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HIV/AIDS:

The future of the

Infected & Affected

An HACEY Book

All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means; electronic, mechanical, photocopying, or otherwise without the prior
written permission of the publisher.

Published by HACEY

For further information on HACEY Publications, visit our website: www.hacey.org or contact
info@hacey.org



Script editors: Rhoda Robinson & Adah Aaron

Cover design: Richard Akinwumi, HACEY Technical Director
Table of content
Preface

Acknowledgements

Dedication

Foreword



Part 1

- Introduction

- Africa's struggle against AIDS

- Historical perspective

Origin of AIDS virus

          AIDS identified

- Prevalence

          On the global scene

Presently in Africa

Presently in Nigeria

- AIDS VS HIV

- HIV/AIDS VS Ignorance

- Cause of AIDS

- How HIV infection spreads

- Symptoms of AIDS

          Opportunistic infections

          Symptoms in children
Part 2

- Infected vs Affected

- Social and cultural perspective

- Stigmatization and discrimination

- Burdens of HIV/aids

Part 3

The urgency of the task

Prevention of HIV/AIDS

HIV prevention for youths in Nigeria

Testing for HIV/AIDS

Treatment of HIV/AIDS

Behaviour vs HIV/AIDS

Counselling

Care for people living with HIV/AIDS (PLWHA)

Recommendations

A future worth beholding
PREFACE
It is said that 'ignorance is the greatest threat to the human race'. The human race faces a greater threat
than that which is posed by ignorance at the discovery of the HIV/AIDS, because the HIV/AIDS has
successfully used ignorance amongst other things to aid its global spread.

Our world cannot afford to overlook the damage already done, our continent- Africa has been the most
hard-hit, the plague of HIV/AIDS stare at us like death.

The negative impact of HIV/AIDS is on the rise; businesses are collapsing, agriculture cannot sustain
hunger anymore, the standard of education is deteriorating by the day, families are falling apart,
children- 'leaders of tomorrow', are dying today- sub-Saharan Africa can tell the full story.

Everybody is affected, millions that are infected are on the rise- what future does tomorrow hold if
HIV/AIDS has claimed the life of millions who have dreams and aspirations to make our world better.

The essence of this book is to help everyone realise the plight of the infected and the affliction of the
affected, the hope in the future, and the urgency of the task ahead.

Sure there is a way out, only if you and I will act now!!!
ACKNOWLEDGEMENTS
Whatever we become in life cannot be detached from the source and sustainer of all potentials, the
omnipotent one, and our saviour, the Lord Jesus Christ- your backing has made us high fliers in the race
of life.

Special gratitude to Dr (Mrs) V.A . Olatunji, those moments spent with you during the writing of this
book was an eternal investment. Your understanding, love and support are great. Special recognition to
that lovely boy Fulfilment.

Thanks to the Owolabi family (Mr & Mrs G. A. Owolabi), your training, discipline, and care has
contributed greatly to the success of this book.

Special thanks to Professor and Mrs A.O Soladoye. Your exemplary leadership is worth emulating, you
are an epitome of excellence.

Thanks to Otunba Olusola Adekanola, your support for this project is profoundly appreciated.

Finally, we greatly appreciate all members of HACEY, your ideas, support, dedication and interest in
making our world a healthier place is of immense value, and these you have displayed as you provided
an enabling atmosphere during the course of writing this book. Always remember that you are great.
DEDICATION
This book is dedicated to the millions of infected and affected individuals all over the world, particularly
in Africa.
FOREWORD
It is with great delight that I write the foreword to this book because the publication represents the
beacon of logic in an apparently logicless situation which is claiming the lives of our youths. Rather than
bemoan the pathetic situation, our youths have faced the challenges of the HIV/AIDS pandemic to add
their voice through the provision of knowledge, resource material, health education, talks, seminars and
counselling. Only education with good material, material based on the truth about HIV/AIDS in which
the youths themselves play active parts, can significantly command the attention of the young victims in
order to stem the tide of HIV/AIDS scourge. The publication is therefore recommended to all our youths
and indeed to the society at large who are committed to fighting the HIV/AIDS pandemic.

Professor Ayo Soladoye

November, 2008
PART 1
Have you ever imagined a virus so subtle you wouldn't know it's there?

Can you imagine an organism so skilled in the art of sabotage you don't recognise its presence till its too
late?

HIV; it steals into a body as a spy sneaks into enemy's territory, making its way stealthily till it reaches its
targets. It infiltrates the defence system and causes so much damage the system self-destructs. But alas!
It isn't destroyed, rather the explosion spreads it to other defence bunkers till it destroys them all.

HIV; it comes in when you least expect it. Just a slight mistake and it slithers in like a snake. It weaves
through vessels and past cells till it gets to its destination, and like a poisonous snake, strikes with
precision and the intent to kill.

HIV; like a thief at night, it forces itself into our lives, and steals our health and joy, leaving behind
misery. It comes and makes the way ready for other illnesses to reign. It makes us vulnerable to the
slightest attack, a once strong body becomes a struggling weakling.

HIV, the bane of the society.



                                                   Beware!

                                          One unguarded moment

                                              can ruin your life.
INTRODUCTION
Acquired Immunodeficiency Syndrome (AIDS) is a human viral disease that ravages the immune system,
undermining the body's ability to defend itself from infection and disease. It is caused by the human
immunodeficiency virus (HIV). AIDS leaves an infected person vulnerable to opportunistic infections—
infection by microbes that take advantage of a weakened immune system. Such infections are usually
harmless in healthy people but can be life-threatening to people with AIDS. Although there is no cure for
AIDS, new drugs are available that can prolong the life span and improve the quality of life of infected
people.

When AIDS emerged from the shadows two decades ago, few people could predict how the epidemic
would evolve, and fewer knew ways of combating it. Now, at the start of a new millennium, we are past
the stage of conjecture. We know from experience that AIDS can devastate whole regions, knock
decades off national development, widen the gulf between rich and poor nations and push already
stigmatized groups closer to the margins of society.

This piece is all about a future where there is hope and joy, and we will like to start by reviewing the
struggles of a continent against AIDS.

Africa has the highest percentage of people living with HIV/AIDS.

AFRICA'S STRUGGLE AGAINST AIDS

Sub-Saharan Africa moved into the 21st century carrying the crippling burden of AIDS, “a disease that is
slashing life expectancy, shattering families, pushing industries to the brink of bankruptcy, and creating a
generation of orphans”. This disease was by far the leading cause of death among adults in much of the
continent at the end of 1999, and yet it was virtually unknown just two decades ago. A 70% of the 33.6
million people living with HIV live in African nations, south of the Sahara, a region that accounts for just
10% of the world's population. A year's course of existing HIV treatment therapies for a single person
costs 20 times the average per capita income for the region. Without such therapies most of those
presently infected will die within the next 10 years. They will join the 14 million Africans who have
already died of HIV-related illnesses according to estimates made at the end of 1999 by the Joint United
Nations Programme on HIV/AIDS and the World Health Organization). Early attempts to measure the
size of the epidemic by calculating backwards from registered AIDS cases and deaths failed because of
confusion over what constitutes an AIDS case, a lack of diagnostic facilities, reluctance to report AIDS as
a cause of death because of the stigma associated with the disease, and poor health reporting systems.

Explanations for the rapid spread of HIV in sub-Saharan Africa remains an issue, though the expansion of
the epidemic itself has been well documented. It is known that it is easier both to contract and to pass
on the virus if a person is also suffering from another sexually transmitted disease (STD). Prevalence of
other STDs is high in much of the continent, and poor access to health facilities means they are less likely
to be promptly treated and cured than in richer parts of the world. High fertility and near-universal
breast-feeding contribute to the transmission of HIV from mothers to children in Africa—nearly half a
million children are born with HIV in Africa each year, compared with 70,000 in the rest of the world.
Large studies of sexual behaviour also suggests that sexual activity begins very early, with high
proportions of both men and women having premarital partners, and that extramarital sex is common,
especially among men.

The pattern of HIV infection is not consistent across the continent. East Africa was the first area to suffer
a major onslaught of HIV and then AIDS. Some countries in this region, notably Uganda, have been
rewarded for extremely active preventive efforts by a fall in new infections in their youngest age groups.
In others, such as Kenya, HIV prevalence rates continue a gradual but steady rise. The most explosive
growth has been in the countries of southern Africa. It is estimated that close to one adult in five aged
between 15 and 49 is currently infected with HIV in Botswana, Lesotho, Namibia, South Africa,
Swaziland, Zambia, and Zimbabwe. West Africa, on the other hand, is less affected by HIV. Information
for populous Nigeria is at best sketchy and Côte d'Ivoire is known to be badly affected, but HIV
prevalence among adults in most West African countries is probably 5% or less. Recent studies have
suggested that these differences may be related in part to near-universal male circumcision in many
areas of West Africa. High proportions of men are infected with HIV in some countries where
circumcision is common.

Economic structure may also contribute to patterns of infection. Large concentrations of men who are
separated from their families to work in mining, commercial agriculture, transport and other industries
tend to provide a ready market for sex workers, who highly contribute to the rapid spread of HIV
because of high partner turnover. When these men go to visit their families, they carry the infection
back into rural areas. The increase in labour mobility following the end of apartheid in South Africa has
doubtless contributed to the rapid spread of HIV. Many efforts have been made to estimate the impact
of HIV/AIDS on the economies of Africa, with little result. Many of the continent's economies are
unstable, and all are subject to a vast array of influences that are both independent of the AIDS
epidemic and interdependent with it. However, an increase in death rates among economically
productive adults will affect economic well-being at many levels. The easiest effect to measure is
probably at the company level. In Kenya several firms report that medical payments have increased 10-
folds in the past decade, while illness and death have leapt from last to first place among reasons for
employees' leaving the workforce. At the family level one of the most visible impacts is the growth in
the number of surviving children who must grow up and make a living without the financial or emotional
support of their parents. UNAIDS estimates that by the end of the century 10.7 million children in Africa
will have lost their mothers or both their parents to AIDS before they reach their 15th birthday.

Can nothing be done to stop the relentless spread of HIV, the incapacitating illness, and funerals across
Africa? Some countries, notably Uganda and Senegal, have managed to arrest and even reverse the
march of AIDS. Their epidemic situations differ, but the responses share common characteristics, very
strong leadership at the highest political level, public acknowledgement of the epidemic and the
behaviours that spread it, efforts to reduce the stigma associated with HIV, active involvement of
community and religious leaders in prevention activities, widespread provision of services, including STD
treatment combined with counseling and voluntary HIV testing, and massive efforts to respond to the
information and sexual health needs of young people. In other countries, these responses have been
diluted by the refusal of leaders to promote sexual behavioural change. Unless efforts are made to
emulate the continent's prevention successes, the future for much of sub-Saharan Africa is stark. As
South African former president, Thabo Mbeki put it, “For too long we have closed our eyes as a nation
[to HIV]. By allowing HIV to spread, our dreams as a nation will be shattered.”

HISTORICAL PERSPECTIVE

Origin of the HIV

Using computer technology to study the structure of HIV, scientists have determined that HIV originated
around 1930 in rural areas of Central Africa, where the virus may have been present for many years in
isolated communities. The virus probably did not spread because members of these rural communities
had limited contact with people from other areas. But in the 1960s and 1970s, political upheaval, wars,
drought, and famine forced many people from these rural areas to migrate to cities to find jobs. During
this time, the incidence of sexually transmitted infections, including HIV infection, quickly spread
throughout Africa. As world travel became more prevalent, HIV infection developed into a worldwide
epidemic. Studies of stored blood from the United States suggest that HIV infection was well established
there by 1978.

AIDS Identified

Beginning in June 1981, the Centre for Disease Control and Prevention(CDC) published reports on
clusters of gay men in New York and California who had been diagnosed with pneumocystic pneumonia
or Kaposi's sarcoma. These two rare illnesses had previously been observed only in people whose
immune systems had been damaged by drugs or disease. These reports triggered concern that a disease
of the immune system was spreading quickly in the homosexual community. Initially called gay-related
immunodeficiency disease (GRID), the new illness soon was identified in population groups outside the
gay community, including users of intravenous drugs, recipients of blood transfusions, and heterosexual
partners of infected people. In 1982 the name for the new illness was changed to Acquired
Immunodeficiency Syndrome, or AIDS.



On the Global Scene
Efforts to combat the impact of AIDS is on every day. In the developed countries, the number of people
living with the virus is reducing from few to none, as almost everyone is aware because of high level of
education and information; yet, the truth must never be neglected. Many are still loosing their precious
lifes due to this virus; no nation can be said to be totally secured as there is always a possibility of
migration between citizens of any nation of the world. Since 2001, when the United Nations Declaration
of Commitment on HIV/AIDS was signed, the number of people living with HIV in Eastern Europe and
Central Asia has increased by more than 150% from 630 000 [490 000 – 1.1 million] to 1.6 million [1.2 –
2.1 million] in 2007. In Asia, the estimated number of people living with HIV in Vietnam has more than
doubled between 2000 and 2005, with Indonesia having the fastest growth of the epidemic.
While cases of AIDS have been reported in every nation of the world, the disease affects some countries
more than others. About 90 percent of all HIV-infected people live in the developing world. AIDS has
struck sub-Saharan Africa particularly hard. Two-thirds of all people living with HIV infection reside in
African countries south of the Sahara, where AIDS is the leading cause of death. New data shows that
global HIV prevalence has levelled off, and that the number of new infections has fallen, partly as a
result of the impact of HIV programmes. However, in 2007 33.2 million [30.6 – 36.1 million] people were
estimated to be living with HIV, 2.5 million [1.8 – 4.1 million] people became newly infected and 2.1
million [1.9 – 2.4 million] people died of AIDS. In countries hardest hit, AIDS has sapped the population
of young men and women who form the foundation of the labor force. Most die while in the peak of
their reproductive years. Moreover, the epidemic has overwhelmed health-care systems, increased the
number of orphans, and caused life expectancy rates to plummet. These problems have reached crisis
proportions in parts of the world already burdened by war, political upheaval, or unrelenting poverty.

