Adolescents living with HIV/AIDS in Nigeria are going through various challenges which are affecting their uptake of service and quality of life. This was revealed by The Program Manager, Positive Action for Treatment Access (PATA), Mr. Francis Umoh, in this interview with Franka Osakwe, during a 14-day camping activities for 54 Adolescents living with HIV (ALHIV), currently on-going at Ronik International School Ejigbo, Lagos.
Tell us more about this event?
The event is our youth mentorship and leadership program for adolescents aged 10-19 living with HIV. It’s usually a summer program and is done during their long vacation. The idea is to bring adolescents from different states together, to promote team bonding, this enables them meet with other peers, share experiences and bond as a group. We also try to educate them on sexual reproductive health issues. They are supposed to be 54 from 7 states but for now we have 50 adolescents from Kaduna State, Federal Capital Territory, Abuja, Akwa Ibom State, Benue State, Anambra State, and Lagos. One of the states is unavoidable absent. We also have their care givers with them; the aim is to ensure they take their drugs. The event The camp is holding from 21st August 2016 to 3rd September 2016, and is organised by PATA in collaboration with UNICEF and Lagos State AIDS Control Agency (LSACA).
The major activities are: comprehensive Sexual education session, vocational skill training, sport and games, excursion and site visit, advocacy meeting with parliamentarians, policy makers and a round table media discussion.
Are the adolescents here aware of their status?
Most of them are, but not all of them are aware of their status, because not all of them got it from their parents. Some may be positive but their parents will not tell them. However, part of the criteria for this program is, knowing your HIV status, because at the camp we mention issues of HIV openly and we don’t want anybody to be embarrassed. But they are not openly positive because we maintain issues of confidentiality.
What challenges are these adolescents with HIV in Nigeria facing?
We have the issues of access to treatment. The drugs are there but sometimes we have isolated cases of stock out at the clinic. Also once in a while, we see cases of stigmatization, we have seen cases where the children are denied admission because of their status. We have some that have been thrown out of their house because of their status- in this case, the parents are dead and the relations tries to take them in, but when they discover their status, they throw them away. In PATA, we have home for this type of cases called ‘Mary’s Home’, named after the first adolescent diagnosed with HIV. We have about 5 adolescents living in the home right now. The home caters for their accommodation, feeding, health and other needs, so they can live a normal life. So stigma is still strong in Nigeria. They also have limited access to information on sexual reproductive health and HIV. We did a research some years ago and we found out that many adolescents with HIV have poorer knowledge of HIV compared to their negative peers, so some of them don’t have basic information. Also some of them experience sexual urge so they need capacity building on issues of sexuality and reproductive health, they also need information on their future careers, so these are some of the issues they face.
Are there ways to reach out to the unidentified adolescents with HIV?
Part of the campaign going on is to promote HIV testing and uptake for adolescents. It is only when you test that you can know if the person is positive or negative, so there is a serious campaign to promote testing and then uptake of service for the positive ones. Right now the whole world is talking about 90-90-90 by year 2020, and HIV free generation by 2030. For us to achieve that, about 20 million have to be tested, the twenty million diagnosed people have to be on drugs and the twenty million on drugs have to have a suppressed viral load. So for Nigeria to achieve this global target there must be massive HIV testing and uptake for adolescents. The only way to do this is to go out to these adolescents, not expect them to come to you. Most importantly, when they test positive, they need to be provided with treatment.
What about the issue of Follow up?
During testing and counselling, of course their basic data are collected and they are linked to service, but one challenge they have is transitioning from paediatric to adult care. This is still a big issue. In Nigeria, ones you are 15, you transit to adult clinic but you know at 15 the child is not yet a full adult. So you have a case of children that is used to paediatric clinic, and instead of transiting the child to adolescent clinic, you move the child straight to adult clinic. This sometimes causes loss to follow up because when they get there and see only adults, they get scared and leave. One way to solve this is to have a day or time set aside to attend to these adolescents. There is need for that kind of platform for adolescents. On our part, we have tried to solve this case by peer mentorship where the peers counsel their peers on transitioning. Also we have the issue of poor attitude of the caregivers. Although this is improving, but the caregivers need to know that an adolescent might not react the way an adult will react so you have to be patient with them.
Does poverty affect access to treatment?
Although treatment is free, poverty indirectly affects uptake of treatment, but this is also related to stigma and discrimination. We have situation where clients have a treatment Centre close to them but because of fear of stigma, they go to a far treatment centre. In this case transport fare becomes an issue. Also when we talk about comprehensive access to treatment, it goes beyond having drugs; you have to have a lab test done, check-ups, viral loads and even nutrition. And all these involve money. If you are taking your drugs and you are not eating well and in school, this affects the children psychologically so yes poverty is still an issue.
Do you think Nigeria have more cases of adolescents with HIV?
Yes it is increasing. As at 2014 according to UNICEF, 160,000 adolescents aged 10-19 were living with HIV/AIDS in Nigeria, in 2013 about 11,000 dies while 17,000 were infected. Although the issue of mother to child infection is being checked, but sometimes, you see some of these women accessing antenatal care but when they want to deliver, they drop out and go to a TBA, this leads to more mother-to-child infection. Nigeria needs to improve on accountability and transparency in implementing HIV reduction program so that service gets down to the people that matter, we also need capacity building for adolescents and adolescent friendly services.
PATA is a nongovernmental organization based in Lagos, that promote access to HIV treatment education, care and services; advocate for access to affordable, qualitative diagnostic and monitoring tests, drugs and commodities to treat HIV and its attendant problem.