By Paul Okah
“The rate of stigma in Nigeria is still high. A lot of people are not coming out to disclose their status”
Over two decades after the first case of HIV infection was diagnosed in Nigeria, Vitalis Offor, a counsellor caregiver with Institute of Human Virology Nigeria, IHVN, of many years’ experience in working with people living with HIV embedded at the National Hospital Abuja says it is sad that the situation is still as bad as stated above.
Speaking to journalists at a journalism training to refocus attention on the need for increased media reporting on HIV in the country with theme “HIV Pre- Exposure Prophylaxis and Self –Testing” in Abuja Offor said it is true that “many people out there don’t even know their HIV status”
He said it is very important for everyone to “know your status so that you can know how to manage yourself” unfortunately he said “sensitisation is dying down. We the health workers are going out to campaign. The media can help us in the advocacy”
Though admitting the country has made many strides in HIV care and management over the years, Offor however says people are staying away from knowing their HIV status using the traditional visits to hospitals and health centres because of the very high level of stigma still in the country.
“But how can one stay at home when you have a health challenge? Is it when you die that you will start accessing health care? he queried adding “when you are avoiding the hospital in order for your neighbours not to know your status, when you die, they will still know. So, it is better for people to access healthcare now. You don’t have to wait for the viral load to run you down”
Dr Philip Nwajiobi – Princewill Consultant Clinical Microbologist at the National hospital Abuja understands very well Offor’s worries. He has been centrally involved in the provision of care to people living with HIV at the hospital in the last 10 years. He says it was for this concern that informed a health seeking behaviour study in HIV in the country in 2018.
“We wanted to know what to look out for as we were about to start rolling out HIV self – testing services in the country. The study was in Lagos and Kano, two of the most populous states in the country and the feedback was mind blowing”
He said from that study it became very obvious to us that people wanted something “very simple and anonymous as the self – testing pregnancy test” especially for the “younger population”. He said the study also showed that there were “a lot of issues with people taking the first step” of knowing their HIV status.
The issues he talked about include culture concerns, stigmatisation, long distance to test sites and young person’s not comfortable with visiting labelled clinics.
Summarizing the findings of the study he said 90% of people given the self – testing kits under the study tested themselves and 90% of those who tested positive called back to say they tested positive and wanted to know the next step to take.
He said the self – testing option comes with a lot of benefits that can help push up the percentage of Nigerians desiring to know their status. Some of the benefits include making the person the master of their destiny at the time of the decision to take the step. He said it is so because the decision is ultimately that of the person taking the decision and no one else.
Dr Nwajiobi – Princewill said other benefits are its anonymity, and the freedom it provides to young persons to privately test to know their status. “it is also very beneficial to discordant couples to keep checking regularly to know if and when their status changes while very useful for people in secluded places like the prison” he added.
Offor agrees. He said from his work “there are indications that the option can increase the number of people know their status in the country when fully available in the country”. For now, he said about 5 health facilities in the Federal Capital Territory Abuja are offering the kits free for the few people aware of its availability now in the country.
Demonstrating how it works, Offor said the test called “Oraquick self-test kit” doesn’t require your blood. It has two pouches: one contains the tube, while the other is the test device, which has a flat pad and has a space with an inscription containing C and T. You will use the flat pad to rub inside your mouth along the gum in your upper and lower mouth. You will then put the flat pad inside the tube to know whether you are positive or negative.
“The flat pad will stay inside the tube for a duration of 20 minutes. Less than 20 minutes will not give you the accurate result, while more than 20 minutes will give you the wrong result. If there is a red line in both the C and T lines, then your positive. But if the line is only in the C line, then you’re negative. If there is no line at all or there is long line of red colour, then you didn’t do the test well. You have to dispose the kit and do another test with a new kit.
“Note that before the test, you must not eat or drink 15 minutes before the test. After the test, a small line will show you the result. If the C line shows red, it means you’re positive. If it does not show red, then it means you are negative.
He says a positive does not mean you “have to cry or try to kill yourself. What you have to do is to go to a nearby general hospital for a confirmatory test to be doubly sure of your status. The confirmatory test must be done in a hospital that has the facilities. When you are positive, the officials will advise you on the next line of action, which maybe Anti-Retroviral Therapy (ART)”
He says counselling is very important throughout the process. Pre – counselling to prepare your mind on the step you are about to take.
“After the test, the hospital official will still take you on a post counselling session. They will prepare your mind on what you are going to expect. It is a confidential session and no other person will to know the outcome of your result” he added.
In a chat with Blueprint Weekend, the Advocacy and Marketing Manager of AIDS Healthcare Foundation (AHF), Mr Steve Aborisade, said that media need to reinvent its reporting on HIV to avoid the present coverage fatigue in the country
“HIV coverage fatigue is one important reason discourses on the virus appear to be taking the back burner in the Nigeria media…interestingly, this should be when serious coverage should occur as there are innovations in treatment, new milestones being achieved and new challenges unheard of being experienced by populations most affected.
“On the other hand, new epidemic and pandemic like Covid-19, Ebola have also come to share of the headlines and compete for attention. All of these in a media environment struggling to survive and facing a conflict of what to prioritize and staying afloat. So, attention goes mostly to issues with revenue generating potentials. Health issue, which HIV is one hardly falls into that category.
“But attention must come to HIV. More than ever, we must focus on a grown population of adolescents, who have known HIV all their lives. We must focus on the mental toll of remaining on a lifelong treatment by those who have been taking ARVs for the past 20 or more years. It is my opinion that journalism should be done right, maybe this problem would be less noticeable.