Presently in Africa...
As with any epidemic for which there is no cure, tragedy shadows the disease's progress. From wreaking
havoc on different populations, to infecting more than one-third of adults in sub-Saharan African
countries such as Botswana, Swaziland, and Zimbabwe at the turn of the 21st century, AIDS has had a
devastating social impact. In Zimbabwe the economy had lagged throughout the 1990s as inflation
soared, and a high level of unemployment led to significant unrest. This political and economic turmoil
took place as the spread of AIDS in Zimbabwe reached epidemic proportions. By the beginning of the
21st century, 1 in 4 adult Zimbabweans was infected, life expectancy had fallen to below 40 years, and
hundreds of thousands of children had been left orphans. In Botswana, the spread of AIDS has had a
devastating effect, where the rate of infection has been one of the highest in the world; by 2000 more
than one-third of the adult population had been infected with HIV, and the growing number of AIDS
orphans loomed as a serious social problem. There were an estimated 1.7 million [1.4 – 2.4 million] new
HIV infections in sub-Saharan Africa in 2007—a significant reduction since 2001. However, the region
remains most severely affected. An estimated 22.5 million [20.9 – 24.3 million] people living with HIV, or
68% of the global total, are in sub-Saharan Africa. Eight countries in this region now account for almost
one-third of all new HIV infections and AIDS deaths globally.

High and stable HIV prevalence rates are bad news, but there is worse news - Prevalence rates do not
reflect the true impact of the epidemic. Across the quadrant of Africa, this nightmare is real, the
ultimate tragedy is that so many people do not know, or do not want to know what is happening. As
AIDS virus sweeps mercilessly through the land, few try to confront the present situation. Many run
away from it, yet children are dying, hospital beds are filled with the sick, parents are not spared, and
some still feel its due to metaphysical powers.

About 90% of all HIV-infected people live in the developing world.
Presently in Nigeria...
With a population of 140 million people, Nigeria is the largest country in Africa and accounts for 47
percent of West Africa's population. Nigeria's population is made up of about 200 ethnic groups, 500
indigenous languages, and two major religions ― Christianity and Islam. Nigeria is also the second
largest economy in sub-Saharan Africa and accounts for 41 percent of the region's GDP. Government
reports claim that over 300,000 Nigerians die yearly of complications arising from AIDS, and over 1.5
million children are said to be orphaned annually.

Over 40% of Nigeria's population is under 15 years old. Young people account for over 30% of HIV cases,
with prevalence nearly three times higher among 15-24 year old females than males. The factors that
increase girls' and young women's vulnerability include early marriage, early sexual debut, and
polygamous relationship (with nearly a third of 15-24 year old females having had sex with a casual
partner in the last 12 months). The factors also include poor economic opportunities, lack of negotiation
skills for sex and condom use, mixed messages around public acceptability of condom use, and lack of
basic information (with only 18% of females aged 15-24 years identifying ways to prevent HIV). Official
figures put the steady rise in HIV prevalence rate from 1.8% in 1988 to 5.8% in 2001, 5.0% in 2003, 4.4%
in 2005 and 5% in 2007, showing the treatment is failing and HIVs are becoming AIDS rapidly. The
average life span of a commoner has dropped to the lowest level - It is 44 Years in Nigeria due to the
impact of AIDS. Lack of sincerity, poor fund administration, unclear motives and lax attitude of
government officials have made situation worse.



HIV VS AIDS
This segment seeks to clarify the difference between the term 'HIV' and 'AIDS'. People often misuse
these words or exchange one for the other.

HIV

The human immunodeficiency virus (HIV) infects cells of the immune system, destroying or impairing
their function. Infection with the virus results in the progressive deterioration of the immune system,
leading to "immune deficiency." The immune system is considered deficient when it can no longer fulfill
its role of fighting infection and disease. Infections associated with severe immunodeficiency are known
as "opportunistic infections," because they take advantage of the weakened immune system.

AIDS

Acquired immunodeficiency syndrome (AIDS) is a surveillance term defined by the United States Centre
for Disease Control and Prevention (CDC) and by the European Centre for the Epidemiological
Monitoring of AIDS (EuroHIV). The term AIDS applies to the most advanced stages of HIV infection,
defined by the occurrence of any of the over 20 opportunistic infections or HIV-related cancers.
HIV/AIDS VS IGNORANCE

Ignorance, it is said, is the greatest threat to the human race and every society pays for it. The AIDS
pandemic has been able to effectively utilise ignorance to enhance its spread, the intention of this
segment is to correct misconceptions about HIV/AIDS.

TRUTH:

If you dont have HIV, you can't get AIDS, if you have AIDS you already have the virus (HIV).

AIDS is not caused by drugs, government conspiracies, metaphysical (spiritual) powers, or anything else
but a virus (HIV).

You can't get HIV/AIDS through casual contacts like hugging, touching, handshakes or staying in the
same office or house with people living with HIV/AIDS.

You can't get HIV/AIDS from mosquito bite or other blood sucking insects.

You can't get HIV/AIDS from sharing utensils like cups, spoons and plates.

You cannot know a person's status from his/her appearance, someone can feel healthy and look good
yet be infected.

Newborn babies can be infected by their mothers during pregnancy, at birth or through breastfeeding.

HIV can be transmitted by all forms of sexual intercourse (oral, anal, and genital).

HIV is not spread by coughing or sneezing.

HIV is preventable but not yet curable.

CAUSE OF AIDS

AIDS is the final stage of a chronic infection with the HIV. There are two types of this virus: HIV-1, which
is the primary cause of AIDS worldwide, and HIV-2, found mostly in West Africa. Inside the body HIV
enters cells of the immune system, especially white blood cells known as T cells (lymphocytes). These
cells orchestrate a wide variety of disease-fighting mechanisms. Particularly vulnerable to HIV attack are
the specialized “helper” T cells known as CD4 cells. When HIV infects a CD4 cell, it commandeers the
genetic materials within the cell to manufacture new HIV virus. The newly formed HIV virus then leaves
the cell, destroying the CD4 cell in the process. The cure to HIV/AIDS is possible by knowledge and
behavioural changes.

The loss of CD4 cells endangers health because these cells help other types of immune cells respond to
invading organisms. The average healthy person has over 1,000 CD4 cells per microliter of blood. In a
person infected with HIV, the virus steadily destroys CD4 cells over a period of years, diminishing the
cells' defensive ability and weakening the immune system. When the density of CD4 cells drops to 200
cells per microliter of blood, the infected person becomes vulnerable to AIDS-related opportunistic
infections and rare cancers, which take advantage of the weakened immune defenses to cause disease.



HOW HIV INFECTION SPREADS

Scientists have identified three ways that HIV infection spreads: through unprotected sexual intercourse
with an infected person, contact with contaminated blood, and transmission from an infected mother to
her child before or during birth or through breast-feeding.

Furthermore, HIV is frequently spread among intravenous drug users and cultist who share needles or
syringes, blades and any other form of sharp objects. In some cases transmission to health care givers
may occur by an accidental prick with a needle used to obtain blood from an infected person- a reason
for carefulness on the side of all health givers.

SYMPTOMS OF AIDS

Without medical intervention, AIDS progresses along a typical course. Within one to three weeks after
infection with HIV, most people experience flu-like symptoms such as fever, sore throat, headache, skin
rash, tender lymph nodes, and a vague feeling of discomfort. These symptoms last one to four weeks.
During this phase, known as acute retro viral syndrome, HIV reproduces rapidly in the blood. The virus
circulates in the blood throughout the body, particularly concentrating in organs of the lymphatic
system.

The normal immune defenses against viral infections eventually get activated to battle HIV in the body,
reducing but not eliminating HIV in the blood. Infected individuals typically enter a prolonged
asymptomatic phase, a symptom-free period that can last ten years or more. While persons who have
HIV may remain in good health during this period, HIV continues to replicate, progressively destroying
the immune system. Often an infected person remains unaware that he or she carries HIV and
unknowingly transmits the virus to others during this phase of the infection.

When HIV infection reduces the number of CD4 cells from around 500 to 200 per microliter of blood, the
infected individual enters an early symptomatic phase that may last a few months to several years. HIV-
infected persons in this stage may experience a variety of symptoms that are not life-threatening but
may be debilitating. These symptoms include extensive weight loss and fatigue (wasting syndrome),
periodic fever, recurring diarrhea, and thrush- a fungal mouth infection. An early symptom of HIV
infection in women is a recurring vaginal yeast infection. Unlike earlier stages of the disease, in this early
symptomatic phase the symptoms that develop are severe enough to cause people to seek medical
treatment. Many may first learn of their infection in this phase.

Opportunistic Infections

The second phase of HIV infection, the asymptomatic period, lasts an average of 10 years. During this
period the virus continues to replicate, and there is a slow decrease in the CD4 count (the number of
helper T cells). When the CD4 count falls to about 200 cells per microlitre of blood (in an uninfected
adult it is typically about 1,000 cells per microlitre), patients begin to experience opportunistic infections
i.e., infections that arise only in individuals with a defective immune system. This is AIDS, the final stage
of HIV infection. The most common opportunistic infections are tuberculosis, pneumonia,
Mycobacterium avium infection, herpes simplex infection, toxoplasmosis, and cytomegalovirus
infection. In addition, patients can develop dementia and certain cancers, including Kaposi sarcoma and
lymphomas. Death ultimately results from the relentless attack of opportunistic pathogens or from the
body's inability to fight off malignancies. A small proportion of individuals infected with HIV have
survived longer than 10 years without developing AIDS. It may be that such individuals mount a more
vigorous immune response to the virus or that they are infected with a weakened strain of the virus.

Symptoms in Children

HIV infection in children progresses more rapidly than in adults, most likely because a child's immune
system has not yet built up immunity to many infectious agents. The disease is particularly aggressive in
infants—more than half of infants born with an HIV infection die before age two. Once a child is
infected, the child's undeveloped immune system cannot prevent the virus from multiplying quickly in
the blood and the disease progresses rapidly. In contrast, when an adult becomes infected with HIV, the
adult's immune system generally fights the infection. Therefore, HIV levels in adults remain lower for an
extended period, delaying the progression of the disease.

Children develop many of the opportunistic infections that befall adults but also exhibit symptoms not
observed in older patients. Among infants and children, HIV infection produces wasting syndrome and
slows growth (generally referred to as failure to thrive). HIV typically infects a child's brain early in the
course of the disease, impairing intellectual development and coordination skills. While HIV can infect
the brains of adults, it usually does so toward the later stages of the disease and produces different
symptoms. Children show a susceptibility to more bacterial and viral infections than adults. More than
20 percent of HIV-infected children develop serious, recurring bacterial infections, including meningitis
and pneumonia. Some HIV-infected children suffer from repeated bouts of viral infections, such as
chicken pox. Healthy children generally develop immunity to these viral illnesses after an initial
infection.
PART 2
He was a little boy living in a big city. Though his parents where rarely around, he didn't really feel their
absence. All the love and care he needed was given by his aunt. Most people thought she was his
mother, and he couldn't have cared less if they did, because sometimes he wished she was.

He grew up with this love and for a long time couldn't think of ways to say thank you to his aunt. Then he
decided, as he left secondary school to give her a gift. When he was older and could afford it, he would
build her the finest house there was, in the best place there is.

He struggled and worked, determined to attain his dream, and say thank you to his loving aunt.
Meanwhile, each time he came home for a school break, he would give her a small gift with a note
attached saying “something big is on its way”.

He came home one day to find her very sick and after some time, his aunt passed away. Like a nightmare
he couldn't awaken from, he was told she had been HIV positive. Her husband had believed it was
metaphysical and they had only gone for the test shortly before she died.

He had lost the focus of his dream. As tears streamed from his eyes, he couldn't see the point of his
struggles anymore. There was no point in building the house anymore. AIDS had claimed the life of his
dearly beloved aunt, and had killed his dream.



Health is a precious thing, and the only one, in truth, which deserves that we employ in its pursuit not
                      only time, sweat, trouble, and worldly goods, but even life...

    As far as I am concerned, no road that would lead us to health is either arduous or expensive.

                                    -Michel de Montaigne (1533 - 1592)
INFECTED VS AFFECTED
The Infected

These are the People Living With HIV/AIDS (PLWHA), they are greatly challenged in every society. They
experience feelings of rejection and isolation because many people show negative attitude towards
them. Remember that PLWHA have the same right as everyone therefore they deserve to be treated
with respect and fairness, regardless of how they became infected.

The Affected

Everybody is at risk of HIV, either directly or indirectly. Directly, anyone who is not careful enough can
be infected. Some people are at special risk of HIV infection, they include commercial sex workers,
homosexuals, cultists, etc. Indirectly, everyone is affected. The raging inferno of HIV/AIDS is enough to
tell its impact on population, health, agriculture, education, and business development.

Millions of dollars are invested each year in different countries of the world to combat HIV/AIDS.
Imagine how many jobs this could create, and how many infrastructure it would put in place. Since the
early 1990s, it has been clear that HIV would help undermine development in countries badly affected
by the virus. Warnings about falling life expectancy, increasing numbers of orphans, extra costs for
business and the destruction of family and community structures are not new. These effects are
becoming increasingly visible in the hardest-hit region of all - sub-Saharan Africa - where HIV is now
deadlier than war itself: in 1998, 200 000 Africans died in war but more than 2 million died of AIDS. AIDS
has become a full-blown development crisis. Its social and economic consequences are felt widely not
only in health but in education, industry, agriculture, transport, human resources and the economy in
general.

This wildly destabilizing effect is also affecting the already fragile and complex geopolitical systems. Even
if you say you are not infected, think about the number of orphans that have become criminals because
of this pandemic, imagine the number of business that have collapsed due to the fact that the sole
owner died of AIDS leaving the employees to their fate of joblessness.

On the long run, no nation or human can claim freedom until everybody is free.

