An analysis of the prevalence of HIV and AIDS at General Hospital Minna using canonical correlation analysis

Chapter One 1.0 General Introduction
Ever since the identification of Human immunodeficiency virus (HIV) as the cause of Acquired Immune Deficiency Syndrome (AIDS) in 1983, the infection has become a global epidemic. HIV/AIDS is a unique and complex crisis that requires immediate attention and long-term solutions. Tumer and Unal (2000) argue that HIV/AIDS is a highly intricate health issue of the 21st century. Despite the significant efforts made in terms of funding, political commitments, and expanding access to HIV treatment, the AIDS epidemic still surpasses all global response measures. Today, the AIDS epidemic has evolved into a global health crisis, posing a significant threat to the world population. With the HIV/AIDS pandemic persistently spreading across the globe at an alarming rate, there is a projected significant increase in the number of individuals affected by this disease by the end of the decade. In addition, based on data from UNAIDS (2006), it is estimated that there are approximately 24.7 million individuals living with HIV/AIDS in sub-Saharan Africa. Meyer (2003) states that HIV/AIDS, considered the fourth-leading cause of death globally, has tragically taken the lives of approximately 25 million people since the start of the epidemic. AIDS is a viral disease caused by HIV, which is typically present in body fluids such as blood, semen, vaginal fluid, and breast milk of infected individuals. The transmission of the virus occurs primarily through sexual intercourse and the sharing of unsterilized instruments such as blades, knives, and syringes previously used by infected individuals. In a study conducted by Olaleye in 2003,

AIDS has left numerous children without parents, many of whom were born with HIV infection. AIDS is devastating the most productive individuals in the population, exacerbating the development gap between developed and developing nations. Furthermore, the health sector is significantly impacted as a substantial amount of funding is directed towards the prevention and control of HIV/AIDS. It is evident that despite numerous efforts to raise awareness about the issue of HIV/AIDS, the infection rate continues to rise. (Omoniyi and Tayo-Olajubu 2006)
According to Cichocki (2010), it is emphasised that HIV testing is crucial as the initial step in determining an individual's status. It is not advisable to base one's determination of HIV infection solely on symptoms. Getting tested for HIV is the only reliable method to obtain accurate information. The significance of early detection of HIV cannot be emphasised enough. Extensive research on HIV and AIDS has conclusively demonstrated that an early diagnosis greatly improves the prognosis and increases the chances of leading a long and healthy life. Meanwhile, there are certain behaviours that pose a higher risk of HIV infection. According to Anochie and Eneh (2001), these behaviours can be attributed to either lifestyle choices or risks associated with healthcare providers. The risk behaviours associated with certain lifestyles include engaging in sexual activity with multiple partners, including prostitutes or casual partners, having unprotected sex, using intravenous drugs, and participating in commercial blood donation, among other activities.
In addition, there have been numerous efforts made by both government and non-governmental organisations (NGOs) to combat the spread of HIV/AIDS. According to Olaleye (2003), these campaigns were centred around strategies to combat the spread of HIV/AIDS. The measures include practicing safe sex by using condoms to prevent infections from unprotected sexual intercourse, ensuring that blood meant for transfusion is screened, maintaining monogamy, and using sterilised sharp objects such as blades, knives, needles/syringes, shaving and barbing instruments. Couples planning to get married are also encouraged to undergo HIV/AIDS testing beforehand. Omoniyi and Tayo-Olajubu (2006) argue that individuals diagnosed with AIDS may develop life-threatening diseases known as opportunistic infections. These infections are caused by microorganisms, such as viruses and bacteria, that typically do not affect healthy individuals. Nevertheless, the HIV virus gradually weakens the immune system, leaving the infected individual susceptible to a wide range of diseases and illnesses. Ultimately, this can result in the complete breakdown of the immune system. At this stage, an individual is considered to be experiencing AIDS. In Nigeria, the HIV prevalence rate among adults ages 15–49 was 3.1 percent as of 2012. Nigeria ranks second in terms of the highest number of individuals living with HIV. The HIV epidemic in Nigeria is a multifaceted issue that exhibits significant regional disparities. There are certain states where the epidemic is more focused and influenced by risky behaviours, while in other states, the epidemics are more widespread and primarily sustained by multiple sexual partnerships in the general population. Young people in Nigeria face a heightened vulnerability to HIV, with young women being at a greater risk compared to young men. There are numerous factors that increase the risk of HIV transmission, such as engaging in prostitution, engaging in high-risk behaviours among itinerant workers, a high prevalence of sexually transmitted infections (STIs), engaging in clandestine high-risk heterosexual and homosexual practices, the international trafficking of women, and inadequate blood screening practices.
Nigeria is transitioning from a period of military rule that lasted for nearly three decades out of the five decades since gaining independence in 1960. As a result, the policy environment lacks full democratisation. Civil society was lacking in strength during the military era, and its ability to advocate and lobby continues to be limited. The logistical and political challenges posed by the size of the population and the nation are particularly significant, given the Nigerian Government's strong commitment to achieving health care equity across geopolitical zones. The need to synchronise programmes concurrently at the federal, state, and local levels adds intricacy to the planning process. The extensive private sector operates with minimal regulation and, significantly, lacks any official affiliation with the public health system, which is the primary provider of HIV interventions. Training and human resource development is significantly lacking in all sectors and will impede programme implementation at all levels. The provision of care and support is hindered by the overwhelming workload of existing staff, who often lack the necessary expertise in crucial technical fields to deliver comprehensive HIV services.
From an epidemiological standpoint, it is estimated by UNAIDS that there are approximately 40 million individuals worldwide who are currently living with HIV/AIDS. Out of this population, around 44% are women, while approximately 7.1% are children. Sub-Saharan Africa is facing a significant impact, with nearly 30,000,000 individuals affected by HIV.
South Africa has the highest number of HIV patients globally, with Nigeria and India following closely behind. The South & South East Asia region has been severely impacted, ranking as the second worst affected. In 2007, it accounted for approximately 18% of the total number of individuals living with AIDS and witnessed an estimated 300,000 AIDS-related deaths.

1.1 Problem Statement
HIV/AIDS is a highly concerning illness that significantly contributes to the global health crisis. The rate of HIV/AIDS infection is on the rise, despite the efforts made by government at federal, state, and local levels. Due to the urgency of the disease, this research aims to examine if the canonical correlation model can identify if literacy level and gender contribute to the risk of HIV/AIDS in Niger State.
 

1.2 Importance of the Study
This study aims to enhance our understanding of HIV/AIDS by contributing new knowledge. It is also beneficial for government and nongovernmental organisations to implement stringent measures to control the spread of the disease.

1.3 Purpose and Goals
The objective of this research is to develop a canonical correlation model to assess the potential relationship between literacy level, gender, and the risk of HIV/AIDS in Niger State.
The above aim is accomplished by pursuing the following objectives: • Assessing the impact of risk factors on the prevalence of HIV/AIDS through the application of canonical correlation.
• To assess the correlation between the canonical variates using Wilk's Lambda test.
In order to assess the homogeneity of variances among the risk factors, Bartlet's test was conducted.
 

1.4 Study Scope and Limitations
This research work is focused on data obtained from General Hospital Minna, specifically the Heart to Heart centre which was established in 2007. The data was analysed using a Canonical correlation model, which is able to establish relationships between two sets of variables. In this case, the variables being examined are literacy level and gender, as well as age, weight, and marital status.