 1967

Self-perception theory (SPT) is an account of attitude formation

developed by psychologist Daryl Bem (1967). It asserts that people develop

their attitudes by observing their own behaviour and concluding what attitudes

must have caused it. The theory is counterintuitive in nature, as the

conventional wisdom is that attitudes determine behaviours. Furthermore, the

theory suggests that people induce attitudes without accessing internal

cognition and mood states. The person interprets their own overt behaviours

rationally in the same way they attempt to explain others’ behaviours. In an

attempt to decide whether individuals induce their attitudes as observers

without accessing their internal states, Bem used interpersonal simulations, in

which an “observer-participant” is given a detailed description of one condition

of a cognitive dissonance experiment. Subjects listened to a tape of a man

enthusiastically describing a tedious peg-turning task. Some subjects were told

that the man had been paid $20 condition. The results obtained were similar to

the original Festinger-Carlsmith experiment. Because the observers, who did

 35

not have access to the actors’ internal cognition and mood states, were able to

infer the true attitude of the actors, it is possible that the actors themselves also

arrive at their attitudes by observing their own behaviour. Specifically, Bem

notes how “the attitude statements which comprise the major dependent

variables in dissonance experiments may be regarded as interpersonal

judgements in which the observer and the observed happened to be the same

individual”. Bem used a series of employed self-perception theory to try to

reduce anxiety in heterosocially anxious or shy college students. The study

conducted by an interaction among members of the opposite sex in order to

overcome their shyness by attributing their successful outcomes to themselves

and their own behaviour. The results indicate that the treatment is highly

effective for both sexes. Also, the effects are fairly permanent and subjects find

it enjoyable. Furthermore, the treatment is not a result of the subject-expectancy

effect.

Empirical Studies
Studies on HIV and AIDS
Ali (2005) carried out a study on the role of community-based

organizations (CBOS) in prevention and control of HIV and AIDS in Bugra

district of Tanzania. The main objective of the study was to examine the

effectiveness of the CBOs on tackling the spread of HIV and AIDS among the

rural population. The design of the study was a descriptive survey. The

population of the study was 75610 inhabitants of 15 communities in the district

of Bugra. The sample for the study was 4,646 respondents made up of 1305
 36

young females less than 18 years, 1250 young males less than 18, 1050 adult

females and 1041 adult males. To draw the sample, stratified simple random

sampling technique was adopted. The instruments for data collection were a

questionnaire titled “community based organizational strategies for AIDS

prevention and control questionnaire (CBOSPCQ) and a focus group discussion

with the villagers. Six (6) research questions and 5 hypotheses were formulated

to guide the study. Mean and standard deviation were used to answer the

research questions while Analysis of covariance was adopted to test hypotheses

at 0.05 level of significance.

The findings revealed that virtually all of the communities with strong

CBOs were using public media: folk drama composed by the local people

themselves usually about the story of progress in combating HIV/AIDS in the

communities. Choirs with themes composed by the local people; popular music

featuring some local singers with small instrumental ensembles of at least

drums; home made instructional and educational videos produced in the

communities. Much of this was part of the general campaign to educate the

communities about HIV/AIDS. Much of this media was part of the local culture

that needed relatively little training. Even the video productions were done in

amateur fashion devised by the local people.

Although the study included questions about the role of radio and other

media in the education of the people, there was almost no mention of radio

programs on health or specifically about HIV/AIDS. The present study is

 37

related in quite many respects but focused on the peer education as a campaign

strategy to sensitize the youth about HIV/AIDS problems in the society.

In a study by Kirby, (1997) on how to use peer education to reduce

sexual risk-taking in US. The author used peer education programs involving 24

adolescents. A Focus Group Discussion was integrated into the programme.

The data generated using the Focus Group Discussion were analysed

qualitatively. It was discovered that participants acquired the skill for reducing

sexual risk-taking easily through peer education unlike their counterparts not

exposed to peer education. The study by Kirby is on sexual risk-taking while

the present study is on awareness and attitude towards HIV and AIDS.

Silva (1997) note that in Sri Lanka, male and female youth peer

educators facilitated discussions with peer groups about virginity, sexual

behaviour, and decision-making first in same-sex and later in mixed-sex group

sessions. Findings from the study showed that single-sex group sessions helped

young women develop a public voice, which enabled them to actively

participate in subsequent group discussions with males. The study also found

that recruitment and retention of participants in these group sessions was

greater for females than for males.

According to Cash; Sanguansermsri, and Busayawong (1997) in

Thailand, both female and male peer educators were trained to facilitate single-

sex and mixed-sex group sessions with unmarried factory workers. Findings

from formative research were used to “create comics and story books that

included male and female characters whose attitudes and behaviours reflected
 38

prevailing gender norms, about communication, sex and HIV prevention pre

and post-intervention interviews with participants demonstrated increased

understanding of how traditional gender roles inhibit HIV–related

communication as well as increased peer and partner communication on HIV

and AIDS and sexual risk reduction. The study also found that young women

were more able to express an opinion and ask questions in girls-only HIV and

AIDS peer education groups as compared to mixed-gender groups which

highlight the importance of special learning environments and message for

women.

Awareness and Attitude towards HIV and AIDS

A study was carried by Onoja (2004) using adolescents male and female

in Otukpo metropolis of Benue state of Nigeria. The study aimed at finding out

the level of awareness of HIV and AIDS among the students. A descriptive

survey was the design of the study while the instrument for data collection was

questionnaire. The results of the study revealed that irrespective of gender the

adolescents within the sampled schools are quite aware of the presence of HIV

and AIDS.

A follow up study was carried out the same year after some months by

the same author. Onoja (2004) sought to find out the extent of awareness of

HIV and AIDS and influence on the attitude of secondary school students

sexual behaviour. The study adopted a descriptive survey using as subject 250

male and female students in Otukpo Benue State. The instrument for data

collection was questionnaire and the data generated were analysed using mean
 39

and standard deviation. The findings among others revealed that the subjects

were aware of the presence of HIV and AIDS but the awareness did not

influence their attitude towards sexual issues.

Eze (2006), carried out a study on knowledge level of undergraduates in

South east towards HIV and AIDS. The study employed a descriptive design

while the subjects for the study were undergraduates in Nsukka and Enugu of

Enugu State. The subject of the study was selected through random sampling

technique. The instrument for data collection was questionnaire and the data

generated were analysed using mean and standard deviation. The result of the

analysis revealed that undergraduates within the area are quite aware of the

presence of HIV and AIDS.

Adekunle (2003) carried out a study in South West Nigeria among

secondary school students to determine the influence of their level of awareness

of HIV and AIDS on their attitudes towards risky sexual behaviour. The

subjects for the study were 260 composed through random sampling from Oyo

State, Nigeria. The instrument used for data collection was a questionnaire and

data collected were analysed using mean and standard deviation. The results

among others revealed that the awareness level of the students has no influence

on their attitudes towards HIV and AIDS among in-school adolescents in

Enugu State. Although this study looked at awareness level it did not extend to

their attitude towards HIV and AIDS which the present study is out to

determine. The present study relate to the study of Adekunle the only difference

is that the present is an experimental study and it uses peer education.