SOCIAL AND CULTURAL PERSPECTIVE

Its collateral cultural effect has been no less far-reaching, sparking new research in medicine and
complex legal debates, as well as intense competition among scientists, pharmaceutical companies, and
research institutions. Since the mid-1980s, the International AIDS Society has held regular conferences
at which new research and medical advances were discussed.

In order to raise public awareness, advocates promote the wearing of a loop of red ribbon to indicate
their concern. Activist groups lobby governments for funding for education, research, and treatment,
and support groups provide a wide range of services including medical, nursing and hospice care,
housing, psychological counseling, meals, and legal services. Those who have died of AIDS have been
memorialized in the more than 44,000 panels of the AIDS Memorial Quilt, which has been displayed
worldwide both to raise funds and to emphasize the human dimension of the tragedy. The United
Nations designated December 1 as World AIDS Day.

Regarding access to the latest medical treatments for AIDS, the determining factors tend often to be
geographic and economic. Simply put, developing nations often lack the means and funding to support
the advanced treatments available in industrialized countries. On the other hand, in many developed
countries specialized health care has caused the disease to be perceived as treatable or even
manageable. This perception has fostered a lax attitude toward HIV prevention, which in turn has led to
new increases in HIV infection rates. Because of the magnitude of the disease in Africa, sub-Saharan
Africa in particular, the governments of this region have tried to fight the disease in a variety of ways.
Some countries have made arrangements with multinational pharmaceutical companies to make HIV
drugs available in Africa at lower costs. Other countries, such as South Africa, have begun manufacturing
these drugs themselves instead of importing them. Plants indigenous to Africa are also being scrutinized
for their usefulness in developing various HIV treatments.

In the absence of financial resources to pay for new drug therapies, many African countries have found
education to be the best defence against the disease. In Uganda, songs about the disease, nationally
distributed posters, and public awareness campaigns starting as early as kindergarten have all helped to
stem the spread of AIDS. Prostitutes in Senegal, the clergy, including Islamic religious leaders, work to
inform the public about the disease. Other parts of Africa have however seen little progress. For
instance, the practice of sexually violating very young girls has developed among some HIV-positive
African men because of the misguided belief that such acts will somehow cure them of the disease.

Only better education can battle the damaging stereotypes, misinformation, abnormal behaviour and
disturbing practices associated with AIDS.

          In the United States, some communities have fought the opening of AIDS clinics or the right of
HIV-positive children to attend public schools. Several countries—notably Thailand, India, and Brazil—
have challenged international drug patent laws, arguing that the societal need for up-to-date treatments
supercedes the rights of pharmaceutical companies. At the start of the 21st century many Western
countries were also battling the reluctance of some governments to direct public awareness campaigns
at high-risk groups such as homosexuals, prostitutes, and drug users out of fear of appearing to condone
their lifestyles. For the world of art and popular culture, HIV/AIDS has been double-edged. On the one
hand, AIDS removed from the artistic heritage many talented photographers, singers, actors, dancers,
and writers in the world. On the other hand, as with the tragedy of war and even the horror of the
Holocaust, AIDS has spurred moving works of art as well as inspiring stories of perseverance. From Paul
Monette's Love Alone, to John Corigliano's Symphony No. 1, to the courage with which American tennis
star Arthur Ashe publicly lived his final days after acquiring AIDS from a blood transfusion.
STIGMATIZATION AND DISCRIMINATION

“ No one can make you feel inferior without your consent.”

                        - Eleanor Roosevelt

From the early days of the identification of AIDS, the disease has been powerfully linked to behaviours
that are illegal (such as illicit drug use) or are considered immoral by many people (such as promiscuity
and homosexuality). Consequently, a diagnosis of AIDS was a mark of disgrace, although medical
research revealed that the disease follows well-defined modes of transmission that can affect any
person. As the extent of the epidemic unfolded, misinformation about AIDS and how it is transmitted
triggered widespread fear of contracting the disease. Some communities responded with hysteria that
resulted in violence, and in some African countries neighbours refused to interract with relatives of the
infected. In other communities, parents protested when HIV-infected children attended school. In many
areas of the world, women in particular may face consequences if their HIV status is discovered. Reports
indicate that many HIV-infected women are subject to domestic violence at the hands of their
husbands—even if the husbands themselves are the source of infection. As a result, some women in
developing nations fear being tested for HIV infection and cut themselves off from medical care and
counseling.

In addition to social stigma, people infected with HIV must grapple with more immediate concerns—a
daily struggle for basic medical care and other basic rights in the face of discrimination and fear because
of their HIV status.



BURDENS OF HIV/AIDS

Household Impacts

The few surveys of the impact of having a family member with AIDS show that households suffer a
dramatic decrease in income. Decreased income inevitably means fewer purchases and diminishing
savings.

In urban areas in Côte d'Ivoire, the outlay on school education was halved, food consumption went
down 41% per capita, and expenditure on health care more than quadrupled. When family members in
urban areas fall ill, they often return to their villages to be cared for by their families, thus adding to the
call on scarce resources and increasing the probability that a spouse or others in the rural community
will be infected.

The Orphans Left Behind

Wherever they turn, children who have lost a mother or both parents to AIDS face a future even more
difficult than that of other orphans. According to a report published jointly in 1999 by UNICEF and the
UNAIDS Secretariat, AIDS orphans are at greater risk of malnutrition, illness, abuse and sexual
exploitation than children orphaned by other causes. They must grapple with the stigma and
discrimination so often associated with AIDS, which can even deprive them of basic social services and
education. So far, the AIDS epidemic has left behind 13.2 million orphans—children who, before the age
of 15, lost either their mother or both parents to AIDS.

The Toll on Education

Education is an essential building block in a country's development. In areas where HIV infection is
common, HIV-related illness is taking its toll on education in a number of ways. First, it is eroding the
supply of teachers and thus increasing class sizes, which is likely to dent the quality of education.
Secondly, it is eating into family budgets, reducing the money available for school fees and increasing
the pressure on children to drop out of school and marry or enter the workforce. Thirdly, it is adding to
the pool of children who are growing up without the support of their parents, which may affect their
ability to stay in school. Skilled teachers are a precious commodity in all countries, but in some parts of
the world, they are becoming too sick to work or dying of HIV-related illness long before retirement.

Health Sector Under Stress

Since the start of the epidemic, 18.8 million children and adults have fallen sick and died and almost
twice that number are now living with HIV, with some 5.4 million newly infected people joining their
ranks in 1999. As a consequence, the epidemic's impact on the health sector over the coming decade
will be predictably greater than in the past two decades combined.

However, the increased demand for health care from people with HIV-related illnesses is heavily taxing
the overstretched public health services of many developing countries. In the mid-1990s, it was
estimated that treatment for people with HIV consumed 66% of public health spending in Rwanda and
over a quarter of health expenditures in Zimbabwe.

Impact on Agriculture

Agriculture is one of the most important sectors in many developing countries, particularly when
measured by the percentage of people dependent on it for their living.

The effect of AIDS is devastating at family level. As an infected farmer becomes increasingly ill, he and
the family members looking after him spend less and less time working on the family's crops. The family
begins to lose income from unmarketed or incompletely tended cash crops, has to buy food it normally
grows for itself, and may even have to sell off farm equipment or household goods to survive.

Impact on business

Given the proportion of adults infected with HIV and dying from associated diseases in Africa, it is
inevitable that the business sector, as well as families, schools and other sectors, will feel the cost.
The Bottom Line:

HIV/AIDS is hurting business, family and sustainable development

Although the crisis is enormous and its impact devastating, countries and communities across the
globe should rally to react to the damage and to counter some of its worst impacts.
PART 3
They hadn't eaten all day. Little Tomi had been crying for the past one hour and they didn't know what to
do. Ever since mummy died, their lives had been worse. At least when she was alive, they could eat at
least once a day. The neighbours stopped coming less than a week after the burial and they had stopped
expecting family members to come to their aid. Lara, the eldest of the three, watched as Tomi began to
shiver. He was very sick and nothing they did made him better. There was nothing left in the house, and
they were sure the landlord would be coming anytime soon.

She would fend for what was left of her family. Though no one would employ her, she knew she could
make money, all she needed was the right clothes and a lot of make-up. Tomi was sleeping now. The
doctor said he had the same thing mummy had. She couldn't imagine how a child so young could get so
sick. Mummy had tried to explain why none of the family members would take care of them. Now she
understood. But it wasn't their fault mummy was positive, and they weren't positive either except for
Tomi, but he was just a year old and couldn't help it. She could hear the landlord coming. She prayed she
could find an abandoned building or else they would have nowhere to stay. A knock sounded, it was time
to go.

The rains had began and finding a building their only hope. As the rains mingled with the tears on her
face, her thoughts kept returning to the cause. HIV had stolen their comfort, had stolen their mother,
and now it had taken their home. The life they knew had gone and now they were left with nothing.
Would there ever be hope for something better someday?



AIDS is the most complex, the most challenging, and probably the most devastating infectious
  disease humanity has ever had to face. And we have faced this disease, head on. We have
                                          rallied.

                                        –Dr. Magaret Chan
                                   DG. World Health Organization
THE URGENCY OF THE TASK
“The great end of life is not knowledge but action...”

                         - Thomas Henry Huxley

Just as clearly, experience shows that the right approaches, applied quickly enough with courage and
resolve, can and do result in lower HIV infection rates and less suffering for those affected by the
epidemic. An ever-growing AIDS epidemic is not inevitable; yet, unless action against the epidemic is
scaled up drastically, the damage already done will seem minor compared with what lies ahead. This
may sound dramatic, but it is hard to play down the effects of a disease that stands to kill more than half
of the young adults in countries where it has its firmest hold—most of them before they finish the work
of caring for their children or providing for their elderly parents. Already, 18.8 million people around the
world have died of AIDS, 3.8 million of them children. Nearly twice that many—34.3 million—are now
living with HIV.



PREVENTION OF HIV/AIDS

Without a vaccine for AIDS years away and no cure on the horizon, experts believe that the most
effective treatment for AIDS is to prevent HIV infection.

The following are preventive measures to stay HIV free-

To the School Administrators

Comprehensive sex education programmes in all forms.

Develop peer education group

To the Health Workers

Ensure the use of protective clothing and proper instrument disposal.

Ensure correct screening of donated blood.

Administration of Highly active antiretroviral therapy (HAART).

Genital mutilation should be discouraged

To the Hairdressers and Barbers

Sterilize your hairdressing and barbing equipments.

use hand gloves.

Encourage your clients to use their personal clippers.
To the Married

Be faithful to your partner.

To the Unmarried

Abstinence is the best form of prevention.

To the Child

Do not share or play with sharp objects.

To the Infected

You are not inferior to anyone

Go for counselling and take proper medication

To the Affected

Don't stigmatize or discriminate the infected

Be careful

To the Government

Encourage public education programmes about HIV/AIDS.

Provide easily accessible centres for counselling.

Promote confidentiality and emphasise the rights of people living with HIV.

Promote integrating of HIV and AIDS education into the curricula of schools (beginning at the
primary/basic level)

To Students

Avoid the sharing of sharp objects.

Desist from cult activities or the use of illicit drugs.



HIV PREVENTION FOR YOUTHS IN NIGERIA

Over 40% of Nigeria's population is under 15 years old. Young people account for over 30% of HIV cases,
with prevalence nearly three times higher among 15-24 year old females than males.

Nigeria has three legal systems – civil, customary and religion – operating simultaneously and utilised
differently in different states. This can make the implementation of Federal measures, such as to protect
against early marriage, complex. Overall, the status of females is low, with strong cultural pressures
that, for example, force girls and young women to seek illegal abortion rather than face the ostracism of
being unmarried and pregnant.

HIV Prevention Strategies and Services for Youths in Nigeria

There are five key components that influence HIV prevention, namely:

1. Legal provision

2. Policy provision

3. Availability of services

4. Accessibility of services

5. Participation and rights

LEGAL PROVISION (NATIONAL LAWS, REGULATIONS, ETC)

According to the Child Rights Act (2003), the minimum legal age for marriage is 18 years. However, this
only applies to marriages within the country's civil legal system – as opposed to its customary and
religion systems – and is implemented differently by individual states. In practice, early marriage is
common, with 48% of girls in the Northwest marrying by 15 years. Also, in the country as a whole, 27%
of married 15-19 year old females are in polygamous relationships.

The age of consent for an HIV test is 18 years. However, younger people who are married, pregnant, sex
workers, parents or engaged in risky behaviour can be considered 'mature minors' and give their own
consent.

Mandatory HIV testing is illegal under Federal law, except in the case of some sexual offences. However,
some companies use testing within screening procedures for recruitment and some religious groups
insist on testing for couples that intend to get marry.

Abortion is legal only to save the life of the pregnant woman. Penalties are high for offenders in other
circumstances. In practice, some 1 million abortions are carried out each year, with illegal abortion
responsible for half of all maternal deaths, particularly among young women.

In terms of gender-based violence, some 81% of married women experience verbal or physical abuse by
their husbands, with indications that the lower the age of marriage, the higher the level of risk. While
the law prohibits rape and other forms of sexual harassment, it is silent on young married girls who are
faced with marital rape and domestic sexual violence. There are no state laws that prevent girls and
women from using services, but tradition requires that the woman must obtain permission from the
parent and, if she is married, the husband, to access any service or even go out of the house. Customary
and religious laws that erode the dignity and rights of young girls should be amended / abolished
The federal government has publicly opposed female genital mutilation, but has not introduced
legislation to ban the practice. Edo and Cross River states have, however, passed laws against female
genital mutilation.

The right to life and health of all citizens is outlined in the 1999 Constitution. However, people living
with HIV are still treated with disrespect or may be refused treatment in some hospitals. Most people,
including some medical health workers, are not aware of laws protecting HIV-infected persons.

