HIV: Fear, Stigma Force Pregnant Women To Abandon Treatment
By Chioma Umeha
Over the past five years, there has been a rapid
scale-up of services to Prevent Mother-To-Child Transmission (PMTCT) of HIV.
This has reduced the annual number of new infections among children by 50 per
cent worldwide since 2010.
Global HIV Plan
In the 21 priority countries that were the focus
of the Global Plan towards the elimination of new HIV infections among children
and keeping their mothers alive (Global Plan), AIDS-related mortality among
children under 15 years of age dropped by
53 per cent between 2009 and 2015.
In countries such as Botswana, Burundi, Namibia,
South Africa and Swaziland, even greater reductions, above 65 per cent, were
achieved.
However, this welcome news has some challenges.
For instance, in 2015, there were 1.8 million children under 15 years of age
living with HIV worldwide.
An additional 150, 000 children acquired HIV
globally in 2015 (2,800 a week), and 110, 000 children died of AIDS-related
causes (300 a day).
In some high-burden countries, such as Angola,
Chad and Nigeria, less than half the pregnant or breastfeeding women living
with HIV are receiving antiretroviral medicines.
Reports show that programmes to help women avoid
HIV infection remain underdeveloped and fragile, leading to 900 000 new HIV
infections among women over the age of 15 years in 2015.
They joined the 17.8 million women already living
with HIV, and if they decide to have children, they will need services to
prevent transmission to their children and maintain their health.
The World Health Organisation (WHO) now recommends
treating everyone living with HIV, but it is also essential to maintain good
adherence to antiretroviral medicines in order to ensure their efficacy.
Good adherence suppresses viral load to
undetectable levels, greatly reducing onward transmission to the baby while
restoring the mother’s immune system for better health.
Unfortunately, many pregnant women gradually stop
taking the medicines after they are diagnosed to be HIV positive, increasing
the risk of transmission during pregnancy and placing their health in jeopardy
according to findings.
Safe motherhood
In Nigeria, the goals of the national programme
for PMTCT of HIV include elimination of new infections among children and
ensuring safe motherhood by 2020.
One of the targets’ of the programme is to ensure
that 60 per cent of all HIV positive pregnant women and breastfeeding mothers
receive ARVs by the end of 2018.
However, only 53,677 (30.16 per cent) of the
177,993 HIV-infected pregnant women in Nigeria received antiretroviral drugs to
reduce the risk of Mother – To -Child Transmission (MTCT) of HIV in 2015.
Heart to Heart Centre
A visit to the Heart to Heart Centre (H2H) of the
Badagry General Hospital, Lagos State by The Journalists’ Alliance for the
Prevention of Mother-to-Child Transmission of HIV in Nigeria (JAPiN) shows
that fear is one of the major factors why
pregnant women who are HIV positive abandon treatment.
At the H2H Centre, Shola Adebisi (not real names)
told INDEPENDENT; “The first day I was told of my HIV status, I almost died.
Then, I was pregnant for the fourth child, a baby boy. But, I lost him because I refused to
take my drugs. I also lost the next pregnancy which was twins for similar
reasons. My thought then was that whether I use the drug or not, I will die and
this made me stay away from home for three days. I was affected
psychologically.”
Similarly, Oge John (not real names), narrated how
she lost her first baby due to fear of stigma and death.
John told INDEPENDENT: “This is not my first
pregnancy, I lost the first one. It was during the antenatal that it was
discovered that I was not taking ARV drugs. That was during my first pregnancy,
I was not on ARV drugs, so the baby died. It was a stillbirth. After that, I
started taking the drugs regularly. It was after I came to Heart to Heart
Centre, they counselled me and I started taking drugs.”
On her part, Mrs. Kadiri Oluseyi, Executive
Director, Centre for Positive Health Organisation, Lagos State under the
platform of Abidjan – Lagos – Corridor canvassed for the elimination of stigma
for People Living With HIV/AIDS in line with the global campaign for safer
motherhood and HIV-free babies.
