Nigeria: Why People Flee From HIV/Aids Tests

They are complaining that since Medicine Sans Frontier (MSF) a.k.a Doctors Without Border, left two weeks ago, most of the free treatments they enjoyed are no longer free. Unfortunately, many of them cannot afford to pay for these treatments.

This is because most of them are indigents who have been either abandoned by their husbands or wives. They are calling on NGOs, government and corporate organisations, and individuals to come to their rescue as the hospital alone cannot carry the burden.

Nigeria ranks 158 out of 177 in the UN's Human Development Index, showing that the country is very poor. This perhaps, has posed a challenge to those living with HIV in the country's rural areas. Services provided at most clinics include free HIV testing and counselling, treatment of HIV-related infections, and prevention of HIV transmission from mother to child.

Sadly, in a country with more than three million people living with HIV, many do not have access to these services. Although the government provides free ARV drugs, distance to the officers and availability of the drugs to patients are a problem. Saturday Vanguard's health team looked at the benefits for testing to avert such situations.

Do you know your HIV status? When was the last time you went for an HIV antibody test? Was it done voluntarily or coercively? What form of counselling did you receive before and after?

A survey by Saturday Vanguard indicates that the target of testing in pregnancy is to achieve an uptake of at least 90 per cent. At booking, a midwife is expected to discuss the various tests that are offered, including HIV testing.

For a woman who is not at high risk, this will not require the amount of time and detail as for those who have engaged in risk- taking activity and for whom a positive result is a significant possibility.

Nevertheless, testing should not be done without some discussion with the woman. Experts say people who donate blood are routinely screened for a number of infections including HIV but they should be discouraged from seeing blood donation as a "quiet and easy way" of getting an HIV test. This is so because they do not have the benefit of counselling and they might donate in the window period. Test results should be given simply and in person.

If negative, that is reassuring but with caveats. Essentially, a negative result is not a permit to continue to take risks because next time, it may not be negative. If positive, there will be considerable emotional trauma. The test does not indicate who will convert to AIDS and who will not.

If the result is positive, referral for treatment is required. Attendance is essential as it does make an enormous difference to prognosis.

Many practices have been reluctant to undertake HIV testing with associated counselling as it is seen as complicated and time-consuming. But there is no reason why practices should not write a protocol for counseling and testing that fulfils the various conditions. It does not have to be performed by a doctor and in most situations, it is a nurse who gives the counselling.

The easier it is for the patient to get counselling and testing, the more likely they are to take up the offer.

The survey also established that denial is a major factor in the spread of HIV. Denial may occur at the level of the individual, the community or at a national level. The fact that a person has presented to discuss testing means that the person has faced up to the possibility of infection. While testing may seem inappropriate as the activities were such that the person was not truly at risk.

If there is any doubt then the safe course is to get a test. With effective treatment now available, prognosis is dependent upon catching the disease early. There is also the need to prevent spread of infection.

Hence, there can be little justification nowadays for refusing a test where risk exists. Ignorance and denial are important contributory factors to the spread of HIV.

In the last two decades, voluntary HIV Counseling and Testing programmes (HCT) have helped millions of people learn their HIV status, yet more than 80 per cent of people living with HIV in low and middle-income countries do not know that they are infected. It thus becomes paramount that urgent efforts are provided to increase the provision of HIV testing through a wider range of effective and safe options.

Nigeria: Why People Flee From HIV/Aids Tests

AIDS/HIV