By Motunrayo Alaka

What is the true picture of HIV/AIDS in Nigeria? The answer you get might probably depend on who is giving you a response. The facts remain that like our census figure, which is indeterminate, the number of people who are actually living with HIV/AIDS in Nigeria remain a controversy. Figures are given for several reasons. So many people have said that to justify the huge funding made available it became necessary for officials saddled with the National AIDS response to give the impression that the funding are being utilized. So, don’t be surprised if you hear that prevalence rates are falling. It is a fact that only these officials know the parameters used to measure the rates. The simple fact is that it may be difficult to trust these figures coming from these quarters or those that derived its essence from them.

Lagos State
A very senior official at the Lagos State AIDS Control Agency actually said the figures do not have to be accurate since prevalence rates are “just proxy to have something to work with”. That may explain the 3.3 prevalence ascribed to Lagos, although a part of Lagos, Lagos Island is said to have a prevalence rates of 9%. What quickly come to mind will be the factors that are present on Lagos Island that are not in other parts of Lagos. The most reasonable explanation given by someone concerned is the fact that Lagos Island has the highest concentration of VCT centers in the state, so more people test here. At the Doctors without Borders clinic (MSF) for instance, it was found that over 100 people tests positive every month, and that is just from a single centre.

In Lagos State alone, the number of estimated HIV positive persons (600,000) surpasses that of Ghana (500,000), we can say here that Ghana is a small country, but that is the reality. An enduring response we believe can only come from realistic data of actuality. Over a hundred thousand people actually need treatment in Lagos (read related article) State for instance, and less than 5,000 people have access to treatment. Of this figure 3,000 people are on the MSF (Doctors without borders) and GHAIN’s project. The biggest problem at the moment even with this number that has access is the issue of treatment failure. In several patients, it has been found that treatment has not been effective, and the single biggest factor responsible for this is adherence (read related article) to drugs.

Several reasons have been adduced to this instance, but of these reasons, it was found that over 70% of patients are not adhering as a result of poverty. 72% of patients under the MSF project for instance have had treatment interruption at one time or the other. Over 50% live with less than $1 per day. It was further revealed that 39% borrow money from friends and relatives to access treatment at a time while over 18% actually sold their properties. 2.5% of patients are presently on the second line drugs, which could be serious burden to them because some of the second line drugs have to be kept at certain temperature. The fact is that most patients do not have a means to do this as several people are too poor to own refrigerator, and for those few that has, it is another burden to power them with the power situation in Nigeria. As it is, will it be out of place to call for more credible intervention that will ensure adherence and get more people on treatment.