**5. Conclusion**

This study confirms the prevalence of intergenerational sex in Nigeria and identifies associated factors. It assuages that the practice may promote the spread of HIV infection among Nigeria's teeming youth population leading to HIV infected young women bearing the burden of the disease. The messages are clear that delayed onset of sexual debut; education; women economic empowerment, increased life options for women and working with men to challenge the socio-cultural norms and perceptions that allows for and sanction engagement in intergenerational sex would go a long way to reduce the practice and lead to improvement in the health outcomes of the young women including reduction in HIV infection in the group. The authors have suggested several policy options but policies need to be put in context within the different regions of Nigeria and the health and sustainable development objectives of the country. Importantly, more qualitative studies should be carried out to identify other social factors promoting the practice in Nigeria and studies directed at intergenerational sex and HIV infection would definitely be very instructive.

There is need to make concerted efforts with programmatic responses to counter power imbalances from gender, age and economic or materials differences between young women and their older male partners. As programmatic responses are mounted, it is important that they are accompanied by intervention research to test their feasibility and ultimately, their impact on reducing intergenerational sex or the inherent power imbalances therein, that facilitate vulnerability of the young women particularly HIV transmission and unwanted pregnancy. Furthermore, the authors suggested a number of policy issues, any process to garner policy support must also be accompanied by policy research to document and analyze the most salient elements of the resulting social change process.

#### **6. Acknowledgement**

The authors acknowledge the helpful comments of Dr. Gbenga Ishola of Jhpiego in the preparation of this article. Dr. Dayo Adeyemi of the MEASURE Evaluation/JSI contributed immensely during the multivariate analysis. The contribution of Adrienne Cox and Noureddine Abderrahim both of ICF Macro in the construction of the outcome variable added value to the in-depth knowledge of analysis in the use of NDHS data. Finally, we thank the ICF Macro and National Population Commission, Nigeria for making the data of the Nigeria Demographic and Health Survey (NDHS) available for use. The opinions expressed in this article are solely those of the authors and do not represent the views of their institutions.

#### **7. References**

Abang, Mkpe (1996). Promoting HIV/AIDS prevention on Nigerian campuses: Students take the lead AIDScaptions 111(3).

values affect intergenerational sexual behaviors in Nigeria, more research is required to

The quality of self-reported information particularly the dependent variable may be unreliable. If anything, however, such sexual behavior as high risk sex, ever paid for sex, condom use at last sex and history of STDs would be underreported, biasing the association towards the null. Therefore, any significant association found may be an attenuated one.

This study confirms the prevalence of intergenerational sex in Nigeria and identifies associated factors. It assuages that the practice may promote the spread of HIV infection among Nigeria's teeming youth population leading to HIV infected young women bearing the burden of the disease. The messages are clear that delayed onset of sexual debut; education; women economic empowerment, increased life options for women and working with men to challenge the socio-cultural norms and perceptions that allows for and sanction engagement in intergenerational sex would go a long way to reduce the practice and lead to improvement in the health outcomes of the young women including reduction in HIV infection in the group. The authors have suggested several policy options but policies need to be put in context within the different regions of Nigeria and the health and sustainable development objectives of the country. Importantly, more qualitative studies should be carried out to identify other social factors promoting the practice in Nigeria and studies directed at intergenerational sex and HIV infection would definitely be very instructive. There is need to make concerted efforts with programmatic responses to counter power imbalances from gender, age and economic or materials differences between young women and their older male partners. As programmatic responses are mounted, it is important that they are accompanied by intervention research to test their feasibility and ultimately, their impact on reducing intergenerational sex or the inherent power imbalances therein, that facilitate vulnerability of the young women particularly HIV transmission and unwanted pregnancy. Furthermore, the authors suggested a number of policy issues, any process to garner policy support must also be accompanied by policy research to document and

analyze the most salient elements of the resulting social change process.

take the lead AIDScaptions 111(3).

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Abang, Mkpe (1996). Promoting HIV/AIDS prevention on Nigerian campuses: Students

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**5. Conclusion** 

**6. Acknowledgement** 

**7. References** 


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**HIV Infection and Schooling** 

<sup>1</sup>*Population Council, Nairobi*  <sup>2</sup>*Makerere University, Kampala 3Ministry of Education and Sports* 

> *1Kenya 2,3Uganda*

**Experiences of Adolescents in Uganda** 

Harriet Birungi1, Francis Obare1, Anne Katahoire2 and David Kibenge3

The increased availability of anti-retroviral treatment (ART) for HIV in parts of sub-Saharan Africa (SSA) has enabled many children who were perinatally infected to survive to schoolgoing age and even longer. For instance, a study conducted in 2007 in Uganda among adolescents aged 15-19 years who were perinatally infected with HIV found that about 70% of them were attending school at the time of the survey and many desired to be in school to avoid social isolation (Birungi et al., 2008). With an increasing number of HIV-positive young people attending school, most governments in SSA have begun to recognize the challenges this situation presents to the education sector (Kelly, 2003). Many governments have formulated Education Sector Policies on HIV/AIDS that encompass all learners, employees, managers and administrators in all learning institutions at all levels of the education system (for example, Ministry of Education and Sports- Uganda, 2006; Ministry of Education- Kenya, 2004). The policies predominantly revolve around a legal framework that recognizes and upholds the rights of all people with a special focus on marginalized and vulnerable groups and those with special needs. They also recognize the need for universal access to HIV/AIDS information, access to treatment and care, protection from discrimination and stigma, and care for orphans and vulnerable in-school young people. In spite of the recognition of school-going HIV-positive young people as a vulnerable group, education sector responses to HIV/AIDS in the SSA region are predominantly curriculumbased. The focus is almost entirely on developing the capacity of learners in the areas of better knowledge about the diseases, skills that enhance the ability to protect oneself against infection, and approaches that acknowledge the rights and dignities of those infected and affected (Bennell et al., 2002; Cohen, 2004; Kelly, 2000; Rugalema & Khanye, 2004). Insufficient attention has been paid to ways of supporting in-school HIV-positive young people partly because their needs in school are still largely unknown given that this is an emerging issue in the region. It could also be due to the dilemma of how to tackle the issue of HIV in schools based on fears that having specific programs targeting in-school HIV-

positive young people could reinforce stigma and discrimination against them.

Whatever the reason for the lack of appropriate education sector responses in this area, a key issue that emerges is the need for evidence on in-school experiences of HIV-positive young people in the region. This should in turn inform appropriate interventions aimed at

**1. Introduction**

Wood K, Maforah F, and Jewkes R (1998): "He forced me to love him": putting violence on adolescent sexual health agendas. *Social Science Medicine*, 47 (13):233-242 (13) **4** 
