Human Immunodeficiency Virus
HIV is a virus that is spread through certain body fluids and destroys the immune cells called the CD4 cells which are supposed to help the body fight against infections. As a result of this, the defense mechanism of the body is impaired and the body becomes vulnerable to infections and diseases.
Transmission is basically through the following routes;
- Sexual intercourse with an infected partner; This can be
- Heterosexual i.er male to female.
- Homosexual i.e male to male, female to female.
- Oro-genital sex.
- From an infected mother to her child; This can be
- In pregnancy.
- During labor or delivery.
- Post-partum through breastfeeding.
- Parenteral and others this could be through
- Blood transfusion.
- Sharps and needles etc.
- Artificial insemination.
- Intravenous drug use through needle sharing etc.
Epidemiology of HIV in Nigeria
Nigeria is the most populous African country and 7th most populous globally. According to the National population commission, Nigeria’s population is presently about 180 million with over half of the population below the age 30. This puts a strain on the economy for provision of schools and healthcare services. The HIV/AIDS pandemic has further worsened the burden on the already strained economy and healthcare system. Nigeria has the second largest number of people living with HIV. It is estimated that about 3.4 million people are living with HIV in Nigeria. Nigeria bears almost 10% of the global burden of HIV/AIDS.
The prevalence rate across states differs from 1% in kebbi state to over 12% in Benue state.
The first case of AIDS was reported in 1986 and between 1991 and 2001; the prevalence of HIV has increased exponentially peaking at 5.8% in 2001. However with several interventions, It declined gradually to its current figure of 3.1% since 2014. Over 300,000 new infections were recorded in 2012 and over 200,000 AIDS related deaths in the same year.
Progress has been made by the government by increasing the number of infected persons on treatment from 51,000 in 2005 to over 600,000 in 2013.
90% of HIV transmission is still through sexual intercourse especially among heterosexual partners with 34.6% occurring among couples considered to be involved in low risk sex compared with 23% prevalence among Most At Risk Population (MARPs).
According to the 2015 UNAIDS HIV and AIDS estimates report, of the over 3.4 million people living with HIV in Nigeria, 1.9 million people are women aged 15 and above while over 200,000 are children.
Factors facilitating transmission of HIV
Poverty; This has helped to fuel the spread of HIV infection in various ways for example, young girls have resolved in engaging in commercial sex to meet their financial needs.
Social mobility; HIV/AIDS follows the routes of commerce. As people travel from place to place for commercial reasons, they also inter-relate with one another and sexual activities take place leading to spread of HIV infection.
Stigma and Discrimination: This prevents people from going for HIV test to know there status. As a result preventive measures are not taken to reduce the spread and positive cases are not identified for treatment and care.
Population displacement; when there is war, natural disasters and crisis, people are made homeless and they move from place to place seeking shelter. As they find shelter in other communities, they inter-relate with members of the community and HIV infection could be spread in the process.
Factors Facilitating Transmission in women
Polygamy/multiple sex partners: The African culture has promoted polygamy and has encouraged men to have multiple sex partners in men which have in turn helped to increase the prevalence of HIV among women. A man can have as many wives as he desires and still engage in extra marital affairs. Hence one man can spread HIV to as many women as possible thus making marriage in itself a risk factor for HIV infection.
Early Marriage: Early marriage increases women’s chance of being infected with HIV. Young girls have thinner vaginal membranes than older women making them more susceptible to tears and STIs including HIV. The husbands on the other hand are likely to be older, already sexually active and involved in high risk sex.
Harmful Cultural and Traditional Practices: Harmful cultural practices such as female circumcision, wife inheritance, widowhood-related rituals, have put women at high risk of being infected with HIV.
Gender-Inequality: Gender-inequality fueled by various social, cultural, and religious beliefs has contributed in the spread of HIV. In many cultures it is indecent for women to negotiate safer sex, it is associated with promiscuity. Religious organizations have also contributed by discouraging contraception including condom use and promoting ignorance in women regarding sexual matters in the name of innocence/purity.
Impact of HIV/AIDS
- Feeling of worthlessness and withdrawal from social engagements as a result of stigma and discrimination.
- Decreased productivity due to illness.
- Conflict in marriage and divorce due to mistrust.
- Poverty and poor nutrition due to strains on finances.
- Increased number of orphans in the society.
- Increased burden on health care system.
- Decreased life expectancy.
- Human and economic development is slowed down.
Interventions to Reduce Sexual Transmission of HIV
- Better management of sexually transmitted infections.
- Encouraging fewer sexual partners.
- Abstinence or delayed onset of sex.
- Faithfulness among Partners.
- Safe sex practices and the correct and consistent use of condoms.
- Reduced stigma and discrimination against people infected with HIV.
- Disclosure of status to partners so that measures can be taken to prevent transmission to sexual partners.
Interventions That Reduce Non Sexual Modes of Transmission
- Testing of donors and screening of blood before blood transfusion.
- Application of universal safety precautions such as safe and proper disposal of sharps and needles, not sharing sharps etc.
Interventions That Reduce Mother To Child Transmission of HIV/AIDS
- HIV counseling and testing at all ante natal clinics.
- Anti-Retro viral drugs should be given to both positive mother and her baby.
- Promoting safer delivery practices to prevent infecting baby.
- Encouraging safer feeding options.
National Population Commission. (n.d.). http://www.population.gov.ng/
Sociocultural Factors Influencing the Spread of HIV/AIDS in Africa. (2014, September 16). https://www.linkedin.com/pulse/20140916193747-107857132-sociocultural-factors-influencing-the-spread-of-hiv-aids-in-africa
HIV and AIDS estimates (2015). (n.d.).http://www.unaids.org/en/regionscountries/countries/nigeria