Fears Around HIV, Disclosure

Before 2003, there was a progression in the incidence of Human Immune Virus (HIV)and Acquired Immune Deficiency Syndrome,(AIDS) in Nigeria.

The United Nations AIDS record showed that from 1991 to 1999 the HIV zero prevalence increased from 1.8 percent to 5.4 percent. By 2011 there was a decrease to 4.1 percent.

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More worrisome was the increasing number of infected women and children, and the fact that most of the children infected with the virus contacted it from their mothers.

It was the concern to address the growing challenge of Mother-To-Child Transmission (MTCT) of HIV/AIDS that prompted the Federal Government to initiate the Prevention of Mother-To-Child Transmission (PMTCT) programme. Currently, there are 1,216 PMTCT sites in the country.

A visit to the Heart to Heart Centre (H2H) of the Badagry General Hospital, Lagos State by The Journalists’ Alliance for the Prevention of Mother-to-Child Transmission of HIV in Nigeria (JAPiN) shows that ‎the fear of People Living With HIV and AIDS (PLWA) status disclosure to family, extended family and close associate is still on the high side due to stigma and discrimination.

Though, there is Anti‎-Stigma Law which some State of the federation has adopted but with zero or minimal implementation.

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‎At the H2H Centre, Deborah Lawson said, “I had my first child who is HIV negative before I was tested positive in 2010. I got positive through my husband who did not disclose to me his status while we were still married. It all started when I fell sick and I went to the hospital, I got tested and the result came out positive. I told the doctor I will inform my husband but he said that my husband’s case is worse.‎

“I asked my husband why he didn’t ‎disclose his status before we got married. His response was that he didn’t know how to tell me.‎‎ My husband later died of AIDS. I remarried and told my second husband of my and he said there is no problem since there is drug for it now. He told me that HIV it is just like every other sickness like malaria. So since then we have been living together.

‎”I had started taking my Anti-Retro Viral (ARV) drug before I met my second husband who is negative. I met ‎him where am currently working. I don’t miss my drug so that the child am expecting will come out negative.

“My challenge is that at my place work, during my clinic days, whenever to go for clinic they complain I did not tell them where I am going to. I did not disclose my HIV status to them.‎”

It was a different story for Joy Thomas, who said she had the virus before marriage unknowingly to her, “I and my husband went for infection test before the doctors discovered I was HIV positive. The doctor called me aside to inform me. I was scared to tell my husband for fear that he may divorce me. Before we got married, there was no courtship and we did not go for laboratory test.

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“I confided in the doctor and he helped me out by telling my husband. His attitude towards me later changed sexually. For more than one month, we had no sexual intercourse because he wanted to use condom which I refused. My husband is negative.‎

“At a point he threatened to inform his family of my HIV status but later reconsidered. My status remains between the both of us. We did not disclose my status to both family. Right now, we sexually meet without condom. I am taking my Anti retro viral drugs and the doctor told him what to do in order not to be infected. Things are difficult for us right now. I need help for a job to support my husband. I didn’t attend tertiary institution. Any menial job will do,” she cried.

For Andrew Rasheed, “I was sick so I went to the hospital to test for malaria and typhoid. I was told by the doctor that I have malaria, typhoid and HIV. I couldn’t collect the test result because I felt like dying. The doctor counselled me and ask that I go to the Badagry General Hospital to run a confirmation test which also came out positive.”

“The first day I took the ARV drug, it reacted on my body that I couldn’t stand up. I told my mother about my status and she was very sad because I am her only son but later my sister had to encourage her. My HIV status is between me, my mother and sister. We have not disclosed it to my father as we speak. I resigned from my place of work because the drug always make me weak and the barber shop I later started was demolished by the government.”

Hafisat Adebayo said; “the first day I was told of my HIV status, I almost died. Then I was pregnant for the fourth child, a baby boy but I lost him because I refused to take my drugs. I also lost the next pregnancy which was twins. My thought then was whether I use the drug or not, I will die and this made me stay away from home for three days. I was affected psychologically.

“My husband is negative likewise my first three children. After the mistake of losing my fourth and fifth pregnancy, during the sixth pregnancy, I took my drugs religiously and my boy came out HIV negative. This is my seventh pregnancy and by the grace of God, will be my fifth child. ‎My husband has promised to be there for me. I breast fed my fourth child for one month and three days because I was scared he might contact the virus.”‎

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Mgbechi Mathew, 40, with three children, a widow, said, she contacted the virus from her husband, “I noticed that he was losing weight and always sick. I took him to the hospital and complained. They ran some test on him and discovered he was HIV positive and that it has developed to full blown AIDS. ‎

“I asked him why he did not disclose his HIV status to me but he said nothing. ‎He died in November 2016.‎ A‎fter the burial, I went for test and discovered I also have the virus.

