By Carl Umegboro
Ideally, the response to HIV/AIDS is one that demands concerted drives across vertical and horizontal angles; involving all segments of the society from governments at all levels to civil society organizations (CSOs), professional bodies particularly the media, religious, traditional, community leaders, individual supports down to market leaders. The reason is that HIV/AIDS still exists, and could be contracted by persons of all ages including infants, and with no cure. It entails that a person that is diagnosed of HIV will live with it except to manage it with medications if detected at an early stage. According to the World Health Organization (WHO), HIV/AIDS is a major cause of infant and childhood mortality and morbidity in Africa. This is why sensitization down to rural areas is requisite.
In particular, the roles of Civil Society Organizations (CSOs) is critical and cannot be overemphasized as the fight against HIV and AIDS shifts from an emergency response to a long-term response as the virus remains with the society. In fact, the roles of CSOs, both community-based, non-governmental and faith-based organizations become even more important. With good coordination and support, civil society can play a good role in HIV and AIDS advocacy and service delivery. And without it, fewer services would be only accessible by key populations which implies that people in remote areas would have to travel a distance for services and therefore hinder the targeted population from benefitting from provided remedy.
In fact, CSOs and other stakeholders can explore extensively in advocacy when properly equipped on the response to HIV/AIDS. Aspects of advocacy on HIV/AIDS in which civil society could effectively be engaged with include monitoring to ensure accountability and transparency of government’s commitments; reducing legal and policy structural barriers to a quality HIV response; reducing stigma and discrimination for key populations; supporting civil society networks and coalitions; and promoting the ability of citizens to recognize and demand quality services in their communities.
Nigeria reported the first case of AIDS in 1986. Since then, national HIV prevalence was 1.8% in 1991; 5.8% in 2001; 4.4% in 2005; 3% in 2014, and 1.4% in 2018 (for individuals aged 15-64 years). The prevalence varies across regions and states with the highest prevalence being in the south-south (3.1%) while the north-west has the lowest prevalence (0.6 %). The 2018 HIV/AIDS Indicator and Impact Survey (NAIIS) reveals that 1.9 million people live with HIV in Nigeria. The prevalence of HIV in 2018 was estimated at 8 per 10,000 persons. Prevalence of HIV among adults aged 15-64 years: 1.4%, while prevalence of HIV among children aged 0-14 years was 0.2%. The global estimate in 2018 was 37.9 million, of which 1.8 million were children below 15yrs.
From records, heterosexuality (sexually attracted to members of opposite sex) still accounts for the majority of transmissions of HIV/AIDS in Nigeria with over 90% of transmissions through unprotected sexual intercourse. Thus, heterosexual sex is currently contributing disproportionately to the overall national epidemic. It is also estimated that MSM (men having sex with men) constitutes only about 1% of the Nigerian population, yet this group now contributes 20% of new HIV infections in Nigeria. Dr. A. Eluwa, an expert in Global Health at the University of Oxford maintained that HIV prevalence among MSM has been rising consistently from 14% in 2007 to 17% in 2010 and 23% in 2014.
Other means of transmission are blood transfusion with infected blood and blood products; percutaneous – contact with unsterile needles/sharp skin-piercing objects and instruments used for scarifications, tattoos, and surgical procedures. From research, many people that have died of AIDS-related complications or end stage HIV are as a result of late detection and failure to disclose their status on time. Today, the slip has produced many OVC (orphans and vulnerable children) by loss of parents and guardians who died of AIDS related illnesses.
For a robust impact on the fight against HIV/AIDS, engaging stakeholders, particularly by building and strengthening networks including media advocacy remains a focal action. Action points across the states would include organizing all facilities (public and private) and other service delivery points of HIV services for pregnant women using a ‘Hub and Spoke’ model (a distribution method in which a centralized ‘hub’ exists); establishing and empowering the LGA team to address data, sample logging, commodities and other relevant HIV services is also a critical mechanism. Above all, adequate funding cannot be overemphasized. For example, scores of PLHIV interacted with at a centre narrated the same challenge of lack of needed resources to manage the state accordingly amid unemployment and hardship.
To effectively organize needed training, workshops and seminars is also capital intensive. This is where commitments and contributions from governments including state, national and international bodies will play critical roles in mobilizing resources towards facilitating the advocacy and various support programmes. UNICEF and other implementing partners have continued to make impacts on this. It must be noted that persons living with HIV (PLHIV) need uninterrupted medical attention that demands collective support including eating well and balanced diets. From findings, many PLHIV are out of job or with no stable source of income. And, HIV can be managed with Antiretrovirals (ARVs) but if the drugs are stopped, the viral load increases. In other words, PLHIV who have access to healthcare for Antiretroviral therapy (ART) can still live a healthy life.
Again, the stigmatization and discrimination against PLHIV is a matter that must remain on the front burner. The pair critically requires vigorous sensitizations particularly through the media – television, radio, print-media, online and social media for significant impacts and waves. Instructively, according to National Agency for the Control of AIDS (NACA), HIV cannot be transmitted by casual contact with a person who is diagnosed positive, touching, hugging, playing together, sharing drinking glasses, eating together, contacting tears, saliva, sweat, urine, mosquito or insect bites, and kissing except the person diagnosed of HIV has a cut or bleeding.
Umegboro, a public affairs analyst and social advocate can be reached via: email@example.com