- Doctors and health workers have been accused of discriminating against People Living With HIV in Nigeria
- A person living with HIV said some health facilities deny treatment for patients drugs and treatment through various means
- According to Abiola Ajani, the charges on drugs and treatment are hindering factors to ending HIV prevalence in Nigeria
People Living With HIV (PLWHIV) in Nigeria have decried the level of discrimination they faced in the hands of some doctors and health workers in various facilities across the country.
The PLWHIV called for more training and sensitisation of health workers especially those taking care of these patients in various facilities.
Speaking on the challenges faced in combating HIV/AIDS epidemic in Nigeria, the south west zonal coordinator for the Network of People Living with HIV in Nigeria, Abiola Ajani, said doctors and health workers have devised ways to discriminate against the PLWHIV.
Ajani giving instances said stigmatisation against PLWHIV is still high.
She said: "Sometimes I wonder if we have this level of stigmatisation in Lagos what is happening in the rural areas or states."
She said worst of all is that the stigmatisation is more from the health workers who have been saddled with the responsibility to manage these people.
Ajani said: "For example, about six months ago, a pregnant woman who is one of us went for ANC, and during the ANC treatment, a doctor who have been checking other patients without hand sanitizer claimed she could not palpate the pregnant women because she (the doctor) did not have a hand sanitizer."
"The reason why I'm giving this example is that the patient felt bad and left because this same right in front of her had been carrying out palpitation for other patients without the hand sanitizer," she said.
"What I am trying to make clear here is, can we contract HIV by touching someone, no. So is the doctor can behave like that what do you think others who don't understand the workings of these things will do?" She asked.
To buttress her point, Ajani said: "If she (the doctor) had wanted to use hand sanitizer, use it for everyone, not for specific people."
Citing another instance, Ajani said health workers have also taken to calling colleagues names of diseases while at work.
She said called for training and retraining of professional health workers on approaches towards clients and use of some words or codes that can be demeaning to the patients.
"Just two weeks ago, I visited a heart-to-heart centre and a nurse was calling another colleagues who works with PLWHIV: "HIV!" That mode of communication is stigmatisation especially as patients were also there."
Code naming group of HIV people in facilities
Ajani condemned the use of code names or program names for patients who have come to receive treatments in health facilities.
She said such approach cannot affect the adherence to treatment and drugs by PLWHIV thereby hindering the effort to eliminating the disease prevalence.
In November 2014, the National Assembly enacted the HIV and AIDS (Anti-Discrimination) Act, 2014.
The Act among many others prohibits the discrimination of persons living with HIV by any individual or community or institution in an act that would place a barrier to the constitutionally guaranteed rights of these individuals due to their HIV status.
Part II (6) of the Act states: "It is an offence to discriminate against any person on the basis of their real or perceived HIV status by - (a) denying or removing from such person any treatment, medication or any supporting and enabling facility for their functioning in the society;
(b) refusal to offer treatment by a qualified medical personnel except in such cases wgen special care or facilities specifically required for treatment of HIV/AIDS does not exist in that health facility."
Raising fears, Ajani said her concern with these such challenge is its effect on the issue of viral load of patients which has not been "so encouraging."
"We expect 90 percent of them to be on drugs and those people that are on drugs we expect 90 percent of them to have suppressed viral load. That is where the virus is very minimal to even zero percent transmission possibility.
"Again, this integration in health facilities were patients are categorized, my only concern is these doctors don't see the PLWHIV as their patients, they give them various tags like EPIC patients, FHI patients and all. That is the height of discrimination."
"Everyone who visits the facilities knows that these organisations are for HIV patients and when you ask people why they have been skipping their treatments they tell you they can't go to these facilities because everyone will know they are living with HIV," Ajani noted.
Other challenges to ending HIV prevalence in Nigeria
Also decrying other challenges faced by the PLWHIV, Ajani said charges on drugs, treatment and antenatal care should be looked into by the government.
