Why Are Nigerians Easily Affect by HIV - Case Study Example

Nigeria: The High Prevalence of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDs) Introduction Since the scourge of HIV/ AIDs emerged in 1986, cumulatively around 1.7 million people have died and more that 1.5 million children have been orphaned (Rotberg, 2007: 25). Nigeria’s national HIV/ AIDs prevalence which was found to be 1.8% in 1991 rose to 3.8% in 1993, 5.4% in 1999, and remained almost constant at 5% by 2003, according to the country’s HIV/ AIDs sentinel survey, 2003 (Deji et al, 2007: 10). In 2007 not less than 8 million were affected, taking into consideration the country’s large population. Each year, at least 1,70,000 Nigerians died due to AIDs or AIDs-related diseases. In 2005, the number escalated to 2,20,000 deaths. In Nigeria prevalence levels of the acquired immunodeficiency syndrome (AIDs) caused by the human immunodeficiency virus (HIV), are highest among young people, especially women between the ages of 20 and 29 years. However, there are differences on a regional as well as state level basis, attributed to the marked social and ethnocultural differences at these levels. According to Deji et al (2007: 10), the prevalence “ranged from a low of 2.3% in the south west to a high of 7% in the north central regions”. At State level, the variations are wider; as in Osun and Ogun the prevalence of the disease among pregnant women was 1.2% and 1.5% respectively, as compared to 9.3% in Benue and 12% in Cross River. Projections show that by 2009, some five million Nigerians would have developed AIDs, since the disease takes up to ten years to develop fully into AIDs after the onset of infection. Surveys indicate that both urban and rural areas are affected (Sofo et al, 2003: 14). Nigeria’s government predicts that from 2007 to 2011, the adult prevalence of HIV/ AIDs will reach as high as 26% and up to 15 million people will be infected. By 2011, around 10 million Nigerians would have died from AIDs, and Nigeria would overtake South Africa as the African continent’s most AIDs-affected nation (Rotberb, 2007: 25). Before 2011, it would not be possible to stop the escalation of the disease, but an improved availability of treatment with antiretroviral drugs and better healh infrastructure, would help to increase the life span of sufferers. However, slowing the spread of HIV/ AIDs is considered to be crucial in controlling the disease. The purpose of this paper is to identify the causes of the high prevalence of HIV/ AIDs in Nigeria, and examine the various factors that are related to infection by HIV in the populace. Discussion Professor Rasheed A. Bakare, an accomplished microbiologist and venereologist has stated in an interview (Annals, 2005: 48) that in Ibadan which is the capital city of Oyo State in Nigeria, Africa, the most common agents responsible for sexually transmitted diseases (STDs) which are closely associated with the human immunodeficiency virus (HIV) are chlamydia, trachoma and herpes virus. Nearly all sexually transmitted infections are connected with HIV, and they progress more rapidly in the background of HIV/ AIDs. Recent advances in the prevention of HIV include the use of microbicides and vaccines. The fear of HIV has led to people using protective means for prevention of HIV, and healh promotion strategies. However, the reported prevalence rate of HIV/ AIDs in Nigeria is indicating only the tip of the iceberg. The Main Problems of AIDs Control in Nigeria Various problems in the political, economical, educational, religious, and industrial systems do not permit the AIDs Control Programme (ACP) to have successful results. These problems include: no acceptable local language or terminology for AIDs; increased prostitution among Nigerian women both within the country and when they travel abroad; an obstacle to HIV/ AIDs education in Nigeria being the refusal of Nigerian men to use condoms due to cultural beliefs; inadequate spending by the government for HIV/ AIDs programmes because of the poor economy of the country and the requirement to meet the demands of malnutrition, famine, and the occurrence of many epidemic diseases; as well as the low standard of blood screening for transfusion (Umeh, 1997: 114). Further, stigmatization and prejudice against persons known to be carriers of the virus, irrational fears, misconceptions of facts related to the disease, and condemnation of the sexual behavior of those who are infected, are common features (Olaitan & Ajayi, 2003: 56). This results in the Nigerian culture of secrecy regarding the occurrence of sexually transmitted diseases including AIDs, which has not allowed the rapid spread of information on HIV/ AIDs. Also, the poor health care facilities in the country have caused Nigerians to ignore the extent of the disease’s impact. Screening and diagnosis are the only laboratory investigations conducted in Nigeria, since the country lacks adequate equipment and facilities to conduct advanced HIV/ AIDs research. Moreover, there is a lack of personal dedication or a resolve to serve humanity, since researchers have vested interests to gain vantage positions. Education about the disease is not well integrated into the school curriculum at all levels, hence adolescents have not understood “the causes, modes of transmission, prevention, signs and symptoms of the disease and its effects on the individual, nation and society in general” (Umeh, 1997: 114). Sofo et al (2003: 14) support this view, and add that both within and outside marriage, Nigerian teenagers become sexually active at an early age. Since this factor is not adequately addressed in the educational system, it has serious