Nigeria

Think children are spared the worst of HIV?

HENRY, (not real name),  a 10-year-old orphan born with HIV, lives with his aged grandmother and brother. His grandmother took over his care after his brother moved to another city to work.

Months after, he became terribly ill and died in June 2019 because he had defaulted on his HIV medications. The grandmother, who had difficulty moving, could not ensure he went to the clinic for medical care or to refill his prescription.

Kunle, a 13-year-old boy living with HIV, also died at the University College Hospital after he developed an infection. Despite all that was done to save him, he did not survive.

Abass and Sherifat are siblings whose mother passed away a few years ago, leaving them to be cared for by their security guard father. The five-year-old Abass took ill frequently and at the nearby clinic that his aunt took him to for treatment, tests revealed he had HIV.

These are few of Nigerian children living with HIV. UNICEF in its 2020 report said that in Nigeria about 22,000 new infections occurred in children aged zero to 14 years in 2019, bringing the total number of children living with HIV in the age group to 150,000.

The report released to mark the 2020 World AIDS Day said almost 15 per cent of global AIDS-related deaths in children and adolescents globally occur in Nigeria.

“Approximately, every minute and 40 seconds, a child or a young person under the age of 20 was newly infected with HIV last year, bringing the total number of children living with HIV globally to 2.8 million,” UNICEF said in the report.

Up to half of the babies born to HIV-infected mothers became infected themselves, either in the womb, during labour, or through breast-feeding, unless the mothers and babies are treated with antiretroviral (ARV) drugs.

Dr. Babatunde Ogunbosi, a consultant paediatrician, University College Hospital (UCH), Ibadan, said Nigeria is still house to the largest number of children with HIV in the world due to its high fertility rate, poor access to prevention services and dysfunctional health delivery system.

He added, “not every doctor is comfortable treating children. And when it comes to HIV treatment, it is more difficult because not all facilities offering comprehensive HIV service programmes that provide care for children with HIV.”

Ogunbosi declared that a lot of non-disclosure of HIV status, poverty, stigma, poor access to treatment and prevention in hard to reach areas has contributed to the rise  in the population of children with HIV in Nigeria.

Dr. Ogunbosin said many women still do not tell their husbands that they have HIV, therefore, making adherence to HIV medication very poor.

“Of course, she is going to have children, and they are likely to have HIV. It happens all the time,” he declared.

The expert decried the low number of Nigerian pregnant women who access antenatal care, who get screened for HIV and deliver at health care facilities and if need be, take HIV medications to ensure they can protect their baby from contracting the virus.

According to Dr Ogunbosin, this is a still huge gap in HIV treatment and prevention that needs to be filled, especially with disadvantaged populations.

“There is a whole bunch of psychosocial support that these families and children need that there is no particular attention or funding for. It is difficult, it is challenging but it is a need that must be addressed,” he declared.

Mr Williams Marcus, proprietor, Living Word Missions, an orphanage at Ososami in Ibadan, said government helps to ameliorate the problem of children with HIV by training all homes to manage these children and then accommodate them based on their capacities.

From experience, he stated, having persons living with HIV take care of these children in homes will also ensure they receive better care since they will be acting as their mentor mothers.

“Their care will not be haphazard. They understand the implication of adherence to HIV medications and they will not regulate their contact with them,” he declared.

But Dr Lanre Abass, Executive secretary, Oyo State Agency for Control of AIDS, assured that the agency had been working on closing gaps in the care of children living with HIV and that incidence of new HIV in children the state was going down.

Dr. Abass said Prevention of mother-to-child transmission (PMTCT) intervention is one of the most effective interventions to prevent new HIV cases in children.

He added: “The ARV they are giving is very effective in ensuring that the woman lives a healthy life and her child is born without HIV. If we treat the mother to a point that the viral load is undetectable, we can be sure that the baby will be born without the virus in his or her system.”

The OYSACA boss said in Oyo State, there are more than 80 facilities offering prevention of mother to child transmission of HIV services, aside from the 22 facilities offering ARV as well as 500 facilities rendering highly active antiretroviral therapy (HAART) to the general population.

He added: “Even the pregnant women know that prevention of mother-to-child transmission services is part of the routine they do at facilities, be it primary or secondary or private. And the number of children testing positive is reducing.

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