The HIV/AIDS Epidemic could be getting worse among women
“Girls and women make up more than half of the 36.7 million people living with HIV. Ending AIDS by 2030 requires that we address girls’ and women’s diverse roles by putting them at the centre of the response.” – Joint United Nations on HIV/AIDS (UNAIDS).
In Nigeria today, there are over 3.1 million people living with HIV/AIDS and it is reported that the most populous country in Africa also has the second largest HIV epidemic in the world.
Alongside South Africa and Uganda, Nigeria accounts for approximately half of all new HIV infections in sub-Saharan Africa annually, despite achieving a 5% reduction in new infections between 2010 and 2017.
Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is a band of conditions caused by the human immunodeficiency virus (HIV). HIV is dispersed mainly by unprotected anal and oral sex, contaminated blood transfusions, sharing hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding. Some bodily fluids, such as saliva and tears, do not transmit HIV.
There is no cure or vaccine yet. However, antiretroviral treatment can lower the course of the disease, possibly leading to a near-normal life expectancy. Without treatment, the average survival time after infection is approximately 11 years. A report by the World Health Organisation (WHO) reveals that women, especially adolescents between 15 and 24 years constitute the majority of the people living with HIV globally.
“Adolescent girls and young women account for two out of three new HIV infections.” They also experience a greater risk of sexual abuse and encounter dangerous practices such as child marriage and Female Genital Mutilation (FGM). The report noted that the majority of girls who became sexually active during their adolescent years were often coerced or forced to have sex including other forms of Gender-Based Violence (GBV).
The WHO ascribed the primary cause of these prejudiced health outcomes for women and girls to gender inequality. “Women and girls in areas of conflict and displacement suffer disproportionately as a result of disruption of health systems, exacerbation of barriers to healthcare, and use of rape and other forms of violence as weapons of war.”
A report by National Agency for the Control of AIDS (NACA) also provided evidence-based reasons on why women and girls are more vulnerable to HIV/AIDS. Women, Girls, Gender Equality and HIV in Nigeria: Fact Sheet 2016 states that gender is an inextricable part of the HIV/AIDS equation, and young women are disproportionately vulnerable to infection; elderly women and young girls are also disproportionately affected by the burden of caregiving in the epidemic’s wake.
Gender-based violence and gender inequality are increasingly cited as important determinants of women’s HIV risk. Many women and girls also lack social and economic power to control the effect of the epidemic in their lives. Certain cultural beliefs impress on men to have more than one sexual partner and it is not unusual for older men to have “unprotected” sexual relationship with younger women.
To tackle these issues, NACA in a report, , Gender Responsive Budgeting: Milestone in HIV/AIDS Programming advocates gender-responsive budgeting to ensure milestone in HIV/AIDS programming. “Women and girls vulnerability to HIV is deeply rooted in their biological makeup and this is exacerbated by a complex mix of societal norms and value systems which not only affect women and girls but also men and boys.”
In 2018, the Lagos state Commissioner for Health disclosed that at least 2,131 pregnant women have tested positive to HIV. Stakeholders were concerned that if the rate of HIV infection is high especially among pregnant mothers in a state such as Lagos, with a reasonable level of health awareness and budgetary allocation, then the situation in other states could be greatly pathetic.
Coverage rates for PMTCT, ART, viral load and early infant diagnosis (EID) remain unsatisfactorily low and Nigeria accounts for about one-third of new HIV infections in children (about 60, 000 annually) due to high mother-to-child transmission rates. Only 12 percent of children living with HIV are on ARVs.
Nigeria is a fast-track country, with the highest population in Africa and its response is guided by the National Strategic Framework 2017–2021, which aims at ending AIDS by achieving zero new infections, zero AIDS related deaths and zero discrimination. Elimination of mother-to-child transmission of HIV is a priority. However, stigma and discrimination is still a major challenge, especially towards key populations and people living with HIV.
This report is undertaken with support from Code For Africa to amplify the Gender Gap conversation