By Sola Ogundipe
AS more HIV-infected children and adolescents are surviving into adulthood, experts in Nigeria have called for prioritisation of sustained care and support approaches even as the young patients transit into adulthood.
With an estimated 196,000 adolescents living with HIV/AIDS and over 56,000 children newly infected with HIV in Nigeria, the experts note that purposeful, planned paediatric, child-centred and specialised adolescent services are crucial factors in the long-term health and well-being of an adolescent.
Calling for the establishment of special programmes for parents of HIV positive children, they argue that the transition from childhood to adolescence, and from adolescence to adulthood needs to be carefully planned and managed.
Making the call in Lagos recently, Executive Director at PLAN Health Advocacy and Development Foundation, and member of the Africa Community Advisory Board (AFROCAB), Mr. Obatunde Oladapo, said the transitioning from paediatric to adolescent ARV programme in the country could be much better than it is currently.
Speaking last week at a HIV/AIDS sensitisation meeting held at the Nigerian Institute of Medical Research, NIMR, Yaba, Lagos, Oladapo said parents need to be empowered on how to properly disclose a child’s HIV status to the child.
“I am involved in a programme on preparedness for transitioning from Pediatric ARV to Adolescent ARV, I must tell you the honest truth, it is not good enough. It leaves a lot to be desired in our country.”
“I have seen situations in which children, young children want to comit suicide because of HIV. I have seen situations in which a child will just go into depression, lock himself up in a room not knowing what to do when it comes to coping with the knowledge of status. In some situations, children refuse the transition to adults drugs because they refuse to accept their status and in many cases, abandon their treatment, become rebellious and blame their parents for affecting them.
“There is need to have special programmes for parents of HIV positive children on positive parenting. There should be a special country programme design for opportunities and the best place to introduce such programmes. It could even be at facilities where you know every positive parent brings his or child and from that moment, the guiding steps are led on.
On the best way to make HIV disclosure to HIV positive children, Oladapo noted that parents really need to first get around thinking out of the box, go beyond ordinary things they do.
“Self-confidence is key just as bonding relationship with children is vital in dealing with HIV/AIDS. A positive parent needs to be amongst others to acquire skills on how to grow out of fear and be confident irrespective of literacy level.“
On his part, a member of the Country Coordinating Mechanism, CCM, Nigeria, Mr Ibrahim Umoru, noted that most HIV treatment facilities in Lagos and most States of the Federation are not child friendly.
Umoru, who is former Chairman of the Network of People Living With HIV in Nigeria, NEPWHAN, Lagos State Chapter, said the only facility one can beat one’s chest to have an adolescent clinic is NIMR which he described as far ahead of most.
“When we do not make our treatment centres children-friendly, what is the future our HIV programme? When you have clinics where children aged 1 -15 years come and sit with their mothers and grandmothers, what do you expect?”
Explaining further, Umoru noted: “In HIV Medicine, there is what is called patient-care giver communication. With a child in front of an adult, you will not get any information from the child.
“When you have a clinic that is child-friendly, the child can relate with the care-giver, express his or her concerns and worries. Do you know some of these children are just taking these drugs and are not aware of their status? Imagine what that means. These are real challenges parents are facing and children are facing as well. Now, at what point should a parent disclose to his or her infected child the truth about his status?
The problem a lot of us do not understand is that these young ones we call children are far more intelligent and smarter than us. Those things you think you are hiding from your children, they will teach you after they have read it up online. What we need to do as parent is holistic, unbridged communication with our children. Let your child be your friend and tell your child the basics about himself and he will grow to love and appreciate you otherwise he will learn from outside and hate you.”
Also speaking, Deputy Director, Research at NIMR, Dr Oliver Ezechi said separate treatment clinics are preferable.
“My opinion is that we should stop verticalising programes. We should not put children and adults in the same clinic. Yes, people are talking about family centered clinics, because we do not want mother to come separately with father and come again with children three times a week. This can be achieved with segmentation of clinics but for adolescents, you cannot lump them together.”