Director of Public Health in the ministry, Dr Anyaike Chukwuma, affirmed this commitment yesterday in Abuja during the first annual APIN Public Health Initiative Symposium, themed “Integrating Non-Communicable Diseases and HIV to ensure long and quality lives for Persons living with HIV (PLHIV).
Chukwuma outlined a four-point agenda, emphasizing a holistic approach to governance, capacity development, health system strengthening, and financial measures.
He stressed the importance of collective engagement and expert contributions to ensure a healthier and higher-quality life for PLHIV in the country.
Special Adviser to the President on Health, Dr Salma Anas-Kolo, acknowledged APIN’s pivotal role in HIV care over 23 years.
Anas-Kolo highlighted the need for global integration and societal collaboration in HIV-related initiatives, emphasising the burden of non-communicable diseases and their additional costs associated with HIV infection.
Addressing the symposium, Acting Team Lead for NCD at World Health Organisation (WHO) Africa’s Regional Office, Dr. Barango Prebo, emphasised the significance of hypertension as an NCD risk factor in Africa.
Prebo expressed concern about the high prevalence of the disease affecting one in three adults, with 80 per cent unaware or not receiving treatment, emphasizing the need for increased awareness and healthcare services.
Additionally, he pointed out distinctive challenges in Africa, such as the highest burden of cervical cancer among NCDs.
Addressing Nigeria’s challenging position with NCDs surpassing the global average, Prebo noted that premature NCD rates are at over 70 per cent.
Prebo emphasised that its broader impact on the population goes beyond the poor due to limited access to treatment and healthcare services.
He underscored the urgent need for improved healthcare infrastructure in the region.
He highlighted the challenge of aligning medication distribution, especially for HIV and adjuncts like Atenol, across different time frames, stressing the importance of systematic monitoring.
The critical need for accessible and controllable HIV prevention methods for women is particularly pronounced in Nigeria, which ranks third globally in the burden of the Human Immunodeficiency Virus (HIV) epidemic. Shockingly, the country is home to 1.9 million people living with HIV and AIDS, according to recent revelations. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) reported a national HIV prevalence of 1.4% among adults aged 15 and above, with a more significant prevalence among women (1.8%) compared to men (1.0%). Alarmingly, the prevalence among young women aged 20-24 is over double that of their male counterparts, peaking at 3.1% among 35-39-year-old women.
This sobering statistic serves as the backdrop for the New HIV Vaccine and Microbicide Advocacy Society (NHVMAS)’s proactive response—a three-day journalist training event with the theme: Understanding and Reporting NPT Research. The aim is to confront the challenge head-on by fostering awareness about HIV/AIDS through research facts and advocating for the widespread adoption of new prevention technology (NPT) by the government, ensuring its accessibility for all. Among the ground-breaking HIV prevention products are oral pre-exposure prophylaxis (PrEP), dapivirine vaginal rings, vaccines, CAB/injectable PrEP, microbicides, and post-exposure prophylaxis (PEP). Medical professionals hail these advancements as a significant milestone in the fight against HIV, providing people with a broader range of choices in safeguarding their health. The NHVMAS’s strategic initiative seeks to empower journalists to disseminate accurate information, contributing to increased awareness and the advocacy necessary for the widespread adoption of these transformative prevention methods.
Florita Durueke, the Executive Director of NHVMAS, emphasised the transformative impact of this biomedical toolkit, stating that it empowers women with more options and increased control to protect themselves from the virus. Durueke highlighted a pressing issue, pointing out that many women face heightened vulnerability to various infections due to social disadvantages, limiting their ability to negotiate the use of essential HIV prevention tools like condoms, practising abstinence, or maintaining mutual monogamy. Durueke further underscored the stark reality that women are disproportionately exposed to HIV during sexual encounters compared to men. This heightened risk is attributed to factors such as the larger volume of semen compared to vaginal fluid and the higher concentration of HIV found in semen. The new biomedical toolkit, by providing a range of prevention methods, seeks to address these disparities and empower women in safeguarding their sexual health.
“So, more HIV prevention products help normalise HIV prevention. The dapivirine vaginal ring presents an additional option for women who want to protect themselves from HIV. The ring can reduce HIV incidence among women when used with high adherence. It is a flexible vaginal ring made of silicone that slowly releases an antiretroviral (ARV) drug called dapivirine for one month to reduce the risk of HIV infection. As the family planning field has shown, more options can lead to higher uptake of prevention methods overall. Modelling studies show that multiple prevention options are needed to end the HIV epidemic. Therefore, products like the ring could have a meaningful public health impact as part of a comprehensive prevention strategy. If approved and successfully rolled out, the ring would expand choice and increase the number of women successfully using an HIV prevention method. New, women-centred options, such as the ring, are crucial to achieving HIV epidemic control,” she said.
“Oral pre-exposure prophylaxis (PrEP) is the use of HIV prevention medications (ARVs) by people who are HIV negative to prevent the acquisition of HIV before exposure to the virus while Long-Acting Injectable are antiretroviral drugs given via injections that persist in the blood for long period. Long-acting injectable formulations include cabotegravir-LA and Ripivirine. The duo were tested for long-acting PrEP in HIV-negative people and found to be effective. Injection is administered every two months. It is expected to facilitate adherence and make it easier for people to take.”
During his presentation, the Project Officer, Richard Benson said Nigeria is still struggling with PrEP access for those at substantial risk of HIV infections. According to him, among other people at substantial risk of acquiring HIV infection are men who have sex with men (MSM) and transgender individuals but only couples in HIV serodiscordant relationships were prioritised for access to PrEP in Nigeria. A snapshot of PrEP scale-up, registration and resources for Nigeria showed that 400-600 estimated number of current PrEP users.
“NHVMAS advocates that beyond couples in serodiscordant relationships, adolescents should be prioritised for access to PrEP. The anatomy of a female adolescent increases her risk for HIV infection – a risk significantly higher than that of a female adult. Teenage pregnancy is high. The risk of HIV infection increases 2-3 times during pregnancy and about four times six months postpartum. These figures highlight the need to counsel female adolescents with high HIV-risk behaviour – early sexual debut, multiple sex partners, transactional sex, and having sex partners who are 10 years or older than her – on the need for dual protection. For individuals who do not use condoms, PrEP is the alternative.” Its programme officer, Chidiebere Obi, said with an array of prevention tools, women can choose the HIV prevention method that works best for them and fits into their lifestyle.
Says mom’s fufu business collapsed as people knew about her HIV status
Recalls first encounter with governor’ orderly who became her husband
In the symphony of adversity and triumph, the following narrative by Gloria Asuquo echoes a universal truth: the indomitable spirit of the human will transcending the boundaries of health and societal prejudices. She told DELE ANOFI how in 1999, at the tender age of 11, her life took an unexpected turn. Little did she know that she had embarked not only on a new journey of personal struggle but a story of resilience and triumph against all odds.
It all began amid the excitement of starting junior secondary school in Abuja. A normal development took a dramatic turn when an illness led Gloria Asuquo to a hospital and a diagnosis that would change the course of her life forever was made: HIV positive at the age of 11.
Facing a disciplinary action at school, a routine punishment metamorphosed into a life-altering event. As the teacher’s punishment ensued, Asuquo’s fall to the floor signaled something more sinister than mere disobedience. The gravity of the situation became more apparent as she was rushed to a nearby general hospital where the doctor said she needed uurgent blood transfusion.
With her father on the employ of the giant construction company, Julius Berger, unavailable and her mother deemed unable to donate the needed blood due to her reproductive age, the decision was made to obtain blood from the hospital’s blood bank. Little did they know that the seemingly harmless decision would set the stage for Asuquo’s descent into darkness.
After the blood transfusion exercise, recovery was not as smooth as anticipated. Weeks after leaving the hospital, Asuquo discovered a disconcerting reality: moments of temporary blindness upon rising from a seated position. The return to the hospital prompted a battery of tests leading to a diagnosis that shook the foundations of their world — she was HIV positive.
“I was taken back to the hospital where they conducted all kinds of tests, only for them to refer me to Gwagwalada Specialist Hospital, where another test was conducted and I was pronounced HIV-positive in the end.
“To trace how I got the disease, the specialist hospital started testing my family members. But my father, my mother and my younger ones, every one of them was negative. In the process, they traced it to the hospital where I had undergone a blood transfusion.
“When the doctor who did it was asked why he gave me infected blood, he said I was in a critical condition when I was brought in and the only thing he could do was to save my life first with blood transfusion.
“He said since blood was available in the blood bank, he believed it had been screened and that was why he picked blood from there and did the transfusion. That was the explanation he gave. But I didn’t know what was going on then. All I knew was that they packed a lot of drugs for me to be taking regularly.”
The revelation remained concealed until one night when a father’s cryptic questions revealed the truth. The impact was seismic—HIV positive, unbeknownst to the one living with the condition. The weight of this realization triggered a torrent of emotions, questions, and a resolve to tell the world the story of government negligence.
“As time went on, I started seeing a lot of prominent Nigerians, like the late Prof. Oshotimehin of the National Action Committee on AIDS (NACA) before it turned to an agency, and many others visiting me at the hospital. They would keep talking, asking me questions and taking pictures with me on my hospital bed. I was just curious.
