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AIDS scourge: prevalence in Anambra is steadily dropping, says SACA boss

Insists awareness level is high From Christian Chime, Onitsha

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The Anambra state Executive Director of the HIV/AIDS programme, Dr Onyekachi Ibezim has said that the prevalent rate of AIDS in the state is dropping steadily, -because the state government is not relenting in her drive on awareness, education, counseling and treatment.

He pointed out that it accounted for the dropping from above nine percent to the present 2.8 percent. He confirmed that the national average hovers between 1.7 and 1.9 .

Dr Ibezim, SACA boss:

Reacting to the recent published NACA report which put the state’s prevalent rate of the scourge above the national average, the SACA boss said his team in conjunction with the cooperating partners at virtually every level of human existence in the state have sustained sensitization.

“We are talking about prevalence. It’s didn’t to k the fence between prevalence and incidence. “Prevalence” is the number of old and new cases. So the report is as far back as between 2008 to 2012, it’s a cumulative thing. You remember that Anambra is the gateway to the East, South-South, South-West, and the North generally. We have a high cosmopolitan town -Onitsha where all sorts of things happen.

For prevalence (old cases), if you want to keep your prevalence, you have to step up your treatment. That means that the number of HIV patients that are living are not increasing. But if you don’t step up facilities in the ministry, the co-partners facilities, those that are infected, the newly positive people will actually die out. That is the only way you can reduce the old cases. So when you have cumulative old cases that are purely on treatment and are living plus new cases, and you say Anambra is above the national average of 1.4 -1.9. The study that has not been totally disseminated to the states. It’s important to note that presently Anambra rate is at 2.4. Before when we were using the Prevention of Mother-to-child transmission (PMTCT) data we were at 9.7. It shows that whatever data we had before, we have done a lot of work to stop the incidence of new cases while keeping the old cases alive.

You know we tell people that HIV/AIDS doesn’t kill anymore. But what kills now is stigmatization, hiding from treatment and taking treatment like any other ailment. The diabetic patients take daily drugs while some take twice daily. Then the hypertensive patients have some who are on thrice daily drugs, etc. It’s even cheering that some drugs used now for HIV management are taken once daily. Recently there is an injection that would soon fo into the market to be taken once in two months. There another improvement with the one to be taken once in six months. But before we get to this level we need to keep our people healthy, monitor them, place them on drugs, reduce the number of new cases and then decrease viral load on the infected ones. We constantly advocating treatment as a means of prevention. If someone is HIV positive and his viral load is high and you place him on treatment and he’s following the treatment strictly, it will suppress the viral load. And when the viral load is suppressed to an undetectable level, that person will not infect others. That’s why I stated earlier that we also use treatment as a form of prevention.

So cumulatively I say it’s a win-win situation. Then when we hear data, it’s good some of us critically analyze it. It’s not for us to start having an unhealthy comparative analysis, but for us to work on and notice that it is here. Probably when you quote Abia and Imo and so on you find out that a lot of people se des live here in Anambra state while a lot of Anambra people also live in those and other states. That’s while the National Agency for HIV Control take an approach that is quite holistic. They don’t isolate a state to say this is where it’s happening. Because it could be people in transit, it could be residents, it could be indigenes. It could be anybody. But the most important thing is that as an agency that is vested with prevention, coordination and research this is our own headache. We will continue working till we find out that those that have been infected don’t infect new people. And then we decrease the number of new infections, if possible get it to zero level.

Why do people still expose themselves?

Well our people say all sorts of things including the elites who claim erroneously that HIV is political. Remember there was quote ascribed to a former South African President who also claimed that HIV is a political talk. But all these are due to ignorance. It’s why with the high level of awareness already created people still do things we say they shouldn’t do. It’s our job, headache to continue to drum it into the ears of all that HIV is real.

The report was cumulative survey and naturally it’s areas with high incidences of nightlife and brothels. You also have the youths that are open and into drugs use -of sharp and injectables. These are means of transmitting the virus. And to ensure all parts of the state is covered with the education and awareness on the scourge, we have the Local Government areas offices of our committees and they are all actively working. No area or council is left out. And with the good motorable network of roads where one lives and goes to work from just any location in the state, it makes the need for us to reach all parts with the HIV message very necessary.

The incidences are found to be undeniably more with the youths from our research. This was contrary with the initial erroneous assumption that it was the elderly. The youth are the adventurous segment of the society where a lot of them have taken to a lot of vices. There is what we call high risk behaviours, like when you go out in the streets in the night you ND out that it’s the youth you see enjoying nightlife, not the elderly. But generally everybody should protect and conduct themselves responsibly.

Who are the youths?

Using the World Health Organization standard, persons of 18-35 years of age. Though it’s not so here. Because even the “youth” leader in my community is about 48 who is very strong, energetic young man. So depending on the area and environment, youth is a thing of the mind. But my key message is that HIV is real and preventable. Those that are already infected can be on treatment to suppress the level of virus to an u detectable level in your blood. And then you stop infecting others with that live a healthy life.

Dr Ojekwu:

Dr Elochukwu Ojekwu, a medical practitioner in the state want the state and federal governments to be more proactive in the fight against the AIDS scourge.

According to him, since a healthy nation is a wealthy nation, our government must as a policy invest in the health of citizens. He pointed out that even the World Health Organization(WHO), having considered a lot of indices recommended the setting aside of 15% of each nation’s annual budget for the health sector.