‎That moment I lost hope but the nurses here at H2H unit told me not to give up hope. My three children are negative. I take my ARV drug judiciously. Just that the drugs do make me weak and dizzy. ”

Mrs Kadiri Oluseyi, Executive Director, Centre for Positive ‎Health Organisation, Lagos State said we are partnering with the Badagry General Hospital in working towards HIV prevention, maternal health, tuberculosis prevention, treatment, care and support at the community level.

Oluseyi added that the focus of the organisation is to ensure that information reaches every individual about HIV counselling, testing and treatment, access to care and support, stressing on individuals‎ that are HIV positive and also ensure that there is no infringement on the right of all tested positive.‎

She said, “people infected with the virus is actually reducing. Formerly, between 2013 and 2016, there is hardly a week we don’t record like five to six new cases of newly infected persons but now, in the entire month, we may have like four or five.”

Speaking of PLWA disclosing their status, Oluseyi said, “getting infected is one thing, accepting the result is another thing. They need to digest all information concerning their new status ‎‎and be fully in charge of themselves. They need to know that they should avoid ‎been re-infected or getting other people infected, and with self-confidence, they will own up to disclosing their HIV status to their partners or family. At the initial stage, it is hard to disclose.

“Some difficulties faced is that most of the PLWA are always upset, not owning up to their status but I believe with persistent information, they do succumb. Once a PLWA refuses to be counselled or receive drugs, we do not give up, we open the PLWA eyes on the risk involve of his or her action on himself and his community.”‎

Mrs Bukola Salami, Psychosocial Counsellor for Abidjan- Lagos Corridor, (ACO) support group said her duties as a psychosocial are; “we follow -up PLWA, counsel them to accept their result and register for Anti-retroviral Vaccine. We do not force the PLWA to register for drugs rather we educate them on the negative impact of not registering and adhering to the prescription.

“The psychosocial is very important because, the nurses cannot be in the hospital and track down the PLWA who refuse to come for clinic and drug adherence‎ as some of these PLWA miss their appointment.

“The benefits of registering in a support group like ACO is that, some pregnant PLWA do not know how to go about their new way of life, we educate them on the right path and importance of the drug they are taking.

“The drugs are free but not all the tests are free. The two most important that are free is Cluster of Differentiation 4, (CD4) and Viral Load. We have recorded great success in this project. The PLWA pregnant mothers give birth to negative children. 80 percent of our clients’ babies are negative. The 20 percent of babies born positive with HIV is due to negligence of the mother. On breastfeeding, is dependent on the PLWA CD4,” she explained.

Salami said that the support group which started in March 2017 is in partnership with the Badagry General Hospital Ante natal unit, adding that at inception of the group, it had seven registered member but currently has over 20.

‎She called on government to support the PLWA’s, Non-Governmental Organisations, (NGO’s) working on HIV and Support Groups with funds‎ to function well, stressing for stiffer laws to stem stigmatization and discrimination of PLWA.

According to a 2011, UNAIDS statistics shows that about 34 million people worldwide are living with HIV and AIDS; 3.4 million people infected with HIV and AIDS were children younger than 15years old; 3.1 million Children living with HIV and AIDS were from Sub-Saharan Africa.

About 390,000 children worldwide were newly infected;‎ 250,000 child deaths are estimated to have occurred as a result of HIV and AIDS; and most of the infection in children younger than 15years occurred through ‎‎MTCT. Globally, Nigeria alone accounts for 21 percent of new infections in children

Similarly, a World Health Organisation (WHO) statistics in 2011, Nigeria alone contributes 29 percent to global gap in reaching 90 percent of pregnant women living with HIV in need of ARVs for‎

‎PMTCT.

In a country of about 150 million people and six million births annually, 3.14 million Nigerians are living with HIV, 10 percent of HIV infections are as a result of MTCT and 154,920 new infections are in children out of an estimated 281,180 new infections. The statistics shows that about 229,480 pregnant women are HIV positive annually. This means that if proper and adequate intervention measures are not put in place, about 57,000 infants will be born with the Virus annually.

It is noteworthy that nearly all such infections can be prevented by PMTCT programmes providing highly effective Anti-retro Viral Therapy (ART) and ARV prophylaxis intervention.

 

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