 40

Summary of Literature

The literature reviewed provided conceptual meaning to adolescence

HIV and AIDS, Peer education, awareness and attitude. Adolescence is seen as

a period or state of life when an individual gradually moves from childhood to

adulthood.

Four major theories: social cognitive theory, Health belief Model, AIDS

Risk Reduction Model and Theory of Reasoned Action were reviewed for this

study From the review the social cognitive theory focused on the learning

which occurs within a social environment. In other words the individual

interacts with the environment and allows the environment to interact with him

thus generating behaviour

Health Belief Model looked at cues to action. These are events (internal

and external) which can activate a person’s readiness to act and stimulate an

observable behaviour. Theory of Reasoned Action has it that key components

influence one’s intention to undertake health promoting action. AIDS Risk

Reduction Model advocates for understanding risk behaviour related to AIDS

transmissions. This theory also believed that changing high-risk behaviour is

the only means of preventing transmission of HIV and AIDS.

Furthermore, the empirical aspect looked at gender and attitude towards

HIV and AIDS, Peer education and sexuality, awareness and attitude towards

HIV and AIDS. The empirical studies revealed among others that adolescents

are quite aware of the present of HIV and AIDs and that through peer education
 41

a lot of revelations were made as the adolescents were open in their discussion

considering their age bracket.

The review of empirical studies did not show consistent results. Most of

the empirical studies were concerned with sexuality issues like sexual risk-

taking, control and prevention of HIV and AIDS among others. They did not

look at awareness level and attitudes of students with respect to enhancing

them. This gap the present study tends to fill by investigating the effects of peer

education on awareness and attitude towards HIV and AIDS among in school

adolescents.
 42

CHAPTER THREE

RESEARCH METHOD

This chapter presents the research design, area of the study, population of

the study sample and sampling technique, instrument for data collection,

validation and reliability of the instrument, experimental procedures, method of

data collection and method of data analysis.

Design of the study

The research design adopted for this study is a quasi-experimental

design. It is non-equivalent control group design, involving one treatment and

one control group. According to Ali (2006), quasi-experimental design is a

non-equivalent control group in which participants are not randomly assigned to

groups but Intact group is used instead of randomly assigning participants to

groups to determine the effect of the treatment.

Quasi-experimental design is suitable for this study because pure

randomization is not always feasible in a school system and Intact classes is

used for the study. Also the subjects in both the experimental and control

groups will be pre-tested in which the results will be used in determining the

initial group equivalence.

Non-Equivalent Control Group Design

Non-equivalent group Pretest Treatment Posttest
Treatment groups 01 X 02
Control groups 01 __ 02
Key:
01 = Pretest
02 = Posttest
x = Treatment
_ = None

42
 43

Area of the Study

The study was carried out in Nsukka Education Zone in Enugu State of

Nigeria. The Education Zone is one of the six education Zones of Enugu State.

The Zone is made up of Nsukka, Igbo-Etiti and Uzo-Uwani Local Government

Areas. Nsukka LGA has as its headquarter Nsukka, Igbo-Etiti is Ogbede while

Uzo-Uwani is Umulokpa. There are 61 Secondary Schools in Nsukka

Education Zone spread across urban and rural areas. The University of Nigeria

Nsukka is situated within the zone.

The study was carried out in Nsukka Education Zone. The rationale for

the use of the area is because it is increasingly developing along with the vast

technological awareness. This has brought the adolescents into daily

interactions with some of the films and literature that encourage wrong sexual

awareness and attitudes towards HIV and AIDS.

Population of the Study

The population of the study was made up of all the senior secondary

school students II (SSII) in all the schools in Nsukka Education Zone. The

population figure is 4202, (source: Planning and Statistics Unit PPSMB Nsukka

Education Zone, 2012). The choice of the SSII students is based on the fact that

they are not in examination class and they are adolescents’

Sample and Sampling Technique

The sample was 231 senior secondary II students. Stratified random

sampling techniques was used in drawing the sample. The education zone was
 44

stratified based on local government areas namely Nsukka LGA, Igbo Etiti

LGA, and Uzo-Uwani LGA. A random sampling technique was used to draw

two co-educational schools from each of the local government areas. This gave

a total of 6 co-educational schools. In each of the co-educational school

randomly sampled, one intact class was selected giving 6 intact classes. In each

LGA out of the two schools, one was used for experimental group while the

other was used for control group.

Instrument for Data Collection

The instrument for the study was HIV and AIDS Awareness and Attitude

Questionnaire (HAAAQ) developed by the researcher. It has 30 items, that

were generated after literature reviewed. The questionnaire was used for both

the pretest and post-test to both treatment and control groups. However, the

items of the instrument were reshuffled during the post-test to make it look

different from the pretest. This helped to prevent memory effect of pretest.

The HAAAQ was divided into two parts 1 and 2. The part 1 was on the

personal data of the subjects such as gender and class. The part 2 was the

questionnaire aspect that was divided into two clusters A and B. Cluster A of

the questionnaire is concerned with determining adolescents’ awareness

towards HIV and AIDS while cluster B is concerned with their attitudes

towards HIV and AIDS. Each of the clusters has fifteen items respectively. The

HAAAQ is a four- point rating scale instrument of Strongly Agree (SA), Agree

(A), Disagree (D) and Strongly Disagree (SD). The weight of 4, 3, 2 and 1

points were assigned the options respectively. The students were required to
 45

indicate response on the 4-point scale showing their degree of agreement or

otherwise to each of the statements.

Validation of the Instrument

The face validation of HAAAQ was ascertained by the researcher. This

was done by giving initial draft to three experts from Faculty of Education

University of Nigeria, Nsukka. One expert was from guidance and counselling,

one from Educational Psychology and the third from Measurement and

Evaluation unit respectively. The researcher requested the experts to scrutinize

of the items of the instrument in terms of clarity. They were also required to

ascertain the appropriateness and suitability of the items as well as the response

patterns. In order to achieve a thorough validation exercise, the validates were

equally given the purpose of the study, the research questions and the research

hypotheses. They were also requested to make modifications where necessary.

Based on their comments and correction the final copy was produced (see

appendix I, page 81).