“All this while, I always noticed the sadness in my dad, but I never bothered to ask what was really happening. Even my mom at that time was not in the know of what was going on.
“The curiosity became more intense for me after I was discharged from the specialist hospital and I still kept taking the same medication I was given from the hospital even though I was feeling strong and healthy.
“Also, the fact that my father kept talking to me about taking the drugs at certain hours of the day did not assuage my confusion. I can still remember his screams once it was seven o’clock about the medication and how he’d run after me to make sure I took it at that same period every day.“At a time, I contemplated packing the drugs and throwing them into the refuse dump because I was just fed up with them.
“One night, my dad woke me up at night and asked me that if a friend of mine is HIV positive what would I do? I replied immediately, ‘Back to sender. That will never be my portion’.
“I never knew that the question was directed at me. All that flashed through my head at that moment were the gory pictures of the affected people in skeletons dying. So I rebuked it.
He just told me calmly to go back to bed but think again about it.
“That was when my mom began to wonder why my dad would wake me up at that period of the night, so she began to ask questions to find out what was going on.
“Two or three nights later, my dad woke me up again and asked me whether I remembered the question he asked me the last time, and I said yes. He then asked me the same question again.
“I told him I’d answered his question and that I didn’t understand why he was asking me the same question again. He then said you are the one: you are HIV positive.
“It was like my whole world crashed before my eyes, dawning on me that I was infected all these while and I never knew.
I was inconsolable, I was asking questions: where is the doctor that did this to me? Have they prosecuted him?
“I told my parents that they should take me to him and inject him with my blood as well. I was just asking a lot of questions but I was not getting the right answer.
“So at that point, I made up my mind to just go and die because the environment around me became choking.
“I became more frustrated when I learnt what transpired when my dad went to the church where we worshipped then. Being a senior elder of the church, he had to disclose my situation to the Reverend.
“I learnt that the Reverend told my dad that since he has five children, he should separate me from the rest of the family in order not to infect them.
“It was a trying period for my tender age then, and it got worse when I realised that my father had to spend and borrow a lot of money to get my medication.
“At a point, the Catholic Action Committee on AIDS (CACA) informed my parents that there was a new drug in the United States that they were trying to see if they could import and make available to PLWHA that have been placed on ARV already to see if it is effective.
“My heart broke seeing my dad struggle very hard to see that he got the medication for me, which consequently led to problems at home between him and my mom every time.
“Oftentimes, my mom would tell my dad: ‘Is it this one that will soon die that you are looking for money to buy medication for?’. It became a really huge issue for me when I knew that my condition was not bringing peace at home.
“As more people got to know about my HIV status, my mom’s fufu business eventually collapsed as people stopped buying from her. They didn’t even want to come close to her or members of my family anymore.
“This got to me, and I started thinking of how to leave home for good so that peace can return to my once loving and peaceful home.
“All this while, NACA did not abandon me. They intervened in my parents’ issues. They did everything to bring peace between me, my parents and my siblings.
“But the more they tried, the more the problems grew since my dad wasn’t always at home. He would leave for work early in the morning and come back late, so he didn’t know what I was going through at the hands of my family members who had segregated me.
“All the side derogatory comments, the fact that I couldn’t share anything with anyone in the house; to even touch me was a problem. They would rather push my plate of food to me rather than have our hands or bodies touch each other”.
Escape to the unknown
Unable to endure the escalating challenges at home, little Gloria made a bold decision to escape, armed with a paltry N800. Before then, after discovering her status, Gloria was lucky to have access to the media where she was able to tell her story through interviews on radio and television stations where some good-spirited people assisted her with tokens from which she was able to save about N800.
Boarding a night bus to the East without a destination in mind, a chance stop at Opi Nsukka Opi turned the community into an unexpected sanctuary where an incomplete building offered a refuge. Survival became a daily grind as she carried loads for travellers and sustained herself with achicha, a local delicacy.
She said: “As I was living my anonymous life where no one knew me or my status, I never knew that another angel was watching out for me.
“One morning, as I set out for my daily routine, one man, Dr. Anthony Agwu, stopped me and asked, ‘Little girl, you should be in school by now but I always see you on the street, one clothe, one slippers every day. Why are you not in school? Don’t you have parents?’
“I just broke down and began to cry. He asked me to stop crying and asked me to enter his car and took me to UNN. He was a lecturer there and a medical doctor.
“When we got to his office, he said as a father, I should tell him everything about myself. I opened up and told him my life story. Afterwards, he said he would get across to my parents.
“I promptly told him I had no parents, but eventually, I showed him my dad’s identity card, which I took when I was leaving.
“He said it was okay if I didn’t want my parents to know but he would have to report my case at the police station and make it official to adopt me.
“I was overjoyed. On the way to his house, he pleaded that I keep my HIV status to myself; that I should not tell anyone because he could not be sure how the family members would receive the news and he did not want me to be stigmatised.
That was how he took me into his home, took me back to the school, where I was squatting, and enrolled me there to continue with my education.
“Since no one knew my whereabouts, I later learnt they were searching for me, but I didn’t care.
“One day in 2006, Dr Agwu told me that he heard in the news that the ARV drugs were now free and encouraged me to go and confirm if that was true. He gave me transport fare.
“I left for Abuja, dropped at Gwagwalada and headed to the Specialist Hospital. Immediately Dr. Ajayi who knew about me saw me, he was happy and asked about my wellbeing and why I hadn’t been coming for my drugs.
“I lied that I had been in school, and then other questions followed, after which he gave the medications for three months since I was in school. I returned to Nsukka the same day without bothering to go see my parents.
“Not quite two, three days later, I was in school when I saw Mr Godwin Odumeje. I was shocked. And when he said my father was around, I got angry. I said which father? I don’t have a father.
“I was livid with rage that I was found out. Mr. Odumeje worked with Radio Nigeria before he retired. He was even trying to interview me. I called him all manner of names. I told him I was tired of them using me to achieve their aims.
“I saw the hurt on his face. He calmed me down. He said he was only out to support and look out for me. He said I was more like his daughter and he was always ready to support me.
“He gave me N200,000, and that was the first time I saw that kind of money in my life. Mr. Odumeje supported my education and even supported my parents to see that I didn’t lack.
“At this point, the feeling that I belong in the society began to be reinforced since God sent Dr Anthony my way.”
However, with the sun shining on the horizon, the journey took an unexpected twist again when she sought admission to Madonna University. The institution, a faith-based entity, callously withdrew her admission upon discovering her HIV-status. The rejection ignited a fire within her, and she resolved to combat the discrimination faced by People Living with HIV/AIDS (PLWHA).
This led her to the Education As Vaccine (EVA), where she spearheaded the Red Card campaign, traversing Nigerian tertiary institutions, raising awareness and challenging stereotypes. The campaign’s success paved the way for legislative change, as former President Olusegun Obasanjo rallied stakeholders to ensure free access to Antiretroviral (ARV) drugs and the passage of the Anti Stigma Bill in 2014.
“Eventually, the struggle that commenced in 2009 was rewarded with the Anti Stigma Bill that was signed into law on 2014. And that is what the PLWHA are enjoying today,” she said.
How she found love
In all of this, Gloria found love. Defying her initial resignation to solitude, a supportive partner emerged, leading to a fulfilling marriage and the joy of motherhood which underscores the significance of love, understanding, and breaking societal stereotypes that surround PLWHA.
“I had resigned myself to being alone for the rest of my life because I could not imagine any man, who is not infected with the disease to come and profess love to the point of marriage.
“I was happy doing what I was doing. Speaking for the voiceless PLWHA was enough fulfillment for me, so I wasn’t worried about marriage because I was getting enough love from all the angels God had sent my way.
“It was at a UN summit on HIV/AIDS that this dashing, young, athletic man, an orderly to a former Ekiti State governor, came around after my presentation, where I ended up telling the audience that I didn’t need sympathy but empathy, and that I would not bother going back to school but get a job to be able to continue speaking for this cause.
“At that summit, an Ambassador offered that I should pick any university of my choice in his country and he would facilitate my admission and other processes. I said no, it was a job that I needed. That was how I got a job at NACA with the assistance of those wonderful people.
“Back to the conference, the young man came around and we exchanged pleasantries like it had become the routine for me. Then he told me how strong and brave I was, asking if we could be friends.
“I said yes because I had seen that he could be of help to our advocacy efforts. Even if on his state level alone, that would be great.
“As God would have it, our friendship blossomed and one day he just popped the question about marriage, and as they say, the rest is history.
“We continued our lives, and when we were ready, I got pregnant and gave birth to two healthy twins.
“Although the negligence of the doctor and the nurses at the hospital almost cost my twins their health, God intervened by making me vigilant to the point of asking the right questions that saved my twins from being infected with the virus at birth.”
The mean caregivers
In a poignant recollection, Gloria shared her journey through pregnancy, where the very guardians of health raised concerns rather than providing solace. Negligence in administering crucial medication to prevent mother-to-child virus transmission highlights a systemic flaw, driving her to seek help from external sources and underscoring the unsettling reality that stigma within healthcare institutions compels PLWHA to abandon general hospitals. “I remember vividly when I was pregnant. I took myself to the Matron at the hospital for my antenatal and gave her all the details about my status; that there was no need for HIV tests. I disclosed my status and showed the medications I was on, but her reaction was disappointing.