implications for Nigeria’s growing population, resulting in high fertility, maternal and infant mortality, and the high prevalence of HIV/ AIDs that is rapidly spreading all over the country. The high levels of occurrence of the disease among the youth portends a great danger for Nigeria as “the youth group stands on the verge of an AIDs explosion” (Olaitan & Ajayi, 2003: 51). Further, 6.3% of antenatal care patients between the ages of 20 and 24 years, are infected with HIV which presents the risk of mother to child tranmission of the AIDs virus. The large numbers of females of child bearing age infected with HIV, up to 1.3 million in Nigeria, together with the high rates of fertility, are leading to a large number of children being born infected. It has been estimated that more than 2,00,000 children have already died from AIDs infection (Sofo et al, 2003: 14). Lyman & Dorff (2007: 41) state that infant mortality rates are more than ninety-seven for every one thousand live births. A key factor which is responsible for the rapid spread of the disease is the growth in commercial sex, especially that involving young girls. Among all surveyed populations in Nigeria, the highest incidence of HIV infection was identified in young, female, commercial-sex workers. Around 80% of the spread of the disease takes place through heterosexual contact. The primary source of the spread of HIV infection to women is through the sexual practices of male partners. A 1996 survey estimated that 34.2% of commercial sex workers in Nigeria were infected with HIV (Sofo et al, 2003: 15). Predominance of HIV/ AIDs Among Women in Rural Nigeria In sub-Saharan Africa, Nigeria is one of the most affected countries regarding the high prevalence of HIV/ AIDs among women, who form 57% of the adults infected, and girls form 75% of young people infected. The root cause is attributed to the prevailing high level of gender inequality and disadvantage that women face with respect to accessing resources and participation in decision making. The negative socio-cultural practices against women in Nigeria, which result in the vulnerability of women to HIV/ AIDs pandemic are: women having no voice in the selection of marriage partner and the syndrome of older men marrying young girls; similarly not permitted any participation in decision making regarding the number of children to have in a marriage relationship and in family planning. Further, the perception of rural dwellers in Nigeria regarding HIV/ AIDs, was studied in the research conducted by Deji et al (2007: 10). They found that since the majority of people in rural areas were illiterate and poor without access to modern sources of information, perceptions regarding the disease were biased against women. In Nigeria and other sub-Saharan African countries where agriculture is the mainstay of their economy, women form a major part of the agricultural labour force inspite of the socio-cultural factors which work against women having accessibility to basic economic resources needed for sustainable livelihood. Moreover, the prevalence of HIV/ AIDs, impact more women than men, with subsequent difficulty of developing countries such as Nigeria in feeding their populace with food produced within the country. Additionally, there is extensive increase in the number of female-headed households in Africa “because of the HIV/ AIDs pandemic on the household heads and other dependents, which in most cases leave the women as the caregivers, and eventually the heads of such households in most countries” (Deji et al, 2007: 8). However, there is continued practise of traditional widowhood customs which place women in a serious and dehumanizing situation, causing a sharp fall in agricultural production at the household level, with their properties seized after the death of their husbands. This occurs not only with respect to property inherited by women, but also that which is purchased with their own money after the death of their husbands. The denial of basic human rights and the consequent poverty and helplessness results in women’s “increased vulnerability to sexual exploitation, abuse and HIV” (UNAIDS, 2004: 3). Awareness of and Attitudes to HIV/ AIDs Surveys have revealed that higher levels of knowledge and increased attempts to prevent the disease are observed more among urban dwellers than among rural inhabitants. There is greater awareness in the south-east and south-west of the country, with lowest awareness in the north-west. Awareness is greater with higher levels of education and on the whole men are more aware of the virus than women especially older women and married ones. It was found that more than a quarter of the women, as compared to 17% of the men did not know how to avoid HIV/ AIDs. “Knowledge of methods of disease prevention is higher among young unmarried men and women, although use of condoms as a preventative measure is low, at just 15% of women and 32% of men” (Sofo et al, 2003: 15). However, many women marry young and become reproductively active almost at once. They are at a disadvantage with regard to exposure to sufficient information and guidance on issues concerning sexual health, which especially impacts further spread of HIV/ AIDs. There is an increase in governmental initiatives that are aimed at raising the awareness among people, regarding the virus. Establishment of the Media Health Committee and the National Committee on HIV/ AIDs help to enlighten the public about the various aspects of the disease, and measures are being taken to raise awareness among school children through primary and secondary school curricula (Soho et al, 2003: 16). Poverty, Politics and Lack of Health Care Facilities The