Living well with HIV possible through advances in drug therapy
09 November 2023 |
4:20 am
Stakeholders are unanimous that Human Immuno-deficiency Virus (HIV) that causes Acquired Immunodeficiency Syndrome (AIDS), if untreated, has gone from certain death sentences to chronic disease people can live with.
• Breakthroughs in treatment make virus undetectable, untransmittable
Stakeholders are unanimous that Human Immuno-deficiency Virus (HIV) that causes Acquired Immunodeficiency Syndrome (AIDS), if untreated, has gone from certain death sentences to chronic disease people can live with.
The stakeholders, at a brainstorming co-creation meeting, in Abuja, to ‘Assess Communication Gaps and Opportunities for the HIV Response in Nigeria’, said Nigeria has made giant strides towards achieving the target of using drugs to make HIV undetectable and untransmittable. They said that using PreEP (Pre-Exposure Prophylaxis) before engaging in any risky behavoiur can prevent HIV infection, as well as using PEP (Post Exposure Prophylaxis) after risky encounter like rape can also prevent infection.
The stakeholders, at the meeting put together by the United States President’s Emergency Preparedness Fund for AIDS Relief (PEPFAR) through its partner Henry Jackson Foundation Medical Research International (HJFMRI) Ltd in collaboration with Journalists Against AIDS (JAAIDS) Nigeria and Living Health International, are optimistic that if observed gaps are bridged, the country can meet the Joint United Nations Programme on HIV and AIDS (UNAIDS) target of eliminating the virus by 2030 or rather 95-95-95.
UNAIDS, in 2014, launched the 95-95-95 targets. The aim was to diagnose 95 per cent of all HIV-positive individuals, provide antiretroviral therapy (ART) for 95 per cent of those diagnosed and achieve viral suppression for 95 per cent of those treated by 2030.
The five-day meeting, according to the organisers, is the first in a series of conversations aimed at identifying the gaps across diverse media channels, the emerging HIV trends and format needed to disseminate these key messages across the diverse media platforms.
The meeting brought together journalists, programme implementers, affected communities, religious leaders, communication specialists, academics as well as government agencies, development partners and other key stakeholders to review progress and provide strategic direction.
An Advisor on Science Systems and Services, UNAIDS in Nigeria, Dr. Murphy Akpu, told participants that modern medicines mean HIV is not a death sentence.
Akpu said prior to 1996, HIV was a death sentence, but ART was made to suppress the virus. The physician said, now, a person can live as long a life as anyone else, despite having HIV.
He said drugs were also invented to lower an HIV-negative person’s risk of contracting the virus by 99 per cent. Akpu said, in recent years, research has shown that ART can suppress HIV to such an extent that it makes the virus untransmittable to sexual partners. He said it leaves the person living with the virus on life-long, costly medication, but it does not mean certain death.
“The drug, a triple combination, turned HIV from a fatal diagnosis to a manageable chronic condition. It suppresses the virus, preventing it from developing into AIDS (Acquired Immunodeficiency Syndrome), which makes the body unable to withstand infections.
“After six months of religiously taking the daily pill, it suppresses the virus to such an extent that it’s undetectable.
“And once a person’s viral load is undetectable, they cannot transmit HIV to anyone else, according to scores of studies including a decade-long study by the World Health Organisation (WHO) and the United States National Institutes of Health,” Akpu said.
The physician, who was formerly a Deputy Coordinator of PEPFAR programmes in Nigeria, said public health bodies around the world now acknowledge that U=U (undetectable equals untransmittable).
He said PrEP (pre-exposure prophylaxis) became available in 2012. “This pill works like ‘the pill’ – it is taken daily and is 99 percent effective at preventing HIV infection (more effective than the contraceptive pill is at preventing pregnancy).
“It consists of two medicines (tenofovir disoproxil fumarate and emtricitabine). Those medicines can mount an immediate attack on any trace of HIV that enters the person’s bloodstream, before it is able to spread throughout the body,” Akpu said.
The physician said he is supporting the PEPFAR country team to start the process of re-engagement with the media. He said for the longest time, the HIV programme has really been focused on treatment.
Akpu further explained: “Unfortunately, in trying to do that also, we lost energy. So, we’ve lost a lot of energy in terms of its engagement with Nigerian people, and the extent of what that has resulted in is the fact that today, more than 20 years after we’ve been implementing this HIV programme, the programme has been very successful. The extent to which we have implemented, we find that the everyday Nigerian still, unfortunately, is largely ignorant about the progress that has been made in the last 20 years. This workshop was to bring media experts, people who have large audiences, and influencers of different sorts at different levels, to have a conversation and update knowledge on how the HIV programme has changed in the last 20 years.
