Despite concerted efforts by the Federal Government and donor agencies, Nigeria ranks the second largest country with global burden of HIV/AIDS, and contributes the largest proportion of new vertically acquired HIV infections amongst children. REGINA OTOKPA examines the consequences of not knowing one’s HIV status, as well as the link between living with the virus and being affected
Thirty years since the first celebration of World Acquired Immune Deficiency Syndrome (AIDS) Day, the outlook is still a gloomy one for Nigeria, the second largest country with the Human Immunodeficiency Virus (HIV) in the world. Rather than trickle down, the different figures emanating from different quarters keep shooting up and as it were. The real figure of persons living with the virus cannot be ascertained until results from the ongoing National Aids Indicator Survey (NAIS), is completed and made available in the public domain.
However, the statistics presently available are still quite scary, given the level of awareness and interventions across all boards to ensure a drop in the number of new infections recorded in the country.
Based on global statistics released by the Principal Investigator, AIDS Preventive Initiative Nigeria (APIN), Prof. Oche Agbaji at the occassion of the 2018 World AIDS Day (WAD) celebration, no fewer than 1.8 million people died in 2017 from HIV/AIDS related disease, about 37 million people are presently diagnosed to be living with HIV/AIDS while 9.4 million persons are unaware of their status. In Nigeria, about 3.1 million people are said to have been diagnosed to be living with HIV, of which 200,000 persons were newly infected in 2017 and 150,000 had died.
More statistics show that the reason behind these new infections is not far-fetched from the huge number of persons who up till now, do not know their HIV status.
Recent investigations have tagged religious belief and fear as the major reason behind the laxity displayed by many Nigerians who shy away from running a HIV test even though it is conducted for free; such includes the fear of stigmatisation, the fear of the unknown, the fear of dependence on drug for survival, the fear of the virus itself, the fear of dying too early, the fear of losing one’s job or place in society especially in religious settings, the fear of people’s perception and attitude once they find out and the fear of keeping one’s status a secret.
Dangerously so, what people fail to understand is that not knowing your status poses grave danger to winning the fight against HIV/AIDS, just as it affects the infected person, close friends, relatives, associates and sometimes neighbours who are at risk of being infected as the life of the person infected gradually deteriorates.
Just a timely test at any health facility can save those infected, their family and friends from an avoidable financial, psychological and emotionally stress and trauma. For example, the National Coordinator for Society of Women and Children living with HIV/AIDS in Nigeria, Mrs. Lucy Attah Inya, has been living with HIV for about twenty two years, yet she is full of life and healthy. Diagnosed shortly after she got married and heavy with her first child, she is today a proud mother of three children all free of HIV.
However Joshua Ukwuatu’s younger brother and two cousins were not so lucky some years back. In the case of his brother, his family strongly believed he was suffering from the effects of poison until the very last minute when he was rushed to the hospital and diagnosed of AIDS. If only he had ran the test earlier, there was a chance he would still be alive and taking the Anti-Retroviral Treatment (ART) alongside millions of Nigerians who are currently on the treatment.
Ordinarily, one would have thought that with such bitter experience, all members of the Ukwuaru’s family would encourage people to run periodic tests to know their HIV status. However, Joshua has vowed never to run the test on religious grounds, “I can never run the test; in fact, my church forbids needle prickling in any part of my body. It’s even better if I don’t know my status; what I don’t know won’t kill me,” he said.
Millions of Nigerians fall into Joshua’s category of not wanting to know their status, no little wonder the theme of this year’s WAD was themed ‘Know Your Status’. WAD is marked every December 1 to encourage communities to unite against HIV, show support for people living with the disease, and remember those who have passed away due to the disease.
WHO’s Regional Director for Africa, Dr. Matshidiso Moeti noted that in West and Central Africa, only one in two (2.9 million) people living with HIV know their status
Poised to ensuring Nigeria meets up with the 90:90:90 target, the United Nations Children’s Fund (UNICEF), has said it was necessary for the Federal Government to increase focus on Prevention of Mother To Child Transmission (PMTCT). Expressing worry over the poor ratio of pregnant women attending Antenatal Care (ANC), which stands at 40 per cent, UNICEF’s HIV/AIDS Specialist, Abiola Davies, during a media dialogue in Calabar recently, said Nigeria was still far away from where it should be. She urged government to increase funding to the sector, especially at the state level, saying “we must look at ways to galvanise funds to meet the global target.”
According to the Assistant Director, Prevention of Mother To Child Transmission (PMTCT) at the National AIDS and STIs Control Programme, Dr. Ijaodola Olugbenga, 95 per cent of the national HIV response was funded by foreign donors.
Stressing on the need for government to take ownership of the HIV programme, given recent decline in global funding, he said pregnant women and infants must be tested for HIV and if positive, they must be placed on ART immediately but out of over nine million women who get pregnant in Nigeria every year, only about 40 per cent use established health facilities to access antenatal care.
According to him, 1,358 infants born to pregnant women living with AIDS were diagnosed to be HIV positive in 2017 also, only about 54,000 out of the 221,000 children who are affected by the virus are presently on anti- retroviral treatment.
“To achieve the goal of elimination of Mother To Child Transmission (MTCT), at least 90 per cent of HIV infected women must have access to comprehensive PMTCT services, including anti-retroviral drugs ARVs during pregnancy, delivery and breast feeding periods.’’
Investigations however showed that majority of women diagnosed to be living with HIV stay off health facilities due to poor health workers attitude awash with stigmatisation and discrimination, users fee, which ranges between N500 to N1,000 to access the supposedly ‘free’ AR drugs and the slow method of service delivery resulting from limited number of health workers at the facilities.
But the HIV response seems to have been targeted more at mothers and infants, what happens to the men and adolescents already living with the virus? Many adults do not know they have HIV, and those who do often fail to stick to their treatment plans. Only recently, a UNICEF report indicated that about 360,000 adolescents are expected to die of AIDS by 2030 if investment in HIV prevention is not ramped up.
UNICEF’s executive director, Henrietta Fore noted that projections have shown there will be a decline in the number of children dying from AIDS-related causes but progress is notably slower among adolescents between ages 10 and 19.
The earlier everybody understands that ending the HIV epidemic is everybody’s business, the country will experience a massive turn around in the number of new infections. If government succeeds in launching the National HIV Trust Fund recently revealed by the director-general of the National Agency for the Control of AIDS (NACA), Sani Aliyu, it will go a long way in bridging the funding gap. According to him, the seed money for the take-off of the Fund is about $15 million.
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