HIV prevalence fell last year, but is set to resume growth

The percentage of Nigeria's population infected with the HIV virus fell for the first time last year, according to a government survey of pregnant women tested in ante-natal clinics. However, the sentinel survey conducted by the Ministry of Health showed that the AIDS epidemic was continuing to grow in some regions of the country. It also predicted that the number of Nigerians infected with the virus that causes AIDS would rise sharply over the next five years. The survey concluded that 5.0% of Nigeria’s estimated population of 126 million was infected with the HIV virus in 2003. That represented a fall from the prevalence rate of 5.8% registered by a similar survey in 2001. But government officials and AIDS activists warned that the disease was still a long way from being brought under control in Africa's most populous country. “It is not sufficient to conclude that the epidemic has stabilised or is on a downward trend,” said Health Minister Eyitayo Lambo. Even after this apparent fall in infection rates, Nigeria still has the third largest population of HIV sufferers in the world after South Africa and India. The results of the sentinel survey were published last Friday, shortly before Lambo opened Nigeria's Fourth National Conference on HIV/AIDS in the federal capital, Abuja on Sunday night. Many attendees were angered at the timing of the upbeat report, saying it was a political move by the government which detracted from the serious message of the conference - that HIV/AIDS is a massive and growing problem. “What have we done?” asked Mohammed Farouk, executive director of AIDS Alliance of Nigeria. “We’re talking politics. It doesn’t make sense to talk about a decrease regarding the situation we’re facing,” he said. “The President wants to have results, but unfortunately, it’s not the case for the time being.” The sentinel survey showed HIV prevalence rates in Nigeria's 36 states and the Federal Capital Territory (FCT) ranging from 1.2% to 12.0%. In some states, the number of people infected with the virus that causes AIDS had gone up since the 2001 survey. By UNAIDS definition, HIV prevalence in a community can only said to be declining when two consecutive surveys show a lower prevalence rate. Between 1991 and 2001, HIV prevalence rose consistently in Nigeria. It increased from 1.8% in 1991 to 4.5% in 1996 and 5.8% in 2001. The sentinel survey was compiled from data collected at ante-natal clinics across the country. Pregnant mothers who gave their permission were tested for HIV along with other diseases. The survey based its findings on the results obtained from at least two clinics in each state. However, such a report is a guideline and cannot be considered conclusive. Most Nigerian mothers do not deliver in a clinic and not all of those who do allow themselves to be tested forthe HIV virus. Nonetheless, the report showed clearly that AIDS is very much a national problem. Thirteen states showed a prevalence rate of more than five percent and these were scattered throughout the country. Many rural areas had above average prevalence rates, along with the Federal Capital Territory around Abuja. “The report reaffirms that no state or community is spared by this epidemic. There are wide variations between states and between urban and rural areas across the country,” the health minister said. Cross River State, an oil-rich, but heavily forested territory in the southeastern corner of Nigeria, had the highest prevalence rate of 12%. Osun state in the southwest, which contains many large towns had the lowest of 1.2%. The survey predicted that by 2008, there would be a cumulative death toll from AIDS in Nigeria of 3.6 to 4.2 million. “The number of AIDS cases will continue to rise as this reflects those already infected in the population who will go on to develop the disease,” it said, adding that the number of babies who were born HIV positive was also expected to climb over the next few years. Although HIV/AIDS affects all age groups, the survey concluded that young people aged 15 to 24 were most likely to become infected with the virus. A report on the findings of the survey warned that as a result Nigeria was on “the threshold of an exponential growth of the epidemic.” “It would be dangerous to relax intervention efforts based on the current observations,” it added. However, for activist groups in Nigeria, the announcement that HIV infection rates had fallen, came at a good moment, just nine months after the government launched a new AIDS policy. The Health Ministry noted that impact of new AIDS control programmes may have contributed to the decline. “The public is not only aware of the existence of HIV/AIDS, they were also able to attribute it to sexual intercourse. Condom use among youth and the general population has been shown to be on the increase,” the report said. In August 2003, President Olusegun Obasanjo launched a multi-sectoral approach in fighting against HIV/AIDS, due to combat the stigma attached to the disease and to provide succour, care and support for those living with it. Referring to a National HIV/AIDS and Reproductive Health Survey, conducted last year, the sentinel survey report said“up to 88 % of the public was aware of HIV/AIDS”. But at the AIDS conference in Abuja, not everyone was convinced. “There’s a lot of awareness, but no behaviour change,” said Pat Matemilola, the national coordinator of the Network of people living with HIV/AIDS in Nigeria (NEPWHAN).