Most of the participants had heard about HIV, possibly due to the high prevalence of the disease, especially in sub-Saharan Africa [16]. Nevertheless, the higher awareness rate among the nomadic teachers can be attributed to the better access to information and exposure they have gained considering the nature of their occupation. A similar observation was attested to in a report that having knowledge and information is the first key and necessary element in developing health behaviour; thus, if teachers know about HIV/AIDS, they can transfer such knowledge and positive attitudes to their students [17].
Health workers, followed by media broadcasts, were the primary sources of HIV knowledge for the participants. This justifies the significant health resources invested in creating and utilizing various outlets to deliver HIV/AIDS information to the public. More so, television, radio, newspapers, periodicals, direct counselling from medical staff, and dispersion of information through local family and friend networks have been highlighted as sources of HIV/AIDS information [18]
The perception of many that HIV and TB are either the same or not related is contrary to the opinion shared in some earlier reports that HIV infection constitutes a potent risk factor for TB, and it increases the risk of reactivating latent Mycobacterium tuberculosis infection as well as increasing TB progression [6]. Only 13.6% of participants in this study expressed a similar view that HIV and TB complement each other. This was further validated by Raviglione Raviglione et al. [9], who considered HIV/AIDS the primary threat to TB control programmes in Africa since as HIV prevalence rises, so does TB, and TB rates will plateau once HIV infection does. Furthermore, TB comorbidities, including HIV, diabetes, hepatitis, and malaria, among others highlighted, affirmed the report of TB comorbidities [19]. HIV (53.5%) was the most prevalent comorbidity recorded in this study, followed by diabetes (18.3%) and malaria (18.3%). This further underscores the interaction between HIV and TB. Moreover, the increasing global burden of TB has been linked to HIV infections [6].
More than half of the participants who considered HIV a severe disease demonstrated their understanding of the aetiology of the infection. However, this knowledge has been considered a helpful instrument in managing the disease; thus, the theory of planned behaviour asserts that perceptions of HIV susceptibility severity drive HIV-negative individuals’ motivations to use HIV prevention methods [20, 21]. The seriousness of HIV in the nomads' community, rated below average by the participants, could be associated with the gap in knowledge concerning the burden of HIV infection among the nomadic Fulani of northern Nigeria, although migration, which is a way of life of this population, is known to increase the rate of HIV transmission and limits individuals’ access to treatment and care [22].
Generally, only 13.5% of the participants expressed the correct perceptions of the complementary relationship between HIV and TB. This reveals an enormous gap in the knowledge of the aetiology of TB among nomadic populations. Perception of this category was found to be in line with active TB disease being linked with the breakdown in immune surveillance; this explains the strong association between active TB disease and other infectious or noncommunicable diseases that exercise a toll on the immune system [23]. HIV is the most significant risk factor for activating latent tuberculosis infection [24].
Gender, education levels, and occupation, as the factors found to be significantly associated with participants’ perception of TB-HIV relatedness, affirm the significant influence of social factors on the health outcome of a community [25]. Male participants (14.5%) were revealed as having the correct perceptions of the females, which could possibly be explained by their role as decision-makers in the family [26]. Mainly, the participants at the degree or professional levels (62.5%) demonstrated good understanding, thus affirming the impact of education in receiving and synthesizing information [17]. Similarly, more people in government employment (35%) than other occupations understand the coexisting relationship of TB-HIV infections. In contrast, cattle rearers and crop farmers who practice prevalent occupations in the nomadic community lack knowledge of TB-HIV relatedness [11, 6, 12].