Is HIV Still The Deadly Killer Disease in Nigeria?

Posted On August 22, 2020

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by Privitest and Dr Ogamba

LET’S TALK ABOUT HIV.

Tolu is a 23-year-old final year engineering student at a popular Nigerian university. The last child of his parents and unarguably the most loved, a good example of mummy and daddy’s boy, well behaved and quite ambitious. A good Christian, or at least his parents think so.

His father is a retired civil servant who now pastors a small church of one of the popular denominations in Nigeria, his mother, a retired teacher who gave 35 years of her life to nurturing the future generation. The family can be described to be a loving one where a good example has been set by the parents who raised Tolu and his siblings ensuring they imbibed all the good virtues you can think of. This has paid off, as evidenced by the successes achieved by his four elder siblings who are doing excellently well in their career and family.

It is, therefore, safe to say that Tolu has the best of role models and nothing less was expected of him, not just by his family but by relations, the church, and the society at large.

He is a tall, dark, handsome young man, calm spirited and always wearing a bold smile. Loved by virtually all whoever has anything to do with him, especially the ladies of course. Despite all these, he never had a girlfriend until the second semester of the third year when he met this law student in a night class, Melisa who sat in front of him and he dared to approach her, the rest is history. They both decided to avoid sex until marriage despite the pressure from some of Tolu’s friends.

In the first semester of the fourth year, he joined his friends to attend a night club, had a few drinks more than he had ever taken. He met this lady whom he danced with till they got fatigued and he was too drunk to look for his friends, so he followed the girl home. Tolu cheated on his girlfriend and had sex with the stranger.

HIV AIDS Nigeria

Six weeks later he had flu-like symptoms.

At first he thought it was malaria as it is the usual suspect of flu in Nigeria.

After the self-diagnosis of malaria, with anti-malarial within the reach of everyone, he bought Coartem and completed the dosage but he was shocked when he didn’t notice any improvement.

He reached out to a friend who is a medical doctor who advised he go for a full STI Panel Screening.

His mind kept wandering to that unfortunate night.

Why didn’t I make use of a condom?

You could see restlessness well written on his face.

Could it be HIV?

It could be other sexually transmitted infections like Gonorrhoea or even Chlamydia

He was afraid to go for a test, he did not know what to expect. What if it turns out positive, what next?

Where can he go for the test, a pastor’s son entering a lab to request for HIV test, what if someone recognizes him?

What is he going to tell his parents., siblings, girlfriend?

Is this the end of his life?

These and many more questions rallied through his mind.

WHAT IS HIV/AIDS?

INTRODUCTION (HIV/AIDS)

HIV (human immune deficiency virus ) is a  virus that attacks the body’s immune system and if not managed properly will progress to AIDS( acquired immune deficiency syndrome). The virus is thought to have existed in the US in the late 70s, but first became well defined in the 1980s and took an epidemic proportion soonest. Worldwide the number of people living with HIV has markedly increased with an estimated 38 million people living with HIV worldwide at the end of 2019. Young people between the ages of 15 and 49 years account for 65% of the disease burden especially in Africa which accounts for 2/3 of cases with varying statistics for different regions, countries, and states.

Current studies show that about 3 percent of Nigerians are living with HIV, many of whom are unaware of the condition. All age groups are affected with women affected more than men.

There are two strains of the virus HIV1 discovered in the US and HIV2 discovered in West Africa, both strains are seen in Nigeria with HIV1 being far more prevalent.

The virus is unique in that it possesses a special enzyme known as reverse transcriptase which plays a role in transcribing their genetic material from DNA to RNA in the course of their replication, hence the common name retrovirus. They belong to a family of viruses whose infections manifest typically by a chronic course of the disease, long period of clinical latency/inactivity, and a persistent viral replication.

TRANSMISSION AND RISK FACTORS

Transmission of the virus is from one infected person to another through contact with body fluids, blood, semen, vaginal secretions, rectal secretions (mucus), and breastmilk.

WHO defines “key population” as people at increased risk in all countries and regions and they include, commercial sex workers and their clients, men who have sex with men, people who inject drugs, people in prisons and other closed settings. In addition, given their life circumstances, a range of other populations may be particularly vulnerable and at increased risk of getting infected, such as adolescent girls and young women in southern and eastern Africa and indigenous people in some communities.

 Generally, high-risk sexual behaviors like receptive anal intercourse, most especially when this is done without protection portends greater risk. Others include poor screening of blood and blood products for transfusion, intravenous drug use, communal circumcisions, and rituals that involve blood sharing or sharing sharp objects, etc.