She said most people who need the treatment fail to meet up because they keep considering the amount of money they would spend at the health facilities.
"This is because when people are supposed to go for treatment and they think of what they are going to spend they sit at home and skip their drugs and this affect the results we get," Ajani lamented.
"For example in Nigerian Institute of Medical Research (NIMA), if you're coming for the first time you pay N5,000 and after that, as a follow up patient accessing treatment there, you pay for drug pick up which they claim are free but they pay N1,000 for drugs to be used per month.
"You also do your test, N2,900 and we also pay for consultation, just to see doctor for anything - N2,000 and government is already paying the salary of these doctors; I don't understand these charges," she said.
According to her, these charges are affecting adherence of drugs and treatment by patients negatively.
"Another example, the antenatal clinics at the general hospitals are to expensive, the least that they charge is N30,000 and more and when even the non-PLWHIV hear this amount some of them patronise the Traditional Birth Attendants - without screening - thus exposing them to all sort of risks, including the PLWHIV," she added.
Civil Society Organisation reacts
Confirming Ajani's claim, the executive secretary of the Civil Society for HIV/AIDs in Nigeria (CISHAN), Walter Ugwocha, said stigmatization in the health facility is 'very' real.
Ugwuocha said stigmatisation has remained a major road block to the treatment and elimination of HIV across the country.
Noting the culpability of every sector - from the religious groups, the health facilities and the workers - Ugwuocha said people are constantly being refused treatment because of their status.
He also noted that it is gradually becoming difficult for people living with the infection to access the treatment required to keep them going.
“Stigma is the attitude, discrimination is the action. It is a very big issue for people living with HIV in Nigeria. In Abuja recently, some people were refused treatment because of their HIV status," Ugwuocha said.
“We also had issues of couple preparing for their wedding in two weeks only for the woman to discover she is HIV positive. And the man refused to go ahead with the wedding, thereby pushing the woman into depression,” he added.
Way forward for Nigeria on ending HIV prevalence
However, being optimistic, the head, Research Unit of National Agency for the Control of AIDS (NACA), Ogbonna Amanze, said ending the scourge of HIV/AIDS in Nigeria is a possibility.
Amanze while speaking a one-day training “New Trends in HIV/AIDS" and organised by NACA in Lagos said Nigeria can achieve the target to end HIV epidemic by 2030 with the right actions in place.
He said with the right will in place and the support of the international donors with increasing domestic funds Nigeria will achieve this target.
According to Amanze, the results of the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) showed that, in 2017, 3.1 million (2.1 - 4.4) people were living with HIV/AIDS in Nigeria while 210,000 (110,000 - 320,000) new HIV infections and 150,000 (86,000 - 230,000) AIDS-related death were recorded.
He also said that the new trend shows that there is a decline in the number of people with HIV/AIDS.
Also, NAIIS shows that the current national HIV prevalence is 1.4% among young adult between ages 15-49 years with a total estimate of 1.9 million person living with HIV in Nigeria.
While prevalence rate among female is 1.9 per cent among ages 30 -39 years and it is significantly higher than than 0.9 per cent for the male between the ages of 50-54 years.
"The HIV incidence is 8.0 per cent that is 10,000 persons across both genders and ages group while viral load suppression is 42.3 percent between," Amanze noted.
Meanwhile, Legit.ng previously reported that Nigeria's First Lady Aisha Buhari has called on the minister of health to work towards the mobilisation of funds from various government agencies for tackling challenges faced by PLWHIV.
Aisha while speaking at the launch of the "Nigeria Free To Shine Campaign" on the elimination of HIV/AIDS in Nigeria in Abuja on Friday, December 7, said Nigeria does not need funding from foreign countries and agencies before dealing with issues of HIV in the country.
Reacting to the ordeal faced by women living as narrated by one of the members of the Association of Peoples Living With HIV/AIDS, Aisha said while it is important to note that many people living with the disease in Nigeria are unaware of their status, efforts must be made to ensure the provision of the essential needs of the individuals.
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