Despite countless groundbreaking innovations in the treatment and prevention of Human Immunodeficiency Syndrome (HIV), it still is a death sentence for some, particularly the most vulnerable and the marginalised. Young people living with the virus, who are part of this group, still deal with social stigma and discrimination, which remain the primary drawbacks in the fight against the disease. As the world commemorates this year’s AIDS Day, CHINYERE OKOROAFOR writes that governments at all levels should sensitise communities to the need to raise awareness of the illness to halt its spread
Human Immunodeficiency Syndrome (HIV), may no longer be a death sentence due to the development of low-cost and extremely effective preventive methods such as the use of condoms during sexual intercourse to emergency antiretroviral medications and long-term antiretroviral (ARTs) medications for those already infected with the disease to scientific advances in the development of an HIV vaccine that could potentially prevent novel infections. But, to people living with the virus in Nigeria, stigma and discrimination have prevented many from seeking HIV testing and treatment.
For instance, when medical personnel revealed the HIV status result to the parents of 15-year-old Ifeoma Adizua, her parents stigmatised and discriminated against her despite being their child. After several medications to treat a persistent rash she believed was chicken pox to no avail, she said: “When I turned 16 years old, I fell seriously ill so much so that I was hospitalised and required oxygen support for eight days. The medical team conducted a series of tests, and to my horror, it was confirmed that I had contracted HIV.
“My parents were deeply shaken and began to question me, even going so far as to subject me to a virginity test to prove my innocence. We eventually discovered that I had contracted the virus from a blood transfusion I had received when I was young. The revelation only made things worse as I faced stigma and isolation from my own family. The weight of the situation and the discrimination I experienced left me feeling depressed and lonely. However, I found support in the Association of Positive Youths in Nigeria (APYIN), where I met other young individuals facing the same plight as me.
“Through my interactions with APYIN, I gained a deeper understanding of the virus and was able to educate my family about the realities of living with HIV. Despite the initial hardship and discrimination that I faced, I emerged stronger and more knowledgeable about the condition and found solace in the community of others like me.”
The 2022 UNAIDS Global AIDS update titled “In Danger” revealed that global progress towards HIV prevention is slowing rather than accelerating and “the most vulnerable and marginalised are being hit the hardest.” The vulnerable and marginalised include people who have been disproportionately impacted by social, economic and political challenges: women and girls, people with disabilities, children and the youth.
The Nation reported recently a case of a 19-year-old pregnant girl in Awka Anambra State who was kicked out of the house by her boyfriend on learning that she was HIV positive. It was gathered that the victim’s boyfriend identified as Chibuike sent her parking after getting her pregnant. She was later handed over to a group of health workers who referred her to the Anambra State Ministry of Women Affairs and Social Welfare. Narrating her ordeal, the six-month-pregnant girl said she had been homeless after she was chased out of the house following the discovery that she was HIV positive.
“I had been in a relationship with my boyfriend, Chibuike for three years before he chased me out of the house after discovering that I was living with HIV. I have been homeless since then,” she said.
While revealing her parents’ disappointment over her predicament, the lady thanked the state government for accepting to take care of her. In 2021, young people between the ages of 15 and 24 accounted for more than a quarter (27 per cent) of new HIV cases worldwide, and about three in 10 (31 per cent) of new infections in sub-Saharan Africa. Adolescent girls and young women of the same age group, one of whom becomes infected with HIV every three minutes, are three times more likely to acquire HIV than adolescent boys and young men of the same age in sub-Saharan Africa. The largest HIV survey ever carried out, the National HIV/AIDS Indicator and Impact Survey (NAIIS) conducted in Nigeria in 2018, estimated that approximately 240,000 young people – ages 15 to 24 – were living with HIV in Nigeria in that year. In a recent exclusive interview with The Nation, the Director-General of the National Agency for the Control of AIDS (NACA), Dr Gambo Aliyu, said that stigma and discrimination as the primary challenge of eliminating the virus has remained consistent over the past four decades.
According to information gleaned from the website of the Centre for Disease Control and Prevention, HIV internalised stigma can lead to feelings of shame, fear of disclosure, isolation and despair. These feelings can keep people from getting tested and treated for HIV. Despite years of sensitisation programmes by the government and non-governmental organisations against stigmatisation and discrimination as well as the existence of the HIV/AIDS (Anti-Discrimination) Act of 2014, people living with HIV often experience stigma and discrimination across the country.
