Lowering HIV Prevalence: A Task For All

Sekinah Lawal/

Nigeria now has a lower HIV prevalence rate says a survey recently conducted by the Federal Ministry of Health and the National Agency for the Control of AIDS (NACA).

The new survey, done with funding from PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria, and with technical assistance from the U.S. Center for Disease Control and Prevention, reportedly reached more than 250,000 respondents in nearly 100,000 households.

According to the new survey results, Nigeria has an HIV prevalence of 1.4% as against the previous rate of 2.8%.

The expanded data collection and analysis provides a better understanding of the HIV epidemic in Nigeria.

The new data from the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), one of the largest population-based HIV/AIDS household surveys ever conducted, should be of great help to all stakeholders in taking bolder steps aimed at reducing the number of new cases to the barest minimum, further reduce the prevalence rate and viral load suppression among those living with HIV.

And it could have been anybody since one does not contact it only by being promiscuous or having unprotected sexual intercourse. What of mistakes from a blood transfusion, sharing of sharp objects, mother to child transmission among others.

We all must do more in terms of creating continuous awareness on how to prevent new infections, access to ARV drugs without discrimination and rights to employment by those living with HIV as well as adherence to workplace rights and safety as provided for in the Official Gazette No. 125 Vol. 101 of the Federal Republic of Nigeria.

The HIV and AIDS (Anti-Discrimination) Act, 2014, aimed at protecting the rights and dignity of people living with and affected by HIV and AIDS, eliminating all forms of discrimination based on HIV status among other provisions.

Unfortunately, many people do not even know their rights. This act applies to all employers of labour and employees in the public and private sector including Nigeria armed forces, police, other para-military organisations, hospitals, schools and place of worship.

For instance, no employer, institution, body or individual shall require an HIV test as a precondition to an offer of employment, access to public and private services except in certain cases. This and other rights we need to know.

The NAIIS directly measured HIV prevalence and viral load suppression and was primarily funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). 

According to the NAIIS results presented by Dr Amanze Ogbonna of the Strategic Knowledge Management Department of NACA during training for Journalists in Lagos recently, the HIV prevalence in Nigeria is lower than previously thought, allowing the country to focus on providing services to the areas of greatest need to control the HIV epidemic.

According to the report, in Nigeria, the HIV prevalence – the percentage of people living with HIV – among adults age 15-64 years was 1.5 per cent (1.9 per cent among females and 1.1 per cent among males), and among children, age 0-14 was 0.2 per cent. HIV prevalence was the highest among females age 35-39 years at 3.3 per cent and among males age 50-54 years at 2.3 per cent.

The disparity in HIV prevalence between females and males was greatest among younger adults, with females age 20-24 years (1.3 per cent) having more than three times the prevalence of males in the same age group (0.4 per cent).

Speaking with our Correspondent, many Nigerians commended government efforts aimed at the first step of effectively controlling an HIV epidemic by accurately measuring the epidemic.

“At least for the first time ever in Nigeria, we have robust data that tell us where HIV is concentrated; viral suppression among people living with HIV; the gaps in the HIV response by geography, gender, and age; and what HIV policies and focused resources are needed.

“As a health worker, I feel all stakeholders and partners must use this data to optimize HIV interventions and accelerate progress toward reaching HIV epidemic control,” a nurse, Mrs Ada Nwafor said.

The NAIIS found that the prevalence of Viral Load Suppression (VLS), a widely used measure of effective HIV treatment in a population, among all people living with HIV age 15-64 years in Nigeria was 44.5 per cent (46.2 per cent among females and 40.9 per cent among males).

The disparity in VLS between females and males was greatest among those age 25-34 years, with females age 25-34 years (40.0 per cent) being twice as likely to have VLS compared to males in the same age group (20.3 per cent).

Apart from targeting interventions, the data will also help in reaching at-risk groups, and close the gaps that these data reveal.

“After 15 years of successful scale-up of HIV treatment and prevention services in Nigeria, we can now understand the impact HIV programs have had on the epidemic and where the gaps are in order to pave the ways towards a continued, effective response.”

HIV and tuberculosis (TB) are the world’s two most deadly infectious diseases, and CDC’s Division of Global HIV & TB works with partners to tackle these two epidemics and produce the greatest global health impact.
It’s our hope that our government at all levels will do more in terms of reducing the level of poverty among Nigerians because poverty can increase vulnerability to HIV infection. Unequal socioeconomic status of women compromises their ability to prevent HIV or mitigate the impact of AIDS.

Also, hunger can lead to risk-taking behaviour, undermine HIV treatment adherence and hasten progression to AIDS. As a result, more should be done in making life bearable for the common people.

In addition, it’s a well-known fact that advanced HIV-related illness impairs nutritional status and undermines household food security by reducing productivity, all hands must be on deck to help the situation.

Of great concern is access to quality healthcare services. Lack of universal health coverage, including sexual and reproductive health services, restricts access to HIV prevention and treatment.

Most people acquiring HIV infection acquire it through sexual transmission or transmission from mother to infant during pregnancy, childbirth or breastfeeding.

Globally, about 7 in 10 adolescent girls and women 15–24 years old do not have knowledge of HIV. It’s even worse in Nigeria because the level of sensitisation and awareness have really gone down unlike what we used to have in the past.

We need to take this issue more seriously because HIV-related illness impedes school attendance and learning, as does stigma and discrimination in school settings.

Gender inequalities, discrimination, violence and harmful practices must stop because all these negatively impact women and girls, and men and boys, and increase the risk of HIV infection and its impact.

Everyone must continue to talk about fundamental human rights of those affected as well as safe and secure working environments, facilitating access to HIV services, especially for workers in informal employment, such as undocumented migrants and sex workers.

People living with HIV experience unemployment rates three times higher than national unemployment rates and this is contravening the acts. This must be addressed because income inequality is linked to higher HIV prevalence; HIV affects vulnerable and disempowered communities most severely.

It should be NO TO Stigma and Discrimination. Stigma is a major contributor to high HIV prevalence and linked to lower access to health care and housing.

We really need to do more as a nation in terms of provisions of basic amenities because all these have a lot of impact on the success level in reducing HIV prevalence rate.

Global collective action to improve access to affordable HIV commodities is critical to ending the epidemic and we need to do more as a nation.
Previous estimates had indicated a national HIV prevalence of 2.8%. UNAIDS and NACA estimate that there are 1.9 million people living with HIV in Nigeria.

It’s good that the President of Nigeria, Muhammadu Buhari, welcomed the news that there are fewer people living with HIV in the country than previously estimated and launched the Revised National HIV and AIDS Strategic Framework 2019–2021, which will guide the country’s future response to the epidemic. Nigeria has made good progress in scaling up HIV treatment and prevention services in recent years.

Like our President Muhammadu Buhari said, we must not relent but to increase the momentum. Let us work collectively and push for the last mile. Since we were made to understand the fact that the data from the Nigeria National HIV/AIDS Indicator and Impact Survey, NAIIS, are based on a revised and enhanced methodology. The survey provides a clearer understanding of Nigeria’s HIV epidemic and shines a light on progress and the remaining gaps and challenges.

It’s our hope that with an improved understanding of the country’s HIV epidemic, government functionaries in the field will be able to reach people living with HIV and people at higher risk of acquiring HIV better.  

Nigerian Government and its partners must be commended for conducting this survey, which provides us with a much better understanding of the country’s HIV epidemic but there’s a whole lot of work to be done.
We all must continue with the necessary sensitisation of the populace on HIV/AIDS.

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