Reliability of the Instrument

In order to determine the reliability of the instrument, the validated

instrument was trial tested on a representative sample of 40 SSII students in

community secondary school Ede Oballa. Although the school is within Nsukka

Local Government Area, it is not part of the study. The trial testing enabled the

researcher to generate the relevant data for measuring the internal consistency

of the instrument.
 46

The reliability coefficient index was established for the instrument

HAAAQ. This was done using Cronbach Alpha method to measure the internal

consistency coefficient. The values obtained were 0.80 and 0.79 for the two

clusters respectively. The Cronbach Alpha method was used because the items

were not dichotomously scored and they have no right or wrong answers. (see

appendix III)

Experimental Procedure

The experimental procedure took place in three phases:

Pre-treatment phase: The researcher trained two research assistants who served

as facilitators for the two groups that were involved in the experiment. The

research assistants comprised the school guidance counsellor who is a trained

expert in handling psychological/behavioural problems of adolescents, and a

student of the SSII class to act as a peer educator. The school counsellor was

graduate guidance counsellor in the sampled school. He was chosen because he

has been providing vital information to students about HIV/AIDS. This made

them to participate out of interest and ability. The training provided for them is

on life skills. The student peer educator was one that had a good command of

English Language and also intelligent. The training provided for them is on the

treatment packages.

Peer Educators were trained to handle the treatment group while the

school counsellor was trained to handle the control group. The peer educators

were provided with copies of detailed treatment packages that the researcher
 47

taught them how to implement and evaluate, while the school councilors were

detailed on life skills. The lesson with the research assistants was held from

2pm - 4pm from Monday to Friday.

The first day of the training began with introduction of selves. This was

followed by ground rules. After outlining the rules, the objectives of the

training were discussed, and so before the commencement of the training on

each day, a recap on the previous days’ activities was done. At the end, there

was a reflection on the days’ activities.

Thereafter, the researcher provided the research assistants for the

treatment group with the instructional programme. The instructional

programme focused on the following:-

1. What is HIV

2. What is AIDS

3. Mode of transmission of HIV and AIDS

4. Preventive strategies for HIV and AIDS

5. Reactions towards HIV and AIDS

Treatment Procedure

In the school, sampled for the study, two classes of SSII students were

selected through simple random sampling technique of balloting. One class

represented the experimental group while the other represented the control

group. After determining the experimental and control group, the researcher

visited the school to introduce himself to the school authorities and the research
 48

assistants. The pretest administration was done by the trained research

assistants, who were the school guidance counsellors and SSII student.

The questionnaire instrument was collected from the participants after

administering the pretest. The scores to be generated from the pretest served as

covariates to the students posttest scores. The experimental treatment consisted

of the teaching of topics like definitions, modes of transmission, preventive

strategies and reactions using peer educator.

The experimental treatment was spread for six consecutive weeks. For

each week, there was one lesson period-45 minutes normal length of time

allotted to a lesson period in secondary schools was allotted in the study. Any

topic not covered was continued in the next contact.

The treatment group was taught using peer educator while the control

group was taught by the conventional approach (school counsellor).

Developing the Instructional Programme

The instructional programme used was Awareness Creation and Attitude

towards HIV and AIDS Instruction (ACATHAI). This was developed by the

researcher from literature reviewed.

The content of the instructional programme covered definitions, modes

of transmission, preventive strategies, and reactions towards HIV and AIDS.

The students were exposed to skills on the right perception and attitudes

towards HIV and AIDS.

 49

The researcher identified in the programme the objectives to be achieved,

activities of the peer educator for the experimental group and evaluation to be

adopted. The programme lasted for six weeks.

Control of Extraneous Variable

Extraneous Variables such as Hawthorne effect, subject’s variability,

pretest posttest effect, instability of instrument among others, which could

affect the result of the study were controlled through the following measures:

1. “Hawthorne effect” is a factor that the researcher shall control. This is a

situation in which noticeable difference may occur if the students are

aware that they are engaged in an experiment. To avoid this, the research

assistant used was their school guidance counsellor who often interacts

with them and a fellow student of the same class level with them.

2. In order to ensure that all the groups receive uniform instruction, the

researcher ensured that the research assistants were given intensive

training at the same periods on the objectives the experiments. The

research assistants were given the opportunity to show their extent of

mastery of the instruction by allowing them to ask questions for

clarifications during the training sessions.

3. In order to remove researcher’s bias and threat to validity due to teacher

variability, the researcher was not directly involved in the instruction, nor

in administering of both pretest and posttest to the treatment and control

groups respectively, instead the two research assistants were used.

 50

4. Statistical control was achieved by the use of Analysis of Covariance

(ANCOVA). This is because, it is effective in removing from the treatment

those differences which could be linearly correlated with the covariant and

to adjust the post treatment means for differences between the various

groups in the experimental conditions. This ANCOVA corrects errors

arising from the covariant (Pre-test scores).

Method of Data Collection

Prior to the commencement of the instruction, the researcher visited the

sampled schools and explained the purpose of the study to the school head. The

researcher handed over copies of the questionnaire to each of the research

assistants for immediate pretesting of the student participants. The researcher

went back later in the day to collect the filled questionnaire from various

research assistants after students responses. This ensured a high return rate after

the pretest and were used as pretest result. At the end of the treatment, the

researcher distributed the same number of the questionnaire (with renumbered

items) to the research assistants who administered them to the student

Participants as posttest. The researcher collected them back later in the day also

to ensure a high return rate.

Method of Data Analysis

The data collected was analyzed in line with each research question and

hypothesis. Descriptive statistics such as mean and standard deviation was used

in answering the research questions. A bench mark of 2.50 will be used as a

criterion value for agreeing or disagreeing with the items of the questionnaire.
 51

Analysis of Covariance (ANCOVA) was used to test the hypotheses at

P< .05 level of significance. ANCOVA was also used to determine if there were

any significant differences in the mean scores of the groups. The data was

presented in tables.
 52

CHAPTER FOUR

DATA ANLYSIS AND PRESENTATION OF RESULTS

Research Question 1

What is the effect of peer education on students’ awareness towards HIV

and AIDS in Nsukka education zone of Enugu State when compared with the

control group?

The answer to this research question was given by calculating the mean and the

standard deviation of the experimental and control groups in the pre-awareness

and post awareness tests in Table 1.

Table 1:

Mean scores and standard deviation of students in the experimental and

control groups in pre-test and post-test (Awareness)

Groups N Pretest Posttest Mean Gain Remark

X X X
Experiment 109 36.92 45.00 8.08 Effective
Control 122 36.56 37.12 0.56

Table 1 shows that with pretest mean score of 36.92 and posttest mean

score of 45.00 and mean gain score of 8.08, the adolescents treated with peer

education performed better than those in the control group who had pretest

mean score 36.56 and posttest mean score of 37.12 and 0.56 mean gain score in

their awareness towards HIV and AIDS.

52
 53

To further ascertain that the noted difference in the students’ mean score

is statistically significant, hypothesis one was therefore tested.

Hypothesis 1

HO1: There is no significant difference in the mean scores of in-school

adolescents exposed to peer education and those exposed to conventional

counselling on their awareness towards HIV and AIDS. The hypothesis was

therefore tested using two-way analysis of covariance (ANCOVA). The results

are given in Table 2.

