CHAPTER THREE: UNDERSTANDING THE MENACE OF HIV/AIDS

3.1 DEFINITION AND EXPLAINATION OF THE TERMS HIV/AIDS

3.1.1 WHAT IS HIV?

HIV is a composite of three (3) alphabetical words; H, I, and V, which translates for

Human Immunodeficiency Virus. It is the virus that causes the emergence of the killer

disease called AIDS. Once introduced into the blood stream, HIV attacks certain cells of the

immune system called the ‘helper – T- Cells,’ or CD4 Cells, which are responsible for

helping the body, fight off infections. 1 The study of Biology teaches us that the immune

system functions as the protective agent which protects our body against germs, whose main

components is white blood cells – the white blood cells sort out and destroy invading

organisms, including bacteria and viruses. Notwithstanding ‘HIV avoids been destroyed by

the immune system by repeatedly changing its outer coat, a feature common to viruses. 2

Furthermore, ‘Progression of HIV infection is evident by high viral load, when HIV test is

positive, there is low CD4 count, increase in clinical systems and on set of opportunistic

infection.’3 HIV virus can be classified into HIV 1 and HIV11. Outside of the human

organism it cannot grow or reproduce on its own; in other words it must affect cells of living

organism in other to replicate and reproduce. Outside of a human cell, HIV exists as roughly

spherical particles (sometimes called virions). The surface of each particle is studded with

lots of little spikes. An HIV particle is around 100-150 billionths of a metre in diameter.

That's about the same as:

o Microns
o 4 millionths of an inch
o One twentieth of the length of an E. coli bacterium

1
Ajiki Pius T.T., Troubling Ethical Waters: A Christian Perspective of Human Sexuality,( Lagos: Sovereign Prints
Nig.Ltd.), 2010, p.149
2
Mbanaso A., and Akubugwo E., Understanding the Scourge OF HIV/AIDS ( Abia: ABSU PRESS LIMITED), 2007,
P.5
3
Ibid.

1
 o One seventieth of the diameter of a human CD4+ white blood cell.

Unlike most bacteria, HIV particles are much too small to be seen through an ordinary

medical instrument called microscope. However they can be seen clearly with an electron

microscope. HIV particles surround themselves with a coat of fatty material known as the

viral envelope (or membrane). Projecting from this are around 72 little spikes, which are

formed from the proteins gp120 and gp41. Just below the viral envelope is a layer called the

matrix, which is made from the protein p17. The proteins gp120 and gp41 together make up

the spikes that project from HIV particles, while p17 forms the matrix and p24 forms the

core. The viral core (or capsid) is usually bullet-shaped and is made from the protein p24.

Inside the core are three enzymes required for HIV replication called reverse transcriptase,

integrase and protease. Also held within the core is HIV's genetic material, which consists of

two identical strands of RNA.4

AIDS DEFINED

AIDS is an acronym which means AQUIRED IMMUNO DEFICIENCY SYNDROM.

It is caused by a germ called HIV (Human Immune Virus). Sequel to this claim, AIDS is the

medical designation for a set of syndromes, opportunistic infections and laboratory markers

and indicating that a person is in an advanced stage of HIV infection, with an impaired
5
immune system. Furthermore AIDS is a medical condition. A person is diagnosed with

AIDS when their immune system is too weak to fight off infections. Since AIDS was first

identified in the early 1980s, an unprecedented number of people have been affected by the

global AIDS pandemic. Today, there are an estimated 33.3 million people living with HIV

and AIDS worldwide.6

4
http://www.avert.org/structure of HIV.htm accessed on the 23/11/2010 1:30 am.
5
Ajiki Pius T.T., op cit. Pp 148-150
6
UNAIDS (2010) 'Report on the global AIDS epidemic' (accessed http://www.avert.org/aids.htm 30/11/2010)

2
 Fig1: The proteins gp120 and gp41 together make up the spikes that project from HIV

particles, while p17 forms the matrix and p24 forms the core.

NOTE: In this computer generated image, the large object is a human CD4+ white blood cell,

and the spots on its surface and the spiky blue objects in the foreground represent HIV

particles. Computer generated image available at http://www.avert.org/structure of HIV.htm.

3
3.2 HISTORY OF HIV/AIDS

3.2.1 THE EMERGENCE OF HIV/AIDS THE IN WORLD

Several historical accounts have been narrated and posited by scholars, authors,

scientists, medical practitioners and Health Care Workers about the actual emergence of

HIV/AIDS in the world. The debate as regards the genuine root, region, zone or country from

which the opportunistic infection and pandemic actually originated from, has left us with

varying positions. Notwithstanding, the history of HIV/AIDS in the United States began in

the early 1980s when doctors in Los Angeles, New York City, and San Francisco began

seeing young men with Kaposi’s Sarcoma, a cancer usually associated with elderly men of

Mediterranean ethnicity; these men eventually died owing to fact that were gay. 7

Subsequently, ‘as the realization that men who had sex with men were dying of a mysterious

cancer, it spread like wild fire throughout the medical communities. Furthermore sequel to

this rumours the syndrome began to be called by the colloquialism “Gay Cancer”. 8 The

discovery by medical scientists revealed that the syndrome included other manifestations

such as Pneoumocystis pneumonia (PCP, which is a rare form of fungal pneumonia, its name

was later changed to “GRID”, or Gay Related Immune Deficiency. No doubt this had an

effect of boosting homophobia and adding stigma to homosexuality in the general public,

particularly since it seemed that unprotected anal sex was the prevalent way of spreading the

disease.9 Within the medical community, it quickly became apparent that the disease was not

specific to men who had sex with men as blood transfusion patients, heroin users,

heterosexual and bisexual women and newborn babies became added to the list of the

afflicted. The Centres For Disease Control and Prevention (CDC) renamed the syndrome

AIDS in 1982. In Africa, HIV was first noticed about the year 1983 among men and women

7
Mbanaso et al., op.cit. p.7
8
Ibid
9
Ibid. Pp.8-9

4
who had multiple sexual partners. The first confirmed case of AIDS in Africa was reported in

1984 in Nairobi, Kenya. In the same year, concerns about the HIV/AIDS infection were

raised in Nigeria. By 1986, the official report on HIV/AIDS was made by the Federal

ministry of health, Nigeria.10 Over the course of time, some theories have been propounded

by renowned, respected and highly acclaimed scientists which are associated with HIV/AIDS

namely:

 The hunter (The African Green Monkey) Theory

 The Oral Polio Vaccine(OPV) Theory
 The Conspiracy Theory

3.2.2 HISTORICAL TIME-LINE OF HIV/AIDS

1959

 Scientists isolate what is believed to be the earliest known case of AIDS.

 The discovery suggests that the multitude of global AIDS viruses all shared a
common African ancestor within the past 40 to 50 years.

1978

 Gay men in the US and Sweden -- and heterosexuals in Tanzania and Haiti -- begin
showing signs of what will later be called AIDS.