“She recoiled and immediately called the Mentor Mother to come and attend to her people. That sent a very negative message to me on the perception of caregivers to PLWHA.
“Notwithstanding, on every antenatal appointment of mine, I always relay the same information about myself and that I don’t want to go through normal delivery but Cesarean section, that, that was what my pregnancy was planned for.
“On the delivery day, the CS was done. My babies came out but the critical nevirapine which is supposed to prevent mother-to-child transmission of the virus was not administered to them until after four days.
“Four days after the CS when I started getting my senses back, something nudged me to ask if evirapine had been given to the babies and they said no.
“I got agitated. What kind of negligence is this from those who are supposed to be professionals? What if I hadn’t been knowledgeable about this issue? Is that how my children’s health would have been compromised due to the carelessness of some so-called experts like they did to me?
“One of the doctors even had the effrontery to challenge me that I am a wicked person; why didn’t I tell them that I am HIV positive only for them to be touching me?
“I made him realise how insensitive that statement was, because even inside the operating theatre, I told everybody, like I’ve always done on every antenatal day.
“Besides aren’t they supposed to have my records with them? Because of my reaction, they left my babies in the incubator until I started calling everybody when they began to run up and down. The media also got on the issue.
“I had to eventually call AIDS Healthcare Foundation to come and give nevirapine to the babies. The MD of that hospital had to challenge me that was it because I knew a lot of people that a petition was written against them?
“At that point, I had to change to another facility because I no longer felt safe in the hands of the people in that hospital”.
From outcast to breadwinner
From adversity emerges triumph as Asuquo transforms, dismantling societal norms.
She said: “Now I’m the breadwinner of the home where I faced hell but for my father. Now, there is no decision they will take that I will not be there. The house they are living in now, I built it for them. They no longer live in a rented apartment.
“I stopped my mom from fufu business. That was the only business I knew her with growing up. I stopped her because of the stress and old age. Now she is doing what she likes.
“My twins live with my parents now. They come to visit us on weekends, and the love and care for them by my parents glow all over them.
“So I became the light and I’ve come to realise that God knows why he allowed all these things to happen.
“My message to everyone out there is that testing is key to breaking the chains of fear surrounding HIV/AIDS. It is no longer a death sentence but a manageable condition. It is important to avoid careless living, adhere to medications, and the limitless potential of individuals living with HIV is endless.
“To healthcare providers, they should foster a caring and hopeful environment. But the government should sustain its proactive stance on this issue.
“Local production of antiretroviral drugs and other consumables should be prioritised to make them more accessible, contributing to the global goal of ending AIDS as a public health threat by 2030.
“I still believe God knows why everything happened the way it did. If not for the HIV, I don’t know how and why I should be here (NACA) let alone board a plane in the first place.
“If it were not for HIV, how would I have travelled around the world, come across all the prominent people in Nigeria and abroad; those people that showed me love, who made sure I completed my secondary education, that insisted I go to the university, that refused to let go even when I was rejected by a faith-based university; the wonderful people that gave me a job so that I don’t become a liability to myself, my family and my society to the point of having a loving husband and wonderful healthy children?
“God has a reason for my case. I’ve come to believe that, and that is why I resolved to speak for the voiceless PLWHA”
Anambra State AIDS Control Agency (ANSACA) has called on Ministry of Education to consider integration of family life and health education into state’s school curriculum.
The agency said such integration would not only assist in addressing growing Human Immunodeficiency Virus (HIV) crisis among young people, but reduce stigma and discrimination associated with the scourge.
Speaking during an advocacy visit to the ministry, Executive Director, Johnbosco Ementa, also called on the ministry to consider allocating resources for teachers’ training, curriculum development and programme rollout.
He regretted that Anambra currently has the highest prevalence of HIV in the South East region, cautioning that absence of intervention for in-school-youth could result in increasing new infections, especially among adolescents.
He, however, expressed confidence in the ministry’s capacity to provide the required leadership in monitoring and evaluating the programme’s performance and impact in collaboration with relevant stakeholders.
He said: “The increasing prevalence of HIV among adolescent youths is a public health issue. Currently, Anambra State has witnessed a disturbing rise in HIV infection rates among adolescents.
“The purpose of this advocacy brief is to present the case for incorporating Family Life and Health Education into the state school curriculum.
“This, of course, has the potential to equip our youth with the information and skills they need to take care of their health, including preventing HIV/AIDS. This advocacy brief highlights the critical need for the implementation of comprehensive family life and health education within schools in the state.
“By providing adolescents with knowledge and skills to make informed decisions about their sexual and reproductive health, we can significantly reduce HIV transmission rates.
“The inclusion of Family Life and Health Education in schools is crucial towards empowering adolescents with knowledge about HIV prevention.
“It provides adolescents and young people with relevant and age-appropriate information and skills necessary for rational decision-making about their sexual and reproductive health.”
Responding, Commissioner for Education, Prof. Ngozi Chuma-Udeh, assured her ministry’s readiness to partner the agency in the fight against the scourge.
She said: “The highest scourge humanity has witnessed outside tuberculosis is HIV and syphilis. So, it’s a thing of joy that there are people out there battling to secure and safeguard the lives of others.
“As a ministry, apart from establishment of HIV awareness clubs in the schools, I don’t think there’s actually much we can do since our curriculum flows from national curriculum.
“The only thing we can do is to domesticate the programme by adding some extracurricular in form of students clubs, which are not mandatory. So, the onus still lies on the principals.
“I’m going to institute a committee in the ministry that will kick off this in schools to support what you’re doing. You can count on our support because the fight is everybody’s responsibility.
“We all have children. Once we visit barbing salon, markets, etc, we’re all concerned. If you see such initiatives and look away, you’re like one throwing stones in market place.”
Over the past few years, Nigeria has made remarkable strides in the fight against HIV/AIDS – identifying cases, providing treatment and pioneering innovative solutions to combat the disease. In this exclusive interview, the Director-General of the National Agency for the Control of AIDS (NACA), Dr Gambo Aliyu, delved into Nigeria’s HIV management and control strategies, the transformative initiatives undertaken and the vision that propels the nation toward an HIV-free future. From local manufacturing of essential medications to empowering communities through awareness campaigns, Dr Aliyu discussed the state of HIV control in Nigeria, HIV Trust Fund, HIV self-test kit and other germane issues. He spoke with Associate Editor ADEKUNLE YUSUF. Excerpts:-
Why Nigeria hosted West and Central African HIV prevention workers
The gathering aims to unite champions and probation experts for a collaborative exchange of ideas and knowledge. With representatives from every state in addition to our own team from Nigeria, the goal is to foster a fruitful dialogue. By sharing insights and experiences, we hope to recognise effective strategies, not only within our nation but also in the broader regional context. This collective effort will help us identify successful approaches that merit continued focus, while also guiding us in re-evaluating methods that may need adjustment as we move toward the year 2030.
This meeting serves as a platform for probation experts and champions to come together and exchange ideas, despite the fact that we should have convened much earlier in our respective countries. We all face challenges and successes in our individual efforts. The sooner we start sharing these experiences, the better for all of us. Those embarking on new initiatives can learn from the mistakes of those who started earlier, avoiding similar pitfalls. Similarly, those who have achieved rapid progress in certain areas can share their successes, guiding newcomers on the same path to cost-effectiveness. These discussions should have been an integral part of our programme from the beginning, but the realisation has come a bit late. However, as we are nearing the year-end, it’s crucial for us to intensify our efforts. As challenges decrease, our expectations to contribute more or innovate further will increase.
We aim to learn from their (other African countries) experiences, particularly in reaching out to adolescents and young people. Understanding their methods of communication and how they generate demand among this demographic is crucial. Engaging and connecting with them is at the core of our agenda. Additionally, we have an existing programme that we fear might not be sustainable in the long run. Many programmes face this challenge over time; they need to be integrated back into the mainstream. As we contemplate reintegrating our standalone programme into the mainstream, we seek insights from those who have already successfully mainstreamed their programmes. Understanding their achievements and the hurdles they faced will guide us in addressing similar challenges. One specific programme we have is focused on providing comprehensive healthcare services for the adolescent and young population. This programme operates as a centre for adolescents nationwide, ensuring maximum privacy, confidentiality, and protection of rights. However, with the approaching year 2030, sustaining standalone facilities might not be feasible. We grapple with questions about how to seamlessly reintegrate these services into the mainstream. Our concerns revolve around maintaining privacy, ensuring confidentiality, eradicating stigmatisation and discrimination, and safeguarding the rights of the individuals seeking our services. Learning from others’ experiences in this realm is vital as we navigate these challenges.
The state of HIV management and control in Nigeria
Nigeria has made significant strides in the past four years, especially in identifying cases and linking individuals to HIV treatment. 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. Thanks to these efforts, we have witnessed a decline in new HIV infections, hospitalisations related to HIV and AIDS-related deaths.
However, our primary challenge remains consistent over the past four decades: stigma and discrimination. The fear of social exclusion prevents many from seeking HIV testing and treatment. Breaking this cycle of fear and prejudice is essential to our mission. We urge the community 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 entirely. 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. Additionally, we have made HIV medication more accessible than ever before, with over 2000 centers across the country offering free treatment. 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.