 54

Table 2: Two-way ANCOVA result on students’ post mean score in

awareness of HIV and AIDS

Source Type III df Mean F Sig. Result

Sum of Square
squares
Corrected Model 8372.2 4 2093.05 60.82 .000 S
intercept 3441.5 1 3441.5 100.0 .000 S
preawe 4468.3 1 4468.3 129.85 .000 S
Group 2947.2 1 2947.2 85.6 .000 S
Gender 138.7 1 138.7 4.03 .046 NS
Group*Gender 57.8 1 57.8 1.68 .196 NS
Error 7776.8 226 34.4
Total 401432.0 231
Corrected Total 16149.07 230

a. R Squared = .518 (Adjusted R Squared = .510)

Note: S = Significant at P = 0.05) NS = Not significant

The results in Table 2 revealed that the noted difference between the mean

scores of the experimental and control group is significant at 0.05 level of the

study. This is shown by the calculated F value of 85.65 which is significant at

.00 which is less than the criterion significant value of 0.05. Therefore, the null

hypothesis of no significant effect of treatment on student was rejected.

Research Question 2

What is the gender differences in the effect of peer education on the

adolescents’ awareness towards HIV and AIDS?

To answer this research question, the mean and the standard deviation of the

experimental and control groups were calculated. Table 3 below gives the

results. Means and standard deviation of students in the Experimental and

 55

control group for pre-test and post-test on influence of gender on students’

awareness towards HIV and AIDS

Table 3: Gender differences in the effect of peer Education on adolescents

who received peer education on their awareness of HIV and
AIDS

Gender N Pretest Posttest Mean Remark

X X Gain X
Male 46 36.47 45.06 8.59 More
effective
Female 63 37.24 44.95 7.71

In Table 3, it was observed that male adolescents had a pretest mean

score of 36.47 and posttest mean score of 45.06 and mean gain score of 8.59 in

the peer education performance than the females who had pretest mean score of

37.24 and posttest mean score 44.95 and 7.71 mean gain score in their

awareness towards HIV and AIDS. This shows that the peer education is more

effective on male adolescents than \the female adolescents as shown by high

mean gain score.

Hypothesis 2

HO2: There is no significant difference in the mean scores of male and female

adolescents exposed to peer education on their awareness towards HIV

and AIDS.
 56

Table 4: Two-way ANCOVA Result on students’ post-awareness scores

towards HIV and AIDS
Source of Type III Df Mean F Sig Result
variation sum of square
squares
Corrected model 7453.25 4 1749.05 53.83 .000 S
Intercept 2553.64 1 2331.47 98.02 .000 S
Preawe 4338.42 1 2837.26 128.8 .000 S
Group 2417.82 1 2837.32 42 .000 S
Gender 127.68 1 .148.65 74.67 456 NS
Group*Gender 59.91 1 58.91 4.57 .172 NS
Error 7223.76 225 36.41 1.73
Total 400422.00 229
Corrected Total 16048.07 230

The result of Table 4 showed that the noted difference between the mean

awareness (post- awareness) of the experimental and control group is not

significant at 0.05 level of the study. This is because the F. value of 4.57 is not

significant at .45 and at 0.05 levels. This implies that there is no significant

influence of gender on awareness of students towards HIV and AIDS after peer

education. This shows that male students’ awareness towards HIV and AIDS

were not affected differently from those of the female students. Therefore,

gender is not a significant factor influencing awareness towards HIV and AIDS.

In other words, gender did not make significant difference in the influence of

the treatment given to the experimental group. The null hypothesis is therefore

not rejected. Gender therefore has no significant influence in the awareness

towards HIV and AIDS.

 57

Research Question 3

What is the effect of peer education on students’ attitude towards HIV

and AIDS when compared with the control?

Table 5: Pretest-posttest mean scores and standard deviation of the effect

of peer education on students’ attitude towards HIV and AIDS.

Group N Pretest Posttest Mean Gain X Remarks

X X
Experiment 109 33.63 38.87 5.24 Effective
Control 122 32.53 33.25 0.72

Table 5 shows that with pretest mean score of 33.63 and posttest mean

score of 38.87 and mean gain score of 5.24, the adolescents treated with peer

education performed better than those in the control group who had pretest

mean score of 32.53 and posttest mean score of 33.25 and 0.72 mean gain score

in their attitude towards HIV and AIDS.

The data in the Table 5 above clearly show that students exposed to peer

education has higher post test mean score than those in the control group. This

is an indication of the effectiveness of the peer education, and that the students

benefited significantly from the treatment they were exposed to. The

significance of this benefit was confirmed by a further test of hypothesis 3.

Hypothesis 3

HO3: There is no significant difference in the mean score of in-school

adolescents exposed to peer education and those exposed to conventional

counselling on their attitude towards HIV and AIDS.

 58

Table 6: Summary of analysis of covariance (ANCOVA) on students post-

test mean score on attitude towards HIV and AIDS

Source Sum of df Mean F Sig. Result

Square Square
Pre attitude 74.74 1 74.74 2.73 .000 S
Group 220.07 1 220.07 8.03 .000 S
Gender .223 1 .23 .01 .93 NS
Group*Gender 1.09 1 1.09 .04 .84 NS
Error 6192.97 226 27.40
Total 348479.00 231
Corrected Total 6425.66 230
a. R Squared = .036 (Adjusted R Squared = .011)

Data in Table 6 show that treatment as main effect is significant on

students’ attitude towards HIV and AIDS. This is evidenced by the calculated F

value of 8.03 which is significant at .00 which is less than the criterion

significant value of 0.05. Thus, the null hypothesis of no significance effect of

treatment on students’ attitude towards HIV and AIDS is rejected.

Research Question Four

What is the gender differences in the effect of peer education on the

attitudes of adolescents towards HIV and AIDS?

Table 7: Gender differences in the effect of peer education on adolescents who

received peer education.

Group N Pretest Posttest Mean Remarks

X X Gain X
Male 93 37.06 38.49 1.43
Female 138 35.04 38.47 3.43 More effective
 59

In Table 7, it was observed that male adolescents had a pretest mean

score of 37.06 and posttest mean score of 38.49 and mean gain score of 1.43 in

their peer education performance less than the females who had pretest mean

score of 35.04 and posttest mean score of 38.47 with mean gain score of 3.43 in

their attitudes toward HIV and AIDS. This shows that the peer education is

more effective on female adolescents as shown by high mean gain score.

A corresponding hypothesis raised to further address the research

question 4 is:

Ho4: There is no significant different in the mean score of male and female and

adolescents exposed to peer education on their attitude towards HIV and AIDS.

