AIDS: Holes in the Campaign

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AIDSNIGERIA - "AIDS is real, Avoid casual sex," "Abstinence is the best protection against AIDS," "Avoiding AIDS, as easy as... (ABC) Abstain, Be faithful (to your partner) Condom use," "A Hug gives comfort, not HIV/AIDS, Show love and care to people living with HIV/AIDS," "Stop AIDS, Keep the Promise,"... and so the campaign against the spread of the Human Immuno-deficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) on bill boards the world over seem innumerable.

Bill boards are not the only media used to mount the campaign against the spread of the pandemic. News reports, jingles and programmes are aired and televised in the broadcast, and news reports, features, opinions, editorials and advertisements published in the print media against its spread, have permeated the surface of the globe. All these are apart from public awareness rallies.

The campaigns increase and rage broader by the day, seemingly at the same speed with the reported spread of the pandemic, at some instances, seeming at a higher speed, to remoter human settlements, especially in African and Asian countries, most especially in those reportedly having the highest prevalence rate.

About four decades ago, precisely since 1981, when it was reported to have claimed its first victim in the United States of America, over 38 million people are reported to have contracted the disease, and 25 million are reported to have died of it. In 2005 alone, it was reported to have claimed three million people, and widowed and orphaned several millions globally. According to the maiden edition of ActionAid International, Nigeria's Human Security Watch last April, it has orphaned 13.4 million children. NACA report says, in Sub-Saharan Africa alone, it has orphaned about 12 million children in the age range of 0 and 17, out of which about one million are Nigerians.

India is currently reported to have the highest prevalence rate in the world. South Africa ranks second and Nigeria, third.

In Nigeria, the prevalence of HIV/AIDS infection from its reported emergence in the country in 1986 rose to 5.8 percent of the entire population in 2001, dropping to 5.0 in 2003 and 4.4 in 2005. According to the National Action Committee on AIDS (NACA), over two million Nigerians have died of the ailment in the last 15 years. The current infection figure is about three million.

Over the last 40 years, all over the globe, hundreds of civil society organizations have been established to battle the spread of HIV/AIDS, in collaboration and corroboration with international agencies, religious, cultural and gender-based organizations and governments of countries. The amount of resources spent in the battle, the world over, seem unquantifiable.

In Nigeria, ditto the world over, campaign strategies essentially target age groups, professional/trade unions, educational institutions etcetera, chiefly the youths as the most vulnerable, and the warnings in the various media messages have continued to be: Abstinence (for the singles), Faithfulness to one's partner (for the married - avoid infidelity) and Condom use (for the compulsive pre and extra marital sex indulgers).

So, the campaign rages on. Yet infection soars, or so a large section of the public believes, in spite of the officially reported prevalence rate drop from 5.8 percent in 2001 to 4.4 percent in 2005. The public is beginning to contrast the efficacy of the campaign, instanced by the prevalence rate drop, with what it observes as practically happening on the spread across the land.

The public measures the campaign efficacy on the scale of what it observes as spread according to its level of education on HIV/AIDS, remarking that the anti-spread campaign has so many shortcomings it must overcome to record success commensurate with the prodigious resources spent and commitment expressed.

"They say HIV/AIDS can also be contracted through manicure, using the same needle with its patient and taking a donation of blood from its patient, apart from sex, but gradually the sex factor has gained higher pitch in the campaign, and the other factors are becoming so silent that many people now forget about them as factors until they see them in bill board drawings," one Richard, who works in a hotel at Dei-Dei, Abuja, maintained.

According to him, most media campaigns now emphasise the sex factor "and the other factors are mostly seen in drawings only in the hospitals, and most patients observed to have contracted it through women or men (sex) may actually have done so through the other factors. So, if they don't want us to begin to believe that all the noise about AIDS is aimed at stopping us from bearing children, to check our population increase, the campaign should also raise the other factors to an equal pitch with the sex factor."

Garba Musa resides at Suleja. "For me, if the campaign is mainly to check promiscuity, it is not achieving enough. More people go about enjoying themselves with the opposite sex in spite of the campaign against its spread, and since there are a lot of those infected who are not known by medical records, then it is spreading, as more unknown people get infected."

According to Garba, "more people are indulging in high risk casual sex and along-the-street manicure. They don't know if they are immediately infected and, therefore, they are not known. I cannot talk on the issue of blood and needles in the hospitals."

He posits strongly: "If the campaigns are essentially to make people love and guard their health and life more, then there is something wrong with the campaign, which should be corrected. Most people infected would never have preferred risking their health and lives. I cannot attribute the in-spite-of-the-campaign spread to the conscious stubbornness of people."

Ladi (real name withheld) is a prostitute at Dei-Dei. "Whoever comes to me, I ask him, 'with or without condom?' If he says 'without condom,' I shun him. If he says, 'with or without condom,' then I choose to go with him with condom, because I will happily believe that he has given me the choice on how to serve him. If he just says, 'with condom,' then I am immediately happy with him. For me, although I am searching for money, if you are not a friend of condom, you are not my friend, and you are not my own at all."

According to Ladi, "Most of us (young prostitutes) are hypocritical on the use of condom. They only tuck condom between the folds of their wrappers and go about the business, just in case their boy-friends ask for it or pose as those who are so clean and conscious of their health that they don't do anything without it. They may even pose as losing interest in the affair if they observe that they (the girls) are the care-free type which goes about the business with or without condom. Actually, such girls are not condom-friendly."