Local manufacturing of HIV drugs and self-test kits
Our ongoing discussions with prominent pharmaceutical companies revolve around a crucial topic: local manufacturing of HIV drugs. It’s heartening to note that the Global Fund and the United States have shown keen interest in promoting this initiative. Incentives are being offered to companies, either those already manufacturing or those on the verge of starting production. These incentives serve as a catalyst for change, transforming the landscape from what it was several years ago. In the past, large pharmaceutical companies hesitated to manufacture locally. They preferred supplying drugs to Nigeria from abroad, thereby reaping significant profits. However, our vision for the future is different. We want these companies to establish manufacturing facilities within our borders. This approach not only ensures timely access to essential drugs but also generates employment opportunities for our citizens. By manufacturing drugs locally, we create jobs, pay taxes to the government, and bolster the nation’s economy. The impact of this shift became evident during the COVID-19 pandemic. While we managed to procure medications, global disruptions in logistics and supply chains delayed their delivery. If these drugs were manufactured domestically, we could have swiftly obtained them, ensuring a more efficient response to the crisis. Furthermore, local manufacturing aligns with our principle of maximising the benefits meant for Nigeria. When funds are allocated for our country, we aim to extract every advantage, empowering our people, boosting our economy, and securing the healthcare needs of our citizens. This initiative not only ensures a stable supply of HIV drugs but also paves the way for a self-sufficient healthcare ecosystem, enhancing our resilience in the face of future challenges.
The strides we’ve made in HIV testing are truly remarkable. Today, you can comfortably sit in your room, conduct a test, and know your status without leaving your home. You have the freedom to choose where you receive treatment, and we’re here to assist you in that choice. There have been significant advancements in treatment methods. In some places, instead of daily medication, individuals have the option to receive injections every two or three months. We aim to improve this further, offering alternatives for those who prefer injections over oral medication. These injections can be administered every few months, providing a convenient option for long-term treatment. We’re closely observing the outcomes of these methods in other regions to learn from their experiences and adapt these approaches to our system. These innovations are already available in our communities. If you ask those around you, they might have one of these kits with them. We distribute them widely during our meetings to create awareness. Your role as members of the press is crucial here; by showcasing these advancements through your articles and images, you contribute significantly to raising awareness among our population. We’re actively working to make these kits more accessible. Currently, we’re focus ng on specific populations, especially those at higher risk. As acceptance grows, these kits will become readily available in pharmacies, allowing anyone to walk in, purchase one, and conduct a test in the privacy of their home.
Funding for HIV prevention and HIV Trust Fund
The primary funding for HIV programmes in Nigeria comes from sources such as the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund. We are currently working on ensuring the authorisation for continued funding after 2025, hoping that the efforts will be successful. However, in the event of challenges with the authorisation, we are preparing to strategise. We are considering how to maintain essential services with the limited resources available, including government funds, global funding, and contributions from local donors. To address this concern, we initiated discussions approximately two years ago, leading to the establishment of the HIV Trust Fund of Nigeria. The goal was to engage the private sector and encourage states to take a proactive role in response efforts. While the Trust Fund operates independently from the government, it is driven by the private sector. We communicate our needs to them, and based on their resources, they determine the extent to which they can support these requirements. Several pledges have been made, and we are actively pursuing their fulfillment. Additionally, individuals have made generous donations, which continue to come in. We urge people to learn more about the HIV Trust Fund and consider contributing. Donations, regardless of the amount, are welcomed and will be utilized to provide vital services to individuals living with HIV/AIDS in Nigeria. You don’t need to be a billionaire to make a meaningful impact; every contribution matters and will be put to good use.
Message for Nigerians as season of festivities draws nearer
My message is one of gratitude to the Nigerian people. We are deeply thankful for the remarkable acceptance and response to HIV services in our country. Over the past four years, we have witnessed positive changes in communities, largely due to the proactive engagement of Nigerians with our HIV programmes. I want to urge my fellow Nigerians, especially those living with HIV, to continue their commendable efforts. Keep visiting our healthcare facilities for regular check-ups and to access the medications provided. It’s crucial not only for your well-being but also for the safety of your loved ones. For those who are unaware of their HIV status, I implore you to actively join our fight against HIV. Your contribution begins with a simple act: get tested. Knowing your HIV status is a powerful step in preventing the spread of the virus. If you are HIV-positive, please ensure you don’t transmit it to others; keep the virus contained within yourself. This responsible action is what we encourage every Nigerian to embrace. And for those who are HIV-negative, continue to protect yourself and others by getting tested regularly. Together, we can make a significant difference in the fight against HIV/AIDS in Nigeria. Let us stand united in our efforts to create a healthier, safer future for all.
The United States (US) has invested over $5 billion in the fight against HIV/AIDS in Nigeria, it was learnt.
The US has also the largest commitment globally in the fight against the scourge with $80 billion investment.
The US Ambassador to Nigeria, W. Stuart Symington, disclosed this during an event organised by the US President’s Emergency Plan for AIDS Relief (PEPFAR) – Nigeria-Programme, where 16 nominated individuals were honoured and given awards for their contributions to the control of HIV in Nigeria.
“PEPFAR is the U.S. government’s response to the global HIV/AIDS epidemic and represents the largest commitment in history, by any nation, to address a single disease,” Symington said.
He stressed that, through the leadership and generosity of the American government and people, together with the work of many partners, PEPFAR has saved millions of lives, averted millions of infections, and changed the course of the AIDS epidemic. The envoy explained that the war against the disease cannot be fought by one institution or group of officials ‘tasked by the government,’ saying “people, not programmes solve problems and they only do it by working together.”
He said the prevalence of the disease poses a big threat, urging the Nigerian government to ensure that its citizens know their status for effective treatment options. The awardees are Professor Babatunde Olukayode Bamidele Osotimehin; Prof. John Idoko; Dr. Sani Aliyu; Mrs. Samuel, Grace Toni; Mr. Victor Olaore Omoshehin; Ms. Tobore Ovuorie; Dr. William Blattner; Ukam Reginald Assumpta; Dr. Patrick Olabiyi Matemilola; Mrs. Lucy Attah Enyia; Alban Anonyuo; MWO Musa Emmanuel (rtd); Major General Ogbonnaya Simon Njoku (rtd); Major-General Tahir Umar (rtd); Major-General Life Ajemba (rtd); and Brigadier-General Nurudeen Ayoola Hussain (rtd).
No public health value keeping HIV positive kids from learning- UN
Nigeria’s HIV epidemic affects all population groups and geographic areas of the country. Consequently, February 2015, the Federal Government signed into law the HIV/AIDS anti-discrimination bill to protect the rights and dignity of people living with HIV. Thus, making it illegal to discriminate against people based on their HIV status.
In this fifth and concluding part of the investigative series across seven states in Nigeria- Ogun, Lagos, Edo, Delta, Imo, Benue and the FCT Abuja, TOBORE OVUORIE, in her diary-like session, narrates traumatic experiences of children of school age living with HIV. She travels with these kids- back and forth- different phases of their lives full of discrimination, stigmatization, shaming and isolation by the society. The investigation also discloses how kids living with the virus are denied their human rights to educational opportunities.
THE STORY’S ARRIVAL
It all began sometime in February 2018 when I pitched a story; this story actually, to the Code For Africa. I was to decide everything editorial. The states to be combined and those to go independent in the publications. Code For Africa, as a policy, has no control whatever over editorials.
My-colleague-turned-to-friend-and-sister, Vanessa Offiong of Daily Trust Newspaper, had introduced me to the group. So, I confided in her. She warned me not to go to any school around where I live.
“Don’t even go to a school within the jurisdiction where you live. Tobore, we are Nigerians. The news will spread so fast that your kids have HIV. You don’t want to start hunting for a new apartment because your landlord won’t understand.”
The story?
I was to move around as many schools as possible, across seven states, on a simple mission: to find out if the school authorities will grant my kids admission without any form of biases because of their health status.
What about their health status?
They are supposedly living with HIV.
Yes! The Human Immunodeficiency Virus.
“MY MUMMY SAID I SHOULD NOT PLAY WITH YOU AGAIN BECAUSE YOU ARE DANGEROUS. I WILL DIE IF I DO.”
“My mummy said I should not play with you again.” Mimidoo’s head was bowed. Mivaaga sat arm-to-arm with her. She rubbed Mimidoo’s back with her left hand.
“Why did her mum tell her that?”
No response. Didn’t raise her head either. Mivaaga gave me what I needed. “That we are dangerous.”
I sighed. Deeply.
“That she will die if she comes close to us.” Mimidoo raised her head but staring at something invisible in the air. She was yet pained though it happened eight years ago.
I had known it would be very emotional taking these 13 year old girls back to when they were five years old. But I never expected this. Dissociation. She was there physically, her eyes wide open but had left Mivaaga and I.
I stopped the interview.
I stood up, walked across from where I was seated in the living room, went on my knees and arranged her legs together with her feet firmly on the ground. And placed her palms on her thighs. Mivaaga continued rubbing her back with her palm. This time, had slid it under Mimidoo’s blouse.
I gently called her name to see if she could hear me. She was still staring at the unseen stuff in the air. Lips sealed. I told her she is safe. No one can shame or bully her anymore. And what happened is not her fault. The persons who shamed them are the ones to cover their faces in shame. Not her. Not her sister.