Table 8: Two-way ANCOVA Result on influence of gender on students’

attitude towards HIV and AIDS.
Source Type III Df Mean F Sig. Result
sum of Square
Squares
Corrected Model 597.26 4 149.32 5.575 .000 S
Intercept 6104.08 1 6104.08 227.896 .000 S
Preatti 473.92 1 473.92 17.694 .000 S
Group 59.42 1 59.42 2.219 .138 NS
Gender 11.51 1 11.51 .430 .513 NS
Group*Gender 52.54 1 52.54 1.962 .163 NS
Error 26.78 226 26.78
Total 231
Corrected Total 230
a. R Squared = .090 (Adjusted R Square = .074)

Results presented in Table 8 indicate that there is no significant effect of

gender on students’ attitude towards HIV and AIDS as a result of their exposure

to peer education. This is based on the ground that the F. value of 2.22 was not

significant at 0.14 which is greater than the criterion significant level of 0.05.
 60

The null hypothesis of no significant influence of gender on attitude of students

towards HIV and AIDS as a result of their exposure to peer education was not

rejected. This implies that male student’s attitude towards HIV and AIDS were

not affected differently from those of the female students. Therefore gender is

not a significant factor influencing attitude towards HIV and AIDS. In other

word gender did not make significant difference in the influence of the

treatment given to the experimental group. The null hypothesis is therefore

accepted. Gender therefore, is not a significant factor in the attitude towards

HIV and AIDS.

Ho5: There is no significant difference in the interaction effect of treatment and

gender on students’ awareness towards HIV and AIDS.

Results presented in Table 2 above show that there is no significant

interaction effect of treatment and gender as measured by their mean scores.

The observed F – value of 1.68 was not significant at .196 and also not

significant at 0.05 levels. The null hypothesis of no significant interaction

effects of treatment and gender on student’s awareness towards HIV and AIDS

is therefore accepted. This means that the interaction effect of treatment and

gender on awareness towards HIV and AIDS was not significant.

Ho6: There will be no significant difference in the interaction effect of

treatment and gender on students’ attitude towards HIV and AIDS.

Results presented in Table 6 above show that there is no significant

interaction effect of treatment and gender as measured by their mean scores.

The observed F-Value of .040 was not significant at .842 and also not
 61

significant at 0.05 levels. The null hypothesis of no significant interaction effect

of treatment and gender on students’ attitude towards HIV and AIDS is

therefore accepted. This means that the interaction effect of treatment and

gender on attitude towards HIV and AIDS is not significant.

Summary of Findings

The major findings of this study based on the analysis of data were:

1. In-school adolescents exposed to treatment (peer education) had higher

awareness of HIV and AIDS compared to those of the control group.

2. Peer education is more effective on male adolescents than the female

adolescents in their awareness towards HIV and AIDS.

3. In-school adolescents exposed to treatment (peer education) had a higher

positive attitude towards HIV and AIDS compared to those of the

control.

4. Peer education is more effective on female adolescents than the male

adolescents in their attitude towards HIV and AIDS.

5. There is no interaction effect of gender and peer education on in-school

adolescents awareness towards HIV and AIDS.

6. There is no interaction effect of gender and peer education on in-school

adolescents attitude towards HIV and AIDS.

 62

CHAPTER FIVE

DISCUSSION OF RESULTS, CONCLUSION, IMPLICATIONS,

RECOMMENDATIONS AND SUMMARY OF THE STUDY
In this chapter the discussion of the major findings, their educational

implications, conclusion, recommendations, suggestions for further study and

summary of the study are presented.

Discussion of Results

The findings of this study were discussed in line with the research

questions and hypotheses raised in the study under the following subheadings.

• Effect of peer education on students’ awareness towards HIV and AIDS.

• The influence of gender on students’ awareness towards HIV and AIDS.

• Effect of peer education on students’ attitude towards HIV and AIDS.

• The influence of gender on students attitude towards HIV and AIDS.

• The interaction effect of gender and peer education on students’

awareness towards HIV and AIDS.

• The Interaction effect of gender and peer education on students’ attitude

toward HIV and AIDS.

Effect of peer education on students’ awareness towards HIV and AIDS

The result of the study shows differences in the pretest result of the

treatment and control groups. These differences in the pretest results provided

basis on which it could be established that both the treatment and control

groups had an equivalent awareness background towards HIV and AIDS at the

commencement of the treatment. The overall result indicates that students

62
 63

exposed to treatment using the peer education (treatment group) had significant

improvement on their awareness towards HIV and AIDS than those who were

not exposed to treatment (control group). This is clearly indicated by their

expression of what HIV and AIDS stand for. The students expressed more

knowledge and awareness after being exposed to the treatment. The finding on

enhanced mean score at posttest is in line with the study carried out by

Richeter, Vincent and Re O (1997) proved that secondary school students

improved on their awareness and attitude towards sexual transmitted infection

after being exposed to any form of sexuality education programme using their

fellow students as facilitators. The authors found that 64% of the students had

basic knowledge about STDs especially HIV and AIDS and almost 100% had at

least heard of it. The authors concluded that after peer interaction among the

students, their level of awareness and knowledge increased. This development

they attributed to being free in discussion or interaction as they see themselves

as equals.

The result also agreed with Fisher, Fisher, Bryan and Misovich (2002)

that sexuality education breeds sustained changes in HIV prevention behaviour

of rural students, improved HIV prevention intentions of rural than urban

students and a marginally significant interaction effect between the school

based intervention location on the students’ knowledge and attitude towards

HIV prevention relative to controls.

 64

The Influence of Gender on Students’ awareness towards HIV and AIDS

The influence of gender on students’ awareness towards HIV and AIDS

was explored in this work. The computed post-test mean scores for male and

female students respondents exposed to peer education on awareness showed

that the male students benefited more from the peer education, than their female

counterparts as shown by higher mean score. However, when the data were

further subjected to statistical treatment of hypotheses testing, the result

indicated that gender is not a significant factor that influence their awareness

towards HIV and AIDS.

The present finding agrees with Ifelunni and Okorie (2003) who found

that females have earlier sexual experience in medium and low density areas

(semi urban and rural locations respectively), than males in high density areas

(urban locations) who make love with more than one sex partner than the

females. This is an indication that gender has no influence in their sexual

behaviour but the males indicated having high awareness of the consequences

of such behaviour than the females. In the same vein, in a study by Onoja

(2004) using adolescents male and female in Otukpo metropolis of Benue State

of Nigeria to find out the level of awareness of HIV and AIDS among the

students, the result revealed that irrespective of gender, the adolescents within

the sampled schools are quite aware of the presence of HIV and AIDS.

In contrast to the findings of this study is that of Okafor (2001) who

studied gender dimension of extent of awareness of HIV and AIDS in Anambra

State of Nigeria. The study revealed that the females are more aware of
 65

negative consequences of STIs including HIV and AIDS than the males. The

author maintained that this is as a result of early education on the need for

hygiene especially during their mensutral period.

