title: Individual and contextual socioeconomic determinants of knowledge of the ABC approach of preventing the sexual transmission of HIV in Nigeria: a multilevel analysis.
abstract: BACKGROUND
  Nigeria has the highest number of people living with HIV/AIDS in the world after India and South Africa. HIV/AIDS places a considerable burden on society's resources, and its prevention is a cost-beneficial solution to address these consequences. To the best of our knowledge, there has been no multilevel study performed to date that examined the separate and independent associations of individual and community socioeconomic status (SES) with HIV prevention knowledge in Nigeria.
  
  
  METHODS
  Multilevel linear regression models were applied to the 2008 Nigeria Demographic and Health Survey on 48871 respondents (Level 1) nested within 886 communities (Level 2) from 37 districts (Level 3).
  
  
  RESULTS
  Approximately one-fifth (20%) of respondents were not aware of any of the Abstinence, Being faithful and Condom use (ABC) approach of preventing the sexual transmission of HIV. However, the likelihood of being aware of the ABC approach of preventing the sexual transmission of HIV increased with older age, male gender, greater education attainment, a higher wealth index, living in an urban area and being from least socioeconomically disadvantaged communities. There were significant community and district variations in respondents' knowledge of the ABC approach of preventing the sexual transmission of HIV.
  
  
  CONCLUSIONS
  The present study provides evidence that both individual- and community-level SES factors are important predictors of knowledge of the ABC approach of preventing the sexual transmission of HIV in Nigeria. The findings underscore the need to implement public health prevention strategies not only at the individual level, but also at the community level.
authors.affiliation: Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, CV4 7AL, UK.
authors.forename: Olalekan A
authors.initials: OA
authors.lastname: Uthman
authors.forename: Gbenga A
authors.initials: GA
authors.lastname: Kayode
authors.forename: Victor T
authors.initials: VT
authors.lastname: Adekanmbi
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D055361:Multilevel Analysis; D009549:Nigeria; D012746:Sexual Abstinence; D012747:Sexual Partners; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D012959:Socioeconomic Factors; D055815:Young Adult