Some minutes later, her fingers started moving as I kept talking gently to her. Their mother all the while had returned to the living room and sat beside her. I had made signs with my hands that she should not hold her yet. Goose pimples had taken over Mimidoo’s body. And tears began the stroll down her very pretty oval chocolate-colored face. Two whitish snakes at unequal intervals, possibly looked to the left and right, to ensure they were safe, then started crawling out of her nostrils.
“This is part of what I have been going through,” their mum looked very sad.
“She is having flashbacks,” I whispered.
“What’s that?” Mrs. Betty Terfa asked.
“She is remembering the terrible experiences but as if they are happening now.”
“You are a doctor?” the twin’s mother was now curious. She knew me to be a reporter.
“No.” I took my eyes off Mimidoo and focused them on Mrs. Terfa.
MRS TERFA
Our eyes jammed. She didn’t take hers away. I did. Gave them to Mimidoo, again.
“In 2014 I struggled too. Badly. I was shipped away to America. That is where social health workers and other medical caregivers taught me these. And a lot more.”
“They (people) told you bad things too?” Mivaaga found her voice. Though shaky and had lost its jingles.
“Yes. They did. But I don’t permit them anymore.”
“How do you do it?” Mivaaga was becoming curious.
“Now, I end any discussion that is not good for my health. It doesn’t matter who the other person is. I create distance with people who affect me negatively. I now create boundaries and let such people know what I will take and what I won’t ever tolerate.”
“And they worked for you?” Their mum too was curious.
“Yes. They have. Now, my mind is at rest and I feel very confident again like I used to be.”
“Please, can you teach the girls?”
“Of course. Today, I will teach them some grounding techniques and other coping mechanisms.”
“You are not doing the interview again?”
“I can’t continue today.”
“But, you came all the way from Lagos for it?”
“I know. But the health and safety of whoever I am interviewing is crucial to me. I must never re-traumatize anyone who has survived difficult experiences. My conscience won’t let me. Especially as I have been there before and know how it feels.”
“Hmmmn.” Mrs. Terfa sighed deeply.
“Yes. Rather, I help such persons.”
“Ok.” She was staring at me, so didn’t notice when Mimidoo returned to us.
I pulled a white plastic chair idling away in a corner. Sat opposite the girls and started putting them through breathing exercises.
“Gently take a deep breath. Hold it while I count one to 20.”
They did.
“Now, gradually breath out.”
They did. Their mum joined us. I continued at it for over 15 minutes before moving onto other coping skills.
Though the interview was canceled, I didn’t consider my first workday in Makurdi, Benue state, a waste.
…
“CAN’T ADMIT HIV POSITIVE KIDS IN THIS SCHOOL. WE HAVE A STANDARD. WE ALWAYS KEEP IT. WE MUST MAINTAIN IT…!”
I had spent over five minutes going through the school fees breakdown for Famous Group of Schools, Okpaka, Warri in Delta state. I had lamented bitterly that the N30,000 slated for just books for primary one is quite exorbitant.
Mr. Eli the school administrator, kept repeating theirs is a standard school. “Look at the facilities we have here…Education is the best legacy you can give to your kids…” he reeled with a sort of plastic foreign accent.
I had developed enough shock absorber when he gave me the breakdown for primary three. It was for my supposed son.
Then, I went on to tell him there was something more I needed to share but didn’t know if it would be sort of a challenge for the school. “One of them is HIV positive,” I calmly announced.
Mr. Eli screamed. The ‘W-H-A-T!?” sounded like a puppy learning how to bark but something in its throat stifling the outpouring.
He immediately regained himself. Recovered his foreign accent. Then apologized. “Oh. Sorry. Emmm…”
I continued like nothing happened. “The one in primary two. So, hope you people don’t mind.”
Mr. Eli interjected. “Wait. The one you talk about in primary two is…?”
“Yeah,” I filled the blank space.
“Did I hear you clearly again?”
“Yeah. So, hope you guys don’t mind admitting the child in school.”
“Emm. Ok. Emmm. Emmm. Emmm.” He kept repeating the “emmm.” Then continued “This is emmmm, emmmm, emmmmm. This is emmmmm, emmmm. Emmmm. Emmmm. You know, emmmm. Ok.”
He tried to recover from the shock, I think, of meeting the mother of a HIV positive kid. Then asked “how old is the child?
“Six years,” I answered.
“Ok. Ok. Ok. Ok. Emmm. It’s a, it’s a, it’s a, you know, these things are, wow! Oh gawd (God). Ok. I will put it this way.”
He paused for some seconds. It seemed like forever to me.
Then he continued. “How about the one, the seven?”
“No. That one is not (HIV positive).”
“Ok. It’s just the,” we both chorused “the one in primary two.”
“Ok. Alright. Alright. So, this is what I’m going to tell you. Emmm. We always seek the best and at the same time, like I told you, we have a standard, and that standard, we always like to keep. And we have to maintain it.”
He reeled on “It’s not us. It’s about people who have their children here. I welcome this child if it’s to be my decision to make. I will like to have this child be a part, you know, but the issue here are the guardians; parents, you know, with their peer groups, if they come to find out, it can escalate.”
I already knew where he was headed but allowed him reel on.
“And we would not want to put the child in that kind of risk. To us, it’s a risk. And it’s a risk to the child. And it’s also a risk to us because we have all the children. And parents don’t want to hear such a thing. Hope you are getting my picture.”
“Yeah, I am getting it,” I answered though I was actually confused.
“I welcome her. But this reason, you know, it is well. It is well. For the other child of three, class three, I think, that one is welcome. I don’t know, for this child,”
“So, that means we have to bring only the one for primary three.” It was a statement. Not a question. I helped him hit the nail.
“That would be fine. That’s fine. That’s fine by us.”
I sighed.
“It’s just emmm, you know, it’s glorious! This is wonderful! Emmmm. Like I said, we don’t want to put the child in some certain level, and they are still children. It’s different. I hope you understand that.”
I stressed my ok.
“Right then,” he continued.
I told him I would keep in touch and thanked him while he stressed the “you are welcome.” He allowed me go with the school fees breakdown. But before leaving, he asked for my name.
“Ok. I’m Rachael.”
Then he told me he is Mr. Eli. And kept repeating “you are welcome.” He was yet to recover fully from the shock, I guess.
He gave me his card and said I can always phone him anytime.
Mr and Mrs Terfa and their daughters used to live in a neighborhood very close to the Petroleum Training Institute, Warri. Her husband, a businessman, traveled often. So, she felt it was better and safer her twin girls schooled very close to home.
So, one day in the month of July 2010, she went school-hunting for the girls who were about clocking age five. And she found a very beautiful one close by. But, exactly what befell me with Mr. Eli happened to her. Although my experience with Mr. Eli happened at Warri in Delta state, I reserved it for this phase of the story because of Mrs. Terfa’s experience. And they both occurred in the same state.
“Why did you inform the school?” I asked with my eyes searching her face and eyes for more.
“Because I felt it was the right thing to do. They used to experience so much discomfort after taking their drugs. I was afraid they wouldn’t be at school during hospital visits and their teacher will notice all these. So, I decided to open up.”
Mrs. Terfa narrated how the school proprietor shouted ‘J-E-S-U-S!’ Then told her he couldn’t admit the girls anymore for it was risky for the school.
“So, what did you do?” I asked, with fatigue suddenly taking over my body.
“I went home and cried.”
“Why?” I had slid my right hand into my bag which was on the floor by my side, brought out one of the tough-balls and applied much pressure while holding it jealously. A coping mechanism to keep me grounded.
“The proprietor looked at me in this demeaning way. He judged me. His face and eyes accused me of being sexually irresponsible. It was all over him. He blamed me.”
She was still visibly shaken eight years later.
I stood up, walked across to her side of the living room and paused my recorder that was on the center table. Then handed her some tissue paper. I bought a dozen of them while packing my bags for the trip. From personal experiences of traveling to difficult pasts during (medical) sessions, I knew the tissue papers would be very important during all interviews with persons living with the virus.
While blowing her nose and wiping tears from her eyes, I poured some drinking water but added much quantity of the glucose I came with into it. I was doing exactly what one of my caregivers did during those emotional sessions back in the United States. I handed her the water. “She would be needing so much energy to go through this,” I told myself silently.
…
HIV: BENUE STATE, NIGERIA AND THE WORLD
The Joint United Nations Programme on HIV and AIDS (UNAIDS) says Benue is one of the six leading states in Nigeria which account for 41 percent of people living with HIV in the country. These states include: Kaduna, Akwa Ibom, Benue, Lagos, Oyo, and Kano. HIV prevalence is highest in the South-South with 5.5 percent and lowest in the South-East with a prevalence of 1.8 percent. Rural areas have higher prevalence rates with four percent, while urban strive with three percent prevalence rate.
The National Agency for the Control of AIDS (NACA) and UNAIDS in a joint 2017 Spectrum Estimates indicates Benue state as one of the priority states in the fast tracking HIV treatment and PMTCT programs in Nigeria.