“In particular, we reflected on issues around how the treatment is now simpler. We also reflected on the fact that today we don’t have anybody with full-blown AIDS. And so, most people who are HIV positive today are well, they are not sick, and they are living normal lives. It’s the success of what we have done in collaboration with the government and also reflecting on the fact that even HIV treatment, the treatment itself is simpler. Drugs are simpler, before there used to be a lot of drugs that you had to take.
“ Now, it has become so much simpler and ultimately, there’s now this concept of U equals U. When somebody is undetectable, the viral level of the person’s blood is undetectable, according to the way we measure it. And that person is unable to transfer HIV to somebody else.
“So, that U equals U concept, and the fact that people living with HIV can live healthy lives and not transmit HIV to other people. Nigerian people, unfortunately, are not conversant with that movement. So, unfortunately, HIV still continues to bear a lot of stigma, discrimination, and just because people are not knowledgeable about it. “
“One of the things we talked about in the workshop also was the fact that our people still have very negative nomenclature. The way they name HIV in our rural context, our local languages, does not reflect this positive change that’s happened. People living with HIV today look like you and I. Healthy people walking around, and it’s not that ugly, sick picture that we used to know way back before this programme started”
Akpu said UNAIDS, PEPFAR and other partners want to start the process of re-engaging with Nigerian people to give them this knowledge and in the process, now begin the conversation of how to de-stigmatise HIV. “Begin to think about it like any other clinically managed condition. Hypertension, diabetes, you know, for now, people have to take treatment for life, but the innovation around it is also changing. And who knows what tomorrow will come with? We may eventually find a cure for HIV. So, this is about reducing stigma, this is about updating the knowledge of Nigerian people about where we are with the programme so far and also celebrating the success of the past 20 years,” he said.
Coordinator of Living Health International, Dr. Gbenga Adebayo, said the take-home message from this workshop is thatHIV treatment has evolved in a very, very positive way. Adebayo said people are not dying anymore because of that and then people can live with HIV and live very normal lives. “If they are undetectable, then they will not transmit HIV to others. So, in essence, we should now begin to craft a message around or a push around how we de-stigmatise HIV because stigma makes everything worse. It makes people unable to step forward to access treatment. It makes it difficult for people to engage with the community and other public services as they should be. And it makes people vulnerable in the sense of how they relate to other people.
“So, let that positive message now become our new message around HIV. Let’s begin to re-educate our people. Things have changed a lot since we started talking about HIV and it’s important that right now, we start to reflect that positive change that has happened in the way we are communicating HIV to the world,” Adebayo said.
Associate Director, PEPFAR, HJFMRI Nigeria, Dooshima Uganden-Okonkwo, said: “We are an organisation that is directly supported by the US Department of Defense Programme in Nigeria. Now, in our role as an implementer for the programme in Nigeria, we have some funds that have been channelled to us and those funds are channeled to the PEPFAR Nigeria office. Now, those funds are to engage with civil society organisations in Nigeria to support activities that are important to achieving certain objectives and deliverables in the HIV space, which the civil societies in Nigeria feel are very important and that is what we do.
“ Now, one of those activities is what you are currently in now, and that is media. So, we have some of the media organisations on that, our engagement platform, specifically JAAIDS and Living Health International, who have reached out to see how we can better engage the media around communicating, around some of these HIV programmes we do and the trends that are emerging. So, this engagement is just beginning.
“This is the first of a series of engagement and the first one is what you are in now, is the co-creation meeting with the different media representatives from print, TV, radio, and social media. The goal is that at this point, we just want to listen to each other, want to listen to you, want to listen to representatives of those who provide HIV and AIDS, and also beneficiaries. Let’s talk to one another. The content we get from this meeting will now help the CSO leaders to now develop the content for training, because we want to train representatives from different media on reporting on these things in a way that is correct and is consistent so that we can reach more and more people about what is going on.”
National Coordinator, JAAIDS, Laide Akanni, said: “We want to ensure that the information that’s out there is correct, is consistent, and also, it’s not, in itself, stigmatising because if we’re not careful, some of the choices of words we use, in itself, are stigmatising. I’ll give you an example. We say HIV victims. We always put the condition before the people. I’m not sure they say that anymore. So, these are some of the things we are hoping that, even in the reportage, the language will be empowering. It will not be, in itself, stigmatising. To show that this is the only condition that people are living with and that they can overcome and do well.”
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