Effect of Peer Education on Students’ attitude towards HIV and AIDS

The effect of peer education on students’ attitude towards HIV and AIDS

was explored in this study. The result of the study shows differences in the

pretest result of the treatment and control groups. These differences in the

pretest results provided basis on which it could be established that both the

treatment and control groups had an equivalent attitude background towards

HIV and AIDS at the commencement of the treatment. The overall result

indicates that students exposed to treatment using peer education (treatment

group) had significant improvement on their attitude than those who were not

exposed to treatment (control group). This is evidenced by the students’

manifestation of more rational attitude towards HIV and AIDS. In other, words,

the students adopted more rational attitude after being exposed to the treatment

therapy.

This finding on manifestation of more rational attitude at posttest is in

line with the study of Walground, Prones, Hayos, Ellic and Roah (1993) who

found that the education activities using peers carried out prior to their study

has an effect on their attitude towards sexually transmitted infections including

HIV and AIDS. In the same vein, Adegbenro (2004) conducted a research using

two groups where one group students were allowed to take part in an interactive

sexuality programme where educations peer was adopted while students from
 66

the other group were not allowed. The result revealed that the proportion of

students who dropped out of school from among students who participated in

the programme declined from to 41% to 13% whereas there was an increase

from 11% to 25% in their counterpart schools.

Also, Kirby, (1997) found out that participants in their study acquired the

skill for reducing sexual risk-taking easily through peer education. The finding

above is an indication that the use of peers in educating their colleagues yielded

positive outcome as there was a manifestation of positive attitude towards HIV

and AIDS by those exposed to the treatment.

The Influence of Gender on Students’ attitude towards HIV and AIDS

The influence of gender on students’ attitude towards HIV and AIDS

was explored in the present study. The posttest mean scores for male and

female student respondents exposed to peer education on attitude towards HIV

and AIDS showed that the female students benefited more from peer education

than their male counterparts as shown by a higher mean score. Although, when

the data was subjected to statistical analysis to test the hypothesis of no

significance influence in the mean rating, the result showed that gender is not a

significant factor influencing their attitude.

The finding therefore is in contrast with the study by Cash;

Sanguansermsri, and Busayawong (1997) in Thailand, in the study, both female

and male peer educators were trained to facilitate single sex and mixed-sex

group sessions with unmarried factory workers. Findings from formative

researcher were used to create comics and story Books that include male and
 67

female characters whose attitudes and behaviours reflected prevailing gender

norms about communication, sex and HIV prevention. Pre and post-

intervention interviews with participants demonstrated increased understanding

of how traditional gender roles inhibit HIV –related communication as well as

increased peer and partner communication on HIV/AIDS and sexual risk

reduction. The study also found out that young women have more ability to

express an opinion and ask questions than girls – only HIV/AIDS peer

education groups as compared with mixed-gender groups which highlights the

importance of special learning environments and message for women.

In the same Vein, Silva (1997) noted that in Sri Lanka, male and female

youth peer educators facilitated discussions with peer groups about virginity,

sexual behaviour, and decision-making, first in same-sex and later in mixed-sex

group sessions. The findings from the study showed that single-sex group

sessions helped young women to develop a public voice, which enabled them to

actively participate in subsequent group discussions with males. The study also

found that recruitment and retention of participants in these group sessions was

greater for female than for males.

The Interaction Effect of Gender and Peer Education on Students’

awareness towards HIV and AIDS

The result show that there is no significant interaction effect of treatment

and gender on students’ awareness towards HIV and AIDS. The present study

agrees with the study carried out by Oroedien and Oloyede (2003) which found

no significant interaction effect between gender and a sexuality programme on

 68

sexual arousals. The results of the present study however disagree with that of

Maduewesi (2005) which posited that girls were more restricted in their sexual

behaviours than boys and therefore may benefit more when allowed to educate

themselves.

Culturally too, the males are the ones who go for females for sexual

relationships. Girls on the other hand are expected to be reserved and dependent

oriented based on the cultural orientation hence gender differences may appear

to exist based on the cultural expectations of the society (Okeke, 2000). The

point however is that sexuality education through peer interaction does not have

direct effect on students’ sexual behaviour (attitude) just because they are males

or females. Hence the present study indicated no interaction effect of treatment

and gender on students’ awareness towards HIV and AIDS.

The Interaction Effect of Gender and Peer Education on Students’ attitude

towards HIV and AIDS

The study reveals that there is no significant interaction effect of

treatment and gender on students’ attitude towards HIV and AIDS. The finding

agrees with Ezedum (2003) which examined students’ heterosexual behaviour

pattern and came up with a conclusion that students heterosexual behaviour

pattern was not significantly influenced by their gender. According to the

author, the treatment was not significant and was not affected by gender

difference, both gender benefited from the treatment they were exposed to.
 69

The findings disagreed with Doswell and Patrick (2007) that significant

interaction effect exists between sexual abstinence intervention programmes

and gender. Doswell et al maintained that premarital sexual attitude and

abstinence self-efficacy predict premarital sexual drive for males but attitude

and norms influence premarital sex for females.

Conclusions

From the findings of the study, it was concluded that there is a significant

improvement on the awareness of students exposed to treatment compared to

the control group while gender has no significant influence on students’

awareness towards HIV and AIDS.

Also, it was concluded that there is significant improvement on the attitude

of students exposed to treatment compared to the control group while gender

has no significant influence on students’ attitude towards HIV and AIDS.

Finally, the interaction effect of treatment and gender on students’

awareness towards HIV and AIDS is not significant.

Educational Implications of the Findings

The findings of this study have some far reaching educational

implications for teachers, guidance counsellors government/policy makers,

curriculum planners and students. The study provides an empirical evidence of

the effectiveness of peer education on students’ awareness towards HIV and

AIDS. The finding that student exposed to peer education improved on their

awareness towards HIV and AIDS significantly implies that there can

remarkable acquisition of knowledge of HIV and AIDS through peer education.

 70

The findings of the study imply that there is serious and urgent need to provide

environment where students will be free to interact with one another especially

to have awareness of the HIV and AIDS. This opportunity would enhance

sexuality teaching that is comprehensive among peers.

The present study has provided some useful empirical basis for the

teaching and learning of sexuality issues especially on risky aspects that may

expose the students to unhealthy sexual behaviour. The findings that gender has

no significant influence on both awareness and attitude of the students towards

HIV and AIDS imply that the idea of separating the males from the female

when certain sexuality issues is being discussed will be counter productive.

There is the need therefore, to integrate the two groups especially when they are

providing the information for themselves. Boys and girls should therefore be

co-educated more especially when sexuality education is delivered or taught in

schools.

The results revealed that both male and female benefited from the peer

education programme that improved positively on their awareness and attitude.

