HIV testing, condom use: Nigeria, other African countries may not meet 2030 targets

By Tobore Ovuorie

ANALYSIS of data from 38 African countries indicates very few, if any, are on track to reach the UNAIDS targets for HIV testing and condom use by the year 2030.

This was one of the major highlights in HIV prevention research announced Tuesday at the 4th HIV Research for Prevention Conference (HIVR4P), convened by the International AIDS Society (IAS). The annual gathering of researchers, thinktanks, amongst others in the HIV field holds virtually this year, due to the COVID-19 epidemic.

Based on 114 nationally-representative datasets representing more than 1.4 million sexually active people, the study presented by Phuong Nguyen of St. Luke’s International University revealed that overall, the probabilities of reaching the 2030 targets were very low for both HIV testing at 0 percent to 28.5 percent and condom use with 0 percent to 12.1 percent.

The study predicts the countries with the highest coverage of annual HIV testing in 2030 will be Eswatini with 92.6 percent, Lesotho with 90.5 percent and Uganda with 90.5 percent. Eswatini (85 percent), Lesotho with 75.6 percent and Namibia with 75.5 percent respectively, are revealed as the countries which would have the highest proportion of condom use.

CREDIT: Google photo

However, if I were to interpret it as an HIV advocate and expert on prevention, what it means is: the study team estimated that the probability of African countries meeting the UNAIDS testing and condom use targets of 95% coverage by 2030 is not feasible. This estimated expectation is birthed by the poor annual HIV testing and condom use recorded by each country.

HIV phenomenon in Nigeria

No fewer than 1.9 million persons are estimated to be living with HIV in Nigeria. A 2019 national survey partnership conducted by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the National Agency for the Control of AIDS (NACA) titled: ‘Nigeria National HIV/AIDS Indicator and Impact Survey (NAIIS),’ indicates the national HIV prevalence has reduced to 1.4 percent among adults aged 15-49 years when compared to the previous 2.8 percent, estimate.

The survey states that girls and women between the ages of 15 and 49 are more than twice more likely to be living with the virus than men. A differential ratio of 1.9 versus 0.9 percent is stipulated for both the male and female gender, respectively.

However, the difference in HIV prevalence between women and men is greater among younger adults, with young women aged 20-24 years more than three times more likely to be living with HIV compared to men in the same age group. At the national level, viral suppression among people living with HIV aged 15–49 years stands at 42.3 percent. That is, 45.3 percent among women and 34.5 percent among men.

According to the 2019 national data, Nigeria’s South-South zone has the highest HIV prevalence at 3.1 percent among adults aged 15-49 years. The North-Central zone has a prevalence rate of 2.0 percent while the South-East has a 1.9 percent rate.

The survey indicates South-West has a lower HIV prevalence at 1.1 percent while the North-East and North-West Zones follow in same stride with 1.1 percent and 0.6 percent, respectively.

CREDIT: National Population Commission

The HIV/AIDS virus remains one of humankind’s greatest global health challenges as it has spread across all countries. The spread is on the increase among heterosexuals and bisexual males but predominantly among young persons in African countries like Nigeria. The rapid growth of HIV positive cases in the last few years globally and in Africa shows the majority of Nigerians infected with the virus are the youths. The UNAIDS says the virus is predominant among young people in Africa because they constitute larger percent of the society.

In November 2016, the National Population Commission put Nigeria’s populations at 182 million people with a widening youth bulge because more than half of these persons were under 30 years of age. However, by Friday, June 26th, 2020 at 9.44 am, Worldometer elaboration of the latest United Nations data indicates the current population of Nigeria is 206,018,277.


HIV in the last five years: Nigerian perspective         

In the last five years, there has been a significant expansion in the country’s response to HIV. The number of hubs providing treatment has tripled with over 201 centres, unlike previous years. For instance, the number of centres providing services to prevent mother-to-child transmission of HIV has increased eightfold and the number of HIV counselling and testing sites has increased fourfold. A total of 11.3 million adults were counselled and tested for HIV in 2016, four times as many as in 2012. But studies emanating from theHIVR4P 2021 conference indicate this is not enough as Nigeria remains off track in meeting the 2030 UNAIDS testing targets.

    Again, the country is still lagging behind in the provision of counselling, test and treatment centres strictly for young persons who make up most of Nigeria’s population. Available statistics and data reveal the West African most populous nation has not prioritized tailor-made policy for HIV control such as testing, even for young persons.

    Condom usage in Nigeria

    Research findings indicate condom is used both for prophylactic and family planning or pregnancy prevention purposes. However, adverse experiences, gender-related fears, cultural and religious beliefs, amongst others hinder the wide usage of condoms in Nigeria.

    CREDIT: Google photo

    For instance, purchase and use of condoms are associated with illicit sex in Nigeria, particularly when purchased and introduced by females – married and single – to their partners. Many Nigerian men believe condoms limit sexual pleasure, while others believe condoms have side effects after use. Many beliefs about condoms abound in Nigeria; one of which is it causes vaginal dryness, inflammation and diseases and a woman’s womb could become dry after repeated use of condoms. Some Nigerian men sampled for this story believe condoms are coffins. They claim condoms not only kill sexual pleasures but overtime affects reproductive organs.

    Based on the projections revealed at the ongoing HIV4RP Virtual conference,  Nguyen while presenting the study titled: ‘Progress toward HIV elimination goals: Trends in and projections of Treatment as Prevention strategy in 38 African Countries’ concluded that there is currently “little prospect of reaching global targets for HIV/AIDS elimination,” and calls for “more attention to funding and expanding testing and treatment” in Africa.

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