POLICY PROVISION (NATIONAL POLICIES, PROTOCOLS, GUIDELINES, ETC)

The HIV/AIDS National Strategic Framework for Action (2005-2009):

Emphasises a full continuum of strategies, including prevention, care, support and treatment. It also
promotes the integration of HIV/AIDS, sexual and reproductive health services.

Promotes confidentiality and emphasise the rights of people living with HIV.

Specifically commits to reducing HIV prevalence. It also prioritises women, young people and orphans
and vulnerable children.

Commits to increasing access to comprehensive gender-sensitive services, as well as increasing the
amount of gender-sensitive policy, legislation and law enforcement.

Complements the Adolescent Reproductive Health Policy and promotes adolescent-focused
interventions, including increasing access to youth-friendly reproductive health services and developing
in and out of school peer education projects.

Commits to expanding access to gender-focused and youth-friendly voluntary counselling and testing.

Commits to scaling prevention of mother-to-child transmission services and integrating voluntary
counselling and testing into all antenatal/reproductive health clinics. Places high priority on nationwide
access to antiretroviral therapy for all pregnant women living with HIV.

Promotes integrating HIV and AIDS education into the curricula of schools (beginning at the
primary/basic level) and developing peer education. The government has developed a curriculum on
Family Life Education, addressing relevant knowledge, skills and attitudes.

However, it is not being implemented in all schools and there are concerns about lack of political will
and resources, including trained personnel.

 The adolescent health policy, national reproductive health policy, sexuality curriculum for secondary
schools, HIV and AIDS policy and plan of action are all aimed at making HIV prevention for youths better.
However, implementation of the policies has been a problem.

The adolescent reproductive health policy emphasizes safer sex among young people, especially girls, to
protect them from HIV and other sexually transmitted infections.
The federal government has a curriculum for family life and HIV and AIDS education. It has been
approved for use in the schools, but only Lagos is fully using it, while other states are not using it yet.

The government has developed a comprehensive curriculum for all level,. but implementation has been
slow, due to an inadequate number of trained teachers, poor funding and resistance from stakeholders.

There are policies that sit on government shelves, but no clear-cut laws that make HIV prevention easy.

AVAILABILITY OF SERVICES (NUMBER OF PROGRAMMES, SCALE, RANGE, ETC)

As of 2002, some degree of sexual and reproductive health services were available at 8,953 maternity
and primary health care centres, and teaching hospitals.

There are some 228 voluntary counselling and testing centres.

A national programme is scaling up the availability of services for prevention of mother-to-child HIV
transmission from 11 operational sites in 2002 to over 200 sites across the country, including the
Federal capital territory. However, uptake is low. For example, according to data from 2003, only 12% of
pregnant 15-19 year olds were counselled about HIV during an antenatal visit.

The number of sites offering antiretroviral treatment is increasing, with at least 74 centres established.

There are various HIV prevention programmes at the community level with some specifically targeting
young people. However, while some address areas such as life skills and relationships, an increasing
number are predominantly focussed on abstinence and faithfulness, rather than providing a full range of
options for behaviour change. Many projects also suffer from a lack of male involvement and parental
approval.

Most communities do not have voluntary counselling and testing or HIV service centres. These are
located in big hospitals and some NGO centres which provide drugs for infected persons. The problem
with the services is that they are only available in urban cities and some peri-urban areas.

Even if [men] go for voluntary counselling and testing and are found positive, they don't reveal it to their
wives at home. They will be going to the hospital secretly and taking antiretrovirals, but the wives will be
left suffering with one disease or the other since they are not tested.

“All communities must work towards delaying marriage so that girls can get a full education, at least to
secondary school level - so that they can make their own decisions, have some skills in generating
income and not be over-dependant on husbands or liabilities to the family or community.



ACCESSIBILITY OF SERVICES (LOCATION, USER-FRIENDLINESS, AFFORDABILITY, ETC)

Nigeria signed both the Convention on the Rights of the Child and the Convention on the Elimination of
all Forms of Discrimination against Women in January 1990. It has not signed the Convention on Consent
Marriage, Minimum Age of Marriage and Registration of Marriages.
The HIV/AIDS National Strategic Framework and National Policy on HIV/AIDS emphasise the human
rights of people living with HIV, including non-discrimination in relation to education, employment and
access to health care. The Policy cites the denial of HIV and AIDS care and support as unethical and
illegal.

“Girls and young women usually have difficulties adjusting to their new HIV positive status and to the
threat and effects of stigma, especially from their peers, family and friends.

Reducing the stigma of people living with the virus will help HIV prevention services and make them
more accessible.

We need to break the parental barrier of access to services through increased parent-child
communication, with parents respecting the rights of a child and interventions targeting parents with
sexual and reproductive health and HIV information.

The country needs a social reorientation to make every person gender conscious.

TESTING FOR HIV/AIDS

These test check for antibodies to HIV, which appear from four weeks to six months after exposure. The
most common test for HIV is the enzyme-linked immunosorbent assay (ELISA). If the result is positive,
the test is repeated on the same blood sample. Another positive result is confirmed using a more
specific test such as the Western blot. A problem with ELISA is that it produces false positive results in
people who have been exposed to parasitic diseases such as malaria; this is particularly troublesome in
Africa where both AIDS and malaria are rampant. Polymerase chain reaction (PCR) tests, which screen
for viral RNA and therefore allow detection of the virus after very recent exposure, and Single Use
Diagnostic Screening (SUDS) are other options.

TREATMENT OF HIV/AIDS

While no medical treatment cures AIDS, in the relatively short time since the disease was first
recognized, new methods to treat the disease have developed rapidly. Health-care professionals focus
on three areas of therapy for people living with HIV infection or AIDS:

Antiretroviral therapy using drugs that suppress HIV replication.

Medications and other treatments that fight the opportunistic infections and cancers that commonly
accompany HIV infection.

Support mechanisms that help people deal with the emotional repercussions as well as the practical
considerations of living with a disabling, potentially fatal disease.
BEHAVIOUR VS HIV/AIDS

In most countries, the HIV epidemic is related to behaviours that expose individuals to the virus and so
increases the risk of infection. Information about HIV and the level and frequency of risky behaviours
related to the transmission of HIV is pertinent/ important in identifying, and for better understanding of
populations or group of people most at risk for HIV.

Many prevention programs focus on increasing people's knowledge about sexual transmission, hoping
to overcome the misconceptions that may be acting as a disincentive to behavioural change.
Information on behaviours is also critical for assessing changes over time as a result of prevention
efforts.

It is important to collect information on higher risk male-male sex, on sexual behaviour among sex
workers, on both injecting behaviour and sexual behaviour among drug users, and on sexual behaviours
among other groups that may be at higher risk. Finally, sexual behaviours among the general population
and among young people should be of great interest to all groups/ sectors concerned with HIV/AIDS
prevention.

COUNSELLING

Either you are positive or not, try to visit counsellors on HIV/AIDS to help you and others live a healthier
life.

Try to know your HIV status, live responsibly and be determined to achieve an HIV/AIDS free population
beginning with yourself. Dont be ignorant, learn and make use of the facts about HIV/AIDS.

Knowing your HIV status can have two important benefits:

If you learn that you are HIV positive, you can take the necessary steps before symptoms appear to
access treatment, care and support, thereby potentially prolonging your life for many years.

If you know that you are infected, you can take precautions to prevent the spread of HIV to others.



CARE FOR PEOPLE LIVING WITH HIV/AIDS(PLWHA)

“You are great when you love the unlovable and give hope to the hopeless, friendship to the
friendless, and encouragement to the discouraged.”

                  -      Zig Ziglar.

In addition to antiretroviral treatment, people with HIV often need counselling and psycho social
support. Access to good nutrition, safe water and basic hygiene can also help an HIV-infected person
maintain a high quality of life.
We must realize that all PLWHA are people like us who even possibly engaged in less risky behaviours
than we did but still had the virus. We must extend to them our warmth and love, in no way are they
inferior to anyone. HIV/AIDS is not the only form of incurable illness, people have learned to live with
and manage other incurable ones.

PLWHA are very relevant to us and the society in general. It is worthy of note that many victims die as a
result of psychological trauma occasioned by societal stigmatization.

People Live What They Learn;

If People living with HIV live with criticism,

They learn to condemn.

If People living with HIV live with hostility,

They learn revenge.

If People living with HIV live with ridicule,

They learn to feel inferior.

If People living with HIV live with shame,

They learn to feel guilty.

If People living with HIV live with encouragement,

They learn confidence.

If People living with HIV live with praise,

They learn to appreciate.

If People living with HIV live with fairness,

They learn justice.

If People living with HIV live with security,

They learn faith.

If People living with HIV live with-out discrimination,

They learn to like themselves.

If people living with HIV live without stigmatization,

They learn to love the world.
If People living with HIV live with acceptance and friendship,

They learn to be happy.



RECOMMENDATIONS

A number of programmatic, policy and funding actions could be recommended to enhance HIV
prevention in the most hard-hit countries. These are what key stakeholders – including government,
relevant intergovernmental and non-governmental organisations, and donors – should consider.

Review and strengthen action on the aspects of the Political Declaration on HIV/AIDS.

Strengthen and/or introduce measures within the country's legal systems to protect against marriage
before the age of 18 years.

Significantly strengthen and/or introduce comprehensive gender-sensitive legislation and policies to
ensure a comprehensive definition of gender-based violence (that includes marital rape) and enshrine
the rights of all girls and young women, including access to sexual and reproductive health services.

Ensure a 'core package' of free youth-friendly services is available in at least each major district of more
than 5000 people providing integrated sexual and reproductive health and HIV/AIDS support.

Promote a positive model of voluntary counselling and testing.

Implement a widespread proactive campaign to address the stigmatising and discriminatory attitudes of
health care givers, by systematically incorporating youth-friendly approaches into their training.

Implement a comprehensive rights-based approach to universal access to HIV prevention, treatment,
care and support for sex workers.

Scale up universal access to antiretroviral therapy, while also promoting positive prevention. Ensure that
girls and young women living with HIV can receive treatment in an environment that not only addresses
their HIV status, but recognizes their needs in relation to their gender and age.

Implement a prepared curriculum on Family Life and HIV/AIDS Education as a priority in all primary,
secondary and tertiary educational establishments.

Promote models of HIV prevention programmes that offer adolescents and young people wider choices
that include, but go beyond, abstinence.

Complement HIV prevention efforts with young people by raising awareness among parents, traditional
and religious leaders about the validity and importance of girls and young women being empowered to
protect themselves from HIV infection and to access services.
Facilitate the empowerment and participation of girls and young women, especially those living with
HIV, in national planning and programming relating to HIV and AIDS.

Support programmes that work through existing young people and HIV/AIDS groups and networks to
build members' capacity in both life skills (such as self esteem and negotiation) and advocacy skills (such
as decision-making and public speaking).




A Future Worth Beholding...
I imagine a day when the old will say, “a long time ago, there was a virus that killed people, destroyed
businesses, and affected the economy negatively. People contacted it by any form of blood contact.
The virus was HIV, but now it's no more”.

I imagine a day when the World Health Organisation, United Nation, health related organisations, and
all countries of the world will count the cost they had spent combatting HIV/AIDS, and they will say
“though it's much, but the virus is no more”.

I imagine a day when all the scientist, and other forms of professionals that have been dedicated to
the research, education and awareness will rejoice because the virus is no more.

I see a day when the major caption on television and newspapers will be “ No more HIV/AIDS cases”.

Imagine a world free from HIV/AIDS.

It begins with you.




                              Everyone should know that there is more to

                                  HIV/AIDS than just unprotected sex.

                                    There is not a type of person that

                                        cannot contact HIV/AIDS;

                                              ANYONE CAN.
REFERENCES

Iwuagwu, S., Durojaye, E., Oyebola, B., Oluduro, B., and Ayankogbe, O. (2006) HIV/AIDS and Human
Rights in Nigeria - Background Paper for HIV/AIDS Policy Review in Nigeria. Federal Government of
Nigeria National Policy on HIV/AIDS.

U.S Department of State, Country Reports on Human Rights Practices (2003).

Nigerian National HIV & AIDS Policy, HIV/AIDS National Strategic Framework for Action (2005-2009).

Nigeria: What You Should Know About Condoms (2006). www.allafrica.com.

Encyclopedia Britanica (2006)

Encarta Microsoft (2009)

World Health Organization: www.who.int
HEALTH ACTIONS CONCERNING THE ENVIRONMENT AND YOU (HACEY)

HACEY is a non-governmental organization formed to create a coalition of caring individuals who have
committed consistently to inform people on issues concerning their health and environment.

Specifically, we are aggressively working to make a difference in the quality of life for the child,
adolescent, youths, adults including students of various institutions ( primary, secondary, and tertiary),
and also the rural communities.

HACEY is dedicated to providing the finest resources for education, training and development for all
members of our society.

Our Vision

To become a leading centre that empowers youths and adults for the total development of their being-
physically, psychologically and emotionally.



Information on our Most Recent Programmes

NOV. 30TH & DEC. 1ST 2007- HACEY organised a world AIDS day event, where students from different
schools ( secondary and tertiary) and also members of the general public were informed on the subject-
HIV/AIDS- CHALLENGES AND CHANCES. It was a great atmosphere for education, entertainment, talent
shows and empowerment as the message was passed across in its best form.

FEB. 2008- HACEY hosted a speech contest among university students. This programme served as a
medium to inform the students on issues concerning carbon dioxide and the environment (green house
effect), and also on the effects of cosmetics on the body- the good, the bad and the ugly. It was a peer
educative forum.

APRIL. 2008 – HACEY went to various places in Ilorin, Kwara state, Nigeria to educate members of the
general public on the effect of climate change on health.

DEC. 2008- Our 2nd world AIDS day programme, it was educative and informative, it featured lectures,
music, drama, competition, comedy, and interactive session and students. Everyone expressed
themselves freely.

Opportunity to Help

HACEY CREATIVITY CENTER - At HACEY, a music club, drama club and readers club are organized to train
and empower the youth in the emerging field of health and environmental protection.