1980

 Deaths in US -- 31 (includes all known cases 1981 and before)

1981

 On June 5th, the CDC reports that in the period October 1980-May 1981, 5 young
men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii
pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients
died. All 5 patients had laboratory-confirmed previous or current cytomegalovirus
(CMV) infection and candidal mucosal infection.
 On July 4th, the CDC reports that during the past 30 months, 26 cases of Kaposi
Sarcoma have been reported among Gay males, and that eight have died, all within
24-months of diagnosis.
 Number of known deaths in US during 1981 -- 234
10
J. V. Akpera et al Introduction to HIV/AIDS Education, Kastina-Ala: Gold Ink Company, 2007,p.11 cited by
Akpagher Christopher D., The Scourge of HIV/AIDS and Stigmatization in MInna Diocese: A Pastoral Approach,
Jos: St. Augustine’s Major Seminary, 2009, p.19

5
1982

 CDC (U.S.) links the new disease to blood.

 The term AIDS ("acquired immune dificiency syndrome") is used for the first time on
July 27th.
 Larry Speakes, President Reagan's press secretary jokes about AIDS during press
briefing on October 15th.
 US President Ronald Reagan has not mentioned the word "AIDS" in public yet.
 The Gay Mens Health Crisis is founded in New York City.
 Number of known deaths in US during 1982 -- 853

1983

 CDC (U.S.) warns blood banks of a possible problem with the blood supply.
 Institut Pasteur (France) finds the virus (HIV).
 US President Ronald Reagan has not mentioned the word "AIDS" in public yet.
 Number of known deaths in US during 1983 -- 2304

1984

 Dr. Robert Gallo (US) claims he discovered the virus that causes AIDS; however, this
is about a year after the French discovery.
 US President Ronald Reagan has not mentioned the word "AIDS" in public yet.
 Opus BBS is released, becoming the first mainstream software system to donate
100% of its proceeds to AIDS care/research.
 Number of known deaths in US during 1984 -- 4251, including -- Gaetan Dugas,
listed in The Band Played On as "patient zero."

1985

 The FDA (US) approves the first HIV antibody test. Blood products begin to be tested
in the US and Japan.
 The first International Conference on AIDS is held in Atlanta (US).
 US President Ronald Reagan mentions the word "AIDS" in public for the first time in
response to a reporters questions on September 17, 1985. See, also: Associated Press,
Los Angeles Times
 AmFAR is founded in Los Angeles.
 The first AIDS-related play -- The Normal Heart, by Larry Kramer -- opens in New
York.
 Number of known deaths in US during 1985 -- 5636, including -- Rock Hudson, film
star.

1986

 President Reagan mentions AIDS in his Message to the Congress on America's

Agenda for the Future on February 6, 1986.

6
 US Surgeon General Everett Koop publishes a report on AIDS. It calls for sex
education.
 Switzerland begins testing of blood products.
 Ben Gardiner's AIDS BBS goes on-line in San Francisco, CA (U.S.).
 Number of known deaths in US during 1986 -- 2960.
 Cumulative known deaths: 16,301.

1987

 AZT (zidovudine, Retrovir®) -- ViiV Healthcare (formerly GlaxoSmithKline) --

becomes the first anti-HIV drug approved by the FDA. The recommended dose is one
100mg capsule every four hours around the clock.
 Canada stops distribution of tainted blood products.
 The US shuts its doors to HIV-infected immigrants and travelers.
 On April 2nd, with virtually no mention made in the interim, President Reagan
appeared before the College of Physicians in Philadelphia, to deliver his first "major
speech" on AIDS, calling it "public enemy number one." Vice President George Bush
is heckled when he calls for mandatory HIV testing.
 ACT UP is founded in New York City in March.
 A family -- including three HIV-positive sons (hemophiliacs) -- are driven from their
home (Arcadia, Florida, US) after their home was torched by an arsonist.
 After an ACT UP demonstration, the FDA announces a two year shortening in the
drug-approval process.
 The AIDS Memorial Quilt is started in San Francisco (US).
 And The Band Played On by Randy Shilts is published.
 Number of known deaths in US during 1987 -- 4,135, Liberace, entertainer
(PCP).Michael Bennett, Broadway director (Chorus Line).

1988

 US bans discrimination against federal workers with HIV.

 US mails 107 million copies of "Understanding AIDS," a booklet by Surgeon General
C. Everett Koop.
 FDA (US) okays importation of non-approved treatment for PWA personal use.
 Number of known deaths in US during 1988 -- 4,855.

1989

 Haiti stops distribution of tainted blood products.

 FDA (US) approves pentamidine mist for use against PCP.
 After two years of intense ACT UP protests over the price of its drug, AZT,
Burroughs Wellcome lowers AZT's price by 20%.
 Number of known deaths in US during 1989 -- 14,544.
 Amanda Blake, TV star ("Miss Kitty" on Gunsmoke)

7
1990

 Ronald Reagan apologizes for his neglect of the epidemic while he was president
(US).
 ÆGIS is founded by Sr. Mary Elizabeth and the Sisters Of St. Elizabeth Of Hungary.
 Number of known deaths in US during 1990 -- 18,447. Halston, American fashion
designer. Keith Haring, artist, Ryan White, teenager, hemophiliac, AIDS activist.

1991

 ddI (didanosine, Videx®) -- Bristol-Myers Squibb -- a nucleoside reverse

transcriptase inhibitor, is approved for use in the U.S..
 10 million have HIV worldwide (WHO). More than a million are in the US (CDC).

 Professional basketball player Magic Johnson tells the world he has HIV.
 Kimberly Bergalis, who apparently got HIV from her dentist, asks the US congress to
force health care workers to be tested for HIV.
 Number of known deaths in US during 1991 -- 20,454. Rock Singer Freddie Mercury

1992

 ddC (zalcitabine, Hivid®) -- Roche -- a nucleoside reverse transcriptase inhibitor, is

approved for use in the U.S..
 First clinical trial of multiple drugs is held.
 FDA (US) starts "accelerated approval" -- interim licensing -- to get promising drugs
to PWAs faster.
 PWAs Bob Hattoy and Elizabeth Glaser give speeches to the US Democratic National
Convention.
 Number of known deaths in US during 1992 -- 23,411. Robert Reed, actor

1993

 CDC (US) revises its definition of AIDS, including new opportunistic infections.
 The so-called "female condom" is approved. In the US, the FDA refused to allow
testing for anal sex, saying sodomy is illegal in too many states.
 Four French blood bank officials sent to prison for allowing HIV-tainted blood into
French blood banks.
 Researchers in Europe show taking AZT (monotherapy) early in the disease has no
benefits (Concorde study).
 Number of known deaths in US during 1993 -- 41,920. Arthur Ashe, tennis legend,
Rudolf Nureyev, ballet dancer

1994

 d4T (Zerit®) -- Bristol-Myers Squibb -- a nucleoside reverse transcriptase inhibitor, is

approved for use in the U.S.

8
 A Benneton advertisement depicts US Pres. Ronald Reagan with K.S. lesions.
 Number of known deaths in US during 1994 -- 32,330. John Curry, Olympic figure
skater. Randy Shilts, Chronicled rise of AIDS. Elizabeth Glaser, CrU.S.der for
Pediatric AIDS. Dack Rambo, actor

1995

 Saquinavir (Invirase®) -- Roche -- is approved for use in the US. This is the first anti-
HIV drug in the protease inhibitor class.
 3TC (lamivudine; Epivir®) -- ViiV Healthcare -- a nucleoside reverse transcriptase
inhibitor, is approved for use in the US.
 Germany convicts four of selling HIV-tainted blood.
 US admits it was the Institut Pasteur (France), not Robert Gallo (NIH, US) who
discovered the virus that causes AIDS.
 Olympic diver Greg Louganis reveals that he has AIDS.
 Number of known deaths in US during 1995 -- 48,371. Eric "Easy-E" Wright,
"gangsta" rap star. Paul Monette, Writer of Gay anguish.