There is the need, therefore, for teachers and educational authorities to provide

the enabling environment where both male and female students should be given

opportunities to teach themselves. The inability to create such room will make

such group that was not exposed to peer co-education not to be comfortable in

expressing their feelings and views. This will equally remove the practice of

teaching males different topics and females different topics. The implication of

this is that females should not only be made to possess equal educational
 71

opportunities with males but should be seen to exhibit the same level of sexual

behaviour as the males. The findings of the study would generally assist

government, curriculum planners and other stakeholders to develop curriculum

policies and experiences that would increase students awareness and attitude

about HIV and AIDS.

Recommendations

The following recommendations have been proffered based on the

findings, conclusions and implications of the study:

1) Based on the findings of the study the study recommends the use of peer

interaction or education in sexuality education in schools so as to give

the adolescents the opportunity of self expression;

2) All secondary school students should be exposed to peer education

irrespective of gender as a means of enriching their awareness as well as

improving their attitude towards sexual transmitted diseases (STDs)

3) Curriculum planners need to review and implement secondary school

curriculum towards integrating the principle of peer education to enable

students improve on their awareness and attitude towards HIV and AIDS

and

4) School authority should integrate peer education in the teaching of

sexuality issues as this will provide opportunities for students to utilize

peer approach in learning about HIV and AIDS.

 72

Limitations of the Study

The generalizations made to this study are however subject to the

following limitations:

1) The study was delimited to Nsukka Education Zone of Enugu State and

Six Selected Schools and Selected Students were used for the study. It

was not feasible therefore, to generalize the findings across Nigeria.

Such generalization should be done with caution as results in other areas

may or may not be the same. However, the fact that the study is an

experimental one warrant the use of small manageable samples as were

the case of this study and the representatives in terms of sampling and

the rigors of the experiment are enough alibi to counter the above

limitation.

2) Some set-backs such as the faking of responses, distortion of facts by the

respondents and the lukewarm attitude of some respondents posed a great

limitation because questionnaire was used as the instrument for data

collection.

3) No follow-up measurement of covert behaviour was recorded after the

treatment. In some situation covert feelings of students must be changed

before any overt changes in behaviour can be expected.

Suggestions for Further Study

The following suggestions are made for further studies:

1) Replication of this study in other states of the federation with different

cultural background.
 73

2) Further research could be conducted on the effect of peer education on

adolescents reproductive health seeking behaviour.

3) Also further research could be conducted on the effect of peer education

of students attitude towards risky sexual behaviour.

4) Finally, a similar study among the out-of-school adolescents could be

carried out in order to compare results.

Summary of the Study

Adolescents especially those in secondary schools are among the most

sexually active segment of the population. This may have affected their level of

knowledge and attitude towards HIV and AIDS that is of concern to all

concerned in the reproductive health. The study was designed to determine the

effects of peer education on awareness and attitude towards HIV and AIDS

among in-school adolescents in Nsukka education zone of Enugu State. To

guide this study, six research questions were posed and six null hypothesis

formulated and tested at p < 0.05 level of significance.

The research design used in this study was Non-Equivalent Control

Group Quasi experimental involving experimental and control groups. The

sample for the study was made-up of 231 students in SS11, selected using a

stratified random sampling technique based on Local Government Areas. A

random sampling technique was used to draw two co-educational schools from

each local government area and they were randomly assigned to both

experimental and control groups. Three trained research assistants were used

for the experiment while the control group was not exposed to any treatment.
 74

The instrument for the study was a researcher constructed questionnaire

titled HIV and AIDS Awareness and Attitude Questionnaire (HAAAQ). The

instrument was a 30 item questionnaire. The reliability of the instrument was

determined using Cronbach Alpha which yielded 0.80 and 0.79 values for the

two clusters.

Measures were taken to control extraneous variables. A pretest of the

questionnaire instrument was administered before the treatment that lasted for

six weeks. The treatment consisted of peer education. The data collected were

analysed using mean, standard deviation and Analysis of Covariance.

Results of the study show that:

1) Students exposed to treatment on peer education had higher awareness of
HIV and AIDS compared to those of the control group.
2) Gender is not a significant factor influencing students’ awareness
towards HIV and AIDS.
3) Students exposed to treatment on peer education had a higher positive
attitude towards HIV and AIDS compared to those of the control.
4) Gender is not a significant factor influencing students’ attitude towards
HIV and AIDS.
5) There is no interaction effect of gender and peer education on students’
awareness towards HIV and AIDS.
6) There is no interaction effect of gender and peer education on students’
attitude towards HIV and AIDS.
Based on the findings, conclusion was drawn, educational implications
highlighted and recommendations made.
 75

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 APPENDIX A
79

TREAMENT PACKAGES
THE DETAIL OF PEER EDUCATION PROGRAMME ON HIV/AIDS
SESSIONS OBJECTIVE CONTENT TRAINERS TRAINEES STRATEGIES MATERIALS EVALUATION
ACTIVITY ACTIVITY
SESSION I At the end of this The instructor highlights The instructor will This is question Make the The instructor uses The instructor will find
programme the students will Ground Rules: ask the participants time participants not to the books written out to what extent the
know the purpose of their - Punctuality to ask questions feel shy by telling on Peer Education stated objectives are
being together – to be aware - Days of meeting based on the the participants by other resource being attained. He can
of HIV/AIDS and their and time objectives and rules some short stories. persons. give the participants an
attitude towards it especially - Co-operation from already stated. (explanative assignment.
among the Adolescents. participants discussion)
- Regularity
- Mode of conduct
- Duration
- Reinforcers of
positive
contributions.

SESSION 2 The research assistants Awareness Creation The trainer will Students study the Questioning Resource books on The Instructor uses
create rapport. Give the towards HIV/AIDS and display the picture of picture and Explanation Peer Education on revision questions to
definition and explanation of the type of attitude to be the people living diagram. Students Explanative HIV/AIDS test the level of
HIV/AIDS. adopted towards people with HIV and AIDS. answer questions discussion. concerning understanding of the
HIV=Human Immune living with HIV/AIDS Discusses the picture aimed at clarifying adolescents. lesson.
Deficiency Virus affect (Especially the and gives reasons the lesson. Discussion
only Human beings. It adolescents). why the PLWHA Question Diagram depicting The student
attacks Human The Instructor gives looks emaciated. The participants Explanation. healthy adolescents participants will be
Immune System, the the meaning of AIDS will demonstrate and another allowed to ask their
body’s defence against thus their acquisition of showing PLWHA questions for
invading disease. A=Acquired The trainer copies a the concepts and and compare. clarifications. The
AIDS=Acquired Immune Meaning “to get note on the definition of research assistant
Deficiency Syndrome from” from others chalkboard for the HIV/AIDS, equally asks them
infected. participants to copy. Awareness and questions to determine
I=Immune meaning Attitude. the extent they have
protection or learnt.
defence. That is the
body is defended
against foreign