According to her, support from the government
through increased funding and access to anti-retroviral (ARV) drugs will help
to ameliorate the challenges of PLWHA, especially pregnant mothers and help in
the elimination of Mother-To- Child- Transmission (eMTCT) of HIV.
Oluseyi spoke when members of JAPiN, Lagos state
Chapter recently made the special investigative visit to the office of
Abidjan-Lagos Corridor Organisation, in Badagry General Hospital, Lagos,
recently.
Oluseyi said: “Government should support the
People Living with HIV/AIDS (PLWHA), non-governmental organisations (NGOs) and
partners working in the area of HIV, support groups with funds.
“Being a PLWA is not an easy task. PLWA is faced
with a lot of discrimination. For instance, a lady came to us and complained
that she was sacked from work because she is positive.
“Government should put more efforts to address
stigmatisation. There should be intensive education on eliminating
discrimination of PLWA. ”
According to her, the Abijan-Lagos Corridor
Organisation is a HIV support group project that is working in partnership with
the Badagry General Hospital ante natal unit.
The group is working towards HIV prevention,
maternal health, tuberculosis prevention, treatment, care and support at the
community level, she added.
“Our focus is that information reaches every
individual about HIV counselling, testing, and treatment. We also provide
access, care and support especially to those that have tested positive. We
believe that all those that have tested HIV positive must be treated with equal
right. We stand for justice,” the Executive Director emphasised.
“Some of the difficulties we face is that most of
the PLWA are always upset, not owning up to their status or visiting the
hospital in line with the directive of their psychosocial counsellor. Some of
them often refuse to be counselled or receive drugs. However, we don’t give up,
we counsel the PLWA on the risk involved of his action on himself and the
community. With persistent information, they often succumb.”
“Getting infected is one thing and accepting the
result is another, likewise taking it upon oneself to live a positive life is
also another thing. First, they need to accept that they are positive and
second, is access to treatment. By the time they are beginning to access
treatment and now fully in charge of themselves, knowing that they have to
remain on treatment and live a positive life to avoid getting fresh infection
or getting other people infected, definitely, the information would have become
valuable.”
Corroborating earlier views, Mrs. Salami Bukola,
Psychosocial Counsellor Abidjan- Lagos Corridor, said:” We monitor and
follow-up PLWA, counsel them to accept their result and register to receive ARV
drugs. We don’t force the PLWA; rather we tell them the negative impact of not
registering and adhering to the prescription of the ARV.
Challenges
It could be recalled that more than 150 people who
attended the interfaith pre-conference, which held last year in Durban, heard
urgent challenges to reduce stigma and discrimination; increase access to HIV
services; and defend human rights as key elements of ending AIDS as a public
health threat by 2030.
Various presentations during the opening plenary
enjoined faith representatives to unite and accelerate all HIV interventions so
that more people are tested and treated, with greater respect and promotion of
all human rights so as to reduce new infections.
New infections, which for awhile had reduced, have
started to rise alarmingly, according to a UNAIDS report presented by Cesar
Antonio Nunex, director of UNAIDS Latin America and Caribbean.
“Progress has stagnated. There are even increases
in several regions of the world,” he warned.
Rights language, he also acknowledged, sometimes
generates resistance among religious communities.
At the event, Faghmeda Miller, a health
promoter/counsellor at the University of the Western Cape and the only Muslim
woman openly living with HIV in South Africa particularly challenged
participants to be the agents of change.
“In my 22 years of living openly with HIV, people
like myself continue to be discriminated against. Although antiretrovirals
(ARVs) are now available at clinics, they are not accessible to all because the
clinics are HIV-unfriendly places,” she said.
“We cannot look the other way whilst people living
with HIV die – we need to start talking about HIV and stop labelling people. A
person can live long with the virus; what is killing us is the stigma attached
to the virus. Stigma kills more people than HIV and AIDS.”
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