1996

 The HAART (Highly Active Antiretroviral Therapy) era begins.

 A combination of at least three ARV (antiretroviral) drugs are recommended.
 Nevirapine (Viramune®) -- Boehringer Ingelheim , approved for use in the US. This
is the first anti-HIV drug in the class called non-nucleoside reverse transcriptase
inhibitor.
 Ritonavir (Norvir®) -- Abbott -- a protease inhibitor, is approved for use in the U.S..
 Indinavir (Crixivan®) -- Merck -- a protease inhibitor, is approved for use in the U.S..
 Japan busts Green Cross Pharmaceutical Corp. for dealing in HIV-tainted blood.
 Researchers at Columbia University identify herpesvirus-like DNA sequences in
AIDS-associated Kaposi's sarcoma
 Brazil becomes the first country to offer anti-AIDS drug "cocktails" to those who
need them.
 TIME magazine's 1996 Man of the Year is AIDS researcher Dr. David Ho.
Basketball star Magic Johnson returns to play basketball.
 Heavyweight boxer Tommy Morrison announces he is HIV positive.
 California voters passed Proposition 215 (55.7% to 44.3%) to allow medical use of
marijuana. Arizona passed Proposition 200 by a much larger margin, 65.3% to 34.7%.
 Number of known deaths in US during 1996 -- 34,947, including: Peter Adair,
filmmaker. Fela Anikulapo-Kuti, internationally renowned Afro-beat musician.

1997

 Zidovudine/Lamivudine (Combivir®) -- ViiV Healthcare--, is the first combination

pill approved in the U.S.
 Delavirdine (Rescriptor®) -- ViiV Healthcare -- is approved for use in the U.S.
 Nelfinavir (Viracept®) -- ViiV Healthcare -- is approved for use in the U.S.

9
 CDC reports first case of probable HIV transmission through kissing.
 The UN reports it had been underestimating AIDS transmission rates.
 The CDC reports annual AIDS deaths dropped in the U.S. for the first time since the
early 1980's. CDC also reports that HIV incidence declined for the first time.
 Researchers report from the 37th Interscience Conference on Antimicrobial Agents
and Chemotherapy (ICAAC) they are beginning to understand the effect anti-HIV
therapy has on CD4 T-cell counts.
 The American Medical Association and the U.S. Conference of Mayors call on U.S.
Congress to revoke the 1988 law prohibiting needle exchange programs.
 Food and Drug Administration (FDA) approves Nelfinavir (Viracept®) and Ritonavir
(Norvir®) for use in children.
 Number of known deaths in US during 1997 -- 21,399
 Approximate total worldwide death count -- 6,400,000.
 Approximate number of HIV-positive people worldwide -- 22,000,000. To put this
number in perspective, it is larger than the total population of the continent of
Australia.

1998

 Abacavir (Ziagen®) -- ViiV Healthcare -- and Efavirenz (Sustiva, Stocrin) ® --

Bristol-Myers Squibb -- are approved for use in the U.S.
 12th International AIDS Conference opens on June 28 in Geneva, Switzerland with
the theme "Bridging the Gap". The conference reports that nearly 90% of people
living with HIV disease are in developing countries where there have been little
advancements in HIV/AIDS treatment and care.
 Efavirenz (Sustiva®, Stocrin®) -- Bristol-Myers Squibb -- , the third non-nucleoside,
reverse transcriptase inhibitor (NNRTI), is approved by the FDA for use in the U.S..
 First formal trial begins to determine if people living with HIV/AIDS can stop taking
anti-AIDS drugs safely.
 Researchers in France conclude that long-term breastfeeding by HIV-positive mothers
increases the risk of HIV transmission to their babies substantially.
 Number of known deaths in US during 1998 -- 17,403.
 Approximate number of HIV-positive people worldwide -- 33.4 million.

1999

 Long-term side effects on metabolism from anti-AIDS therapy become increasingly

worrisome.
 A team of researchers determine HIV came from chimpanzees.
 Number of known deaths in US during 1999 -- 18,491.
 For the first time there are more women living with HIV disease in Africa than men.
 South African Judge Edwin Cameron announces he is HIV positive.

10
2000

 Zidovudine/Lamivudine/Abacavir (Trizivir ®) -- ViiV Healthcare -- and Lopinavir

(Kaletra, Aluvia®) -- Abbott -- are approved for use in the U.S.
 At a special UN Security Council meeting, HIV/AIDS is deemed a security threat for
the first time.
 South African President Thabo Mbeki asserts HIV does not cause AIDS.
 Scientists from around the world sign the Durban Declaration, a document affirming
HIV is the cause of AIDS.
 13th International AIDS Conference is held in South Africa. During the conference,
demands are made for anti-AIDS drugs for pregnant women to reduce mother-to-child
transmission.
 Sandy Thurman is named the first US envoy on AIDS by President Clinton.
 Number of known deaths in US during 2000 -- 17,741.

2001

 Tenofovir (Viread®) -- Gilead Sciences -- is approved for use in the U.S.

 HIV/AIDS is now the leading cause of death in sub-Saharan Africa.
 Brazil assists with World Trade Organization deal on medical patents giving poor
countries access to discounts on drugs for AIDS.
 Number of known deaths in US during 2001 -- 18,524.
 Young South African activist Nkosi Johnson dies of AIDS.

2002

 Rapid HIV test kit is approved by the FDA.

 The CIA's National Intelligence Council issues report stating HIV/AIDS is major
threat to five countries.
 Barbados receives first World Bank loan to combat AIDS.
 14th International AIDS Conference is held in Barcelona, Spain.
 Number of known deaths in US during 2002 -- 17,557.
 Cumulative deaths in US through 2003 -- 524,060.

2003

 Emtricitabine (Emtriva®) -- Gilead Sciences -- , Atazanavir (Reyataz®) -- Bristol-

Myers Squibb -- , and Fosamprenavir (Lexiva, Telzir®) -- ViiV Healthcare -- are
approved for use in the U.S.
 President George W. Bush announces his Emergency Plan for AIDS Relief
(PEPFAR), a five-year, $15 billion initiative to fight HIV/AIDS, primarily in Africa
and the Caribbean.
 WHO and UNAIDS unveil 3 by 5 Initiative, a program to provide anti-retroviral
drugs to three million people in developing countries and those in transition by 2005.
AIDSVAX, an experimental AIDS vaccine, fails to block HIV infection among the

11
 more than 2,000 intravenous drug users who volunteered for the first large-scale
clinical trial of an AIDS vaccine.