With a 5.65 percent prevalence rate, no fewer than 176,725 persons from 15 years above are HIV positive. Of these, 59.05 percent are covered by the ART scheme. The duo health bodies in the survey state no fewer than10,144 kids between the ages of zero to 14 years are living with the virus in the state, while 91.66 percent of them are on ART coverage. Unfortunately, no fewer than 7,757 persons in Benue freshly contracted the virus last year, while not less than 10,640 mothers are in need of Prevention of Mother To Child Transmission (PMTCT) care.
The UNAIDS says around 2.6 million children have been orphaned by AIDS. This, the global health body says can impact the kids’ health, safety and wellbeing negatively. Statistics from the organization indicate 20 percent of orphans and vulnerable children are frequently absent from school, while about 18 percent of them have been sexually abused.
In Nigeria, HIV continues to impact negatively on kids as they often become caregivers at such tender ages to parents living with the virus. Girls, researches and surveys so far, indicate are the affected ones. Thus, possibly one of the reasons why there are more boys in classrooms in many parts of the country.
Reports from a 2017 National Health Survey showed that 15 percent of girls and four percent of boys in Nigeria have sex before they are 15 years old. Another survey carried out in 2017 discovered 41.2 percent of females between ages 15 and 24 had had a sexual partner 10 or more years older than them in the previous year. Hence, inter-generational sexual relationships being very common. In the National Health Survey, it is stated that “this increases HIV risk among this group, as often, the virus is passed from older men to young girls.”
…
Mimidoo and Mivaaga were born with the virus but never knew about it until a neighbor mocked them with it when they were 11. They almost discovered in 2010 when their friend ended the friendship on the instruction of her mum. But never did because they moved to Abuja.
The Federal Capital Territory was a fun place to live until 2015 when their peers started avoiding them. “We felt like no one wanted us but didn’t know why,” Mimidoo spoke for her twin sister as well.
They started staying indoors playing alone. At school, they had lost interest in everything and were scared to mingle with the other kids. “We knew others were avoiding us but no one told us why,” Mivaaga added.
They have never really known their relatives. “We only hear about and see them in pictures on Facebook and Instagram,” Mivaaga continued. The only family member they had known was their maternal grandma, who unfortunately died in 2011.
“My husband’s family still blame me for his death. He took ill in 2015 and never recovered.”
“Why are you being blamed for his death?”
“They claim my husband contracted the virus from me.”
I sighed deeply. Still looking at her.
She continued “He didn’t contract it from me.”
“He infected you?”
“Yes.”
“How do you know?”
“We got married in 2001 but I was unable to conceive. There was nothing wrong with us medically. But his family kept harassing me. Then, they threw my things out in 2003. He immediately married another wife, but she left him for a richer man in 2004. So, he came back to beg me. Two months before I returned to him, I donated blood for my sister. I was tested for HIV before donating. I was negative. My (immediate) family didn’t want me to return to him. But the shame was too much.”
“What shame?”
“People mocked me that I couldn’t keep a man.”
“Who are the people?”
“Cousins, friends, aunties, uncles, neighbours, in short everywhere I went, they called me names.”
“But it wasn’t your fault,” I was already numb and very sad.
“I was too ashamed to face the society as a divorcee. So, I went back against their (my family) will. I conceived the second month of my returning to him.”
“Did you register for antenatal?”
“Yes.”
“How come your status was not discovered during antenatal visits?”
“Our family doctor managing me at the time said I must have contracted it during pregnancy. I was negative during my first trimester. Since I got married, no man except my husband has seen me naked. Even after his death.”
“So, why is everyone staying away from you and the kids?”
“My family members are angry I didn’t listen to them not to return to him. They said the family must never be known for HIV so I should bear my shame alone. His family claims I killed him. They say my daughters and I are useless. They say we have a killer disease, so are not part of their family.”
“So, why did you leave Abuja?”
“After their father’s death, his family practically fought me for our properties. The whole neighborhood got to know through them that my husband died of AIDS related complications. The news spread to my kids’ school. Everyone avoided them until a neighbor’s daughter mocked them openly.”
“How?”
“She called them walking bomb. She jeered at them during an argument. That is how they got to know about their status. I couldn’t bear it anymore, so left Abuja for Makurdi.”
“Do people here know (their status)?”
“No. It’s our secret.”
“Are you sure?”
“Yes.”
“And, how do you ensure it never leaks?”
“I am working on us relocating. Hopefully by December, we should be out of Nigeria for good.”
“Really!? December this year?”
“Yes, December this year.”
…
Investigations so far reveal people’s negative attitude towards persons living with HIV is not only born out of stark ignorance about the virus but contributes to why there is so much secrecy about living with it. Ironically, persons who stigmatize and discriminate against those with HIV don’t want to be served the same food they dish out. This I discovered in interviews conducted in all states I have been to http://bit.ly/2MFdOBh , http://bit.ly/2MBQkNk, http://bit.ly/2LDXJGw, http://bit.ly/2PQ9NYI
Unfortunately, more interviews conducted revealed such parents and families are many across the country. For instance, Mr Anosisi Ibe, a trader, believes that disclosing his child’s HIV status to the school will lead to the termination of his studies by the authorities. He asked if HIV is curable. I told him it is not curable but is manageable.
“Manageable?” he repeated as if trying to make sense of the word. Then continued “how?”
I tell him there are medications to be taken, hence, will lead to a healthy life and HIV is not a death sentence. Mr. Ibe marveled at the ‘revelation’ I made. A friend of his who was close by interjected “you can take it and the thing will go out of you.” I didn’t know if that was a question or statement.
I told them when persons taking the medications- antiretrovirals, do so regularly, their viral load become undetectable, and they cannot infect others anymore.
So, I asked if he would still inform the school if his child tests positive? “No. No.” he answered. His friend rather suggests the government should create a place where kids living with HIV be kept. Mr. Ibe agreed with the friend. He believes that HIV should not be spread but kept a secret until the person living with the virus is okay.
He said I should simply call him Mr. T. He wouldn’t disclose what he does for a living. But said if his child tests positive to the virus, he wouldn’t disclose it to the school because he will be discriminated against. He rather thinks special schools be created by the government for persons living with the virus “until they get alright.”
However, he believes that any godly person living with HIV wouldn’t spread the virus but keep it within him or herself until he or she is cured.
Mrs Patience Omo, a trader, kept quiet for sometime before answering the question; what she will do if her child’s classmate were HIV positive. When she recovered her voice, she said she will educate her child not to play with sharp objects. Then I turned the table around. If her daughter were HIV positive, would she disclose it to the school authorities while seeking admission?
“For the child not to feel bad, I won’t say it,” she answered after recovering her voice again.
(MRS OMO PIC)
I asked why.
“Maybe because of that they may not take her. And they will not allow others go close to her.”
But she will ensure the child is taking her medication.
If already in school and her daughter is diagnosed HIV positive, Mrs. Omo will not let the school have an inkling about it for fear of stigmatization. Everyone, she said, will mind the way they play with her and “she will look different.” She fears schools which are already in the habit of discriminating against kids with other conditions will look down on her daughter.
Mrs. Stella Momoh, a food vendor, said she will go to the school to inquire what the school will do about it. According to her, children sharpen their pencils with razorblades and this is very dangerous. The food vendor went on to say “if the owner of the school is in his right senses, he should take away that child from that class, so that other children will not contact the disease.”
I asked doesn’t she think the child has a right to education? She agreed but argued about kids being kids “without self control”. She suggested such kids have their own school. I asked if she doesn’t feel that is stigmatization? She doesn’t think so. “I am preventing my own (child from contracting the virus),” she added.
But when I turned the table around- if her child were the one living with HIV, she interjected “God forbid! I cannot answer such question.” I explained that is why I included God forbid and said for instance. She maintained “Those are not my portion. That is not my portion. So, I can’t answer such.”
Mrs. Rose Edwards, a grandmother, said if her grandchild who is not yet in school were diagnosed HIV positive, she will first take her to church because the school cannot help her. Rather, the school authorities will tell her to go get the child treated. From church, she will then take her to the hospital to be treated. She believes there is no way the school authorities wouldn’t notice a child is living with the virus.
She said if the child is already in school, she will first get a cure for the HIV before allowing her go back to school.
SPECIAL SCHOOLS MUST NEVER BE CREATED FOR HIV POSITIVE KIDS!
Mr. Steve Aborisade, Advocacy and Marketing Manager, AIDS Healthcare Foundation (AHF), opines that most people who are HIV positive in the country will rather keep it to themselves because of the stigma.
He said parents who suggested in interviews that special schools be created for kids living with HIV “are saying that out of ignorance.” He continued “Because you are HIV positive, why will you need to be in a special class?”
Mr. Aborisade said when persons living with the virus are on treatment, the viral load become undetectable as it reduces significantly.
…
HIV BURDEN: FCT, ABUJA AND THE WORLD
The FCT, Abuja tops fifth with a 7.5 percent prevalence rate of persons living with HIV. This is according to NACA in her ‘Nigeria Prevalence Rate.’ However, in a 2017 NACA/UNAIDS joint spectrum estimates, the country’s capital territory has the lowest disease burden among all geopolitical zones with a 3.2 percent rating.
Other zones’ disease burden ratings include: South East- 9.5 percent; North East- 13.3 percent; North Central- 15.8 percent; North West- 16.5 percent; South West- 20.8 percent and South South with the highest rate at 20.9 percent.
