1.1 Introduction
The human Immunodeficiency Virus also known as acquired immunodeficiency syndrome (HIV/AIDS) epidemic is in its third decade and has reached to alarming proportions worldwide. HIV/AIDS is a disaster which disrupts the family’s equilibrium by placing a dark and frightening cloud over their future; it is one of the most challenging public health problems of our country. Stigmatization in any magnitude has multiple effects on the lives of people living with HIV/AIDS and more broadly on members of society, creating disruptions in social functioning, and increasing people's vulnerability to infection and reducing the overall caring capacity of communities. Stigma is perhaps a pervasive problem that affects health globally, threatening an individual's psychological and physical well-being. HIV/AIDS epidemic has significant effect on the economic and sociological wellbeing of victims.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
HIV/AIDS has become a threat to public health in Nigeria as a result of its devastating consequences, which are manifested in forms of prolonged sickness, deaths and increase in number of orphans and widows/widowers. Nigeria has an estimated population of about 150 million of which about 3.5 million are infected by HIV/AIDS (FMINO, 2007). HIV/AIDS was first identified in Nigeria in 1985 and reported at an International Conference in 1986 (Adeyi et al, 2006). The HIV/AIDS pandemic led to the death of 170,000 Nigerians in 2007 (UNAIDS, 2008). According to Edewor (2010), Nigeria has already surpassed the 5 percent explosive prevalence phase and the disease has killed more than 1.3 million people and orphaned more than 1 million children (FMINO, 2007). The infection rates of HIV/AIDS vary across the six geopolitical zones of Nigeria.
People living with HIV/AIDS (PLWHA) are known to have great emotional needs and they require enormous support for coming to terms with dire affliction status. In addition to being a disease that is associated with a number of physical malfunctions and progressive discomforts like pain, shortness of breath, altered sexual functions and disfigurement, HIV/AIDS is associated with social stigma, it is highly stigmatized disease and this stigmatization can lead to a progression of other grievous psychological stressors such as anxiety, depression, fear, suicidal tendencies and so on, on the prospect of real and anticipated losses, worsening quality of life, fear of physical decline and death, coping with uncertainty, unemployment, homelessness, financial doldrums and the breakup of relationships.
The HIV/AIDS infected patients can live healthy lives for longer if proper care and support is provided; their immune system can be strengthened by medical treatment, healthy food, regular exercise, rest, care and support. They need a compassionate multifaceted assistance and support which will enable them to find meaning to life, appraising their survival, taping new resources of psychic strength and courage. Some of the feelings the PLWHA experience include shock or anger at being positively diagnosed with HIV, fear over how the disease will progress, fear of isolation by family and friends and worries about infecting others. By bearing such a heavy burden, it is not surprising that depression is twice as common in PLWHA compared to general population (American Psychiatric Association, 2013).
Psychological problems have also been associated with HIV/AIDS risky behaviors, non adherence to HIV/AIDS related medicated and shortened survival rates (Farinpour et al., 2013; cook et al; 2014). The Psychological impact is disproportionately high on those with low socio-economic status as they might be faced with fear, anxiety and hopelessness on the uncertainty of future treatment affordability due to high cost of treatment and care. Globally, there are about 33.3 million PLWHA, in South East Asia region it has been estimated that about 3.5million people are living with HIV/AIDS, India has the world’s third highest total HIV burden, the prevalence of the infection is estimated to be about 0.34% of the population which translates to 2.3million people.
In Nigeria, it is estimated that about 3.1million people are living with HIV, 2.8% adult HIV prevalence (15-49years), 210,000 new HIV infections, 150,000 AIDS- related deaths, 34% adults on retroviral treatment. Nigeria has the second largest HIV epidemic in the world, unprotected heterosexual sex accounts for 80% of new HIV infections in Nigeria with the majority of HIV infections occurring in affected populations such as sex workers. In addition, at times, depression is noted to be often linked with major causes of HIV transmission. These include alcohol consumption before sex, unprotected sexual contact, intravenous drug use, the sharing of HIV contaminated syringes and needles, and (Saylors and Daliparthy, 2015; Luber, 2012).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Effect of Group Counselling on the Psychological Adjustment of People Living with HIV / AIDS.
1.3 Statement of Problems
Investigation revealed that the problems of psychological implication on PLWHA. Despite advances in HIV care, PLWHA face numerous psychological challenges, HIV stigma has been defined as the social discrediting and devaluation of HIV infected persons. PLWHA are sometimes abandoned by their families and are forced to live in destitution which may lead to psychological devastation, inadequate family and community support may lead to poor drug adherence and non-disclosure of their disease status thus arising complications.
HIV/AIDS can lead to ostracism and social isolation; some children have a difficult time because of the interminable bullying and mockery at school and neighborhood which may lead to loneliness and low self esteem. Because of the stigma of HIV/AIDS, families are fearful of disclosing the diagnosis and have limited support systems from both inside and outside their family. It is estimated that up to 50% of PLWHA suffer mental illness and substance abuse issues (Bing et al; 2009).
Depression is noted to be often linked with major causes of HIV transmission, these include; unprotected sexual contact, intravenous drug use, alcohol consumption before sex and the sharing of HIV contaminated syringes and needles (Saylors & Daliparthy, 2010; Luber, 2012). Despite the prevalence of psychological distress experienced by PLWHA, the available body of evidence indicates that depression is frequently under diagnosed and goes untreated on a large scale. Hence, the intent of this study is to investigate the Effect of Group Counselling on the Psychological Adjustment of People Living with HIV / AIDS in Nigeria.
1.4 Aim and Objectives of Study
The aim of this study is to ascertain the Effect of Group Counselling on the Psychological Adjustment of People Living with HIV / AIDS in Nigeria. Specifically, this study seeks to achieve the following;
- To ascertain the impact of counseling on the psychological well-being of HIV/AIDS patient in the area under study;
- To investigate the role of counseling on the life span of people living with HIV/AIDS in the area under study;
- To ascertain the effect of counseling on the psychological adjustment of HIV/AIDS patient in the area under study; and
- To investigate the relationship between counseling and psychological adjustment of HIV/AIDS patient in the area under study.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the impact of counseling on the psychological well-being of HIV/AIDS patient in the area under study?
- What is the role of counseling on the life span of people living with HIV/AIDS in the area under study?
- What is the effect of counseling on the psychological adjustment of HIV/AIDS patient in the area under study?
- What is the relationship between counseling and psychological adjustment of HIV/AIDS patient in the area under study?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between counseling and psychological adjustment of people living with HIV/AIDs in Nigeria
- H1: There is a significant relationship between counseling and psychological adjustment of people living with HIV/AIDs in Nigeria
Hypothesis Two
- H1: Counseling does not have any significant effect on the psychological adjustment of people living with HIV/AIDs in Nigeria.
- H1: Counseling does have a significant effect on the psychological adjustment of people living with HIV/AIDs in Nigeria.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will be of great importance to HIV/ AIDs patient in the country as the study seek to enumerate the benefit of counseling to the general well-being of the Patients, the study will also be of benefit the medical practitioners and the employees of Centers for Disease Control and Prevention, as the study laid emphasis on the benefit of counseling and guidance on the life span of HIV/AIDs patient in the country.
The study will also be useful to researchers who intend to embark on research in similar topic. Finally the findings of this study will also be immense benefit to government, academia, scholars, researchers and the general public.
1.8 Scope of Study
The scope of this research is focused on the Effect of Group Counselling on the Psychological Adjustment of People Living with HIV / AIDS in Nigeria.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
HIV/AIDs: Human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV).