In addition to this we train student in various schools to become peer educators and help them organize
health programmes.
PROTECT YOUR ENVIRONMENT- This programme is a campaign we organize at HACEY that promotes
environmental protection as the duty of everyone. We go to schools, offices, and the media to pass the
message.

AT YOUR DOORSTEP- This is a village outreach programme that we undertake at HACEY in different
villages across the country giving them information to increase their quality of life

THE CARE APPROACH- At HACEY, we go to the homeless and the prisons to inform them on various
health and environmental issues. We also organize training programmes that empower them to be good
readers, writers, and speakers. In addition to this, we also use the effort of our creativity centre to
develop their talents.

GREAT PEOPLE and GREAT LIFE - At HACEY, we organize a a special programme for underprivileged
people training them on different vocation. It also involves a behavioural lesson to build their self-
esteem.

For more information about joining HACEY visit- www.hacey.org or email- info@hacey.org

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Hiv book future of infected and affected

  • 1.
  • 2.
  • 3. HIV/AIDS: The future of the Infected & Affected An HACEY Book All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means; electronic, mechanical, photocopying, or otherwise without the prior written permission of the publisher. Published by HACEY For further information on HACEY Publications, visit our website: www.hacey.org or contact info@hacey.org Script editors: Rhoda Robinson & Adah Aaron Cover design: Richard Akinwumi, HACEY Technical Director
  • 4. Table of content Preface Acknowledgements Dedication Foreword Part 1 - Introduction - Africa's struggle against AIDS - Historical perspective Origin of AIDS virus AIDS identified - Prevalence On the global scene Presently in Africa Presently in Nigeria - AIDS VS HIV - HIV/AIDS VS Ignorance - Cause of AIDS - How HIV infection spreads - Symptoms of AIDS Opportunistic infections Symptoms in children
  • 5. Part 2 - Infected vs Affected - Social and cultural perspective - Stigmatization and discrimination - Burdens of HIV/aids Part 3 The urgency of the task Prevention of HIV/AIDS HIV prevention for youths in Nigeria Testing for HIV/AIDS Treatment of HIV/AIDS Behaviour vs HIV/AIDS Counselling Care for people living with HIV/AIDS (PLWHA) Recommendations A future worth beholding
  • 6. PREFACE It is said that 'ignorance is the greatest threat to the human race'. The human race faces a greater threat than that which is posed by ignorance at the discovery of the HIV/AIDS, because the HIV/AIDS has successfully used ignorance amongst other things to aid its global spread. Our world cannot afford to overlook the damage already done, our continent- Africa has been the most hard-hit, the plague of HIV/AIDS stare at us like death. The negative impact of HIV/AIDS is on the rise; businesses are collapsing, agriculture cannot sustain hunger anymore, the standard of education is deteriorating by the day, families are falling apart, children- 'leaders of tomorrow', are dying today- sub-Saharan Africa can tell the full story. Everybody is affected, millions that are infected are on the rise- what future does tomorrow hold if HIV/AIDS has claimed the life of millions who have dreams and aspirations to make our world better. The essence of this book is to help everyone realise the plight of the infected and the affliction of the affected, the hope in the future, and the urgency of the task ahead. Sure there is a way out, only if you and I will act now!!!
  • 7. ACKNOWLEDGEMENTS Whatever we become in life cannot be detached from the source and sustainer of all potentials, the omnipotent one, and our saviour, the Lord Jesus Christ- your backing has made us high fliers in the race of life. Special gratitude to Dr (Mrs) V.A . Olatunji, those moments spent with you during the writing of this book was an eternal investment. Your understanding, love and support are great. Special recognition to that lovely boy Fulfilment. Thanks to the Owolabi family (Mr & Mrs G. A. Owolabi), your training, discipline, and care has contributed greatly to the success of this book. Special thanks to Professor and Mrs A.O Soladoye. Your exemplary leadership is worth emulating, you are an epitome of excellence. Thanks to Otunba Olusola Adekanola, your support for this project is profoundly appreciated. Finally, we greatly appreciate all members of HACEY, your ideas, support, dedication and interest in making our world a healthier place is of immense value, and these you have displayed as you provided an enabling atmosphere during the course of writing this book. Always remember that you are great.
  • 8. DEDICATION This book is dedicated to the millions of infected and affected individuals all over the world, particularly in Africa.
  • 9. FOREWORD It is with great delight that I write the foreword to this book because the publication represents the beacon of logic in an apparently logicless situation which is claiming the lives of our youths. Rather than bemoan the pathetic situation, our youths have faced the challenges of the HIV/AIDS pandemic to add their voice through the provision of knowledge, resource material, health education, talks, seminars and counselling. Only education with good material, material based on the truth about HIV/AIDS in which the youths themselves play active parts, can significantly command the attention of the young victims in order to stem the tide of HIV/AIDS scourge. The publication is therefore recommended to all our youths and indeed to the society at large who are committed to fighting the HIV/AIDS pandemic. Professor Ayo Soladoye November, 2008
  • 10. PART 1 Have you ever imagined a virus so subtle you wouldn't know it's there? Can you imagine an organism so skilled in the art of sabotage you don't recognise its presence till its too late? HIV; it steals into a body as a spy sneaks into enemy's territory, making its way stealthily till it reaches its targets. It infiltrates the defence system and causes so much damage the system self-destructs. But alas! It isn't destroyed, rather the explosion spreads it to other defence bunkers till it destroys them all. HIV; it comes in when you least expect it. Just a slight mistake and it slithers in like a snake. It weaves through vessels and past cells till it gets to its destination, and like a poisonous snake, strikes with precision and the intent to kill. HIV; like a thief at night, it forces itself into our lives, and steals our health and joy, leaving behind misery. It comes and makes the way ready for other illnesses to reign. It makes us vulnerable to the slightest attack, a once strong body becomes a struggling weakling. HIV, the bane of the society. Beware! One unguarded moment can ruin your life.
  • 11. INTRODUCTION Acquired Immunodeficiency Syndrome (AIDS) is a human viral disease that ravages the immune system, undermining the body's ability to defend itself from infection and disease. It is caused by the human immunodeficiency virus (HIV). AIDS leaves an infected person vulnerable to opportunistic infections— infection by microbes that take advantage of a weakened immune system. Such infections are usually harmless in healthy people but can be life-threatening to people with AIDS. Although there is no cure for AIDS, new drugs are available that can prolong the life span and improve the quality of life of infected people. When AIDS emerged from the shadows two decades ago, few people could predict how the epidemic would evolve, and fewer knew ways of combating it. Now, at the start of a new millennium, we are past the stage of conjecture. We know from experience that AIDS can devastate whole regions, knock decades off national development, widen the gulf between rich and poor nations and push already stigmatized groups closer to the margins of society. This piece is all about a future where there is hope and joy, and we will like to start by reviewing the struggles of a continent against AIDS. Africa has the highest percentage of people living with HIV/AIDS. AFRICA'S STRUGGLE AGAINST AIDS Sub-Saharan Africa moved into the 21st century carrying the crippling burden of AIDS, “a disease that is slashing life expectancy, shattering families, pushing industries to the brink of bankruptcy, and creating a generation of orphans”. This disease was by far the leading cause of death among adults in much of the continent at the end of 1999, and yet it was virtually unknown just two decades ago. A 70% of the 33.6 million people living with HIV live in African nations, south of the Sahara, a region that accounts for just 10% of the world's population. A year's course of existing HIV treatment therapies for a single person costs 20 times the average per capita income for the region. Without such therapies most of those presently infected will die within the next 10 years. They will join the 14 million Africans who have already died of HIV-related illnesses according to estimates made at the end of 1999 by the Joint United Nations Programme on HIV/AIDS and the World Health Organization). Early attempts to measure the size of the epidemic by calculating backwards from registered AIDS cases and deaths failed because of confusion over what constitutes an AIDS case, a lack of diagnostic facilities, reluctance to report AIDS as a cause of death because of the stigma associated with the disease, and poor health reporting systems. Explanations for the rapid spread of HIV in sub-Saharan Africa remains an issue, though the expansion of the epidemic itself has been well documented. It is known that it is easier both to contract and to pass on the virus if a person is also suffering from another sexually transmitted disease (STD). Prevalence of other STDs is high in much of the continent, and poor access to health facilities means they are less likely to be promptly treated and cured than in richer parts of the world. High fertility and near-universal breast-feeding contribute to the transmission of HIV from mothers to children in Africa—nearly half a
  • 12. million children are born with HIV in Africa each year, compared with 70,000 in the rest of the world. Large studies of sexual behaviour also suggests that sexual activity begins very early, with high proportions of both men and women having premarital partners, and that extramarital sex is common, especially among men. The pattern of HIV infection is not consistent across the continent. East Africa was the first area to suffer a major onslaught of HIV and then AIDS. Some countries in this region, notably Uganda, have been rewarded for extremely active preventive efforts by a fall in new infections in their youngest age groups. In others, such as Kenya, HIV prevalence rates continue a gradual but steady rise. The most explosive growth has been in the countries of southern Africa. It is estimated that close to one adult in five aged between 15 and 49 is currently infected with HIV in Botswana, Lesotho, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe. West Africa, on the other hand, is less affected by HIV. Information for populous Nigeria is at best sketchy and Côte d'Ivoire is known to be badly affected, but HIV prevalence among adults in most West African countries is probably 5% or less. Recent studies have suggested that these differences may be related in part to near-universal male circumcision in many areas of West Africa. High proportions of men are infected with HIV in some countries where circumcision is common. Economic structure may also contribute to patterns of infection. Large concentrations of men who are separated from their families to work in mining, commercial agriculture, transport and other industries tend to provide a ready market for sex workers, who highly contribute to the rapid spread of HIV because of high partner turnover. When these men go to visit their families, they carry the infection back into rural areas. The increase in labour mobility following the end of apartheid in South Africa has doubtless contributed to the rapid spread of HIV. Many efforts have been made to estimate the impact of HIV/AIDS on the economies of Africa, with little result. Many of the continent's economies are unstable, and all are subject to a vast array of influences that are both independent of the AIDS epidemic and interdependent with it. However, an increase in death rates among economically productive adults will affect economic well-being at many levels. The easiest effect to measure is probably at the company level. In Kenya several firms report that medical payments have increased 10- folds in the past decade, while illness and death have leapt from last to first place among reasons for employees' leaving the workforce. At the family level one of the most visible impacts is the growth in the number of surviving children who must grow up and make a living without the financial or emotional support of their parents. UNAIDS estimates that by the end of the century 10.7 million children in Africa will have lost their mothers or both their parents to AIDS before they reach their 15th birthday. Can nothing be done to stop the relentless spread of HIV, the incapacitating illness, and funerals across Africa? Some countries, notably Uganda and Senegal, have managed to arrest and even reverse the march of AIDS. Their epidemic situations differ, but the responses share common characteristics, very strong leadership at the highest political level, public acknowledgement of the epidemic and the behaviours that spread it, efforts to reduce the stigma associated with HIV, active involvement of community and religious leaders in prevention activities, widespread provision of services, including STD treatment combined with counseling and voluntary HIV testing, and massive efforts to respond to the information and sexual health needs of young people. In other countries, these responses have been
  • 13. diluted by the refusal of leaders to promote sexual behavioural change. Unless efforts are made to emulate the continent's prevention successes, the future for much of sub-Saharan Africa is stark. As South African former president, Thabo Mbeki put it, “For too long we have closed our eyes as a nation [to HIV]. By allowing HIV to spread, our dreams as a nation will be shattered.” HISTORICAL PERSPECTIVE Origin of the HIV Using computer technology to study the structure of HIV, scientists have determined that HIV originated around 1930 in rural areas of Central Africa, where the virus may have been present for many years in isolated communities. The virus probably did not spread because members of these rural communities had limited contact with people from other areas. But in the 1960s and 1970s, political upheaval, wars, drought, and famine forced many people from these rural areas to migrate to cities to find jobs. During this time, the incidence of sexually transmitted infections, including HIV infection, quickly spread throughout Africa. As world travel became more prevalent, HIV infection developed into a worldwide epidemic. Studies of stored blood from the United States suggest that HIV infection was well established there by 1978. AIDS Identified Beginning in June 1981, the Centre for Disease Control and Prevention(CDC) published reports on clusters of gay men in New York and California who had been diagnosed with pneumocystic pneumonia or Kaposi's sarcoma. These two rare illnesses had previously been observed only in people whose immune systems had been damaged by drugs or disease. These reports triggered concern that a disease of the immune system was spreading quickly in the homosexual community. Initially called gay-related immunodeficiency disease (GRID), the new illness soon was identified in population groups outside the gay community, including users of intravenous drugs, recipients of blood transfusions, and heterosexual partners of infected people. In 1982 the name for the new illness was changed to Acquired Immunodeficiency Syndrome, or AIDS. On the Global Scene Efforts to combat the impact of AIDS is on every day. In the developed countries, the number of people living with the virus is reducing from few to none, as almost everyone is aware because of high level of education and information; yet, the truth must never be neglected. Many are still loosing their precious lifes due to this virus; no nation can be said to be totally secured as there is always a possibility of migration between citizens of any nation of the world. Since 2001, when the United Nations Declaration of Commitment on HIV/AIDS was signed, the number of people living with HIV in Eastern Europe and Central Asia has increased by more than 150% from 630 000 [490 000 – 1.1 million] to 1.6 million [1.2 – 2.1 million] in 2007. In Asia, the estimated number of people living with HIV in Vietnam has more than doubled between 2000 and 2005, with Indonesia having the fastest growth of the epidemic.