The FCT, according to the spectrum estimates, is one of the priority states under the fast tracking HIV treatment and PMTCT programs in the country.
The UNAIDS reports that no fewer than 240,000 adolescents between the ages of 10-19 years were living with HIV in 2016. These, that year, made up seven percent of the total number of persons with the virus in Nigeria. HIV prevalence among this age group, the global health body says varies regionally, with 4.3 percent of 15-19 years old living with HIV in the South South, compared to 1.3 percent in the South East.
Unfortunately, the UNAIDS reports health outcomes for adolescents living with HIV in Nigeria are poor, while Nigeria is the only country globally where mortality in zero to 14 year olds is on the increase.
The UNAIDS’ 2017 report indicates no fewer 270,000 children between ages 0-14 years are living with HIV in Nigeria. The global health body says 24,000 children between 0-14 years of age died as a result of AIDS in 2016, while only 21 percent of the country’s kids living with the virus are on antiretroviral. However, 13,097 kids between ages 0-14 years newly started the ART recently. Unfortunately, only 74 children are known to be on ART 12 months after starting.
Despite their elevated risk, the global health organization’s report indicates that few adolescents in Nigeria test for HIV regularly. For instance, in 2017, according to the UNAIDS, only two percent of males between 15-19 years and four percent of females tested for HIV that year.
Surveys carried out through distribution of questionnaires in all seven states investigated in this series reveal all teacher-respondents have not received any form of formal training (within and outside their schools) on how to care for students living with HIV. Majority indicated their knowledge of HIV was and is still acquired from what they hear around them.
Over half of the teacher-respondents to my research questions say they will ensure there are no sharp objects in the classroom made up of HIV positive and negative kids. They also indicated would not the children (HIV positive and negative) have much contacts with themselves. Among other research findings, over half of the teacher-respondents indicated they will separate the food and spoons of HIV positive students from those without the virus.
All participants in the survey were assured utmost confidentiality. Thus, their names were not requested anywhere in the psychometric properties (questionnaires) filled.
The full research findings on ‘Schools’ knowledge And Preparedness In Managing HIV Positive Students’ carried out in Lagos, Ogun, Delta, Imo, Edo, FCT Abuja, and Benue states would be published in the followup update to this series.
Meanwhile, school headmasters/headmistresses and principals who participated in this survey have almost same experiences and thoughts as the teachers. None of them have organized any form of formal training for members of staff on how to care for students living with HIV. Neither do they have a written policy on the management of kids and staff members who are HIV positive.
Many, in their responses were honest to indicate they wouldn’t know how to manage known students living with the virus. Some indicated they wouldn’t admit such students into the school, and wouldn’t allow them remain in the school if already students. Some others indicated they would seek another staff member’s suggestion on how to handle the situation. The latter was the case at Government Secondary School, Karu, Abuja.
“THE PRINCIPAL WOULD HAVE REJECTED YOUR HIV POSITIVE CHILD HAD I NOT SPOKEN IGBO TO HER!”
Honestly, I had started asking myself why my supposed kids were rejected at most schools I went to. “Is there something I am doing wrong? Or, is it how I make the disclosure? Or, is it because I am a woman?” I queried myself.
So, I decided to try someone neutral. I got a guy. Tall, huge and good-looking. I call him Fine Man.
I didn’t tell Fine Man it’s a story. I told him I wanted to transfer my kids’ school but couldn’t get to Government Secondary School, Karu, Abuja by myself. I told him all the questions I wanted answered during the inquiry.
“But please, record all the discussions,” I had added.
“Why?” He had asked.
“So that I can have a feeling of the persons who will be caring for my kids. Remember, I told you one of them is HIV positive?”
“Yes.”
“From their voices I can tell if my kids will be safe with them or not.”
“Oh. Ok.” Fine Man agreed.
…
Fine Man had been directed around and even given a list. No, told to snap a list with his phone’s camera. The clerk who appeared to be more knowledgable on the job than the principal, had debated with the latter, the admission process for Fine Man’s kids. I don’t know why they thought the kids were his. While the principal told him to go to ERC, madam clerk said he was to purchase some scratch cards.
“ERC is for those already schooling within the FCT. And the child is coming from outside,” madam clerk had argued further.
Indeed, my supposed kids were relocating from Ilorin to the FCT.
The principal left her to handle that.
Then, Fine Man walked up to the principal for another talk. He explained there was something that needed to be sorted, as well.
The principal’s attention was his. He said it had to do with the child’s health. The principal sounded concerned. He went straight to the point.
“The child is HIV positive, hope it wouldn’t matter…” Fine Man said calmly.
“Ehn!?” The principal’s eyes were wide open, he later told me.
“The child is HIV positive…,” he repeated.
“I don’t know anything about that o. May be, let me ask.” The principal was naive about HIV and its management.
So, she turned to her clerk. They said somethings in Igbo.” Then, she returned to Fine Man.
“Ok. The child doesn’t need to tell anybody that she has that problem. But we the school, I think we should be able to know that this is the child’s problem, because in the process of admission, they do medical fitness exam. So, it should be stated there (in her form) so that we would note it, in order not to engage the child in highly difficult manual labour or whatever. That is the only way we can come in.”
She went on to say “the child will do thorough medical exam. Well, I don’t think that is an issue because it’s a personal issue. ”
She began commenting about the political program on the TV.
Then Fine Man took his exit.
On his way out, the clerk walked up to him for feedback.
“What did she tell you about the child’s case?”
“That she will do the medical checks but that I will let the school know about the issue.”
“When you mentioned it, she wanted to object. I now used (Igbo) language and told her, you know, she just entered newly. I told her the child can come, but the school authority should be able to know the child’s case; so that if there is any crisis, they will be able to know what to do at that particular time. And that is why your phone number is very important. So that if there is anything, you should be contacted.”
…
As I journeyed around, asking Nigerians questions on HIV, results of parts of the 2017 National Health Survey kept surfacing. Statistics from the survey indicate only 29 percent of females and 27.9 percent of males between the ages 15 to 24 could correctly identify ways of preventing transmission of HIV, and reject myths around transmission.
Such is the case with Tunmise James, a 19 year old who is acquiring skills to become a hairstylist at a saloon. I had asked her what she would do should any of her friends test positive to HIV.
Her response?
“I will not eat with a friend who is HIV positive. I will not speak with her because she has HIV.”
These are her preventive measures because she fears contracting the virus when she speaks and eats with a friend living with the virus.
But if she were the one living with HIV, she wouldn’t let anyone know about it while seeking admission into a school. She thinks she would be denied admission because of her status.
Feyitayo Shodeoluwa, a student, says she will tell her younger sister not to use sharp objects in school should any of her classmates test positive to the virus. She doesn’t stop there. “I will tell her to move a little bit away from her, so she should not really play with her very well like that.”
I asked what she meant by ‘move a little bit away from her.’
“So that she will not be able to contract the HIV. You know, kids they play a lot and they can injure themselves when they are playing. In that process, she might contract the HIV.”
Feyitayo wouldn’t allow her sister share spoons with a fellow child living with the virus. She fears her sibling may contract the virus when she shares a spoon used by the child who is HIV positive.
“HIV POSITIVE CHILDREN POSE NO RISK IN SCHOOLS”
Ms. Magda Conway, Consultant and Service Development Specialist, Children’s HIV Association, (CHIVA), United Kingdom, in the publication titled ‘HIV in schools: A summary of the good practice guide to supporting children living with and affected by HIV, emphasizes the need for schools’ management to ensure all members of staff have up-to-date knowledge about HIV; routes of transmission; and firmly establish the need for confidentiality.
According to Ms. Conway, if a child discloses his or her HIV status in school, he or she should be assured of confidentiality by the school authority. “Agree who will inform the parent that this information has been shared,” Ms. Conway advises.
The specialist who works extensively on HIV in children and adolescents states further that:
A child living with HIV in a school:
* Poses no risk
* Presents no additional insurance issues
* Requires no additional resources
In the publication, she stressed that “What they do face is a high level of stigma, the impact that this stigma can have on their wellbeing, and the additional complications that managing a long-term health condition may present to a family.”
According to CHIVA, HIV is a ‘non-notifiable disease’ because all persons living with it, including pupils and staff in schools cannot transmit the virus during daily contacts.
Ms. Conway says “Schools want to be places where all children are safe and able to equally access education. They are places where children’s attitudes and understanding of the world are developed; therefore schools should model an educated and calm response to HIV, as they would with any other health condition.”
KEY FACTS
* HIV CANNOT be passed on through normal daily contact, which includes playing and normal childhood interactions.
* Vast majority of HIV positive pupils acquired HIV from their mothers during pregnancy, birth or breastfeeding.
* A pupil (or teacher) living with HIV poses no risk to the school community
* There has NEVER been a case identified of a child passing HIV to another child, teacher or member of the school community within a school.
* People living with HIV are able to live long, healthy lives
* Confidentiality is critical to people living with HIV due to stigma that is still present in the society
SOURCE: Children’S HIV Association (CHIVA) United Kingdom
“HIV POSITIVE KIDS ARE MEMBERS OF THE SOCIETY”
Dr. Bolanle Ola, Consultant Psychiatrist and Head of Psychiatry, Lagos State University Teaching Hospital (LASUTH) said schools’ rejection of students on account of their HIV status are discriminatory acts and these are not supported by the law.