Nigerian economy has deteriorated over the last nearly three decades with economic decline, huge international debts which have to be repayed at cripplingly high rates (Olaitan & Ajayi, 2003: 62). The poor economic conditions in Nigeria has led to the absence of health policies which are necessary for health management research and control of ethical issues in health care and research. The chaotic political situation in the country from 1992 to 1998 fuelled the rapid spread and dramatic increase of the HIV/ AIDs epidemic. Suppression of political freedom disregards citizens’ rights to adequate health care to be met by the government. People from lower economic backgrounds are more likely to engage in high risk behaviour, including using illegal drugs and engaging in commercial sex. Since this group is also less likely to have received adequate education, they have low access to information on prevention or action to be taken once infected. Also, the high costs of HIV/ AIDs management are prohibitive to the poor. Even where there is access to limited health care services, many people cannot afford the cost (Olaitan & Ajayi, 2003: 56). Medical care provision is severely taxed by the disease. The health care system in Nigeria is functioning at a very low level of efficiency, “from the late eighties to date most of the hospitals have been reduced to mere consulting clinics” (Olaitan & Ajayi, 2003: 54), with a complete lack of basic health measures such as provision of essential drugs, adequate maternal and child care, adequate treatment, and lack of systems for screening blood before undertaking blood transfusions due to the high cost of processing blood for transfusion. Further, availability of inadequately qualified and insufficient numbers of health care personnel, crude methods of delivery that often result in infection with diseases like HIV/ AIDs especially due to the high prevalence of the disease in pregnant women. Increasing numbers of orphaned children, reduced availability of labour because greater numbers of occurrences involve young men and women, and large scale decline in economic conditions of the country are the results of the spread of HIV/ AIDs in Nigeria (Sofo et al, 2003: 15). The growth of urbanization and increased migration from rural to urban areas in Nigeria results in living in overcrowded conditions, where poverty and low standards of living are the norm. These factors coupled with lack of access to guidance and awareness of the disease, have also cause uncontrolled rise in the prevalence of the disease (Olaitan & Ajayi, 2003: 57). Conclusion This paper has examined the prevalence of HIV/ AIDs in Nigeria, and the economic, socio-cultural and political factors that cause the increasing spread of the debilitating and fatal disease. The Nigerian government had implemented the National AIDs Programme to reduce the spread of HIV/ AIDs. However, the government’s increasing efforts to control the widely spreading disease is inadequate, since there is a requirement for the integrated efforts of everyone to effectively eradicate the disease. The Nigerian government is aware that AIDs is not only a health problem, it has far-reaching impacts on other sectors of society. Hence, the government has mobilized other sectors to guide the National AIDs Programme; due to which the programme is supported by a high-level multisectorial committee which has representatives from various departments of the government ministries of planning, social welfare, information, education, youth and industry as well as from the private sector and non-governmental organizations (Umeh, 1997: 115). In spite of the state revenues and royalties from Nigeria’s oil wealth as well as huge sums of international humanitarian aids, the country is undergoing economic decline and inability to cope with rising problems including the spread of HIV/ AID. The country’s wealth has historically benefited only a handful of people in strategic governmental and political positions, who have appropriated billions of dollars through their Swiss bank accounts. Thus, it is expected that the factors that will continue to influence the future of Nigeria will be the HIV/ AIDs pandemic, lack of economic growth, insecure borders, growing scarcity of resources, and the balance of power within the country among ethnic and regional groups. On the other hand, a positive development in Nigeria is that the youth are working towards empowering themselves in order to fuel changes in the country, through political engagement (Lyman & Dorff, 2007: 69). References Annals (Annals of Ibadan Postgraduate Medicine). 2005. Sexually transmitted infections in Nigeria: an interview with Professor R.A. Bakare. Annals of Ibadan Postgraduate Medicine, 3 (2): 48-51. Deji, O., Williams, S. & Deji, S. 2007. Socio-cultural factors influencing the feminization of HIV/ AIDs in the rural areas of Nigeria: implications for food security. Research Journal of Social Sciences, 2: 7-13. Lyman, P.N. & Dorff, P. 2007. Beyond humanitarianim. New York: Council on Foreign Relations. Olaitan, J. & Ajayi, J.O. 2003. The HIV/ AIDs epidemic in Nigeria. Italy: Editrice Pontificia Universita Gregoriana. Rotberg, R.I. 2007. Nigeria: elections and continuing challenges. New York: Council on Foreign Relations. Sofo, C.A., Ali-Akpakiak & Pyke, T. 2003. Measuring poverty in Nigeria. Oxford: Oxfam Publishers. Umeh, D.C. 1997. Confronting the AIDs epidemic. Nigeria: Africa World Press. UNAIDS (The Joint United Nations Programme on HIV/ AIDs). 2004. Report on the global AIDs epidemic. UNAIDS, Geneva. Accessed on 16th August, 2008 from: http://www.unaids.org/bangkok2004/GAR2004_html/GAR2004_03_en.htm#TopOfPage Read More