In the fight against HIV/AIDS, communities can make a lot of difference: World AIDS Day 2019

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Editor’s Note: For World AIDS Day 2019, Dr. Obehioye Aimiosior, Medical Officer, Augustine University, Ilara, reflects on the importance of the theme, “Communities make a difference,” and proffers ways that we can all ensure that Nigeria reaches the important UNAIDS target of 90–90–90. 

World AIDS Dayis celebrated on December 1 every year and is dedicated to raising awareness about the HIV/AIDS pandemic. Beyond awareness, it celebrates progress, successes and global partnerships to eradicate the disease. This year’s theme was“Communities make the difference” and the World Health Organization (WHO) is highlighting the difference these communities are making to end the HIV epidemic while drawing global attention to the need for their broader engagement in strengthening primary health care.

HIV is a major global public health issue that has claimed more than 32 million lives so far. It has become a more manageable today, enabling infected people to lead long and healthy lives due to increasing access to HIV prevention, diagnosis treatment and care. Over 37 million people were living with HIV at the end of 2018 with more than one million newly infected in 2018 alone. Over two-third (25.7 million) of all people living with HIV live in the WHO African countries (excluding Morocco, Libya, Egypt, Sudan, Somalia and Djibouti). This is the population of some countries or cities in Africa. Imagine an entire city or country living or dying from HIV related causes.

In Nigeria the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) revealed that 1.9 million Nigerians are living with HIV/AIDS, and of that number 1.1 million knew their status. The National Agency for the Control of AIDS (NACA) is working to ensure that everyone who has HIV is aware of their status and can get treatment.

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A gentle reminder
Sometimes we can get too complacent and run the risk of forgetting why it matters in the first place. We get detached from the people behind the data and get distracted with the infographics and other images that we are usually inundated with. So a little reminder is sometimes needed why we do what we do.

Have you wondered what it is like living with HIV? Like 52-year-old Dorothy (not real name) who tested positive for HIV when she was 30. It all started with flu-like symptoms. Five months later, her and her husband were diagnosed with HIV, despite being in a monogamous relationship throughout her university days. She was also pregnant at the time of diagnosis. Thankfully, her child has remained negative. She takes her antiretroviral drugs daily and within two months of starting the drugs, her viral load dropped. Today she is happy and healthy.

While everyone living with the virus may not understand the technicalities and science behind the treatment of HIV/AIDS, sharing the basics is one important way to help them understand why their bodies react in different ways. Awareness may also help reduce the number of people who stop taking their medication. WHO has information pages and factsheets that carefully ​explains the treatment of HIV and is easy to understand, irrespective of the individual’s literacy level.

Image credit: WHO

Keeping to commitments
World AIDS Day also serves to track progress and global targets to end the HIV/AIDS pandemic. One of these targets is UNAIDS’s 90–90–90 target. It is an ambitious target to ensure that by 2020, 90% of all people living with HIV will know their HIV status out of which 90% will receive sustained antiretroviral therapy. Also, 90% of all people receiving antiretroviral therapy will have viral suppression. As of 2018, Nigeria was at 79–62–53.
 
The only way to make greater progress is if people know their status by getting tested. Efforts led by youth-led organisations are trying to ensure more people get tested. Following a 2016 guidance released by WHO in 2016, the Population Council conducted a study which showed high acceptance of self-testing among key populations. A youth-led organisation, Active Voices also received support from Fondation Merieux to leverage on technology to develop an Anonymous Partner Notification Service. These initiatives are targeted at ensuring that the first 90 is met especially among key populations who account for 54% of new HIV infections globally.

Image credit: WHO

Communities can make the difference

The theme for this year is apt as the landscape of community engagement and advocacy is gradually shifting from advocating for communities to empowering communities to advocate for themselves. Advocacy is more effective when communities are involved because there is only so much that organisations can do.
 
Mr Onyeka Onumara, who has been organising World AIDS Day activities since 2007 stumbled unto this fact this year. He has always organised the events in cities but this year, he decided to organise an event in his village. They found out that most of the adults in his community have never checked their HIV status. A faith-based organisation (FBO) that participated in the discussions sessions agreed to review their policy on refusing to wed couples where one is HIV positive. He said they bridged the knowledge gaps that fuelled discrimination. He said FBOs can do a lot better when they openly discuss sexual and reproductive health-related issues. “They can help curb discrimination and stigmatisation of Persons Living with HIV (PLWH) as well as encourage treatment at health facilities than ‘miracle centres’,” he said.

Onumara’s experience summarises some of WHO’s key messages for policymakers on World AIDS Day 2019 on how communities can make a difference because these issues are closer to them than anyone else. One of the six messages emphasises that community-based HIV treatment and monitoring saves money and reduces the workload for doctors, nurses and other healthcare professionals.

World AIDS Day 2019: HIV community advocates making the difference

Everyone has a role to play to help end HIV. The government can expand access to HIV self-care kits, improve HIV treatment by strengthening HIV care and support networks. Most importantly, the government can take ownership by committing more funds and ensuring that funds from donor agencies are used judiciously.
 
As individuals, we can learn more about HIV, help educate others about prevention, testing , and treatment to help reduce stigma. We can stay healthy by talking to healthcare providers about ways to stay safe. We support and encourage those who are on medication to stick to treatment.
 
Remember to wear a red ribbon during next year’s World AIDS Day, as it symbolises solidarity with people living with HIV and reminds us of those who have died from AIDS-related illnesses.

Dr. Obehioye Aimiosior is a Nigerian Medical Doctor who obtained her MBBSin 2017 from the University of Ibadan, graduating as the best medical student. She has a keen interest in health education and has used the community development service as an avenue to educate her local community about common medical conditions. She is a volunteer with the Neo-Child Initiative where she takes part in health outreaches to children in underserved communities and with Sustyvibes, an organisation redefining sustainability advocacy in Nigeria.

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