**Psychosocial Needs and Support Services Accessed by HIV/AIDS Patients of the University of Ilorin Teaching Hospital, Nigeria**

Yahaya, Lasiele Alabi and Jimoh, A.A.G.

*1Department of Counsellor Education, University of Ilorin, Ilorin 2Department of Obstetrics and Gynaecology University of Ilorin Teaching Hospital, Ilorin Nigeria* 

#### **1. Introduction**

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. According to Edewor (2010), the mode of HIV transmission in Nigeria is mainly through unprotected sex, and other factors which contribute to the spread of the virus include poverty, Sexually Transmitted Infection (STI), social and religious norms and political and social changes (National AIDS/STD Control Programme, 1999).

Parke and Aggleton (2007) noted that negative social attitudes toward marginalised populations, policies mandating the testing of high risk groups and limited legal protections based on HIV status may exacerbate stigma. They stressed further that increase vulnerability to discrimination complicates the social and psychological adjustment of Persons Living With HIV/AIDS (PLWHA). The victims require necessary assistance to be able to live happily and contribute meaningfully to the development of the society. Thus, they need psychosocial supports to be able to cope with their challenges.

Psychosocial needs can be described as social, mental and spiritual requirements of PLWHA in order to live quality life and contribute to development of the society. The needs can be viewed from a psychological theory propounded by Abraham Maslow in 1943. According to Maslow (1954), the hierarchy of needs is often portrayed in the shape of a pyramid, with the largest and most fundamental levels of needs at the bottom, and the need for selfactualization at the top. The most fundamental and basic four layers of the pyramid contain what Maslow called "deficiency needs" or "d-needs", esteem, friendship and love, security,

Psychosocial Needs and Support Services

mainstream care provision were emphasised.

**2. Research questions** 

**3. Methodology** 

Teaching Hospital, Nigeria?

Ilorin Teaching Hospital, Nigeria?

problems.

Accessed by HIV/AIDS Patients of the University of Ilorin Teaching Hospital, Nigeria 129

St. Petersburg, Russia. Sample of the study consisted of 470 persons with HIV/AIDS at St. Petersburg HIV care and service agencies. The participants completed anonymous selfadministered questionnaires on social and psychological characteristics of HIV, serostatus disclosure, discrimination experience and risk practices. The study found that HIV infected persons in Russia experienced a wide range of social, psychological and care access

Jordans, Kein and Pradhan (2007) investigated the counsellors' and beneficiaries' perception of psychosocial counselling in Nepal. Semi-structured interviews were conducted with clients, para-professional counsellors and managers of organisations in which psychosocial counselling was taking place. The study revealed that stakeholders generally presented a positive view of the significance and supportive function of psychosocial counselling, and the issues of training, supervision, confidentiality and integration of counselling within the

Although, a lot of studies (Ostrow et al. 1992; Kelly, Murphy, 1992; Slugget, 2003; Amirkhanian, Kelly & McAuliff, 2003) have been conducted on the psychosocial needs and support services of PLWHA across the world, but little or no attention had been paid to the patients of the University of Ilorin Teaching Hospital, Nigeria in this direction. The need to make up for part of this gap provided the major impetus for this study. To this end, the study investigated the psychosocial needs and support services accessed by HIV/AIDS patients of the University of Ilorin Teaching Hospital, Nigeria. Kuh (1982) noted that assessment of clients' needs is crucial for effective determination of developing effective services to address the clients' needs. The objective of this study therefore, was to investigate the psychosocial support needs and support services being accessed by the

1. What are the psychosocial needs of HIV/AIDS patients of the University of Ilorin

2. What are the support services accessed by HIV/AIDS patients of the University of

The study is a descriptive survey which employed quantitative and qualitative measures to obtain data from the respondents. An estimated 2,365 patients living with HIV/AIDS at the University of Ilorin Teaching Hospital, Nigeria constituted the study population while all the literate HIV/AIDS patients (i.e. those who can read and write in English) at the hospital constituted the target population. The sample for the study comprised 125 HIV/AIDS patients who indicated interest in participating in the study. Thus, a purposive sampling technique was adopted for the study. The researchers explained the purpose of the study to the respondents and emphasised that it aimed at identifying the needs of HIV/AIDS patients in order to provide better services and supports. The researchers obtained the list of HIV/AIDS patients at the Teaching Hospital, identified the educated ones through personal data and interactions. The consents of the respondents were sought before the questionnaires designed for the purpose of the study were distributed to them. This was followed by a scheduled interview with 15 randomly selected respondents. The interview

HIV/AIDS patients at the University of Ilorin Teaching Hospital, Nigeria.