Lamenting what he saw a mere lip service to the health of the people by the governments, Ojekwu observed that the obvious reluctance by the governments has forced most of the cooperating partners to be withdrawing their financial and technical supports. They had expressed reservation that while they strive to provide the required support to our governments, the officials rather than stepping up action, chose to embezzle the required funds.

He pointed out for example the AIDS test/treatment kits that was hitherto given out to all registered health facilities has for a long time declared “out-of-stock” in the state. It becomes worrisome when each patient who presents him/herself in his hospital normally now as a policy undergoes screening before any form of treatment commences.

It’s through this that most of those who under normal circumstances would not go to check their status were made to do it. This now enables anyone who was tested positive to start off treatment at once. While their they are encouraged to bring in their partner/s to receive treatment too.

Dr Ojekwu therefore called for intensified awareness and education on the disease.

Dr Okeke:

Another medical practitioner -Dr Christian Okeke, of Chukwunonso Hospital whose hospital is located at Nkpor, a suburb of Onitsha, stated that contrary to whatever opinion anyone holds the AIDS scourge is on the decline in the state. The downward trend he pointed out could be traced to the increase in awareness and knowledge of the dangers of the ailment.

So more people are now taking precaution and self preservation, self protection and less indiscriminate sexual involvement.

This, Dr Okeke noted accounted for the drastic reduction in mother-to-child transmission. Again, more people have come to realize that being infected is never a death sentence, but that infection is treatable as long as the patient addresses his mind to taking his drugs with dedication.

Dr Jigide Okwudili, proprietor of Devine Hospital/Maternity, Awka:

We treat mainly pregnant women and the prevalent rate is not much. You cannot take the experience here as high because once in a while you see one person who tested positive.

Dr Jigide Okwudili

That’s in a period of about say six months you may get one. So with that I will not say the prevalent rate is high. Because with our experience here it’s not.

I cannot speak about other centres or hospitals, but here it’s not much. At every ante-natal day we have about sixty attendants and we get none positive. It may turn out that one case might be reported in about six months.

Antics of carriers:

He confirmed that the failure of persons who tested positive to bring in their partners or spouse/s poses great set back to tackling the scourge. Dr Okwudili therefore appealed to government and her cooperating partners to incorporate in their sensitization messages the need for all HIV patients to bring in their sex partners for counseling, tests and consequent treatment where infected already.

Awareness creation:

Taken on the adequacy or otherwise of the level of sensitization, education and awareness creation of the HIV problem in the state, Dr Okwudili said the level has generally increased even at the national level.

He also disclosed that experience from interviews with women generally revealed that most men refuse to use protective decides like condoms during sexual intercourse. This was at the high risk of their health, that of their partner, getting unwanted pregnancy or diseases.

Consequently, Dr Okwudili urged the women to get wiser and put their feet down to insist on the use of condom, in their own interest. It’s their lives that we are talking about. Especially when dealing with a man whose sexual indiscretion was notorious.

He called on the men even married ones in polygamous setting to embrace the use of condom if they indulge in promiscuous acts outside their wives, with persons they were not sure of their HIV status. That it would help giving their wives rest of mind from sexually transmitted diseases(STD) and such issues.

The medical doctor would like everyone to get screened at intervals to ascertain and be sure of their status. He admitted that most be who are into bad habits run away from getting screened due to fear of finding out they were already carriers. He however said it would be a lot better for all sexually active adults to ascertain the HIV status and to stay safe than running away from it.

Test kits:

It was sad to disclose that virtually all the medical doctors interviewed disclosed that no one gives them HIV test kits any longer. Okwudili disclosed that his hospital buys theirs, “…and it’s quite expensive”. But the treatment still remain free.

Dr Cyril Ezenyeaku, a Consultant Obstetrician/Gynecologist:

While not entirely dismissing the report which claimed that HIV prevalent rate in Anambra state as being above the national average, Dr Cyril Ezenyeaku said he don’t normally look at such data on just the surface. “Because as a medical scientist, one would like to know the quality of the study. How it was conducted. Whether it met the necessary qualities of a good study one can quote reliably.

Dr Cyril Ezenyeaku

But assuming it was a well-structured study that can give a reliable result, the society is dynamic of which Anambra state is part. The state has a huge population, we all know that most of these HIV patients are youths whose approach, lifestyle and social attitude to life help the spread of HIV virus. Anambra also has a lot of commercial hotspots at Onitsha, Nnewi, Amawbia, Ekwulobia, Ihiala, Awka, Nkpor, etc. and suspect that the concentration from the findings of the report would be around these commercial hot spots.

On the adequacy of the awareness creation so far, the medical consultant described it as appreciable. “Yes. I don’t want to believe that in this state and in Nigeria today that there is any adult that doesn’t know about HIV and how it is spread. Though people tend to deceive themselves using religion and self-deceit. Religion is found to be one of the influences that helps in the spread of the virus, unfortunately.”

He also confirmed the reluctance of citizens from screening to know their status because they don’t like to be told the truth about their health generally, not just about HIV. If you mount a screening test for cancer, people will also run away because no one want to be told you have it. They would rather prefer to be living in self denial and self deceit. But that is just the way we are; because it’s not just for this HIV issue. The root cause of that if often found in religion. We indeed abuse Christian religion.

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