Thursday, February 9, 2012


Uchenna Anozie

HIV new infection rate has been a long lasting fight for more than two decades globally but unfortunately in sub Saharan Africa the incidence of new HIV infection rate has been prominent and a thing of concern.
Irrespective of the fact that figures given by different ministries of health of various African countries in Africa show a decrease of HIV prevalence rate, the truth remains that our record keeping and data management is nothing to write home about.
Fake figures are always given and method of data collection is dependent on sentinel method, for instance, in Nigeria Pregnant women that go for antenatal check are mandated to go for HIV screening and that serves as a source of data collection for HIV infection.
The fact remains that many pregnant women are still left out in the screening process especially those that are in the rural areas, those that are attended by traditional birth attendants, and even those that go to private hospitals where there are no data collection for HIV positive patients.
From my working experiences in Senegal, Gambia, Burkina Faso and Nigeria, there is gross lagging in keeping health data and unfortunately HIV new infection tends to be on the high side. In countries like Senegal females within the ages of 17 to 30 are mostly infected and males ranging from 35 to 50 are mostly infected, in Nigeria females within the ages of 25 to 35 are mostly infected while males ranging from 25 to 45 are mostly infected. This shows that those that are still in their productive age are mostly infected and these are people that are mostly sexually active.
I have also asked myself several questions like: why is HIV thriving tremendously in Africa? Why is it that mostly married people are infected? Why is HIV new infection rate high? Why are we Africans mostly discriminating against the people living with HIV/AIDS and yet we are not cautious over sex issues?
I had to carefully interview my clients that came for voluntary HIV testing and counselling and for the past six years I found out that Africans have the knowledge of HIV/AIDS transmission and risks, they equally have the skills to protect themselves but attitude towards HIV/AIDS/STI/RH/FP remains a problem.
Amongst these problems I mentioned above the most worrisome is consistent and correct use of condoms. Most Africans are not interested in condom message; many are against the use of condom, some don’t trust the use of condom as a protective measure, some ladies see it as disrespect and that condoms are used for prostitutes not for regular sexual partners.
Promiscuity has been since the days of Adam, it is as old as the bible, and it is not surprising to learn that in Africa both men are women are promiscuous especially amongst the married.
It is interesting to note that women remains the most infected population due to their vulnerable nature of their genital organs, financial limitations and lack of education and empowerment.  Unfortunately women suffer more than men when infected because people discriminate and stigmatize women that live with HIV/AIDS than men.
Men are considered promiscuous in Africa and women are considered to be prostitutes if they test HIV positive, cases are worst if their husbands test HIV negative.
People in Africa rarely believe that there are other ways of getting HIV infected other than through sexual intercourse. This has led to many frustrated women living with HIV/AIDS, majority are even divorcees as a result of their HIV status and we still have lots of ladies that are widowed by this pandemic.
Irrespective of the fact that we hear, see and read articles, posters, policies that condemn the stigmatization and discrimination of people living with HIV/AIDS, the act of discrimination and stigmatization remains very pronounced. It is most unfortunate that health workers champion these ugly acts, they are the ones that break the law of confidentiality and they go ahead to tell people in the community about people’s HIV status triggering open stigmatization and discrimination of people living with HIV/AIDS. The manner of approach exhibited by health workers in the health facilities towards patients are unimaginable and this discourages patients to keep to thier medical appointments and strict adherence to HAART (highly active antiretroviral therapy).
In Senegal I found out the health workers were kind and respectful towards people living with HIV /AIDS, talking with lots of patients in CTA Dakar, Senegal, they were very encouraged and confidentiality was maintained, patients were truly encouraged to continue treatment and keep to medical appointments. They were even given food and transport money for medical checks. Efforts were made to make the patients feel at home at the health facilities and a sense of love and concern was showered on them.
In Nigeria the reverse was the case, patients in various parts of the country were massively shown hostility by the health workers, most times government hospitals where HAART were administered to patients freely failed to provide these drugs dues to multiple industrial actions taken by health workers over salary increment and agitation for better working conditions.