SESSION At the end of this lesson,
3 participants establishes
rapport
- Able to recapitulate
the previous
instruction
- Identify modes of
transmission of
HIV/AIDS.
SESSION 4 At the end of this session
participants will know the
preventive strategies for
HIV/AIDS
80
bodies (diseases).
D=Deficiency Meaning
not enough
indicating that the
immune system is
not enough to
defend.
S=Syndrome Meaning
that it comes with a
lot of sickness etc.
Awareness= Knowledge
level as it relates to
HIV/AIDS.
Attitude=Reactions or
feelings as it relates
to HIV/AIDS.
MODES OF The research Participants will be The participants Resource persons’ The instructor will find
TRANSMISSION assistants take a roll asked to say one will be given the evidences and out to what extent the
- Blood fluids call. He makes a after the other what opportunity to ask books dealing on stated objectives are
- In blood flash back on the they feel will be the questions for the modes of being attained by
(including ground rules as a causes of clarifications. transmission and giving them take home
menstrual blood) reminder. The HIV/AIDS so as to Identifying modes preventive assignments, and on
- Breast milk researcher highlights know their of transmission measures. the spot questions.
- Anal or Vaginal more on the awareness level. common within
sex. objectives of the students’
- Unsterilized sharp programme. environment,
objects (Razor,
clippers, needles)
- Infected blood
transfusion.
Preventive The instructor will try to The participants Determining the Material like The instructor will ask
Strategies for ascertain from the group will be asked to preventive books, pen, will be them questions
HIV/AIDS. what they should do to avoid examine the picture measures for not distributed to them. relating to the
The purpose of contacting HIV/AIDS. Then of the PLWHA. being infected by Non material like preventive strategies
coming together the following will be This is because HIV/AIDS. hugging, clapping as a means of
for the programme presented to them as pictures stimulate to show clarification,
as well as modes of preventive strategies and help further recognition. - Closing time
transmission of i. Condom use study, help the with a ritual.
HIV/AIDS. ii. Abstinence participants or the
 81

iii. Delay of sex trainees to take

iv. Voluntary active interest in
counseling and the topic presented.
Testing (VCT)
v. HIV/AIDS
Education.
SESSION At the end of this session Determining their The instructor will The participants The instructor will Materials like cap, The participant will be
5 participants must have attitude to the enumerate ways through will be asked to call the infected vest, and novels, given the opportunity
learnt how to build a source or PLWHA. which participants can narrate the story of person if possible pen will be to ask questions based
positive attitude towards developed positive attitude an infected person to dance with the distributed. on the discussion. The
HIV/AIDS as well as the towards HIV/AIDS by and what would be trainees, sit down instructor will equally
ground rules will be indicating the following their attitude to the with them and even ask them questions for
highlighted. i. A person infected source. to eat with non- more clarifications.
can engage in infected people The session will be
normal activity. (participants) closed with a ritual
ii. HIV/AIDS is no after a recap of the
more an end to life discussion
SESSION 6 Termination The instructor will After this, an entertainment Exercise books and
Entertainment go through the will be provided for all the pen will be
Closing with a ritual of whole process participants. received by the
closing songs, exchange of starting from participants.
greetings, hugging. session I to session
5.
 APPENDIX B
INSTRUMENT

Department of Educational Foundations

Faculty of Education
University Nigeria, Nsukka
Date……………
Dear Respondents,

HIV and AIDS Awareness and Attitude Questionnaire

The researcher is a postgraduate Student of the above department in the
Faculty of Education, University of Nigeria, Nsukka. The researcher is
conducting a study on Effect of Peer Education on Awareness and Attitude
Towards HIV and AIDS among Adolescents in Enugu State.
The researcher wishes to know the extent of your awareness and attitude
towards HIV/AIDS. Your candid response to the attached questionnaire will help
in achieving the objective. The information you provide will be used for the study
alone and will be treated with confidence.
Your cooperation is most kindly required. Thanks

Sincerely,

Rev. Fr. Ugwuanyi, J. N.

PG/Ph.D/09/50584

82
 83

SECTION A
PERSONAL DATA
1. Gender: Male
2. Female

3. Class: ………………………………..

4. School: ……………………………

SECTION B
QUESTIONNAIRE
This section has some statements with a four point rating responses of
strongly Agree (SA), Agree (A), Disagree (D) and Strongly Disagree (SD).
Please tick only one option of a statement that appeals to you.
AWARENESS OF HIV AND AIDS

S/NO SA A D SD
1 HIV and AIDS are mere ploy adopted to reduce
people’s sexual activity.(Cognitive belief)
2 There have been serious killer diseases and people
have equally been living their normal sexual life.
(behavioural action)
3 HIV and AIDS can only be contacted through sexual
intercourse.
4 HIV and AIDS has no cure
5 The use of contaminated sharp objects exposed to
one’s blood can make one to contact HIV and AIDS.
6 Unprotected sexual activity with a carrier can lead to
HIV/AIDS.
7 Engaging in oral sex can make one have HIV and
AIDS
8 Engaging in anal sex can make one contact HIV and
AIDS
9 Having a thorough bathing after sexual intercourse can
help one not to contact HIV and AIDS
10 People must die of one thing or the other and
HIV/AIDS must be one of the agents of death
(affective value feeling)
11 Body contact with HIV and AIDS person can result to
one contacting it.
 84

12 Mouth kissing has nothing to do with sexual areas and

therefore cannot lead to HIV and AIDS.
13 Abstaining from sexual intercourse will make one not
to acquire HIV and AIDS.
14 Having sexual intercourse with many people with
condom can secure one from having HIV and AIDS.
15 HIV and AIDS can be cured with herbal medicine.

ATTITUDE TOWARDS HIV AND AIDS

S/NO SA A D SD
1 That has HIV/AIDS does not mean such person is
useless (cognitive belief).
2 There is nothing wrong sleeping with a person
living with HIV and AIDS ((behavioural action)).
3 I can play with a person living with HIV and
AIDS (behavioural action)
4 When one contact HIV and AIDS his or her life
cannot be managed.
5 The only way to avoid contacting the disease is by
not associating with the person living with
HIV/AIDS (affective value feeling).
6 A person living with HIV and AIDS should be
discriminated against as they are the cause of their
own problem. (Cognitive belief).
7 One should avoid having a contact with a PLWHA
as the person’s coughing can be contacted
(behavioural action)
8 There is nothing wrong in determining one’s status
through voluntary counseling and testing
9 There is the need for one to erase entirely the issue
of sexual intercourse from mind
10 Negative relationship towards the PLWHA of HIV
and AIDS should be advocated if one will be free
from the disease. (behavioural action)
11 People should not go to the same toilet with a
PLWHA.
12 There is nothing wrong in eating with a person of
HIV and AIDS in the same plate (affective value
feeling).
13 People should discourage their relations from marrying
a person living with HIV and AIDS (Cognitive belief).
14 People should avoid engaging in any physical activity
with PLWHA (behavioural action)
15 People with HIV and AIDS should be distanced in a
social setting.