  • 14. While cases of AIDS have been reported in every nation of the world, the disease affects some countries more than others. About 90 percent of all HIV-infected people live in the developing world. AIDS has struck sub-Saharan Africa particularly hard. Two-thirds of all people living with HIV infection reside in African countries south of the Sahara, where AIDS is the leading cause of death. New data shows that global HIV prevalence has levelled off, and that the number of new infections has fallen, partly as a result of the impact of HIV programmes. However, in 2007 33.2 million [30.6 – 36.1 million] people were estimated to be living with HIV, 2.5 million [1.8 – 4.1 million] people became newly infected and 2.1 million [1.9 – 2.4 million] people died of AIDS. In countries hardest hit, AIDS has sapped the population of young men and women who form the foundation of the labor force. Most die while in the peak of their reproductive years. Moreover, the epidemic has overwhelmed health-care systems, increased the number of orphans, and caused life expectancy rates to plummet. These problems have reached crisis proportions in parts of the world already burdened by war, political upheaval, or unrelenting poverty. Presently in Africa... As with any epidemic for which there is no cure, tragedy shadows the disease's progress. From wreaking havoc on different populations, to infecting more than one-third of adults in sub-Saharan African countries such as Botswana, Swaziland, and Zimbabwe at the turn of the 21st century, AIDS has had a devastating social impact. In Zimbabwe the economy had lagged throughout the 1990s as inflation soared, and a high level of unemployment led to significant unrest. This political and economic turmoil took place as the spread of AIDS in Zimbabwe reached epidemic proportions. By the beginning of the 21st century, 1 in 4 adult Zimbabweans was infected, life expectancy had fallen to below 40 years, and hundreds of thousands of children had been left orphans. In Botswana, the spread of AIDS has had a devastating effect, where the rate of infection has been one of the highest in the world; by 2000 more than one-third of the adult population had been infected with HIV, and the growing number of AIDS orphans loomed as a serious social problem. There were an estimated 1.7 million [1.4 – 2.4 million] new HIV infections in sub-Saharan Africa in 2007—a significant reduction since 2001. However, the region remains most severely affected. An estimated 22.5 million [20.9 – 24.3 million] people living with HIV, or 68% of the global total, are in sub-Saharan Africa. Eight countries in this region now account for almost one-third of all new HIV infections and AIDS deaths globally. High and stable HIV prevalence rates are bad news, but there is worse news - Prevalence rates do not reflect the true impact of the epidemic. Across the quadrant of Africa, this nightmare is real, the ultimate tragedy is that so many people do not know, or do not want to know what is happening. As AIDS virus sweeps mercilessly through the land, few try to confront the present situation. Many run away from it, yet children are dying, hospital beds are filled with the sick, parents are not spared, and some still feel its due to metaphysical powers. About 90% of all HIV-infected people live in the developing world.
  • 15. Presently in Nigeria... With a population of 140 million people, Nigeria is the largest country in Africa and accounts for 47 percent of West Africa's population. Nigeria's population is made up of about 200 ethnic groups, 500 indigenous languages, and two major religions ― Christianity and Islam. Nigeria is also the second largest economy in sub-Saharan Africa and accounts for 41 percent of the region's GDP. Government reports claim that over 300,000 Nigerians die yearly of complications arising from AIDS, and over 1.5 million children are said to be orphaned annually. Over 40% of Nigeria's population is under 15 years old. Young people account for over 30% of HIV cases, with prevalence nearly three times higher among 15-24 year old females than males. The factors that increase girls' and young women's vulnerability include early marriage, early sexual debut, and polygamous relationship (with nearly a third of 15-24 year old females having had sex with a casual partner in the last 12 months). The factors also include poor economic opportunities, lack of negotiation skills for sex and condom use, mixed messages around public acceptability of condom use, and lack of basic information (with only 18% of females aged 15-24 years identifying ways to prevent HIV). Official figures put the steady rise in HIV prevalence rate from 1.8% in 1988 to 5.8% in 2001, 5.0% in 2003, 4.4% in 2005 and 5% in 2007, showing the treatment is failing and HIVs are becoming AIDS rapidly. The average life span of a commoner has dropped to the lowest level - It is 44 Years in Nigeria due to the impact of AIDS. Lack of sincerity, poor fund administration, unclear motives and lax attitude of government officials have made situation worse. HIV VS AIDS This segment seeks to clarify the difference between the term 'HIV' and 'AIDS'. People often misuse these words or exchange one for the other. HIV The human immunodeficiency virus (HIV) infects cells of the immune system, destroying or impairing their function. Infection with the virus results in the progressive deterioration of the immune system, leading to "immune deficiency." The immune system is considered deficient when it can no longer fulfill its role of fighting infection and disease. Infections associated with severe immunodeficiency are known as "opportunistic infections," because they take advantage of the weakened immune system. AIDS Acquired immunodeficiency syndrome (AIDS) is a surveillance term defined by the United States Centre for Disease Control and Prevention (CDC) and by the European Centre for the Epidemiological Monitoring of AIDS (EuroHIV). The term AIDS applies to the most advanced stages of HIV infection, defined by the occurrence of any of the over 20 opportunistic infections or HIV-related cancers.
  • 16. HIV/AIDS VS IGNORANCE Ignorance, it is said, is the greatest threat to the human race and every society pays for it. The AIDS pandemic has been able to effectively utilise ignorance to enhance its spread, the intention of this segment is to correct misconceptions about HIV/AIDS. TRUTH: If you dont have HIV, you can't get AIDS, if you have AIDS you already have the virus (HIV). AIDS is not caused by drugs, government conspiracies, metaphysical (spiritual) powers, or anything else but a virus (HIV). You can't get HIV/AIDS through casual contacts like hugging, touching, handshakes or staying in the same office or house with people living with HIV/AIDS. You can't get HIV/AIDS from mosquito bite or other blood sucking insects. You can't get HIV/AIDS from sharing utensils like cups, spoons and plates. You cannot know a person's status from his/her appearance, someone can feel healthy and look good yet be infected. Newborn babies can be infected by their mothers during pregnancy, at birth or through breastfeeding. HIV can be transmitted by all forms of sexual intercourse (oral, anal, and genital). HIV is not spread by coughing or sneezing. HIV is preventable but not yet curable. CAUSE OF AIDS AIDS is the final stage of a chronic infection with the HIV. There are two types of this virus: HIV-1, which is the primary cause of AIDS worldwide, and HIV-2, found mostly in West Africa. Inside the body HIV enters cells of the immune system, especially white blood cells known as T cells (lymphocytes). These cells orchestrate a wide variety of disease-fighting mechanisms. Particularly vulnerable to HIV attack are the specialized “helper” T cells known as CD4 cells. When HIV infects a CD4 cell, it commandeers the genetic materials within the cell to manufacture new HIV virus. The newly formed HIV virus then leaves the cell, destroying the CD4 cell in the process. The cure to HIV/AIDS is possible by knowledge and behavioural changes. The loss of CD4 cells endangers health because these cells help other types of immune cells respond to invading organisms. The average healthy person has over 1,000 CD4 cells per microliter of blood. In a person infected with HIV, the virus steadily destroys CD4 cells over a period of years, diminishing the cells' defensive ability and weakening the immune system. When the density of CD4 cells drops to 200
  • 17. cells per microliter of blood, the infected person becomes vulnerable to AIDS-related opportunistic infections and rare cancers, which take advantage of the weakened immune defenses to cause disease. HOW HIV INFECTION SPREADS Scientists have identified three ways that HIV infection spreads: through unprotected sexual intercourse with an infected person, contact with contaminated blood, and transmission from an infected mother to her child before or during birth or through breast-feeding. Furthermore, HIV is frequently spread among intravenous drug users and cultist who share needles or syringes, blades and any other form of sharp objects. In some cases transmission to health care givers may occur by an accidental prick with a needle used to obtain blood from an infected person- a reason for carefulness on the side of all health givers. SYMPTOMS OF AIDS Without medical intervention, AIDS progresses along a typical course. Within one to three weeks after infection with HIV, most people experience flu-like symptoms such as fever, sore throat, headache, skin rash, tender lymph nodes, and a vague feeling of discomfort. These symptoms last one to four weeks. During this phase, known as acute retro viral syndrome, HIV reproduces rapidly in the blood. The virus circulates in the blood throughout the body, particularly concentrating in organs of the lymphatic system. The normal immune defenses against viral infections eventually get activated to battle HIV in the body, reducing but not eliminating HIV in the blood. Infected individuals typically enter a prolonged asymptomatic phase, a symptom-free period that can last ten years or more. While persons who have HIV may remain in good health during this period, HIV continues to replicate, progressively destroying the immune system. Often an infected person remains unaware that he or she carries HIV and unknowingly transmits the virus to others during this phase of the infection. When HIV infection reduces the number of CD4 cells from around 500 to 200 per microliter of blood, the infected individual enters an early symptomatic phase that may last a few months to several years. HIV- infected persons in this stage may experience a variety of symptoms that are not life-threatening but may be debilitating. These symptoms include extensive weight loss and fatigue (wasting syndrome), periodic fever, recurring diarrhea, and thrush- a fungal mouth infection. An early symptom of HIV infection in women is a recurring vaginal yeast infection. Unlike earlier stages of the disease, in this early symptomatic phase the symptoms that develop are severe enough to cause people to seek medical treatment. Many may first learn of their infection in this phase. Opportunistic Infections The second phase of HIV infection, the asymptomatic period, lasts an average of 10 years. During this period the virus continues to replicate, and there is a slow decrease in the CD4 count (the number of
  • 18. helper T cells). When the CD4 count falls to about 200 cells per microlitre of blood (in an uninfected adult it is typically about 1,000 cells per microlitre), patients begin to experience opportunistic infections i.e., infections that arise only in individuals with a defective immune system. This is AIDS, the final stage of HIV infection. The most common opportunistic infections are tuberculosis, pneumonia, Mycobacterium avium infection, herpes simplex infection, toxoplasmosis, and cytomegalovirus infection. In addition, patients can develop dementia and certain cancers, including Kaposi sarcoma and lymphomas. Death ultimately results from the relentless attack of opportunistic pathogens or from the body's inability to fight off malignancies. A small proportion of individuals infected with HIV have survived longer than 10 years without developing AIDS. It may be that such individuals mount a more vigorous immune response to the virus or that they are infected with a weakened strain of the virus. Symptoms in Children HIV infection in children progresses more rapidly than in adults, most likely because a child's immune system has not yet built up immunity to many infectious agents. The disease is particularly aggressive in infants—more than half of infants born with an HIV infection die before age two. Once a child is infected, the child's undeveloped immune system cannot prevent the virus from multiplying quickly in the blood and the disease progresses rapidly. In contrast, when an adult becomes infected with HIV, the adult's immune system generally fights the infection. Therefore, HIV levels in adults remain lower for an extended period, delaying the progression of the disease. Children develop many of the opportunistic infections that befall adults but also exhibit symptoms not observed in older patients. Among infants and children, HIV infection produces wasting syndrome and slows growth (generally referred to as failure to thrive). HIV typically infects a child's brain early in the course of the disease, impairing intellectual development and coordination skills. While HIV can infect the brains of adults, it usually does so toward the later stages of the disease and produces different symptoms. Children show a susceptibility to more bacterial and viral infections than adults. More than 20 percent of HIV-infected children develop serious, recurring bacterial infections, including meningitis and pneumonia. Some HIV-infected children suffer from repeated bouts of viral infections, such as chicken pox. Healthy children generally develop immunity to these viral illnesses after an initial infection.
  • 19. PART 2 He was a little boy living in a big city. Though his parents where rarely around, he didn't really feel their absence. All the love and care he needed was given by his aunt. Most people thought she was his mother, and he couldn't have cared less if they did, because sometimes he wished she was. He grew up with this love and for a long time couldn't think of ways to say thank you to his aunt. Then he decided, as he left secondary school to give her a gift. When he was older and could afford it, he would build her the finest house there was, in the best place there is. He struggled and worked, determined to attain his dream, and say thank you to his loving aunt. Meanwhile, each time he came home for a school break, he would give her a small gift with a note attached saying “something big is on its way”. He came home one day to find her very sick and after some time, his aunt passed away. Like a nightmare he couldn't awaken from, he was told she had been HIV positive. Her husband had believed it was metaphysical and they had only gone for the test shortly before she died. He had lost the focus of his dream. As tears streamed from his eyes, he couldn't see the point of his struggles anymore. There was no point in building the house anymore. AIDS had claimed the life of his dearly beloved aunt, and had killed his dream. Health is a precious thing, and the only one, in truth, which deserves that we employ in its pursuit not only time, sweat, trouble, and worldly goods, but even life... As far as I am concerned, no road that would lead us to health is either arduous or expensive. -Michel de Montaigne (1533 - 1592)
  • 20. INFECTED VS AFFECTED The Infected These are the People Living With HIV/AIDS (PLWHA), they are greatly challenged in every society. They experience feelings of rejection and isolation because many people show negative attitude towards them. Remember that PLWHA have the same right as everyone therefore they deserve to be treated with respect and fairness, regardless of how they became infected. The Affected Everybody is at risk of HIV, either directly or indirectly. Directly, anyone who is not careful enough can be infected. Some people are at special risk of HIV infection, they include commercial sex workers, homosexuals, cultists, etc. Indirectly, everyone is affected. The raging inferno of HIV/AIDS is enough to tell its impact on population, health, agriculture, education, and business development. Millions of dollars are invested each year in different countries of the world to combat HIV/AIDS. Imagine how many jobs this could create, and how many infrastructure it would put in place. Since the early 1990s, it has been clear that HIV would help undermine development in countries badly affected by the virus. Warnings about falling life expectancy, increasing numbers of orphans, extra costs for business and the destruction of family and community structures are not new. These effects are becoming increasingly visible in the hardest-hit region of all - sub-Saharan Africa - where HIV is now deadlier than war itself: in 1998, 200 000 Africans died in war but more than 2 million died of AIDS. AIDS has become a full-blown development crisis. Its social and economic consequences are felt widely not only in health but in education, industry, agriculture, transport, human resources and the economy in general. This wildly destabilizing effect is also affecting the already fragile and complex geopolitical systems. Even if you say you are not infected, think about the number of orphans that have become criminals because of this pandemic, imagine the number of business that have collapsed due to the fact that the sole owner died of AIDS leaving the employees to their fate of joblessness. On the long run, no nation or human can claim freedom until everybody is free. SOCIAL AND CULTURAL PERSPECTIVE Its collateral cultural effect has been no less far-reaching, sparking new research in medicine and complex legal debates, as well as intense competition among scientists, pharmaceutical companies, and research institutions. Since the mid-1980s, the International AIDS Society has held regular conferences at which new research and medical advances were discussed. In order to raise public awareness, advocates promote the wearing of a loop of red ribbon to indicate their concern. Activist groups lobby governments for funding for education, research, and treatment, and support groups provide a wide range of services including medical, nursing and hospice care, housing, psychological counseling, meals, and legal services. Those who have died of AIDS have been