2004

 Abacavir/lamivudine (Epzicom®) -- ViiV Healthcare -- and Tenofovir/emtricitabine

(Truvada®) -- Gilead Sciences -- are approved for use in the U.S.
 The Three Ones, a landmark agreement to coordinate global efforts to fight
HIV/AIDS and increase support was reached by the international community in
partnership with UNAIDS.
 The first installment in the President's Emergency Plan for AIDS Relief (PEPFAR)
has been distributed.
 The U.S. porn industry is hit by fears of an HIV outbreak among its stars. By May,
five actors have been found to be HIV-positive.
 Keith Cylar, the co-founder, co-president and COO of Housing Works, passed away.

2005

 FDA grants first tentative approval of HIV drug regimen for use under PEPFAR.
 Nelson Mandela announces the death of his son from AIDS-related complications.
 Kenneth Cole, in conjunction with KNOW HIV/AIDS, a joint public education
initiative of Viacom Inc. and the Kaiser Family Foundation, and am FAR today
unveiled the "We All Have AIDS" campaign to reduce the stigma of HIV/AIDS.

2006

 FDA approves Atripla as the first once-a-day treatment option.

 CDC releases revised HIV testing recommendations for health-care settings,
recommending routine HIV screening for all adults 13-64 years old.
 First annual national Women and Girls HIV/AIDS Awareness Day in US.

2007

 Another major HIV vaccine trial is halted after preliminary results show no benefit.

 Around 33 million people are living with HIV, according to revised estimates in the
2007 AIDS Epidemic Update.

2008

 17th International AIDS Conference takes place in Mexico City. It is the first time the
conference is held in a Latin American country.
 Swiss researchers issue a report suggesting people on anti-HIV therapy drugs will not
pass the virus to others.
 POZ magazine calls for a national AIDS strategy.

12
  Francoise Barre-Sinoussi and Luc Montagnier share the Nobel Medicine Prize for
their discovery of the HIV virus.
 2008 marks the 20th anniversary of World AIDS Day.
 CDC releases new HIV incidence estimate - 56,000 new infections in the U.S. each
year.

2009

 President Barack Obama lifts the HIV travel ban.

 The first National AIDS Strategy is unveiled in the U.S.
 Dennis deLeon, lawyer, former New York City human rights commissioner, co-
founder of the Latino Commission on AIDS dies.

2010

 The World Health Organization estimates 5.2 million people are now receiving HIV
treatment.
 The Council of the Global HIV Vaccine Enterprise develops the Scientific Strategic
Plan for an AIDS vaccine.11
 World AIDS DAY marked amidst great cheers and enthusiasm. Theme for the

3.3.1 THE HISTORY OF HIV/AIDS IN NIGERIA

Nigeria is one of the most populated countries in the Sub-Saharan African continent

which has witnessed the invasion and menacing presence of the opportunistic infection,

HIV/AIDS. No doubt as a nation she is blessed with natural resources, habitable vegetation

and highly populated. It is reported that “the first two cases of HIV and AIDS in Nigeria were

identified in 1985 and were reported at an international AIDS conference in 1986.12

Sequel to this, in 1987 the Nigerian health sector established the National AIDS

Advisory Committee, which was shortly followed by the establishment of the National

Expert Advisory Committee on AIDS (NEACA). At first the Nigerian government was slow

to respond to the increasing rates of HIV transmission13 and it was only in 1991 that the

Federal Ministry of Health made their first attempt to assess Nigeria's AIDS situation. The

11
Copied and abridged from http://www.aegis.com/topics/timeline/
12
Adeyi et al. (2006) ‘AIDS in Nigeria: A nation on the threshold’. Chapter 2: The epidemiology of
HIV/AIDS in Nigeria. Harvard Centre for Population and Development Studies. Cited by
www.avert.org

13
results showed that around 1.8 percent of the population of Nigeria were infected with HIV.

Subsequent surveillance reports revealed that during the 1990s HIV prevalence rose from

3.8% in 1993 to 4.5% in 1998.14 At the dawn of democracy, When Olusegun Obasanjo

became the president of the Federal Republic of Nigeria in 1999 after so many years of

military dictatorship and lack of concern, HIV prevention, treatment and care became one of

the government’s primary concerns. Owing to this trend, ‘the President’s Committee on

AIDS and the National Action Committee on AIDS (NACA) were created, and in 2001, the

government set up a three-year HIV/AIDS Emergency Action Plan (HEAP) and worthy of

mention, Obasanjo hosted the Organisation of African Unity’s first African Summit on

HIV/AIDS, Tuberculosis, and Other Related Infectious Diseases.15 In 2005 a new framework

was developed covering the period from 2005 to 2009. Despite increased efforts to control

the epidemic, by 2006 it was estimated that just 10 percent of HIV-infected women and men

were receiving antiretroviral therapy and only 7 percent of pregnant women were receiving

treatment to reduce the risk of mother-to-child transmission of HIV.16 In 2010 NACA

launched its comprehensive National Strategic Framework to cover 2010 to 2015, which

requires an estimated N756 billion to implement. 17 Some of the main aims included in the

framework are to reach 80 percent of sexually active adults and 80 percent of most at-risk

populations with HIV counselling and testing by 2015; ensure 80 percent of eligible adults

13
Kanki, P.J & Adeyi, O., (2006) ‘AIDS in Nigeria: A nation on the threshold’. Chapter 1: Introduction.
Harvard Center for Population and Development Studies.
14
Sofo, C.A. Ali-Akpajiak and Toni Pyke (2003) ‘Social development and poverty in Nigeria’, Chapter 3
in ‘Measuring poverty in Nigeria', Oxfam Working Paper cited by www.avert.org
15
Adeyi et al. (2006) ‘AIDS in Nigeria: A nation on the threshold’. Chapter 2: The epidemiology of
HIV/AIDS in Nigeria. Harvard Center for Population and Development Studies, cited by
www.avert.org
16
UNAIDS (2008) 'Report on the global AIDS epidemic
17
AllAfrica (2010, 30th March) 'Nigeria: NACA launches N756 billion national HIV and Aids response

14
and 100 percent of eligible children are receiving ART by 2015; and to improve access to

quality care and support services to at least 50 percent of people living with HIV by 2015.18

Despite being the largest oil producer in Africa and the 12th largest in the world, 19

Nigeria is ranked 158 out of 177 on the United Nations Development Programme (UNDP)

Human Poverty Index.20 This poor development position has meant that Nigeria is faced with

huge challenges in fighting its HIV and AIDS epidemic owing to the prevalence rate which

varies according to regions, states, Local Government Areas (LGA) and Communities.