There could also be transmission from a mother to her baby while she is pregnant, at birth,or while breastfeeding, and there are guidelines to prevent this.

Behaviours and conditions that put individuals at greater risk of contracting HIV include:

  • having unprotected anal or vaginal sex.
  • having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhoea, and bacterial vaginosis;
  • sharing contaminated needles, syringes, and other injecting equipment and drug solutions when injecting drugs;
  • receiving unsafe injections, blood transfusions and tissue transplantation, and medical procedures that involve unsterile cutting or piercing; and
  • experiencing accidental needle stick injuries, including among health workers

Individuals cannot be infected through ordinary day-to-day contacts such as hugging, kissing, shaking hands, sharing personal objects e.g. cup, food, or water.

It is worthy of note that people with HIV who are taking their antiretroviral drugs and are virally suppressed do not transmit the virus to their sexual partners. Early access to antiretroviral therapy and support to remain adherent to treatment is therefore critical not only to improve the health of people with HIV but also to prevent transmission to others.

HOW IT AFFECTS THE IMMUNE SYSTEM

In the absence of treatment, 75% of those who test positive would have developed AIDS IN 10 to 15 years.

Seroconversion normally appears 2 to 12 weeks after infection and the individual tests positive to the antibody tests, and in some weeks to months, the individual develops an acute self-limiting febrile illness that may last for one or two weeks.

The disease AIDS is due to the gradual deterioration of the host immune system characterized by the progressive depletion of CD4 elements of the immune system, the loss of which leads to and explains most of the pathological consequences of HIV infection.

CD4 count is a measure of the number of a type of blood cell (t-lymphocyte) in the blood, this begins to drop soon after the infection is acquired.

Full blown clinical picture of AIDS is characterized by severe fatal opportunistic infections, malignancies and neurological affectations.

SIGNS AND SYMPTOMS

Some people will have flu-like symptoms 2 to 4 weeks after the infection, this is called the acute phase while others will not, the symptoms may include;

HIV AIDS Nigeria

Fever, Chills, Night sweats, Muscle aches, Sore throat, Fatigue, headache, Swollen lymph nodes, Mouth ulcers etc.

These may last a few days or several weeks and stop, and these symptoms are not definitive of HIV infection as they could be of other illnesses.

The only way to be sure is to see a healthcare professional if you think you have been exposed and having these symptoms, so you can get tested. 

Frequently Asked Questions About HIV/AIDS

Can I get HIV through Oral sex?

The risk of getting HIV by receiving oral sex is very low but it is not impossible especially if you consider a scenario that your partner might be bleeding in the mouth.
The risk of getting HIV by giving oral sex is low when compared to unprotected vaginal and anal sex but increases if there is a sore in your mouth.

If I am on HIV medication and my viral load is low, can I still pass the virus through sex?

According to the United States Center for Diseases Control“People who take their medications daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner.” But if the virus is detectable, it is best you make use of a condom. It is important to note that HIV medications will not protect you against other sexually transmitted infections like gonorrhoea, chlamydia, etc.

I had sex with an HIV positive person without a condom, can I protect myself from getting the virus?

If you had unprotected sexual intercourse either without the use of a condom or the condom busted or the condom was worn during the act and there is a risk of getting HIV, you can protect yourself from becoming infected with the virus by making use of Post Exposure Prophylaxis (PEP). This is best taken immediately after the sexual act up to 72hrs after. Remember Post Exposure Prophylaxis will not protect you against other STIs like Chlamydia, Syphilis. If your partner is HIV positive, we recommend you make use of Pre-Exposure Prophylaxis.

Who Should Get Tested?

Privi Test recommends that you should get tested when;

  • When you do not know the HIV status of your partner
  • You just had unprotected sexual intercourse with a new partner
  • Where you and your partner are not 100percent faithful to each other
  • When there are symptoms suggestive of other sexually transmitted diseases

Where to Get Tested?

There are many places you can get tested for HIV in Nigeria

Diagnosis

HIV can be diagnosed through rapid diagnostic tests that provide same-day results. This greatly facilitates early diagnosis and linkage with treatment and care. People can also use HIV self-tests to test themselves. However, no single test can provide a full HIV diagnosis; confirmatory testing is required, conducted by a qualified and trained health or community worker at a community centre or clinic.