  • 21. memorialized in the more than 44,000 panels of the AIDS Memorial Quilt, which has been displayed worldwide both to raise funds and to emphasize the human dimension of the tragedy. The United Nations designated December 1 as World AIDS Day. Regarding access to the latest medical treatments for AIDS, the determining factors tend often to be geographic and economic. Simply put, developing nations often lack the means and funding to support the advanced treatments available in industrialized countries. On the other hand, in many developed countries specialized health care has caused the disease to be perceived as treatable or even manageable. This perception has fostered a lax attitude toward HIV prevention, which in turn has led to new increases in HIV infection rates. Because of the magnitude of the disease in Africa, sub-Saharan Africa in particular, the governments of this region have tried to fight the disease in a variety of ways. Some countries have made arrangements with multinational pharmaceutical companies to make HIV drugs available in Africa at lower costs. Other countries, such as South Africa, have begun manufacturing these drugs themselves instead of importing them. Plants indigenous to Africa are also being scrutinized for their usefulness in developing various HIV treatments. In the absence of financial resources to pay for new drug therapies, many African countries have found education to be the best defence against the disease. In Uganda, songs about the disease, nationally distributed posters, and public awareness campaigns starting as early as kindergarten have all helped to stem the spread of AIDS. Prostitutes in Senegal, the clergy, including Islamic religious leaders, work to inform the public about the disease. Other parts of Africa have however seen little progress. For instance, the practice of sexually violating very young girls has developed among some HIV-positive African men because of the misguided belief that such acts will somehow cure them of the disease. Only better education can battle the damaging stereotypes, misinformation, abnormal behaviour and disturbing practices associated with AIDS. In the United States, some communities have fought the opening of AIDS clinics or the right of HIV-positive children to attend public schools. Several countries—notably Thailand, India, and Brazil— have challenged international drug patent laws, arguing that the societal need for up-to-date treatments supercedes the rights of pharmaceutical companies. At the start of the 21st century many Western countries were also battling the reluctance of some governments to direct public awareness campaigns at high-risk groups such as homosexuals, prostitutes, and drug users out of fear of appearing to condone their lifestyles. For the world of art and popular culture, HIV/AIDS has been double-edged. On the one hand, AIDS removed from the artistic heritage many talented photographers, singers, actors, dancers, and writers in the world. On the other hand, as with the tragedy of war and even the horror of the Holocaust, AIDS has spurred moving works of art as well as inspiring stories of perseverance. From Paul Monette's Love Alone, to John Corigliano's Symphony No. 1, to the courage with which American tennis star Arthur Ashe publicly lived his final days after acquiring AIDS from a blood transfusion.
  • 22. STIGMATIZATION AND DISCRIMINATION “ No one can make you feel inferior without your consent.” - Eleanor Roosevelt From the early days of the identification of AIDS, the disease has been powerfully linked to behaviours that are illegal (such as illicit drug use) or are considered immoral by many people (such as promiscuity and homosexuality). Consequently, a diagnosis of AIDS was a mark of disgrace, although medical research revealed that the disease follows well-defined modes of transmission that can affect any person. As the extent of the epidemic unfolded, misinformation about AIDS and how it is transmitted triggered widespread fear of contracting the disease. Some communities responded with hysteria that resulted in violence, and in some African countries neighbours refused to interract with relatives of the infected. In other communities, parents protested when HIV-infected children attended school. In many areas of the world, women in particular may face consequences if their HIV status is discovered. Reports indicate that many HIV-infected women are subject to domestic violence at the hands of their husbands—even if the husbands themselves are the source of infection. As a result, some women in developing nations fear being tested for HIV infection and cut themselves off from medical care and counseling. In addition to social stigma, people infected with HIV must grapple with more immediate concerns—a daily struggle for basic medical care and other basic rights in the face of discrimination and fear because of their HIV status. BURDENS OF HIV/AIDS Household Impacts The few surveys of the impact of having a family member with AIDS show that households suffer a dramatic decrease in income. Decreased income inevitably means fewer purchases and diminishing savings. In urban areas in Côte d'Ivoire, the outlay on school education was halved, food consumption went down 41% per capita, and expenditure on health care more than quadrupled. When family members in urban areas fall ill, they often return to their villages to be cared for by their families, thus adding to the call on scarce resources and increasing the probability that a spouse or others in the rural community will be infected. The Orphans Left Behind Wherever they turn, children who have lost a mother or both parents to AIDS face a future even more difficult than that of other orphans. According to a report published jointly in 1999 by UNICEF and the UNAIDS Secretariat, AIDS orphans are at greater risk of malnutrition, illness, abuse and sexual
  • 23. exploitation than children orphaned by other causes. They must grapple with the stigma and discrimination so often associated with AIDS, which can even deprive them of basic social services and education. So far, the AIDS epidemic has left behind 13.2 million orphans—children who, before the age of 15, lost either their mother or both parents to AIDS. The Toll on Education Education is an essential building block in a country's development. In areas where HIV infection is common, HIV-related illness is taking its toll on education in a number of ways. First, it is eroding the supply of teachers and thus increasing class sizes, which is likely to dent the quality of education. Secondly, it is eating into family budgets, reducing the money available for school fees and increasing the pressure on children to drop out of school and marry or enter the workforce. Thirdly, it is adding to the pool of children who are growing up without the support of their parents, which may affect their ability to stay in school. Skilled teachers are a precious commodity in all countries, but in some parts of the world, they are becoming too sick to work or dying of HIV-related illness long before retirement. Health Sector Under Stress Since the start of the epidemic, 18.8 million children and adults have fallen sick and died and almost twice that number are now living with HIV, with some 5.4 million newly infected people joining their ranks in 1999. As a consequence, the epidemic's impact on the health sector over the coming decade will be predictably greater than in the past two decades combined. However, the increased demand for health care from people with HIV-related illnesses is heavily taxing the overstretched public health services of many developing countries. In the mid-1990s, it was estimated that treatment for people with HIV consumed 66% of public health spending in Rwanda and over a quarter of health expenditures in Zimbabwe. Impact on Agriculture Agriculture is one of the most important sectors in many developing countries, particularly when measured by the percentage of people dependent on it for their living. The effect of AIDS is devastating at family level. As an infected farmer becomes increasingly ill, he and the family members looking after him spend less and less time working on the family's crops. The family begins to lose income from unmarketed or incompletely tended cash crops, has to buy food it normally grows for itself, and may even have to sell off farm equipment or household goods to survive. Impact on business Given the proportion of adults infected with HIV and dying from associated diseases in Africa, it is inevitable that the business sector, as well as families, schools and other sectors, will feel the cost.
  • 24. The Bottom Line: HIV/AIDS is hurting business, family and sustainable development Although the crisis is enormous and its impact devastating, countries and communities across the globe should rally to react to the damage and to counter some of its worst impacts.
  • 25. PART 3 They hadn't eaten all day. Little Tomi had been crying for the past one hour and they didn't know what to do. Ever since mummy died, their lives had been worse. At least when she was alive, they could eat at least once a day. The neighbours stopped coming less than a week after the burial and they had stopped expecting family members to come to their aid. Lara, the eldest of the three, watched as Tomi began to shiver. He was very sick and nothing they did made him better. There was nothing left in the house, and they were sure the landlord would be coming anytime soon. She would fend for what was left of her family. Though no one would employ her, she knew she could make money, all she needed was the right clothes and a lot of make-up. Tomi was sleeping now. The doctor said he had the same thing mummy had. She couldn't imagine how a child so young could get so sick. Mummy had tried to explain why none of the family members would take care of them. Now she understood. But it wasn't their fault mummy was positive, and they weren't positive either except for Tomi, but he was just a year old and couldn't help it. She could hear the landlord coming. She prayed she could find an abandoned building or else they would have nowhere to stay. A knock sounded, it was time to go. The rains had began and finding a building their only hope. As the rains mingled with the tears on her face, her thoughts kept returning to the cause. HIV had stolen their comfort, had stolen their mother, and now it had taken their home. The life they knew had gone and now they were left with nothing. Would there ever be hope for something better someday? AIDS is the most complex, the most challenging, and probably the most devastating infectious disease humanity has ever had to face. And we have faced this disease, head on. We have rallied. –Dr. Magaret Chan DG. World Health Organization
  • 26. THE URGENCY OF THE TASK “The great end of life is not knowledge but action...” - Thomas Henry Huxley Just as clearly, experience shows that the right approaches, applied quickly enough with courage and resolve, can and do result in lower HIV infection rates and less suffering for those affected by the epidemic. An ever-growing AIDS epidemic is not inevitable; yet, unless action against the epidemic is scaled up drastically, the damage already done will seem minor compared with what lies ahead. This may sound dramatic, but it is hard to play down the effects of a disease that stands to kill more than half of the young adults in countries where it has its firmest hold—most of them before they finish the work of caring for their children or providing for their elderly parents. Already, 18.8 million people around the world have died of AIDS, 3.8 million of them children. Nearly twice that many—34.3 million—are now living with HIV. PREVENTION OF HIV/AIDS Without a vaccine for AIDS years away and no cure on the horizon, experts believe that the most effective treatment for AIDS is to prevent HIV infection. The following are preventive measures to stay HIV free- To the School Administrators Comprehensive sex education programmes in all forms. Develop peer education group To the Health Workers Ensure the use of protective clothing and proper instrument disposal. Ensure correct screening of donated blood. Administration of Highly active antiretroviral therapy (HAART). Genital mutilation should be discouraged To the Hairdressers and Barbers Sterilize your hairdressing and barbing equipments. use hand gloves. Encourage your clients to use their personal clippers.
  • 27. To the Married Be faithful to your partner. To the Unmarried Abstinence is the best form of prevention. To the Child Do not share or play with sharp objects. To the Infected You are not inferior to anyone Go for counselling and take proper medication To the Affected Don't stigmatize or discriminate the infected Be careful To the Government Encourage public education programmes about HIV/AIDS. Provide easily accessible centres for counselling. Promote confidentiality and emphasise the rights of people living with HIV. Promote integrating of HIV and AIDS education into the curricula of schools (beginning at the primary/basic level) To Students Avoid the sharing of sharp objects. Desist from cult activities or the use of illicit drugs. HIV PREVENTION FOR YOUTHS IN NIGERIA Over 40% of Nigeria's population is under 15 years old. Young people account for over 30% of HIV cases, with prevalence nearly three times higher among 15-24 year old females than males. Nigeria has three legal systems – civil, customary and religion – operating simultaneously and utilised differently in different states. This can make the implementation of Federal measures, such as to protect
  • 28. against early marriage, complex. Overall, the status of females is low, with strong cultural pressures that, for example, force girls and young women to seek illegal abortion rather than face the ostracism of being unmarried and pregnant. HIV Prevention Strategies and Services for Youths in Nigeria There are five key components that influence HIV prevention, namely: 1. Legal provision 2. Policy provision 3. Availability of services 4. Accessibility of services 5. Participation and rights LEGAL PROVISION (NATIONAL LAWS, REGULATIONS, ETC) According to the Child Rights Act (2003), the minimum legal age for marriage is 18 years. However, this only applies to marriages within the country's civil legal system – as opposed to its customary and religion systems – and is implemented differently by individual states. In practice, early marriage is common, with 48% of girls in the Northwest marrying by 15 years. Also, in the country as a whole, 27% of married 15-19 year old females are in polygamous relationships. The age of consent for an HIV test is 18 years. However, younger people who are married, pregnant, sex workers, parents or engaged in risky behaviour can be considered 'mature minors' and give their own consent. Mandatory HIV testing is illegal under Federal law, except in the case of some sexual offences. However, some companies use testing within screening procedures for recruitment and some religious groups insist on testing for couples that intend to get marry. Abortion is legal only to save the life of the pregnant woman. Penalties are high for offenders in other circumstances. In practice, some 1 million abortions are carried out each year, with illegal abortion responsible for half of all maternal deaths, particularly among young women. In terms of gender-based violence, some 81% of married women experience verbal or physical abuse by their husbands, with indications that the lower the age of marriage, the higher the level of risk. While the law prohibits rape and other forms of sexual harassment, it is silent on young married girls who are faced with marital rape and domestic sexual violence. There are no state laws that prevent girls and women from using services, but tradition requires that the woman must obtain permission from the parent and, if she is married, the husband, to access any service or even go out of the house. Customary and religious laws that erode the dignity and rights of young girls should be amended / abolished
