By Chinonye Ndeokwelu
“HIV is not a killer disease as generally conceived, but the stigmatisation of people living with the virus is capable of sending us to our early graves. So many of us can not openly disclose our HIV status”
These were the words of Osaro Idahosa, a 42-year-old Nigerian business tycoon who has been living with HIV/AIDS for 11 years.
Acquired immune deficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). The illness interferes with the immune system, making people with Aids prone to infections, including opportunistic infections and tumors. The virus and disease are often referred to together as HIV/AIDS.
It is transmitted in many ways, such as: vaginal, oral or anal sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during, pregnancy, childbirth and breast feeding among others.
According to Idahosa, many people believe that living with HIV is an automatic end to life. “But I tell people that there is nothing my mates do that I can’t do. Stigmatisation even kills faster, because once you are stigmatised, you cannot enjoy any assistance from the society, which makes victims psychologically helpless.
“For two weeks now, I have been down with asthma but people who are aware that I’m HIV positive are running away from me thinking that am suffering from the symptoms of AIDS”.
The disease is a major health problem in many parts of the world, and is considered a pandemic, a disease outbreak that is not only present over a large area but is actively spreading. In 2009, the World Health Organisation (WHO) estimated that there are 33.4 million people worldwide living with HIV/AIDS, with 2.7 million new HIV infections per year and 2.0 million annual deaths due to AIDS. In 2007, UNAIDS estimated: 33.2 million people worldwide were HIV positive; AIDS killed 2.1 million people in the course of that year, including 330,000 children, and three quarter of those deaths were inSub-Saharan Africa.
According to worldwide UNAIDS 2009 report, 60 million people have been infected since the start of the pandemic, with some 25 million deaths, and 14 million orphaned children in southern Africa alone.
Genetic research indicates HIV originated in west-central Africa during the late nineteenth or early twentieth century. It was first recognised by the US Center for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s.
Although treatments for HIV/AIDS can slow the course of the disease, there is no known cure or HIV vaccine. Antiretroviral treatment reduces both the deaths and new infections from HIV/AIDS, but these drugs are expensive and the medications are not available in all countries. Due to the difficulty in treating HIV infection, preventing infection is a key aim in controlling the AIDS pandemic, with health organisations promoting safe sex and needle- exchange programme in attempts to reduce the spread of the virus.
UNICEF 2011 report claims AIDS stigma and discrimination exist worldwide, but they manifest differently across countries, communities, religious groups and individuals. They occur alongside other forms of stigma and discrimination, such as racism, stigma based on physical appearance, homophobia or misogyny and can be directed towards those involved in what are considered socially unacceptable activities such as prostitution or drug use.
Stigma not only makes it more difficult for people trying to come to terms with HIV and manage their illness on a personal level, but it also interferes with attempts to fight the AIDS epidemic as a whole. On a national level, the stigma associated with HIV can deter governments from taking fast, effective action against the epidemic, whilst on a personal level it can make individuals reluctant to access HIV testing, treatment and care.
Idahosa continued: “When my wife got to know about my status, I could no longer stay in the house because of her unfriendly attitude. She announced to everyone who cares to listen and finally walked me out of the house. I was not even allowed to touch my own children.
“It is so easy for people to come forward and say I’m hypertensive, I have cancer, I have diabetes but it is very difficult to come out as AIDS patient.”
The danger of this stigmatisation is that more people die daily for fear of being disowned, unloved and rejected. There are several prominent people living with this virus, but have refused to disclose it.
More so, the anti-stigmatisation bill before the Nigerian national assembly is yet to be passed. During the administration of former Nigerian President Olusegun Obasanjo, HIV prevention, treatment and care was one of the government’s primary concerns. The Presidential Committee on AIDS and the National Action Committee on AIDS (NACA) were established, and by 2001, the government had set up a three-year HIV/AIDS Emergency Action Plan (HEAP).
But the present government of the country is yet to pass the bill. Idahosa believes the National Assembly “refused to pass it,” adding that if Nigeria is serious about its populace the health sector of the country must be given adequate attention.
Furthermore, doctor/patient ratio in the country also affects the treatment of HIV victims. Idahosa, disclosed that during clinic days, two doctors attend to 150 patients. This situation hinders effective health care delivery service, especially to HIV patients.
However, according to the latest data from the Nigerian government, the country now accounts for around nine per cent of the global HIV burden. More than .2 million of these people are between the age of 15 and 49, indicating a high prevalence of HIV infection among young adolescents and adults.
Sex is traditionally a very private subject in Nigeria and the discussion of sex with teenagers is often seen as inappropriate/western. Attempts to provide sex education for young people have been hampered by religious and cultural objections. In 2009 only 23 percent of schools were providing life skills-based HIV education, and just 25 percent of men and women between the ages of 15 and 24 correctly identified ways to prevent sexual transmission of HIV.
Some concerned Nigerians have suggested that providing job opportunities or monthly allowance for infected people may serve as an attraction for the virus carriers to come out of the crowd, thereby preventing them from spreading the virus.
One of the doctors at Maitama General Hospital Dr Mary Unuakpor said the spread of the disease is sometimes caused by men who fail to disclose their status to their wives when tested positive. She however advised men to use condom as a means of family planning until they are able to disclose their status.
Idahosa, who is currently bed-ridden, is very optimistic of the future but fears that death could knock at his door at any moment.