National action committee for AIDS Nigeria has failed to monitor HIV/AIDS programmes in the country, there were times we experienced lack of HIV test kits in open and free HIV screening centres just because of the laxity of the ministry of health in Anambra State Nigeria.
Many non government organisations are not monitored and are totally misappropriating funds set for  the fight against HIV/AIDS. Lots of NGOs, CBOs and other concerned organisations are camouflaging in the name of working for people living with HIV/AIDS but are actually not doing so, rather embezzlement of funds remains their priority, they carry out expensive ineffective and inefficient campaigns, health promotion and education against HIV/AIDS.
Some NGOs like family health international, society for family health, institute of human virology, catholic relief service, jphego, aidscap and several other organisations in Africa are working tirelessly to fight against HIV/AIDS in Africa but programme and project sustainability remains a problem in Africa, until we Africans stop depending foreign aid and learn to take over certain projects ourselves we can never achieve much in control of HIV/AIDS especially in Nigeria my country. We virtually rely on foreign donors for condoms, lubricants, anti retroviral drugs, HIV test kits, funds for sensitization activities. This is definitely not a way forward, donors will not be with us forever especially with the way European and American economy are going these days. Africans need to invest in the fight against HIV/AIDS, Africans need to take active part in active research on HIV/AIDS prevention. We don’t need to rely on donations to carry out massive campaigns and health promotion on HIV/AIDS. We need to train and retrain our health workers constantly to manage people living with HIV/AIDS properly.
I was opportune to work in a standard laboratory in Senegal where we carried out various diagnosis ranging from full blood count, CD4,CD3,CD8,liver function test, kidney function test, viral load test and all these things were properly put in place to monitor the efficiency and effectiveness of the anti retroviral drugs administered to patients. During my work exposure, I noticed that lots of patients from far areas of the countries were solely dependent on this facility. I occasionally found out that patients took the pains of travelling from neighbouring countries like Guinea, Bissau etc for HIV medical services due to poor facilities or breakdown of machines in health facilities in other countries. We have to take into consideration the transport fare to travel to the facility in Senegal from other countries, it was not cheap and easy; most patients could not make it and were left to their fate until things were put in place in their home country.
In Nigeria we have lots of facilities spread across the country for HIV/AIDS treatment and other services but there are still lots of limiting factors and challenges that patients face. The attitude of health workers towards patients, constant industrial actions that lead to closure of health facilities, some facilities are over stocked with patients and very few health workers to attend to them, thereby leading to health workers being over laboured, stressed and in turn show hostility to patients instead of care delivery.
Treatments of other STIs are not free of charge in most African countries, ranging from screening to medication and we are all aware that STIs increases the risk of HIV infection. In Senegal, nutrition for people living with HIV/AIDS are taken seriously but unfortunately in many countries including Nigeria we do not pay attention to nutrition for people living with HIV/AIDS.
In conclusion I would like to say that knowledge, attitude and practise on HIV/AIDS management in Africa are all in place but attitude and practise remains a major challenge and need to be improved. Africans should stop relying totally on foreign donors to fight against HIV/AIDS. Health workers need to work on their attitude and encourage patients instead of discouraging them. Africans should stick to consistent and correct use of condoms. We have to come out more openly and discuss sex and safe sex practise. From my findings lots of people that live in Africa do not know about HIV/AIDS management and still see HIV/AIDS as death sentence, this does not only discourage patients but also leads to fear and anxiety in patients. Facts on HIV/AIDS management need to be related to people massively, we need to know the real transmission route and transmission risks and know how to protect ourselves. Sero-discordant couples should be encouraged and guided on how to practise safe sex and manage their sexual practises to reduce chances of cross infection. Africans need more information about HIV/AIDS this will encourage voluntary testing and counselling, encourage acceptance of people living with HIV/AIDS and discourage discrimination and stigmatization in our society at large.

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