3.3.2 THE PREVALENCE RATE IN STATES.

In Nigeria since the first case was reported in 1986, the disease has spread so fast that
every state, Local Government Area and community in the country is affected. Nigeria has
the second largest prevalence (7% in Africa after South Africa which has 30%) 21. It is
reported that in regular surveys carried out in the country since 1999 – 2009, the results show
that HIV is equally distributed among the zones. Current global report shows that the
prevalence rate is between adults and children who are 15 – 49 years old. The report at Zonal
levels in Nigeria is thus: South East 8.4% with Ebonyi having the peak of 11.1%, North West
45% with Kaduna having the peak with 15%. North Central 9.5% with Benue having the
peak with 21%, North East 3.6% with Taraba having the peak with 7%, South West with
Lagos having the peak with 7%, South- South 6.8% with Akwa-Ibom having the peak with
13.3%.22

3.3.3 FACTORS CONTRIBUTING TO THE SPREAD OF HIV/AIDS

18
National Agency for the Control of AIDS (NACA) (2009, December) 'National HIV/AIDS strategic
framework (NSF) 2010-15'
19
Energy Information Administration: Official Energy Statistics from the U.S. Government. (2007)
‘Nigeria Energy Profile’, cited by www.avert.org
20
UNDP (2007/2008) Chapter 3: ‘Human and income poverty: developing countries’. In 2007/2008
Human Development Reports, cited by www.avert.org
21
Akpagher Daniel C., The Scourge of HIV/AIDS and Stigmatization in MInna Diocese: A Pastoral Approach,
Jos: St. Augustine’s Major Seminary, 2009,
22
Lucas A.O, & Gilles H.M., Short Textbook of Public health Medicine for the Tropics(4 th ed) (London: Book
powers, 2003),p.231 cited by Akpagher D C., op. cit p.2

15
 3.3.3.1 HIV TESTING

The level of negligence towards adequate maintenance and monitoring of health status

as portrayed by a vast majority of the Nigerian populace has placed so many under the

custody of diseases, a short life span and putting others at their mercy. Our local communities

are not left out in this regard as most individuals subject their health status to traditional and

supernatural beliefs; the gods are often regarded as all knowing and capable of taking care of

them. In our contemporary dispensation, HIV testing is indentified as one factor which

contributes to a large extent towards the continuous spread of the virus; the fear of the

pandemic scares so many people away from going for tests. At the mention of the name

HIV/AIDS, an immediate fear is created in the minds of people. The fear of been confirmed

positive, militates against the desire and zeal in many people especially the youths to go for

HIV testing. A survey carried out among youths, married couples and the engaged reveal

that, if given an option many will not submit to be tested. Lack of patience during counselling

before the test, tends to discouraged alot of people; for them, one is placed in a state of

psychological trauma. Worthy of mention is the fact that, the egoistic obstinacy of some

individuals makes the case of HIV testing an impossible and unnecessary venture. Owing to

this trend, carriers of the virus go about in ignorance to infect the innocent. No doubt, this

trend put so many at the risk of getting infected in Nigeria.

3.3.3.2 LACK OF SEXUAL HEALTH INFORMATON AND EDUCATION

The vast and rich cultural heritage of Nigeria is one of the factors which place her

above some other countries and nations. Notwithstanding, Sex is traditionally a very private

16
subject in Nigeria and the discussion of sex with teenagers is often seen as inappropriate,

ungodly and a taboo. Attempts at providing sex education for young people have been

hampered by religious and cultural objections.23 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 and

rejected major misconceptions about HIV transmission.24

In some regions of Nigeria girls marry relatively young, often, too much older men in

the name of tradition and providing them with maximum protection and pride. In North

Western Nigeria around half of girls are married by age 15 and four out of five girls are
25
married by the time they are 18 a large majority of them have never any formal education.

Studies have found those who are married at a younger age have less knowledge about HIV

and AIDS than unmarried women, and are more likely to believe they are low-risk for

becoming infected with HIV.26

3.3.3.3 CULTURAL PRACTICES

Man is defined by his culture and his activities are guided by the principles and

structures of the society from which he comes. Nigeria as a nation is blessed with a lot of

cultural practices and heritage handed down from the fathers of old to the populace. It should

be noted that, tribes, ethnic groups, communities and societies are identified through their

culture. However, the Nigerian situation today reveals the fact that cultural practices trigger

the spread of HIV/AIDS in Nigeria. Clients of HIV are termed as unclean, evil, ungodly and

victims of the gods. The patients of HIV/AIDS in some community are barred from public

23
Odutolu, O. et al (2006) ‘AIDS in Nigeria: A nation on the threshold’. Chapter 11: The National Response to
HIV/AIDS. Harvard Center for Population and Development Studies. Cited by www.avert.com
24
UNGASS (2010) 'UNGASS Country Progress Report: Nigeria' cited by www.avert.com
25
The Population Council, Inc (2007) ‘The experience of married adolescent girls in Northern Nigeria’.
Available at www.avert.com
26
Ibid

17
and societal function, at some point even excommunicate, excluded and exiled. Owing to this

trend, the infected become subject of scorn and are discriminated upon by their host

communities; in a bid to pay back, some of the clients go about infecting innocent people.

Furthermore some of the cultural practices which involves initiation into a particular cult or

age group, the circumcision of infants and adults which involves the use of sharp

objects( razor blades, knifes and metal objects) that are contaminated with infected blood

contribute largely to the spread of the pandemic in the communities.

3.3.3.4 POOR HEALTHCARE SYSTEM

The size of the population of the nation, pose logistical and political challenges

particularly due to the political determination of the Nigerian Government to achieve health

care equity across geopolitical zones. The necessity to coordinate programs simultaneously at

the federal, state and local levels introduces complexity into planning. The large private

sector is largely unregulated and, more importantly, has no formal connection to the public

health system where most HIV interventions are delivered. Training and human resource

development is severely limited in all sectors and will hamper program implementation at all

levels. Care and support is limited because existing staff are overstretched and most have

insufficient training in key technical areas to provide complete HIV services. 27 Some of the

Local health centres do not have sufficient supply of the antiretroviral therapy; the clients are

left with no choice but to continue to live unattended to.

3.3.3.4 ECONOMIC RECCESSION

27
2008 Country Profile: Nigeria". U.S. Department of State (2008). Accessed August 25, 2008. This article
incorporates text from this source, which is in the public domain. Online at http: wikkipeadia.com

18
 Of recent the entire world experienced a global economic and financial meltdown

and this situation affected key aspects of national growth and development; Nigeria as a

nation is not left out regardless of her rich natural resources and oil reserves. Economic

recession has led to the inadequate funding of governmental agencies, Programmes,

Campaigns and institutions that are directly involved in the struggle and fight against the

HIV/AIDS pandemic. Furthermore owing to the global economic and financial meltdown,

grants, sponsorships and aides from international charity organisations have been affected;

the indigenous sponsors and companies are not left out. In addition it is pertinent to state also

that economic recession has led to poverty among the people. Such state hinders the

unprivileged poor and low class clients from obtaining adequate antiretroviral therapy (ART)

and information about appropriate life management policies.

3.3.3.5 YOUTHFULFUL EXURBERANCE

According to the former Minister of Health, Prof. ‘Beko Ransome–Kuti [1999],

‘Over 60% of patients presented at Nigerian hospitals with abortion complications are

adolescent girls, abortion complications account for 72% of all deaths among young girls under

the age of 19years and 50% of the deaths in Nigeria’s maternal mortality rate are adolescent

girls, due to illegal abortion. Of 127 pregnant schoolgirls, 52% were expelled from school. 20%

were too ashamed to return, 15% would not return because their parents refused to pay tuition,

and 8% were forced to marry.28

Behavioural, physiological and socio-cultural, immoral actions and factors make young

people more vulnerable to HIV infection. Of recent owing to the rapid globalization

experienced in the world today, it is a common practice among some of our youths to explore

and take risks in many aspects of their lives, including sexual relationships, ungodly lifestyles

and lack of inadequate health care practices without considering the risk factors involved in

28
ERNWACA-Nigeria / HIV/AIDS and education 25 May 2004 / Page 10

19
such practices. Those who have sex may change partners frequently, have more than one

partner in the same time period. As a result of this act, the Nigerian youths are considered as

been vulnerable to HIV/AIDS.

