Nigerian women coping with HIV/AIDS, PMTCT services

Self-stigma has been identified as one of the major issues responsible for the low uptake of services for the Prevention of Mother to Child Transmission (PMTCT) of HIV/AIDS in the country.

Over time, persons especially women that tested positive to HIV/AIDS have consistently lived in self-denial orchestrated by stigma and other factors beyond their control but caused by the society.

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Mrs Anthonia Nzeli, a 35-year-old banker, was diagnosed to be Human Immunodeficiency Virus (HIV) positive during her first pregnancy and was placed on antiretroviral drugs.

Being a young woman, Nzeli could not imagine how she could cope with taking the drugs for the rest of her life and she subsequently stopped taking the medication.

She said her decision was based on the advice of her pastor who discouraged her and asked her to pray as God would solve every problem.

According to her, she was using the local herbs believing it would solve her problem.

Nzeli said after she gave birth, the baby became sick in his three months and was taken to the hospital only to be diagnosed as HIV positive.

“That day, I felt as if the world had come to an end until a nurse came to my rescue; educated me on the necessary things to do to live a better life with the virus,” she said.

According to her, the nurse arranged an appointment for her with a doctor and was advised on how to live with her baby.

“The doctor advised me to come with my husband to carry out test on him but he refused to come.

“Since then, I have been on PMTCT treatment and my baby is also on drugs. And was asked to come for test with my child in order to monitor us,” Nzeli added.

She said lack of proper information on HIV has affected many families and urged the government to ensure that people are properly educated on the virus and how to manage it.

Nzeli said with the proper information obtained, she enrolled in PMTCT treatment to be able to have her second child HIV negative.

She said after five months, the husband agreed to have the test and was positive, adding that the family has been on drugs since then.

“I believe with proper information on PMTCT, many pregnant women would have HIV negative babies,” she said.

In spite of having been tested for HIV during pregnancy, most women have limited knowledge and awareness of the virus and of PMTCT in particular.

There are several potential barriers to the provision of PMTCT including HIV testing without adequately informed consent and counselling.

Others are gaps in HIV and Mother-to-Child Transmission of HIV (MTCT) knowledge among women, perceived stigma at the household and community levels with HIV-related cultural beliefs.

Among women who had been tested for HIV, awareness and knowledge of HIV and PMTCT remained low.

There would be a need for mobile phone communication for improving uptake of antiretroviral therapy in HIV-infected pregnant women.

Socio-cultural and operational challenges, including HIV testing without informed consent, present significant barriers to the scale-up of PMTCT services for women in the country.

Also strengthening local capacity for effective counselling and testing in the antenatal setting is paramount.

HIV is a principal contributor to the high burden of maternal and infant mortality and morbidity in the country.

Some medical experts have given solutions on what the country can do to address the issue of low PMTCT in the country.

Dr Ijaodola Olugbenga, Deputy Director, PMTCT, Lead for the National Prevention of Mother-To-Child Transmission of HIV and AIDS (PMTCT) had advocated for state governments to procure HIV commodities to boost PMTCT services.

According to Olugbenga, there was an urgent need for a clear community strategy to reach the unreached, as well as to mobilise community influencers, especially religious leaders, who would help to educate pregnant women on the PMTCT need.

He said that there was a need to understand why about 60 per cent of pregnant women delivered at home and then respond to their needs with a clear strategy.

Olugbenga also called on the federal government to declare a national emergency on PMTCT.

He said there was an urgent need for a clear community strategy to reach the excluded, recognise the importance of working with all actors, private providers, traditional birth attendants (TBAs), community leaders and networks of people living with HIV.

“There is a need to develop a realistic state-specific approach to improve the development of AnteNatal Clinic (ANC), ANC testing and PMTCT coverage,” said Olugbenga.

Mr Geoffrey  Njoku, UN Children’s Fund (UNICEF) Communications Specialist in Nigeria, said the media needed to provide an update on the current status of HIV and AIDS in the country,  adding that the media needed to bring back HIV and AIDS to the front burner by educating pregnant women on the importance of PMTCT.

Dr Atana Ewa, Associate Professor of Paediatric Respiratory/Infectious Disease, University of Calabar Teaching Hospital, said the management of children living with HIV needed more focus, attention and enlightenment.

Ewa stressed the need for increased screening among women of child bearing age and pregnant women to check the spread of the virus.

She said: “We need to ensure reduction of prenatal transmission, give antiretroviral drugs to pregnant women and during breastfeeding.”

She advised that every pregnant woman should be tested for HIV to have proper data and start PMTCT.

According to World Health Organisation guidelines, all infants who test positive for HIV should be immediately initiated on treatment.

It said the treatment should be linked to the mother’s course of ARV drugs and would vary according to the infant feeding method.

“Breastfeeding, the infant should receive once-daily nevirapine from birth for six weeks. While for replacement feeding, the infant should receive once-daily nevirapine (or twice-daily zidovudine) from birth for four to six weeks,’’ it said.

(NANFeatures)