Victor Olaore Omoshehin is the National Secretary for Network of People Living with HIV/AIDS in Nigeria (NEPWAN), on this year’s World AIDS Day, he told Ndidi Chukwu that living with HIV is beyond the intake of pills, but being knowledgeable of how to manage self.
What is NEPWAN and what do you do?
Network of People Living with AIDS in Nigeria (NEPWAN) is a coordinating body for people living with HIV in Nigeria presently we have 1, 030 support groups across the country and we have state chapters in the 36 States including the FCT. We have six geo-political zones offices where they coordinate the State within the zones. In NEPWAN we have membership of over 300,000 that is people living with HIV that have identified themselves. Actually we know that there are about 3.5 people in Nigeria living with HIV, but only 600,000 thousand people are on Anti Retroviral Therapy (ART) we just have half of this population which is 300,000 that have identified themselves with the support group of people living with HIV in Nigeria. It is not everybody who would want to be identified with the support group, people who are in the grass root communities are people that really need to get information, meet each other and get the support they need.
Discrimination happens to be the reason why these people would not want to come out, how can they overcome this fear?
You are right, stigma and discrimination and fear of the unknown is one of the barriers that hinder a lot of people from identifying with the group even accessing treatment, a lot of people test positive and still hide themselves in the house, some deny accepting their status, I met a girl last week, her mother brought her, she tested positive 5 years back but since then she was in the church, she gave her life to Christ, repented and maintained that she was not positive, but the fact is that she is HIV positive. There are a lot of people like her, aside from religious factor so many people would not want to accept that they are positive and start taking medication. It is a big challenge, people need to fight self stigmatization, accept themselves and live positively by taking the available treatment, so that they can protect themselves and their families, and help Nigeria to reduce the spread of the virus. It is so alarming that Nigeria remains the second country with the highest burden of the epidemic in the world. It should not be a record that we should be celebrating.
Are the ARTs really made available to your members?
For us, treatment is far beyond giving people living with HIV the pill, and testing somebody and telling the person to come back because the CD4 count is high. It should include psychological counselling, nutritional counselling and telling the person what he or she needs to know, and how to get access to screening for Haplites B, TB, Malaria, CD4 count screening, viral load screening and letting the person have access to the treatment of these diseases early. If a pregnant woman tests positive to HIV she should have a place where she can have access to counselling against mother to child transmission, where the baby can be prevented from contracting the virus and the mother gets the treatment. There are so many options that are embedded in treatment; it is not all about the pill. In Nigeria everybody is just interested in the pill but sometimes when you go to hospitals you discover that the CD4 count machine is faulty they can’t check your CD4 count to know if you are eligible to take the ART, so many hospitals don’t have viral loads testing machines, and so a lot of people don’t know their viral load test. We are using this medium to call upon the Nigerian government to be more committed to the response actually about 75 percent of the funding for HIV treatment in Nigeria is donor driven, let Nigerian government take ownership of the intervention, it should be their own project. The funding and treatment options need to be domesticated. Our government should take the responsibility it is there’s.
How can a person living with HIV come out from self discrimination and disclose status to people?
The first thing I would advise anyone living with HIV to do is to accept the status, and come out of self stigmatisation. Disclosure is of different stages, you don’t have to be mad like myself who can go everywhere to say I have HIV, there is partial disclosure, routine disclosure and full disclosure, and they are gradual stages. Partial disclosure is the one you tell your spouse, family members or your religious leader because you need care, and need these people to understand you and be there for you. You just tell them that you are positive without evidence, you observe them if they start misbehaving you can come back and tell them it was a joke. Routine disclosure is what you do in the clinic because it is mandatory for you to disclose your status to your care giver either the doctor or the nurse taking care of you. So they can know how best to take care of you. Full disclosure is when you pass the other two stages and boldly say you are positive, and everybody is aware, routine is very important to all Nigerians living with HIV, many people would not want to disclose their status to their doctor, and the man will be treating something else when they know what is truly wrong with them. You need to let your family members know about your status, especially your partner so that the virus will not be contracted. So many people in Nigeria are at risk because they don’t know their status yet. Knowing your status is the only guarantee that you are negative and you will be taught how to remain negative and those who have done the testing once and are vulnerable to infections are still at risk until the test certifies them negative. Testing has to be routinely.
Between men and women who opens up easily about their status?
With my experience as a field worker, I give kudos to women, most of the women easily disclose to their husband than the men. Many do not care about the consequences, but they open up early to save their partners from getting infected. 8 in 10 men who are infected would not disclose to their wives until the women contract the virus and the women still forgive. A man infected his wife in Kogi State until their child became infected too he could not tell his wife about it. Men really need to be open at this point.
Could you just make a call to the National Assembly on the pending anti-stigma/discrimination bill?
Onbehalf of the 3.5 million people living with HIV, I call on the legislators to accelerate the passage of the anti-discrimination bill, it is long overdue, it is the people’s bill and we have been on this since 2006. People are being ejected out of their houses, job and marriages because of their status. People are denied employment while others are kicked out of their jobs if the bill is passed, this can be controlled. We can use it as a legal toll to seek for justice and redress.
NDIDI CHUKWU IS A JOURNALIST,SHE EDITS THE HEALTH BEAT OF nationalTRAIL NEWSPAPER, ABUJA.