3.3.3.5 INFIDELITY

In the light of our contemporary Nigerian dispensation, infidelity is identified as one

of the major channels, routes through which HIV is transmitted. Extra marital relationship is

on the increase. In the name of seeking pleasure and satisfaction, some fall prey to the

opportunistic infection. To this claim in talking about the scourge of HIV/AIDS in Nigeria,

the catholic bishop’s conference posited that

“We are convinced that the most effective solution to the spread of AIDS is

Premarital chastity and fidelity in marriage” ( September 1996)

Suffice to say that most of the married couples are not faithful to their spouses and either of

them is a risk of getting infected with the HIV virus and subsequently transmitting it to the

other partner. Infidelity has eaten deep into the fabrics of many marital homes subsequently

have catalysed the spread of epidemic in families and the nation at large.

3.4 THE INFEECTED AND AFFECTED

The notion of the infected and affected presents and reveals the true nature of the

HIV/AIDS pandemic which attacks both the clients that is, People Living with HIV/AIDS

and their entire family, friends, loved ones, associates, colleagues; the list goes on and on.

Regardless of the true nature of the virus as an opportunistic and deadly infection which has

no preference in its visiting list, the infected are the People Living with HIV/AIDS. After due

clinical diagnosis and adequate counselling they are confirmed and intimated as been

positive- a carrier. In other words the infected are men, women, youths and children who

20
have been certified as been positive and clients. It should be emphasised that the fact of been

confirmed or diagnosed as been positive, does not limit the value and essence of such

individual’ existence. The period of been infected and development of the virus varies among

the clients. On the other hand, the affected are refer to the families, friends, loved ones,

guardians, benefactors and lots more, of the People Living with HIV/AIDS. Owing to the fact

that the clients are either related to them or met by providence they are left with no choice but

to accept the reality nature and life accords their existence. A chat with a client revealed the

fact that often time, the affected regardless of their health status share immensely in the

stigma and stigmatization; the Nigerian society worsens the situation for the fact that the

affected regardless of their state and status are turned public symbols of mockery and

reference point. Suffice to assert at this point that while the infected struggle to live positively

and a adhere to the routine of their medications, the affected are left with a mark on the

foreheads; one can begin to imagine the number of years such a stigma can last before been

erased. Furthermore the affected are often saddled with the responsibility of taking care of the

infected as primary care givers.

3.5 ROUTES OF TRANSIMISSION, DIGNOSIS OF HIV/AIDS AND STAGES OF

INFECTION

3.5.1 HOW IS HIV/AIDS TRANSMITTED

Debates over the years have emerged as regards the surest and certain routes from

which HIV is transmitted. As stated earlier on, the HIV virus exists only in living organism

and cannot survive outside of it. Research have confirmed that the basic route from which

HIV is transmitted and contracted is through the exchange of bodily fluids such as blood,

semen, vaginal secretions and breast milk from affected individuals to those who are not

infected. It is paramount to posit at this point that, for someone to be infected with HIV, it is

21
proven that HIV must be present; one of the person’s involved is infected with HIV.

Furthermore, it must be in sufficient quantity; the concentration of HIV determine whether

infection may happen and it must get into the blood stream 29

Notwithstanding, scientists have discovered that there are three (3) primary routes or

ways through which HIV is transmitted in Nigeria and globaly. They include:

1. Through sexual contact from an infected person to his or her partner

2. Mother to baby (before or during birth or through breast milk)30

3. Through blood contact, including injection drug needles, blood transfusions, accidents in

health care setting or certain blood products31

HETEROSEXUAL SEX: Approximately 80-95 percent of HIV infections in Nigeria are a

result of heterosexual sex32, heterosexuality accounts for over 70% of all adult HIV

infection.33 Factors contributing to this include lack of information about sexual health and

HIV and high levels of sexually transmitted diseases. Women are particularly affected by

HIV: in 2009 women accounted for 56 percent of all adults aged 15 and above living with the

virus.34 The routes of sexual transmission include Vaginal sex, Anal sex and Oral sex (to a

large extent has very low risk)

MOTHER-TO-CHILD TRANSMISSION: Each year around 57,000 babies are born with

HIV.35 It is estimated that 220,000 children are living with HIV in Nigeria; most of who

became infected from their mothers. Mother to child transmission is also called peri-natal

29
Augustus Mbanaso and Emmanuel Akubugwo, op cit.
30
Ibid. p.29
31
Ibid.
32
UNGASS (2010) 'UNGASS Country Progress Report: Nigeria' available at www.avert.com
33
Adesine, C. B., Strategies for AIDS prevention and control: A call for action in FSP Nation Workshop on
culture,traditional and nation campaign against AIDS, 10-12 TH December, 1996. Pp41-45 cited by Akpagher D,
C., op.cit p25
34
UNGASS (2010) op.cit
35
Ibid.

22
transmission (from an infected mother to her child). Some of the measures embarked upon to

arrest this trend is by enjoining, encouraging and challenging pregnant women to be tested

for HIV and, for those who are infected to receive treatments that can significantly reduce the

risk of transmitting HIV to a newborn.36 Sequel to this claim, this method accounts for 20-30

percent of HIV transfer to children whose mother are positive and did not receive treatment

during pregnancy. No doubt it could occur while the innocent foetus is still lying in the womb

(uterus) or at the point of delivery. In addition, some children may not be infected at the first

two stages as earlier posited, but will still be infected with the virus during the process of

breast feeding. Suffice to say that:

All body fluids from an infected person are capable of harbouring the virus

For this reason, relatives and health workers caring for the patients with the

Virus must handle all body fluids with care to avoid transmission.37

BLOOD TRANSFUSIONS: HIV transmission through unsafe blood accounts for the

second largest source of HIV infection in Nigeria.38 Not all Nigerian hospitals have the

technology to effectively screen blood and therefore there is a risk of using contaminated

blood. The Nigerian Federal Ministry of Health has responded by backing legislation that

requires hospitals to only use blood from the National Blood Transfusion Service, which has

far more advanced blood-screening technology.39 Worthy of mention is the fact that there

abound so many channels and media through which blood to blood transmission as witnessed

in most Nigerian societies, families, social groups, age grades and communities can be

36
Agustus Mbanaso and Emmanuel Akubugwo op.cit p.32
37
Achalu E.I., Communicable and non-Communicable Diseases: Causes and Prevention.(Aba: Simarch Nigeria
Ltd 19
89, pp.126-127 cited by Apkagher D.C. ,op.cit.p.28
38
Federal Ministry of Health (2009) 'National Blood Transfusion’ available at www.avert.com
39
Nigeria Exchange (2008, 6th February) ‘Ministry of health alerts Nigerians to the transfusion of unsafe blood
in hospitals’ available at www.avert.com

23
translated into visible practice. A good example can be given of some cultural practices

where a male or female circumcision is performed with an infected unsterilized instrument.

