By Morenike Taire
IN all likelihood, given the trends over the decades, we will never have a situation in Nigeria that was had in the Eastern and Southern African countries of Uganda, Zimbabwe, Tanzania and Kenya in the 1980s, when every household had a member either infected with the Human Immunodeficiency Virus (HIV) or suffering from full blown AIDS; or that is now had in the Republic of South Africa in the last decade.
Somehow (and even arguably), the Nigerian government appears to have managed to contain the growth, though the scourge remains strong as ever.

While figures vary it is believed, on the average, that about 300,000 people die of HIV/AIDS related complications annually while an estimated four million are living with HIV/AIDS overall. Figures have almost consistently fallen, from almost six per cent in 2001 to less than 4.4% in 2005 to just over three per cent today.

Present numbers stand at 2.6 million people, the second largest number in any country in the world but still a vast improvement. .

The million and one NGOs taking care of the scourge of HIV as well as the huge funds committed to their efforts must have something to do with this. Yet, one big aspect of the fight against AIDS that has got worse is the stigma.

This is significant, because stigma has been traditionally linked with the spread of the HIV virus, while poverty and lack of education has also always been fingered.

The poverty factor, which is supposed to have pushed women into commercial sex whether formally or informally, is responsible for the ever increasing share of women in the virus prevalence share (from 58% in 2005 to 61.5% today of women). And while the number of women using female condoms has increased significantly, it has not improved the figures any.

There is no indication that HIV positive people are empowered to speak about their condition outside the sphere of other HIV positive people, their confirmed healthcare workers or their religious leaders, whom many look up to for healing.

Some churches, chiefly the Catholic Church, have even been said to ask for HIV certificates before joining prospective couples in marriage and here, we are talking of parties of different sexes.

That is only fair, considering there are parties who keep their status away from their partners, married and unmarried. All that has happened, though, is that people with HIV statuses have moved farther and farther from formal society and closer and closer into the fringe, unless they are endorsed by some international organisations to be faces of HIV.

While these kind of endorsements have been useful in other ways, they have not significantly reduced the stigma associated. Attempting to make superstars of individuals on the basis of their indisputable bravery at making their statuses known does not encourage others in the same situation to do so, when they (others) have no establishment backing them up and their very livelihoods are threatened by their disclosure.

What it does is send the message that disease ought to be celebrated, and pill popping as a way of life is okay, even glamorous. In our pill popping lifestyle of today, there appears to be a never ending call to people to go and run tests in order to find out they have increased high blood pressure.

The risk has also increased, therefore, of the whole thing being made into a mega-business. Many private hospitals in Lagos, in order to charge huge sums for free HIV tests perhaps, have been known to use all kinds of nomenclature in speaking about HIV screening.

This lack of openness has interfered with freedom in discussing issues to do, not with things to do with the business side of things such as how to fund procurement of antiretrovirals, but social issues on how the disease and the stigma therefrom have affected our productivity and our effectiveness as a nation as well as medical issues to do with how to find a vaccine and cure, and how the side effects of the drugs can be eliminated or reduced.

Toxicities, in fact, are an issue that is not addressed with as much importance as it ought to. Perhaps if emphasis is placed on this, individuals who engage in risky behavior might change their attitude from a crisis management mentality to a probably behavioral change.

The truth is, living on antiretrovirals is just like living with insulin, blood-pressure regulating drugs and even anti-asthma medications.

It is not fun, it is terribly expensive, it is inconvenient and most importantly of all, fraught with sometimes lethal side effects/toxicities.

If there is anything that the falling figures have taught us, it is that it is possible, and it is more so if we remove the emphasis from giving the impression we are celebrating disease and put it in discussing and working on the issues in a more open manner.