and physical needs. With the exception of the most fundamental (physiological) needs, if these "deficiency needs" are not met, an individual's body gives no physical indication but the individual feels anxious and tense. Maslow's theory suggests that the most basic level of needs must be met before an individual strongly desires (or focuses motivation upon) the secondary or higher level needs. Maslow also coined the term "Metamotivation" to describe the motivation of people who go beyond the scope of the basic needs and strive for constant betterment. "Metamotivated" people are driven by B-needs (Being Needs), instead of deficiency needs (D-Needs)(Wikipedia, 2011). For the purpose of this study, the psychosocial needs adopted comprise physiological needs, safety needs, belongingness needs, esteem needs, aesthetic needs and self-actualization as propounded by Maslow. Physiological needs include food, air and water; safety needs involve housing and security; belongingness implies social interaction and group affiliation; esteem needs involve high regard for self and others; aesthetic needs deal with love of beauty while self-actualization involves becoming what one desires to be in life.

Psychosocial support can be described as a process of providing for the emotional, social, mental and spiritual needs of clients or patients. It is an essential element of promoting human development. Support services are the social facilities which are available and provided by an organization or a community to those in need of such supports in order to assist them to live a good life. The supports can be grouped into spiritual, moral, social, psychological/counselling and financial supports. Spiritual support involves prayer and meditation, moral support implies identification with someone's concerns and encouragement, financial support connotes provision of monetary assistance while psychological support comprises guidance and counselling. In order to meet the needs of PLWHA, an emergency action plan was prepared by the National Action Committee on AIDS in 2001 with a view of institutionalizing best practices in care and support for Persons Living With HIV/AIDS (PLWHA). The plan was designed to mitigate the effects of the disease on the victims, orphans and other affected groups and stimulate research on HIV/AIDS (USAID, 2002). According to the World Health Organization (WHO, 2011), psychosocial supports address the on-going concerns and social problems of HIV infected individuals, their partners and caregivers. WHO stressed that HIV infection affects all dimensions of the victims' life such as physical, psychological and social. The infection could result in stigma and fear for those living with the virus, as well as for those caring for them and the entire family. Infections often result in loss of socio-economic status, employment, income, housing, health care and mobility.

WHO (2011) observed that counselling and social support can help people and their carers to cope more effectively with each stage of the infection and enhances quality of life. The organisation noted that with adequate support, PLWHA are more likely to respond adequately to the stress of being infected and are unlikely to develop serious mental health problem.The psychological supports provided by the patients' partners and their family members can assist them in making appropriate decisions, coping better with illness and dealing more efficiently with discrimination.

The community also has important role to play in assisting PLWHA. It could assist in adding quality to the life of HIV/AIDS patients through provision of economic, social and psychological supports. Thus, psychosocial supports for HIV/AIDS patients need to be scaled up and encouraged in any community.

Amirkhanian, Kelly and McAuliff (2003) conducted a study on the psychosocial needs, mental health and HIV transmission risk behaviour among people living with HIV/AIDS in St. Petersburg, Russia. Sample of the study consisted of 470 persons with HIV/AIDS at St. Petersburg HIV care and service agencies. The participants completed anonymous selfadministered questionnaires on social and psychological characteristics of HIV, serostatus disclosure, discrimination experience and risk practices. The study found that HIV infected persons in Russia experienced a wide range of social, psychological and care access problems.

Jordans, Kein and Pradhan (2007) investigated the counsellors' and beneficiaries' perception of psychosocial counselling in Nepal. Semi-structured interviews were conducted with clients, para-professional counsellors and managers of organisations in which psychosocial counselling was taking place. The study revealed that stakeholders generally presented a positive view of the significance and supportive function of psychosocial counselling, and the issues of training, supervision, confidentiality and integration of counselling within the mainstream care provision were emphasised.

Although, a lot of studies (Ostrow et al. 1992; Kelly, Murphy, 1992; Slugget, 2003; Amirkhanian, Kelly & McAuliff, 2003) have been conducted on the psychosocial needs and support services of PLWHA across the world, but little or no attention had been paid to the patients of the University of Ilorin Teaching Hospital, Nigeria in this direction. The need to make up for part of this gap provided the major impetus for this study. To this end, the study investigated the psychosocial needs and support services accessed by HIV/AIDS patients of the University of Ilorin Teaching Hospital, Nigeria. Kuh (1982) noted that assessment of clients' needs is crucial for effective determination of developing effective services to address the clients' needs. The objective of this study therefore, was to investigate the psychosocial support needs and support services being accessed by the HIV/AIDS patients at the University of Ilorin Teaching Hospital, Nigeria.