A number of small-scale studies have indicated towards a rise in HIV prevalence

among injecting drug users. Although HIV transmission through injecting drug use is not one

of the main transmission routes, it appears to be accounting for an increasing number of new

HIV infections.40

So many articles, journals and books have been written and published by prominent

scholars, medical scientists and Care givers on the issue of how HIV is transmitted. It is of

great importance to buttress the fact that HIV infection is not transmitted in activities such as

insect bites (mosquitoes, flies and a host of others), casual contact with friends and family

members school mates and colleagues at work, donating blood, social activities which take

place at swimming pools and hot tubs, does not exist in pets, sharing of toilets, sleeping on

the same bed and eating from the same plate.

3.5.2 DIGNOSIS OF THE EPIDEMIC

Prior to the confirmation of an individual to be either positive or negative it should be

noted that HIV can be difficult to diagnosis. When HIV enters the body, it begins to attack

the certain white blood cells called T4 lymphocyte cells (helper cells). The immune system

then produces antibodies to fight off the infection. Although these antibodies are ineffective

in destroying HIV, their presence is used to confirm HIV infection. Therefore the presence of

antibodies to HIV test indicates HIV infection. For this test, a sample of blood will be drawn

and then sent to a laboratory, where specialists will look for the presence of HIV antibodies

in the patients system. 41

40
The World Bank (2008) 'West Africa HIV/AIDS Epidemiology and Response Synthesis' available at
www.avert.com
41
Agustus Mbanaso and Emmanuel Akubugwo op.cit p.73

24
 3.5.3 STAGES OF INFECTION

For the purpose of coherence Acute infection stage, Latency stage, Persistent

Generalized Lymphadenopathy (PAL) stage, The stage of AIDS related complex and the

stage of full blown AIDS, have emerged to form the major stages of HIV infection . Acute

infection stage of HIV infection is difficult to fully diagnose owing to the fact that the

antibodies to HIV have not developed hence. They cannot be detected in the blood – initial

infection stage starts, not from the presumptive date of infection but rather roughly from the

sixth week of the infection date. 42 It takes about twelve week or much more after exposition

to infection. This period if often called the window period.

The latency stage usually arrives after infection has occurred, whether with appearance

of an early infection or not. This time it becomes possible to isolate the virus from the

peripheral blood lymphocytes by co-culture and it is at this time that antibody will show

positive. Patients in this group are therefore the so called “HIV carriers”, who get infected,

contain a dormant HIV within them, and may remain infectious for life, without any sign of

the infection showing in their appearance. This is why they are called HIV healthy – carriers,

that is; healthy looking but infectious of HIV.43 Furthermore under the persistent generalized

lymphadenopathy (PGL) stage, the distinguishing factor is the swelling or enlargement of

lymph glands involving two or more anatomically distinct sites in his body: the swellings

found in armpit, neck and mastoid areas and such state can last for up to three(3) months. The

period of AIDS related complex (ARC) reveals to the infected and the affected that the

emergence of full blown AIDS stage is almost near. During this stage, a lot of damage has

already been done to the immune system. In addition, the full blown AIDS is most critical

42
Augustine Nwoye, AIDS Counselling and Nutritional Therapy,( JOS: Fab Publications, 1994,p.57 cited by
Apkagher D.C. ,op.cit.34
43
Augustine Nwoye, AIDS Counselling and Nutritional Therapy, cited by Apkagher D.C. ,op.cit.34

25
stage of HIV infections. Life threatening opportunistic infections like invasive Tuberculosis,

gingivitis, Neurological disorders, Kaposi- sarcoma, Cancer of the Cervix and lots more.

3.5.5 APPARANT SIGNS AND SYMTOMS

Signs and symptoms of HIV infection in this section is limited to its manifestation in

children and adults in Nigeria; scientists and medical practioners classify them into minor

and major signs. Notwithstanding some of the common signs and symptoms of HIV

infections in children include:

 Infectitious Diseases

 Oral Candidiasis

 Respiratory illnesses (PCP, Tuberculosis)

 Diarrheal illnesses

 Lymphadenopathy, Hepatosplenomegaly, Parotitis

 Growth failure: kwashiorkor, Marasmus

 Malignancies (kaposi’s sarcoma)

 Developmental delay or regression

 Peripheral neuropathy44

In adults the common manifestations of HIV/AIDS include:

 Unexplained fever (lasting for more than 1 month)

 Excessive weight loss up to 10%

 Persistent Diarrhoea – for more than 1 month

 Nerve and brain damage

 Mouth and throat sores

44
Agustus Mbanaso and Emmanuel Akubugwo op.cit p.59

26
  Unexplained Lymph node enlargement- limps in the neck, arms and other areas of the

body

 Persistent cough and Tuberculosis (TB) - found in up to 30 – 50% of the people with

HIV/AIDS

 Blister rashes on mouth or genital areas (Herpes), or on one side of the body

(Shingles).45

3.6 MANAGEMENT OF HIV/AIDS

Management of HIV/AIDS clients has become a thing of urgency and necessity in

Nigeria today. Pertinent to assert and affirm the fact that;

“A careful look at the effects of HIV/AIDS brings to limelight a very important fact:

HIV/AIDS is much more than simply a matter of chronic progressive disease.

It devastates the psychological, social, emotional and economic life of the patient

and family. A comprehensive approach to treatment and care with a multidisciplinary

team must therefore be adopted for effective remediation of the effects on both the

infected and affected.” 46

3.6.1 CONTROL AND ADEQUATE PREVENTION OF THE VIRUS

Despite considerable investment and research into the nature and eradication of the

epidemic that has caught across all spheres and wings of the globe, there is currently no

vaccine for HIV, and microbicides (designed to prevent HIV being passed on during sex).

Such efforts are still undergoing trials in scientific and medical laboratories around the world.

However, there are other ways that people can protect themselves from HIV infection, which
45
Ibid. pp59-60
46
Ibid. p86

27
are the basis of HIV control and prevention efforts around the world. Based on this reality,

the control and adequate prevention in Nigeria can be carried out through:

ADEQUATE HIV TESTING

In Nigeria there is a distinct lack of HIV testing programmes. In 2007, just 3 percent of

health facilities had HIV testing and counselling services, 47 and only 11.7 percent of women

and men aged 15-49 had received an HIV test and found out the results. 48 In 2009 there was

only one HIV testing and counselling facility for approximately every 53,000 Nigerian adults,

which shows how desperately the government needs to scale up HIV testing services.49 Some

reports have suggested that health care facilities offering HIV testing in Nigeria do not follow

international standards about confidentiality and ethics. 50 In one particular study, over half of

the people living with HIV reported that they did not know they were being tested for the

virus and around one in seven health care professionals admitted to never receiving informed

consent for HIV tests.51

COMMUNITY CARE AND PUBLIC EDUCATION

Sex is traditionally a very private subject in Nigeria and the discussion of sex with

teenagers is often seen as inappropriate. Attempts at providing sex education for young

people have been hampered by religious and cultural objections. 52 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