Most widely-used HIV diagnostic tests detect antibodies produced by the person as part of their immune response to fight HIV. In most cases, people develop antibodies to the virus within 28 days of infection. During this time, people experience the so-called “window” period –  when HIV antibodies haven’t been produced in high enough levels to be detected by standard tests and when they may have had no signs of HIV infection, but also when they may transmit HIV to others.

TREATMENT

Following a positive diagnosis, people are retested before they are enrolled in treatment and care to rule out any potential testing or reporting an error. HIV can be suppressed by treatment regimens composed of a combination of 3 or more ARV drugs. Current ART does not cure HIV infection but highly suppresses viral replication within a person’s body and allows an individual’s immune system recovery to strengthen and regain the capacity to fight off infections.

The current treatment guidelines include new ARV options with better tolerability, higher efficacy, and lower rates of treatment discontinuation when compared with previously recommended medicines. In 2019, WHO recommends the use of dolutegravir-based or low-dose efavirenz for first-line therapy. 

PREVENTION

There are a number of ways you can protect yourself from HIV, including:

  • using a condom every time you have vaginalanal or oral sex
  • in some countries PrEP is available. This is a course of HIV drugs which if taken consistently as advised by your healthcare professional prevents HIV infection through sex
  • avoiding sharing needles, syringes, and other injecting equipment 
  • taking HIV treatment if you are a new or expectant mother living with HIV, as this will dramatically reduce the risk of passing HIV to your baby during pregnancy, childbirth, and breastfeeding
  • asking your healthcare professional if the blood product you are receiving (blood transfusion, organ or tissue transplant) has been tested for HIV
  • taking precautions if you are a healthcare worker, such as wearing protection (like gloves and goggles), washing hands after contact with blood and other bodily fluids, and safely disposing of sharp equipment
  • if you think you have been exposed to HIV you may be able to access PEP, a 4-week course of ARV drugs taken after possible HIV exposure to prevent HIV infection. You must start PEP within 72 hours of possible exposure to be effective.

Conclusion

Do you know that getting infected with HIV is not the end of the world

Too many people have committed suicide after hearing that their Test result was positive.

10 years ago, getting infected with the virus was like a death sentence but in this day and age, you can live a normal life, marry an HIV negative or positive partner and give birth to HIV negative pretty kids.

It is all dependent on your adherence to your medications

You cant develop immunity against other sexually transmitted infections by taking ART (medications for HIV) but by making proper use of condoms, you can better protect yourself and your partner.

In this century, HIV infections should never progress to AIDS but there are still many challenges to achieving an HIV free world including, not-my-portion syndrome, stigma which is majorly due to poor education of the population, unavailability of testing and counselling services, lack of adherence to the antiretroviral drugs and scheduled clinical visits, etc. and it will take our collective efforts to end these.

WITH YOU AND I, A HIV FREE WORLD IS POSSIBLE

Dr Ogamba

Phew, you stayed till the end, Congratulations.

What if I told you that you can anonymously get tested for HIV in Nigeria or better still buy an HIV self-test kit in Nigeria.

At Privitest.com, you can get tested for different STI’s anonymously.

  • You choose your test package,
  • You Choose a Laboratory/Hospital closest to you ( We have thousands of laboratories and hospitals)
  • You pay online, get an order ID
  • Go to the chosen centre and show them your order ID
  • There is no need interacting with anyone or telling them which medical test brought you there
  • Samples are collected from you e.g. Blood, Urine
  • You go home
  • Your result will be uploaded into your Privitest account

Or you can order for our STD self-test kit package or send an anonymous SMS or Email to your partner when diagnosed with a sexuually transmitted infection through Alert Your Partner

Author profile
Is HIV Still The Deadly Killer Disease in Nigeria?
Dr Ogamba
Founder at Health for Africa Development initiative (HeFADi)

Nzubechukwu Ogamba finished from the University of Nigeria, College of Medicine in 2020. He is a youth leader who has occupied various offices in school including the representative of his class, SUG health director, SUG scholarship board vice-chairman, and many others. He believes in being part of the solution to the myriad of challenges in Africa today hence the reason he started an NGO; Health for Africa Development initiative (HeFADi) aimed at improving the health and well being of young people especially. Also due to his vision to see a different crop of leaders emerge in all spheres of endeavor from Africa he started the movement; Project-Lead Africa. He is committed to mentoring younger ones and encouraging start-ups. He is a global health enthusiast,  a YALI fellow, and committed to continuous personal development.

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