December 1, 2015

Stigmatisation is killing Nigerians faster than HIV infection — Aminat Agboola-Alli, Chairperson NEPHWAN, Lagos Chapter

Stigmatisation is killing Nigerians faster than HIV infection — Aminat Agboola-Alli, Chairperson NEPHWAN, Lagos Chapter

By Chioma Obinna & Gabriel Olawale 

Despite the relatively high  level of awareness about HIV/AIDS, Nigeria may still be far from achieving zero new infections, zero deaths from AIDS – related illnesses and zero discrimination. Almost four decades after the HIV/AIDS pandemic hit the world, stigma and discrimination abound. Current statistics show that even though millions are in need of HIV treatment, only 500,000 are on treatment. 

healthIn a chat with Good Health Weekly, the  Chairperson, Network of People Living with HIV/AIDS in Nigeria, NEPHWAN, Lagos Chapter, Mrs.  Aminat Alli – Agboola, revealed that HIV is no longer the enemy but stigma and discrimination. Aminat who has lived positively with HIV for 15 years, warns that except there is intervention to tackle stigma and discrimination of people living with HIV, more babies of HIV positive women will be born with the virus.

Wondering how Nigeria hoped to achieve the 90-90-90 initiative, she lamented that many persons living with HIV in the country are not on treatment.

She cautions that Nigerians living with HIV may be doomed in view of the new Federal Government directive that makes it mandatory for people living with HIV to pay for treatment through a bank account.

In her argument, Aminat points out that the directive is not helping matters because it is causing default in treatment increase in drug resistance, exposure to Tuberculosis, increased stigma and discrimination, and ultimately death. 



Treatment burden

Many of us are yet to come to terms with the fact that drugs and treatment are no longer free, the charges are not too much but not many can afford it. They vary from clinic to clinic from N500 to N2000. For someone like me that has been on treatment for long, my clinic appointment is every six months. For some others, it’s every three months, and for new people, every month.

At the Nigerian Institute of Medical Research, NIMR, we pay about N2, 900 for laboratory charges. Some of the laboratory services are free, then for drug pick up it is N1,000 and consultation fee is N2000.

We are not used to payment before, so adapting may take a while and some people are already defaulting because they cannot afford the charges.

Another challenge is that for people living with HIV and Tuberculosis to be going about looking for where to make payment, is a high risk.

At the bank, they will ask you what are you paying for, and when you tell them, they will not treat you very cordial. In an idle situation, many of these people on TB treatment should not be moving about.


Stigma at the Bank

Many of the People Living with HIV/AIDS are feeling frustrated following the stigma and discrimination meted to them by some bank’ s officials. The challenge from the directive of the Federal government on the issue of payment into the bank is much. We have specific a government account we are paying into. This began last month, although the Nigerian Institute of Medical Research, NIIMR, is trying for us to avoid going through the stress of going to the bank, unfortunately all the laboratory fees among others have to be paid at the bank.

The problem of payment at the bank is weighing us down. Some people did not disclose their status at home so they come to the clinic alone; some are seriously sick, others are pregnant and some have HIV and TB infection.

Most of the banks have noticed that a group of people come around more frequently. And once they discover you are from NIMR, their behaviour will suddenly change. They will find a way to discharge you.

Plea to government

What we want is that even if the government gave NIMR directive to pay into banks, let there be a way out for our people. Like I said, some are suffering from TB and HIV.  If someone that just started TB treatment is allowed to be walking around to look for a bank for payment, it is high risk for the public.

We also have pregnant women among us going to the clinic alone and might have to go to the bank to make payment without considering the additional problem they are battling with.

I was at the clinic yesterday, some people had to go to the bank and before they returned, the nurse had already called their names and she began to harass them.

Many of those seeking treatment go to the treatment centre around 5am and due to the bank rejections they may not leave until 4pm.Unfortunately, this has automatically increased the workload for the doctors because by the time we find a bank that will accept our payments and come back for our treatment, it is already late. Government to significantly minimize or even stop every fee attached to HIV treatment in the country. Also the payment must be made in the hospital environment.

Elimination of HIV

The 90-9090 is a laudable target but I hope it will be achievable because right now we don’t have everybody on treatment. A lot of us don’t disclose to partners. I don’t know how that will be achievable. The first step is to have everybody on treatment and make people disclose their status.

I have achieved undetectable viral load that is why up to date I have not infected my husband. Treatment has improved rapidly unlike 10 years ago when people were dying of AIDS related infections. Today the story has changed. Now we have healthy people. For instance, when people see me with pregnancy they marvel that I am positive but still very strong. To them I should be dull but it is the opposite because I am on appropriate treatment. Many pregnant women that are pregnant and not positive are down today. We want elimination of mother to child transmission. We don’t want our babies to be born with HIV, but stigma fuels that.

Due to stigma, many women want to breastfeed because other women are breastfeeding. Not minding whether they have low viral load or not. There are criteria to breastfeed.