  • 29. The federal government has publicly opposed female genital mutilation, but has not introduced legislation to ban the practice. Edo and Cross River states have, however, passed laws against female genital mutilation. The right to life and health of all citizens is outlined in the 1999 Constitution. However, people living with HIV are still treated with disrespect or may be refused treatment in some hospitals. Most people, including some medical health workers, are not aware of laws protecting HIV-infected persons. POLICY PROVISION (NATIONAL POLICIES, PROTOCOLS, GUIDELINES, ETC) The HIV/AIDS National Strategic Framework for Action (2005-2009): Emphasises a full continuum of strategies, including prevention, care, support and treatment. It also promotes the integration of HIV/AIDS, sexual and reproductive health services. Promotes confidentiality and emphasise the rights of people living with HIV. Specifically commits to reducing HIV prevalence. It also prioritises women, young people and orphans and vulnerable children. Commits to increasing access to comprehensive gender-sensitive services, as well as increasing the amount of gender-sensitive policy, legislation and law enforcement. Complements the Adolescent Reproductive Health Policy and promotes adolescent-focused interventions, including increasing access to youth-friendly reproductive health services and developing in and out of school peer education projects. Commits to expanding access to gender-focused and youth-friendly voluntary counselling and testing. Commits to scaling prevention of mother-to-child transmission services and integrating voluntary counselling and testing into all antenatal/reproductive health clinics. Places high priority on nationwide access to antiretroviral therapy for all pregnant women living with HIV. Promotes integrating HIV and AIDS education into the curricula of schools (beginning at the primary/basic level) and developing peer education. The government has developed a curriculum on Family Life Education, addressing relevant knowledge, skills and attitudes. However, it is not being implemented in all schools and there are concerns about lack of political will and resources, including trained personnel. The adolescent health policy, national reproductive health policy, sexuality curriculum for secondary schools, HIV and AIDS policy and plan of action are all aimed at making HIV prevention for youths better. However, implementation of the policies has been a problem. The adolescent reproductive health policy emphasizes safer sex among young people, especially girls, to protect them from HIV and other sexually transmitted infections.
  • 30. The federal government has a curriculum for family life and HIV and AIDS education. It has been approved for use in the schools, but only Lagos is fully using it, while other states are not using it yet. The government has developed a comprehensive curriculum for all level,. but implementation has been slow, due to an inadequate number of trained teachers, poor funding and resistance from stakeholders. There are policies that sit on government shelves, but no clear-cut laws that make HIV prevention easy. AVAILABILITY OF SERVICES (NUMBER OF PROGRAMMES, SCALE, RANGE, ETC) As of 2002, some degree of sexual and reproductive health services were available at 8,953 maternity and primary health care centres, and teaching hospitals. There are some 228 voluntary counselling and testing centres. A national programme is scaling up the availability of services for prevention of mother-to-child HIV transmission from 11 operational sites in 2002 to over 200 sites across the country, including the Federal capital territory. However, uptake is low. For example, according to data from 2003, only 12% of pregnant 15-19 year olds were counselled about HIV during an antenatal visit. The number of sites offering antiretroviral treatment is increasing, with at least 74 centres established. There are various HIV prevention programmes at the community level with some specifically targeting young people. However, while some address areas such as life skills and relationships, an increasing number are predominantly focussed on abstinence and faithfulness, rather than providing a full range of options for behaviour change. Many projects also suffer from a lack of male involvement and parental approval. Most communities do not have voluntary counselling and testing or HIV service centres. These are located in big hospitals and some NGO centres which provide drugs for infected persons. The problem with the services is that they are only available in urban cities and some peri-urban areas. Even if [men] go for voluntary counselling and testing and are found positive, they don't reveal it to their wives at home. They will be going to the hospital secretly and taking antiretrovirals, but the wives will be left suffering with one disease or the other since they are not tested. “All communities must work towards delaying marriage so that girls can get a full education, at least to secondary school level - so that they can make their own decisions, have some skills in generating income and not be over-dependant on husbands or liabilities to the family or community. ACCESSIBILITY OF SERVICES (LOCATION, USER-FRIENDLINESS, AFFORDABILITY, ETC) Nigeria signed both the Convention on the Rights of the Child and the Convention on the Elimination of all Forms of Discrimination against Women in January 1990. It has not signed the Convention on Consent Marriage, Minimum Age of Marriage and Registration of Marriages.
  • 31. The HIV/AIDS National Strategic Framework and National Policy on HIV/AIDS emphasise the human rights of people living with HIV, including non-discrimination in relation to education, employment and access to health care. The Policy cites the denial of HIV and AIDS care and support as unethical and illegal. “Girls and young women usually have difficulties adjusting to their new HIV positive status and to the threat and effects of stigma, especially from their peers, family and friends. Reducing the stigma of people living with the virus will help HIV prevention services and make them more accessible. We need to break the parental barrier of access to services through increased parent-child communication, with parents respecting the rights of a child and interventions targeting parents with sexual and reproductive health and HIV information. The country needs a social reorientation to make every person gender conscious. TESTING FOR HIV/AIDS These test check for antibodies to HIV, which appear from four weeks to six months after exposure. The most common test for HIV is the enzyme-linked immunosorbent assay (ELISA). If the result is positive, the test is repeated on the same blood sample. Another positive result is confirmed using a more specific test such as the Western blot. A problem with ELISA is that it produces false positive results in people who have been exposed to parasitic diseases such as malaria; this is particularly troublesome in Africa where both AIDS and malaria are rampant. Polymerase chain reaction (PCR) tests, which screen for viral RNA and therefore allow detection of the virus after very recent exposure, and Single Use Diagnostic Screening (SUDS) are other options. TREATMENT OF HIV/AIDS While no medical treatment cures AIDS, in the relatively short time since the disease was first recognized, new methods to treat the disease have developed rapidly. Health-care professionals focus on three areas of therapy for people living with HIV infection or AIDS: Antiretroviral therapy using drugs that suppress HIV replication. Medications and other treatments that fight the opportunistic infections and cancers that commonly accompany HIV infection. Support mechanisms that help people deal with the emotional repercussions as well as the practical considerations of living with a disabling, potentially fatal disease.
  • 32. BEHAVIOUR VS HIV/AIDS In most countries, the HIV epidemic is related to behaviours that expose individuals to the virus and so increases the risk of infection. Information about HIV and the level and frequency of risky behaviours related to the transmission of HIV is pertinent/ important in identifying, and for better understanding of populations or group of people most at risk for HIV. Many prevention programs focus on increasing people's knowledge about sexual transmission, hoping to overcome the misconceptions that may be acting as a disincentive to behavioural change. Information on behaviours is also critical for assessing changes over time as a result of prevention efforts. It is important to collect information on higher risk male-male sex, on sexual behaviour among sex workers, on both injecting behaviour and sexual behaviour among drug users, and on sexual behaviours among other groups that may be at higher risk. Finally, sexual behaviours among the general population and among young people should be of great interest to all groups/ sectors concerned with HIV/AIDS prevention. COUNSELLING Either you are positive or not, try to visit counsellors on HIV/AIDS to help you and others live a healthier life. Try to know your HIV status, live responsibly and be determined to achieve an HIV/AIDS free population beginning with yourself. Dont be ignorant, learn and make use of the facts about HIV/AIDS. Knowing your HIV status can have two important benefits: If you learn that you are HIV positive, you can take the necessary steps before symptoms appear to access treatment, care and support, thereby potentially prolonging your life for many years. If you know that you are infected, you can take precautions to prevent the spread of HIV to others. CARE FOR PEOPLE LIVING WITH HIV/AIDS(PLWHA) “You are great when you love the unlovable and give hope to the hopeless, friendship to the friendless, and encouragement to the discouraged.” - Zig Ziglar. In addition to antiretroviral treatment, people with HIV often need counselling and psycho social support. Access to good nutrition, safe water and basic hygiene can also help an HIV-infected person maintain a high quality of life.
  • 33. We must realize that all PLWHA are people like us who even possibly engaged in less risky behaviours than we did but still had the virus. We must extend to them our warmth and love, in no way are they inferior to anyone. HIV/AIDS is not the only form of incurable illness, people have learned to live with and manage other incurable ones. PLWHA are very relevant to us and the society in general. It is worthy of note that many victims die as a result of psychological trauma occasioned by societal stigmatization. People Live What They Learn; If People living with HIV live with criticism, They learn to condemn. If People living with HIV live with hostility, They learn revenge. If People living with HIV live with ridicule, They learn to feel inferior. If People living with HIV live with shame, They learn to feel guilty. If People living with HIV live with encouragement, They learn confidence. If People living with HIV live with praise, They learn to appreciate. If People living with HIV live with fairness, They learn justice. If People living with HIV live with security, They learn faith. If People living with HIV live with-out discrimination, They learn to like themselves. If people living with HIV live without stigmatization, They learn to love the world.
  • 34. If People living with HIV live with acceptance and friendship, They learn to be happy. RECOMMENDATIONS A number of programmatic, policy and funding actions could be recommended to enhance HIV prevention in the most hard-hit countries. These are what key stakeholders – including government, relevant intergovernmental and non-governmental organisations, and donors – should consider. Review and strengthen action on the aspects of the Political Declaration on HIV/AIDS. Strengthen and/or introduce measures within the country's legal systems to protect against marriage before the age of 18 years. Significantly strengthen and/or introduce comprehensive gender-sensitive legislation and policies to ensure a comprehensive definition of gender-based violence (that includes marital rape) and enshrine the rights of all girls and young women, including access to sexual and reproductive health services. Ensure a 'core package' of free youth-friendly services is available in at least each major district of more than 5000 people providing integrated sexual and reproductive health and HIV/AIDS support. Promote a positive model of voluntary counselling and testing. Implement a widespread proactive campaign to address the stigmatising and discriminatory attitudes of health care givers, by systematically incorporating youth-friendly approaches into their training. Implement a comprehensive rights-based approach to universal access to HIV prevention, treatment, care and support for sex workers. Scale up universal access to antiretroviral therapy, while also promoting positive prevention. Ensure that girls and young women living with HIV can receive treatment in an environment that not only addresses their HIV status, but recognizes their needs in relation to their gender and age. Implement a prepared curriculum on Family Life and HIV/AIDS Education as a priority in all primary, secondary and tertiary educational establishments. Promote models of HIV prevention programmes that offer adolescents and young people wider choices that include, but go beyond, abstinence. Complement HIV prevention efforts with young people by raising awareness among parents, traditional and religious leaders about the validity and importance of girls and young women being empowered to protect themselves from HIV infection and to access services.
  • 35. Facilitate the empowerment and participation of girls and young women, especially those living with HIV, in national planning and programming relating to HIV and AIDS. Support programmes that work through existing young people and HIV/AIDS groups and networks to build members' capacity in both life skills (such as self esteem and negotiation) and advocacy skills (such as decision-making and public speaking). A Future Worth Beholding... I imagine a day when the old will say, “a long time ago, there was a virus that killed people, destroyed businesses, and affected the economy negatively. People contacted it by any form of blood contact. The virus was HIV, but now it's no more”. I imagine a day when the World Health Organisation, United Nation, health related organisations, and all countries of the world will count the cost they had spent combatting HIV/AIDS, and they will say “though it's much, but the virus is no more”. I imagine a day when all the scientist, and other forms of professionals that have been dedicated to the research, education and awareness will rejoice because the virus is no more. I see a day when the major caption on television and newspapers will be “ No more HIV/AIDS cases”. Imagine a world free from HIV/AIDS. It begins with you. Everyone should know that there is more to HIV/AIDS than just unprotected sex. There is not a type of person that cannot contact HIV/AIDS; ANYONE CAN.
  • 36. REFERENCES Iwuagwu, S., Durojaye, E., Oyebola, B., Oluduro, B., and Ayankogbe, O. (2006) HIV/AIDS and Human Rights in Nigeria - Background Paper for HIV/AIDS Policy Review in Nigeria. Federal Government of Nigeria National Policy on HIV/AIDS. U.S Department of State, Country Reports on Human Rights Practices (2003). Nigerian National HIV & AIDS Policy, HIV/AIDS National Strategic Framework for Action (2005-2009). Nigeria: What You Should Know About Condoms (2006). www.allafrica.com. Encyclopedia Britanica (2006) Encarta Microsoft (2009) World Health Organization: www.who.int
  • 37. HEALTH ACTIONS CONCERNING THE ENVIRONMENT AND YOU (HACEY) HACEY is a non-governmental organization formed to create a coalition of caring individuals who have committed consistently to inform people on issues concerning their health and environment. Specifically, we are aggressively working to make a difference in the quality of life for the child, adolescent, youths, adults including students of various institutions ( primary, secondary, and tertiary), and also the rural communities. HACEY is dedicated to providing the finest resources for education, training and development for all members of our society. Our Vision To become a leading centre that empowers youths and adults for the total development of their being- physically, psychologically and emotionally. Information on our Most Recent Programmes NOV. 30TH & DEC. 1ST 2007- HACEY organised a world AIDS day event, where students from different schools ( secondary and tertiary) and also members of the general public were informed on the subject- HIV/AIDS- CHALLENGES AND CHANCES. It was a great atmosphere for education, entertainment, talent shows and empowerment as the message was passed across in its best form. FEB. 2008- HACEY hosted a speech contest among university students. This programme served as a medium to inform the students on issues concerning carbon dioxide and the environment (green house effect), and also on the effects of cosmetics on the body- the good, the bad and the ugly. It was a peer educative forum. APRIL. 2008 – HACEY went to various places in Ilorin, Kwara state, Nigeria to educate members of the general public on the effect of climate change on health. DEC. 2008- Our 2nd world AIDS day programme, it was educative and informative, it featured lectures, music, drama, competition, comedy, and interactive session and students. Everyone expressed themselves freely. Opportunity to Help HACEY CREATIVITY CENTER - At HACEY, a music club, drama club and readers club are organized to train and empower the youth in the emerging field of health and environmental protection. In addition to this we train student in various schools to become peer educators and help them organize health programmes.
  • 38. PROTECT YOUR ENVIRONMENT- This programme is a campaign we organize at HACEY that promotes environmental protection as the duty of everyone. We go to schools, offices, and the media to pass the message. AT YOUR DOORSTEP- This is a village outreach programme that we undertake at HACEY in different villages across the country giving them information to increase their quality of life THE CARE APPROACH- At HACEY, we go to the homeless and the prisons to inform them on various health and environmental issues. We also organize training programmes that empower them to be good readers, writers, and speakers. In addition to this, we also use the effort of our creativity centre to develop their talents. GREAT PEOPLE and GREAT LIFE - At HACEY, we organize a a special programme for underprivileged people training them on different vocation. It also involves a behavioural lesson to build their self- esteem. For more information about joining HACEY visit- www.hacey.org or email- info@hacey.org