He called on the government to enforce the anti-discrimination laws in the country because persons living with HIV are also members of the society and are entitled to all rights like other members of the society.
He stressed that every child living with HIV is entitled to education; being a fundamental human right. “They need to have access to education, health, recreational facilities and reasonable accommodation,” Dr. Ola added.
He urged persons living with the virus to work with organizations and agencies like Office of the Public Defender (OPD) that will enforce their rights.
Dr. Ola emphasized kids living with the virus are part of the society and special schools for them must not be created because it is stigmatizing and a breach of their human right.
NO PUBLIC HEALTH VALUE KEEPING HIV POSITIVE KIDS FROM LEARNING
Dr. Erasmus Morah, UNAIDS Country Director in Nigeria, says denying children living with HIV education on account of their status would be outrageous.
Addressing the instances of Ogun state owned schools not accepting kids living with HIVdue to alleged directives from the state’s education ministry, Dr. Morah said “Such would be an outrageous policy. Completely outrageous.
“And I don’t think any government of Nigeria be it state, federal or even local government should have such a policy. I don’t believe they have such a policy. If they do, it’s tragic, and it should immediately get to the attention of those who are concerned and change it.
“It shouldn’t be. It’s not consistent with the global practice, and to my knowledge of the Nigerian policy on HIV, it’s also not consistent with it. There is absolutely no public health value to keeping children who are HIV positive from learning. Absolutely none! Zero!”
Editor’s Note: Mrs. Betty Terfa, Mimidoo and Mivaaga are not the real names of the family living with HIV interviewed in this story. They were changed for their privacy. Images of the girls or other identifiers such as voice notes and videos, of the family, are not used to protect them from being recognized and stigmatized.
This story was produced with support from Code For Africa through her Naija Data Ladies Fellowship Programme.
President Muhammadu Buhari on Thursday said that the end of the spread of Acquired Immuno Deficiency Syndrome (AIDS) is in sight in Nigeria.
He made the remark during the announcement of the result of the Nigeria AIDS Indicator and Impact Survey (NAIIS) at the old Banquet Hall of the State House, Abuja.
He urged the various agencies and partners to work together collectively towards pushing out the last aspect of the disease in Nigeria.
He said “Today is a critical turning point in Nigeria for a HIV epidemic that has killed many of our countrymen and women. The end of AIDS as a public health threat by 2030 is truly in sight for our country. Let us therefore work collectively and “push for the last mile.”
Over the last two decades, he said, that the Federal Government and development partners have continued to expend significant resources in the fight against HIV with less than commensurate impact on the disease burden.
He noted that the availability of accurate and reliable HIV data for the country is crucial for planning effective health interventions to arrest the HIV epidemic and ultimately rid the country of the health threat.
He said “Recently, the national HIV programme and our development partners have faced challenges in measuring progress against targets and efficiently utilizing scarce resources due to gaps in our HIV data.
“Since my assumption of office, this Administration has paid particular and deliberate attention to careful planning as a way of implementing effective policies and achieving sustained change.
“The Nigeria AIDS Indicator and Impact Survey is therefore in line with our government’s determination of ensuring sustainable solutions to our development challenges. The survey and its results have come at the right time as we commence the full implementation of the National Health Act that will ensure that every Nigerian has access to comprehensive health services.
“The Nigeria AIDS Indicator and Impact Survey was designed to provide the data we need to plan adequately and consolidate on the progress towards the elimination of HIV in Nigeria. We are already a step ahead in this regard, as the Federal government has ensured that the HIV treatment programme in Taraba and Abia is properly funded this year and accommodation made to resource future expansions in the coming years.
“I am pleased to report that this survey has provided Government with the crucial information needed to enable the national HIV response to move forward and plan for a more sustainable and accountable programme based on credible scientific data.
“I am aware that our development partners have committed enormous resources in supporting Nigeria to conduct this survey. I particularly wish to thank the United States Government, the Global Fund, the United Nations agencies and technical partners for their significant contributions towards this survey.
“The Federal Government was committed to the successful conduct of the Nigeria AIDS Indicator and Impact Survey. The survey was completed in record time to the agreed timetable and budget. I wish to note also the commitment of the people living with HIV, State actors and governments, traditional institutions, religious bodies, civil societies, public and private institutions, the media, and indeed all Nigerians in the support provided toward the successful outcome of this survey.
“I particularly applaud the dedication and resolve of the National Agency for the Control of AIDS, (NACA) and the Federal Ministry of Health in seeing this initiative through to its logical conclusion.
“The official HIV prevalence for persons aged 15-49 years in Nigeria is now 1.4 per cent. An estimated 1.9 million Nigerians are now living with HIV with about one million persons on treatment.
“I am delighted that these more accurate figures indicate that fewer Nigerians are affected by HIV. However, we cannot celebrate yet, as almost a million Nigerians living with HIV are currently not on treatment. Now that we have data that will help us target for impact, I urge all of us not to relent in this fight, but to increase the momentum in a concerted effort to end the epidemic ahead of 2030.
“As we mark this important day in the nation’s HIV response, I will like to reiterate the commitment I made at the UN General Assembly in 2017 to progressively add 50,000 Nigerians on treatment every year using government resources.
“I also welcome the move by the Nigerian private sector to establish a National HIV Trust Fund in the coming months to support our goal of ensuring that all Nigerians have access to high quality HIV treatment and prevention services,” he said.
If Nigeria is to achieve epidemic control and end AIDS in Nigeria, he said, the nation needs a more coordinated and funded national response.
“I am directing NACA and the Federal Ministry of Health to undertake detailed consultations and consensus building with key sectoral Ministries, the legislature, governors of high prevalence states, our development partners and civil society to chart a new strategic path, building on the results of this survey. To guide this process, we are issuing today a “Revised National HIV/AIDS Strategic Framework” document,” he stated.
A London patient has become the second known man to be cleared of AIDS virus after receiving a bone marrow transplant from an HIV resistant donor, according to his doctor.
The patient has shown no trace of previous HIV infection since he underwent the transplant operation three years ago.
“There is no virus there that we can measure. We can’t detect anything,’’ said Ravindra Gupta, a professor and HIV biologist who co-led a team of doctors treating the man.
However, Gupta described his patient as “functionally cured’’ and “in remission,’’ rather than “cured. It’s too early to say he’s cured,” he said.
The first known patient to be functionally cured of HIV is an American man, Timothy Brown, who also underwent similar treatment in Germany in 2007.
Both patients received bone marrow stem cells from donors with a rare genetic mutation known as “CCR5 delta 32,” which confers resistance to HIV.
Between Brown and the new London patient, scientists made several attempts to cure other AIDS patients using the same method, but failed in all of them.
Gupta said the method used is not appropriate for all patients but offers hope for new treatment strategies.
The study is to be published on Tuesday in the journal Nature.
As of 2017, there were approximately 36.9 million people worldwide living with HIV/AIDS.
AIDS-related deaths have been reduced by more than 51 per cent since the peak in 2004, according to the Joint UN Programme on HIV/AIDS.
The authors of the study published Tuesday have also said the technique may not necessarily be effective for all HIV-infected individuals, specifically those carrying the gene CXCR4.
CCR5 is the gene allegedly edited by Chinese scientist He Jiankui, which led to the birth of babies in 2018, who are said to be HIV resistant.
Sarah Palmer, the Deputy Director of the Centre for Virus Research at The Westmead Institute for Medical Research in Sydney, said the study “further confirms the promising HIV curative effects of bone marrow transplantation from the relatively few persons, who have the HIV resistant cells.
“However, this curative process is not yet applicable to tens of millions of other HIV-infected individuals worldwide. The next steps should be focused on how to do so,” she added.
Fast-rising Ghanaian actress, Haillie Sumney, who is set to break into the Nigerian movie scene, in order to attract more fans and get international recognition has said many African actors risk contracting sexually transmitted diseases, STDs.
The fair-skinned actress, who quit her nursing career at the Riverside Hospital, USA, for acting in Africa, said that many African entertainers do not belief in protection during sex.
“Many African actors stand the risk of contracting Sexually Transmitted Diseases and HIV; I say this because African people can be very promiscuous and a lot of them do not believe in using condoms or using protection. They feel like they are ‘supermen’, and that HIV is not real.
“I have friends and I talk to them, especially my male friends and a lot of them say that they do not use protection because they do not like it and that is the only reason that they give. When you mention HIV, a lot of them act as if it does not exist. So I would say that a lot of them are susceptible to HIV and STDs.
According to Sumney, it is better and easier to break into Africa market through the Nigerian film market.
“Nollywood is definitely a large market and well-recognised internationally,” she said.
“So why would I wanted to break into it. And I love Nigeria.
“Even though we have Jollof kind of war going on, Ghana and Nigeria goes hand in hand when it comes to music, movies and other stuffs. We are like brothers and sisters.”
Sumney began her acting career with a TV series, Heels and Sneakers produced by Yvonne Nelson and have featured in a movie, ‘A Way Back home’ alongside with Alex Okubo, IK Ogbonna and a couple of other stars. She also starred in a movie ‘Lagos Fake Life’ produced by Mike Ezerounye.