HIV data in Nigeria
According to the Nigeria HIV/AIDS Indicator and Impact Survey (NAISS) released from expanded data collection and analysis on March 14, 2019, the national HIV prevalence in Nigeria was 1.4 per cent among adults aged 15 to 49 years. Previous estimates had indicated a national HIV prevalence of 2.8 per cent. UNAIDS and the National Agency for the Control of AIDS estimate that there are 1.9 million people living with HIV in Nigeria. Similarly, Statista’s report on February 2, 2023, showed that 1.9 million people in Nigeria were living with HIV in 2021. Women were the most affected group, accounting for 1.1 thousand individuals. Also, children up to the age of 14 who were HIV positive equalled 170,000. The NACA boss said Nigeria has the second-largest burden of HIV infection. “Currently, a total of 1.8 million people are estimated to be living with HIV in the country, out of which about 1.63 million are already on Antiretroviral Therapy (ART), a life-saving medication.
“Approximately, 58 per cent are estimated to be females and 42 per cent are males. The national average Mother-to-Child Transmission rate of 22 per cent is driven by a large number of states with transmission rates above 25 per cent and few states with rates below 15 per cent. Nigeria is responsible for about 30 per cent of the world’s gap in Prevention of Mother to Child Transmission (PMTCT),” it said.
The state of HIV management and control in Nigeria
According to Aliyu, Nigeria has made significant strides in the past four years, especially in identifying cases and linking individuals to HIV treatment, but there is still much to be done to achieve the goal of ending AIDS as a public health threat by 2030. He said: “Our efforts have been bolstered by a meticulous tracking mechanism, ensuring that every HIV-positive individual who receives treatment is accounted for. This approach marks a substantial departure from the past, allowing us to monitor progress, address treatment issues promptly and prevent the virus from spreading further. We have witnessed a decline in new HIV infections, hospitalisations related to HIV and AIDS-related deaths.”
He said the declining figure was achieved with the support of partners and global communities to prevent new infections, increase HIV awareness and knowledge and support those living with and affected by HIV/AIDS. He, however, stressed the need to address social and structural factors that drive the HIV epidemic. “It is imperative that we confront these systemic inequalities head-on and work to ensure that all individuals have equal access to life-saving prevention, treatment and care services, as well as other social services available to Nigerians,” he said.
World AIDS Day 2023 theme explained
The United Nations Programme on HIV/AIDS, UNAIDS, stated that the theme “Let Communities Lead” has been chosen to highlight the significance of communities in raising awareness of the illness and halting its spread. However, communities’ leadership is stagnating, even as HIV prevention and treatment services are being hampered by a lack of funding, obstacles in the form of laws and regulations, capacity issues, crackdowns on civil society and the human rights of marginalised communities, and other issues. UNAIDS stated that “community-led organisations can provide even more impetus to the global HIV response, advancing progress towards the end of AIDS, if these obstacles are removed.”
The UNAIDS Executive Director, Winnie Byanyima said: “The end of AIDS is possible; it is within our grasp. To follow the path that ends AIDS, the world needs to let communities lead.” In line with the theme, Aliyu said that breaking the cycle of fear and prejudice is essential in achieving the goal of ending AIDS as a public health threat by 2030. He urges communities across the country to embrace individuals living with HIV, “treat them with compassion and encourage them to seek treatment without fear of judgment. By fostering an environment of acceptance and support, we can empower people to come forward, get tested, and access necessary treatments.
“We acknowledge the progress we’ve made and the hurdles we’ve overcome, but the battle against HIV is far from over. Our focus now is to eradicate stigma and discrimination. The government cannot achieve this alone; it requires the cooperation of every citizen. By providing transportation assistance to those in need, encouraging them to adhere to their medication regimens and showing empathy and understanding, we can ensure that people living with HIV receive the care they deserve,” he said.
What the government is doing in HIV treatment
Aliyu revealed that HIV medication are more accessible now than before with over 2,000 centres across the country offering free treatment. He said: “We encourage everyone to come forward, get tested and avail themselves of these services. By demanding HIV services, individuals can protect themselves and others, contributing significantly to our goal of ending HIV and AIDS by 2025. We are confident that with continued dedication and community involvement, Nigeria will achieve the 95-95-95 target by 2025, a significant step toward a future without the burden of HIV and AIDS,” he said.
