The World Aids Day, first marked on December 1, 1988, is a day set aside each year for people globally to unite in the fight against the HIV/AIDS scourge. It is a day to show support for people living with the disease and, also, to significantly commemorate those who have died from the ailment. The World Health Organisation (WHO) has estimated that more than 25 million people died from the virus between 1981 and 2007, making it one of the deadliest epidemics the world has ever seen. About 34 million people are currently living with HIV/AIDS worldwide. The virus is particularly widespread in sub-Saharan African countries, having high prevalence rates, with South Africa reported to have the largest number of people living with the disease globally.
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is a disease of the human immune system, caused by infection with HIV. For many years, scientists and researchers have theorised about the origins of HIV since it became known in the 1980s.
HIV primarily attacks the immune system, and weakens the ability to fight infections and disease, while AIDS is the final stage of HIV infection, when the body can no longer fight life-threatening infections. HIV is transmitted mostly via unprotected sexual intercourse, contaminated blood transfusions and hypodermic needles and from mother to child during pregnancy, delivery or breastfeeding. With early diagnosis and effective treatment, most people with HIV will not go on to develop AIDS. Prevention of HIV infection has been primarily through abstinence and needle-exchange programmes. It is a key strategy to control the spread of the disease. Overtly, there has been no cure or vaccine; however, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy.
Regrettably, people living with HIV/AIDS (PLWHA) are often discriminated against, because of the (often unfounded) fear of infection and because infection is negatively associated with promiscuity and drug addiction. Additionally, fear-based HIV campaigns have been known to intensify the stigma against PLWHA. One in three people diagnosed with the virus has experienced HIV-discrimination at certain points in their lives.
According to WHO, Africa, particularly sub-Saharan Africa countries such as South Africa, Nigeria, Swaziland, Uganda, Zimbabwe, etc., are the most affected by the pandemic worldwide, having the highest number of PLWHA. One in every twenty adults is living with the virus and 69% of all people living with HIV are in this region. In Nigeria, the HIV prevalence rate amongst people between the ages of 15 and 49 is 0.9%, and an estimated 3.7% of the total population is living with HIV/AIDS, placing it as having the second largest number of PLWHA. According to the National Agency for the Control of AIDS (NACA), the majority of people living with the disease are women and Benue State tops the high prevalence rate list in the country, followed by Akwa Ibom, Bayelsa, Anambra, the FCT, Plateau and Nasarawa, in that order.
There are many factors that contribute to the spread of the virus in Nigeria, such as high-risk practices among itinerant workers, high prevalence of Sexually Transmitted Diseases (STDs), irregular blood screening and the international trafficking of women. As aforementioned, ARVs are the only drugs available for the management of HIV/AIDS. They attempt to control HIV infection by decreasing the patient’s total burden of HIV, maintaining function of the immune system and preventing opportunistic infections that often lead to full-blown AIDS and death.
There is hope on the horizon for PLWHA, however, for a cure. Ongoing research is being carried out in search of a cure for the disease in different climes worldwide. Consequently, after decades of the epidemic, the discovery of a cure for HIV/AIDS is closer than ever before. In March this year, a baby was functionally cured of HIV after physicians treated the infant with antiretroviral (ARVs) beginning about 30 hours after the child was born. In June, the New York Times reported at the 7th annual international AIDS Society conference in Kuala Lumpur, that preliminary results from a trial in which two HIV-positive people with lymphoma received stem cell transplants and later stopped taking their ARVs, have shown that as of now, neither of them has any sign of the virus.
On November 7, it was reported that scientists at the University College, London had uncovered a ‘molecular cloaking technique’ used by the HIV virus that enables it to become invincible within human cells, preventing the body’s natural defence systems from reacting. This discovery can further assist scientists in finding a drug that can ‘uncloak’ the virus, thus allowing the body’s natural defence/immune system to stop it from replicating.
On November 27, it was reported by Imperial College London, that scientists and clinicians from five leading UK universities will begin a groundbreaking trial from 2014, to test a possible cure for HIV infection. This impending breakthrough will combine standard ARVs with two new weapons – a drug that reactivates dormant HIV and a vaccine that induces the immune system to destroy the infected cells. The researchers expect to know the results of the trials by 2017.
Also, there have been proven and practicable innovations in attempting to curb the spread of HIV through mother-to-child transmission. The transmission of the virus from an HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is referred to as mother-to-child transmission. Nascent innovations have been able to reduce mother-to-child transmission to below 1%, by the appropriate use of HIV treatment during pregnancy and labour; by having a caesarean delivery if you have a ‘high detectable viral load’ and (when safe alternatives are available) by not breastfeeding. For instance, since 2000, in countries like Denmark, there have been no mother-to-child HIV transmissions when guidelines are followed.
World Aids Day also brings about knowledge, awareness and consciousness of HIV/AIDS prevention. In Nigeria, HIV prevention involves the following:
• Encouraging and promoting abstinence.
• The successful dissemination and delivery of education such as life skills-based HIV education and HIV/AIDS education initiatives, especially among youths.
• Prevention of mother-to-child transmission of HIV, improvement in the uptake of HIV testing and counselling and scaling up access to most effective ‘antiretroviral regimens’ for pregnant women, to halt the rising number of children being infected and living with HIV.
• Media and public awareness campaigns on HIV/AIDS, as there is still a reasonable level of denial of its existence in some parts of the country.
• Sharing of needles and injecting equipment contributes to the spread of the virus and this is prevalent amongst drugs users. Reversing this trend should be a priority if HIV transmission is to be minimised.
• Knowing your HIV status. In Nigeria, most people do not know their HIV status and are sceptical about being tested until they begin to get very sick.
HIV/AIDS is no respecter of persons, age, race, class, wealth or gender. With the World AIDS Day just marked, make it your priority to know all the facts about HIV and AIDS. It’s important to know the facts so that you can get ahead of AIDS before AIDS get ahead of you!
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