She continued: "In spite of the campaign on the use of condom, most of us, if they will be truthful to you, will tell you that they don't know how to use it. It is usual to hear many of us telling others when we discuss that the condom worn by their boy-friends got torn, and they just laugh it over. They never express any fear that they could have contracted any disease following the tearing. Look! I don't even know whether we have different brands of Gold Circle (condom), whether some are more durable than others, or whether most people don't know how to use it, because many people complain that it easily breaks, they lack confidence in it and they always have to observe at intervals during intercourse if it is still intact. The campaign should educate people more on condom and its use."

Mary (not real name) is another woman of easy virtue at Nyanya. She picked more holes in the abstinence aspect of the anti-spread campaign than on any other.

"The campaign says if you are single, you must guard your chastity until you marry. You must not 'know' any member of the opposite sex at all but your spouse. You must wait, however long the waiting will be. The campaign has slammed a prohibition on you on where you may have wished to find satisfaction, but it has not told you how to blunt your sexual urge or find satisfaction in something else other than sex until you marry."

She continued: "Many singles, and even the married, especially maniacs, may be so possessed by the urge that they may not endure being chaste until they marry or confine themselves to their spouses. The AIDS campaign should tell them the safe and lawful activity to employ their urge instead of sex until they marry or reduce their urge, to the level that it can be satisfied by their spouses."

Many women of easy virtue and, by extension, perhaps, a substantial population of other women, do not even know that women have a different condom separate from that of men.

Faith Anawo works with Journalists Against AIDS (JAAIDS) of Nigeria. "Since the emergence of HIV/AIDS, the campaigns against it, I think, have been useful because, through them, people know about HIV and AIDS, but more should be done because the disease is still there, people are still infected and affected. The government and all civil society organizations have been doing their best on creating awareness against AIDS, but I can't really say why it has still not been sufficiently curbed. I am sure with time it can because change takes time. It is a process," she said.

She announced that researchers, after a Cape Town, South Africa, meeting this year, are researching into the manufacture of a gel called Microbicide meant for women to use against infection.

For effective campaign against HIV/AIDS spread, according to Faith, "civil society groups should focus not only on prevention but also on treatment, care and support, so that when we get responses on all those other issues then I think we will actually have a greater impact in preventing infection. It is said that it is not HIV/AIDS that kills but the stigma. People still think that if you have HIV/AIDS you are gone. No! It is the opportunistic infections like TB, malaria and the many other little signals that you and I have regularly that kills you, AIDS just reduces your immune system to facilitate such little infections and ailments in the killing." The campaigns, she believes, should educate people more on this.

She stressed the need for people to be more highly and broadly educated. "Education is the key. People need to be informed. If you don't know that a thing will kill you, you will go and touch, but if you know, you will not go near it. People need to be informed properly."

Chidozie Ezechukwu is a Programme Officer with the Network of People Living With HIV/AIDS in Nigeria (NEPWHAN). He said all agencies and organizations concerned with the spread of HIV/AIDS are looking into the possibility of scaling up prevention alongside treatment, as a vital aspect of the campaign strategy. Along this line, we in NEPWHAN are running an advocacy programme among ten countries globally.

He examined the ineffectiveness of the campaign on condom use. "You have to be careful. People assume that condom use is safe. When you say condom use, it does not mean 100 safety. It is important to add that you have used it correctly and consistently, which means that for every sexual activity, you have to use condom, and, not only that, you have to use it correctly and consistently."

Most people do not know how to use the condom correctly, he admitted. "Yes! It was a gap which was noticed. That is why a part of the campaign system is that after every campaign activity, a demonstration is given on the use of condom, especially in NYSC camps. NACA has also come up with its own brand of condom called Options. It is two in the pack. There is a leaflet inside with direction on how to use it. So, once you buy it and read the leaflet, you will succeed in using it properly. Nigerians hardly read leaflets in drugs. That is the problem. When you read the leaflet of Options, it gives you direction on how to tear it open, wear it, use it and remove it after use."

He strongly maintained that the disease has been spreading due to persistent ignorance.

"You assume people know. They don't know. You assume people have enough information. They don't have that information. I was watching the NTA network news one day and they (NTA reporters) were sampling opinions of people in Lagos of all places, where you don't even have rural areas again, women were asked on how HIV is contracted and some of them were still saying by sharing the same toilet with an infected person. Some people were still saying it is by sharing the same cutlery with an infected person, in spite of the campaign in the various media. This is a misconception. It is a misinformation. It tells you that a good percentage of Nigerians have not been reached with accurate information on HIV/AIDS. They are still not properly educated."

Chidozie also picked holes in the campaign from the perspective of economic status. The prevailing belief is that poverty is a principal contributory factor for infection.

"I say affluence also contributes to the spread of the virus. It is just the other side of the coin. If you say poverty contributes to it, that a girl can submit herself for material benefit, somebody is providing that benefit because he can afford it. If the girl is infected, the man will definitely get infected as well. So, with his money, he has acquired HIV/AIDS. Yes! He has bought AIDS with his affluence. That is why I am saying, the problem is ignorance."

Tunde Akanni is the media consultant to NACA. He dismissed the claim that a large section of the public is still ignorant. "This ignorance you are talking about, I don't know what the source is, but I don't think any section of the public is ignorant."

He maintained that there are limits to which campaigns can go in the battle against HIV/AIDS spread. "In our society, people can choose to be licentious. There are rules, regulations and laws. When you are licentious, the law will take care of you. If someone chooses to do what pleases him, what do you do?"

How can the anti-HIV/AIDS spread campaign approach the licentiousness of people on sex? Are other sources of contracting the ailment no more threatening?

Copyright © 2006 Daily Trust.