47
WHO, UNAIDS & UNICEF (2008) ‘Towards universal access: scaling up priority HIV/AIDS interventions in the
health sector’ available at www.avert.com
48
UNGASS (2010) 'UNGASS Country Progress Report: Nigeria’ available at www.avert.com
49
WHO, UNAIDS & UNICEF (2010) 'Towards universal access: scaling up priority HIV/AIDS interventions in the
health sector'
50
Physicians for Human Rights (2006) 'Nigeria: Access to Health Care for People Living with HIV and AIDS' cited
by www.avert.com
51
Ibid
52
Odutolu, O. et al (2006) ‘AIDS in Nigeria: A nation on the threshold’. Chapter 11: The National Response to
HIV/AIDS. Harvard Center for Population and Development Studies. Cited by www.avert.com

28
transmission of HIV and rejected major misconceptions about HIV transmission. 53 In some

regions of Nigeria girls marry relatively young, often too much older men. In North Western

Nigeria around half of girls are married by age 15 and four out of five girls are married by the

time they are 18.54 Studies have found those who are married at a younger age have less

knowledge about HIV and AIDS than unmarried women, and are more likely to believe they

are low-risk for becoming infected with HIV.55 HIV and AIDS education initiatives need to

focus on young married women, especially as these women are less likely to have access to

health information than married women.56

MEDIA CAMPAIGNS & PUBLIC AWARENESS

As Nigeria is such a large and diverse country, media campaigns to raise awareness of

HIV are a practical way of reaching many people in different regions. Radio campaigns like

the one created by the Society for Family Health are thought to have been successful in

increasing knowledge and changing behaviour. "Future Dreams", was a radio serial broadcast

in 2001 in nine languages on 42 radio channels. It focused on encouraging consistent condom

use, increasing knowledge and increasing skills for condom negotiation in single men and

women aged between 18 and 34.57 In 2005, a campaign was launched in Nigeria in a bid to

raise more public awareness of HIV/AIDS. This campaign took advantage of the recent

increase in owners of mobile phones and sent text messages with information about

HIV/AIDS to 9 million people.58 Another high profile media campaign is fronted by Femi

Kuti, the son of Fela Kuti, the famous Afrobeat musician who died of AIDS in 1997. He

53
UNGASS (2010) op.cit
54
The Population Council, Inc (2007) ‘The experience of married adolescent girls in Northern Nigeria’ cited by
www.avert.org
55
Ibid
56
Ibid
57
Population Services International (2003, March) ‘Nigerian radio campaign generates safer behaviour’ cited
by www.avert.com
58
BBC News (2005, 9th November) ‘Texts used for Nigeria HIV drive’ cited by www.avert.org

29
appears on billboards alongside roads throughout Nigeria with the slogan 'AIDS: No dey

show for face', which means you can't tell someone has AIDS by looking at them.59

PREVENTING TRANSMISSION OF HIV THROUGH BLOOD

A person can protect him or herself against HIV infection by ensuring that HIV infected

blood does not enter their body. Injecting drug users who share injecting equipment or works

are at risk of HIV infection. Needle exchange programmes can help to prevent HIV

transmission among drug users by providing clean needles and disposing of used ones. Health

care workers can be exposed to HIV infected blood while at work. The most effective way to

limit their risk of HIV infection is to use universal precautions with every patient, for

example washing hands and wearing protective barriers (gloves, aprons, and goggles). In the

event that a healthcare worker is exposed to potentially HIV infected blood at work, PEP

(Post exposure prophylaxis) is recommended as an HIV prevention measure.

PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV

In 2009, 370 000 [230 000–510 000] children were infected with HIV through mother-

to-child transmission. This is a drop of 24% from five years earlier. However, rapid

expansion of delivery of effective advances in preventing mother-to-child transmission is

being held back by inadequate access to antenatal and postnatal services.60 Nigeria's

programme to prevent the transmission of HIV from mother to child (PMTCT) started in July

2002. Despite 'considerable efforts' to strengthen PMTCT interventions, by 2007 only 5.3

percent of HIV positive women were receiving antiretroviral drugs to reduce the risk of

mother-to-child transmission. This figure had risen to almost 22 percent by 2010, but still

remains far short of universal access targets.40 Never the less, through effective PMTCT

59
Reuters NewMedia (2003, 9th February) 'Nigeria Grammy nominee fights to win for the poor' cited by
www.avert.com
60
UNAIDS ( CHAPTER 3: HIV Prevention/ 2010 Global Report, p.63

30
programmes, the acclaimed risk of HIV transmission from mother – to – child can be greatly

curtailed. Through HIV testing as part of routine antenatal care, appropriate combinations of

antiretroviral (ARV) drug regimens, elective Caesarean section and a complete abandonment

and avoidance of breastfeeding as practiced in industrialized countries in North America and

Europe, mother to child transmission can be tamed.

PREVENTING SEXUAL TRANSMISSION OF HIV

If a person has sexual intercourse with someone who has HIV they can become infected.

‘Safer sex’ refers to things that a person can do to minimise their risk of HIV infection during

sexual intercourse; most importantly, using condoms consistently and correctly. A person can

be certain that they are protected against HIV infection by choosing not to have sex at all, or

by only doing things that do not involve any blood or sexual fluid from one person getting

into another person's body. This kind of sexual activity is the only thing that can be

considered ‘safe sex’. Effective sex education is important for providing young people with

the knowledge and skills to protect themselves from sexual transmission of HIV.

Comprehensive sex education should develop skills and attitudes that encourage healthy

sexual relationships, as well as provide detailed information about how to practise ‘safer

sex’.61

3.6.2 TREATMENT OF HIV/AIDS

Efforts at providing a cure or vaccine which will be capable of liberating and

protecting people from HIV infection by scientists over the years have proved abortive.

Regardless of this prevailing situation, there exists practicable management strategy which

are capable of slowing down the multiplication of the infecting and on the other hand prolong

life expectancy and also provide a more comfortable living with the infection. For the

61
Available at www,avert.org accessed

31
purpose of this study, the management strategy shall be examined from a holistic point of

view. HIV /AIDS patients should be rich in Vitamins and mineral salt. Such state will aide in

boosting the immune system of the client as well as protect the body against other infections.

The consumption of multi- mineral capsules, chelated zinc, vitamins C and B complex,

cartotenoid complex. Researches reveal that vitamins A and E help to boost the mineral and
62
vitamin content in the body cells. Furthermore there should be adequate management of

stress in clients; common phenomenon among People living with HIV/AIDS patients are

anxiety and tension. Treatment of opportunistic infections is another management approach

of the treatment of HIV/AIDS infection. The treatment involves a symptomatic treatment of

AIDS and the opportunistic infections fluid and electrolyte replacement, cough remedies for

cough, analgesics for pains antiprutities of itching.63

Worthy of mention is the use of anti-retroviral drugs in the fight against HIV; the anti-

retroviral developed so far act at different stages of the life cycle of the HIV namely: one that

block binding of HIV to target cell, one that blocks the RNA cleavage, one that inhibit

enzyme reverse transcriptase, one that block the enzyme integrase which helps the proviral

DNA to be incorporated in the host cell chromosome, one that block the RNA to prevent virla

protein production, one that inhibits the enzyme, protease and viral budding inhibitors. Anti-

retroviral drugs are classified into: Inhibitors of viral attachment, Reverse transcriptase

inhibitors, Protease inhibitors, Integrase inhibitors and agents that block virus assembly and

budding. 64

62
Akpagher D. C.,p.39
63
Ibid p38
64
Augustus Mbanaso and Emmenual Akubuchj

32
33