Absztrakt
Nigeria is Africa’s most populous country, and is home to the third largest number of persons living with HIV/AIDS in the world. Poverty, stigma, discrimination, and a poorly coordinated health system constitute major barriers to HIV treatment and prevention efforts. The purpose of this paper is to review the current status of the HIV/AIDS epidemic in Nigeria, analyze the challenges facing provision of HIV/AIDS services, examine the prospects of attaining universal access to HIV prevention, treatment, care and support, and advance recommendations for developing quality, sustainable and efficient HIV/AIDS services in Nigeria. HIV programs in Nigeria must emphasize sustainability of current foreigndonor driven treatment and prevention initiatives by engaging all segments of the society and enhancing community leadership and ownership of the programs.
Key words: HIV/AIDS epidemic, Nigeria, challenges
Résumé
Le Nigeria est le pays le plus people d’Afrique, et est le troisième pays abritant un grand nombre de personnes vivant avec le VIH/SIDA dans le monde. La pauvreté, la stigmatisation, la discrimination et une mauvaise coordination des system de sante constitue une barrière majeure au traitement du VIH et aux efforts de prévention. L’objectif de cette étude est de revoir le status de l’épidémie du VIH/SIDA au Nigeria, d’analyser les défis auxquels font face les provisions de services VIH/SIDA, d’examiner les prospects d’accès universel a la prévention, au traitement, aux soins et support des patients ayant le VIH, des recommandations pour une amélioration de la qualité et l’efficacité des services VIH/SIDA au Nigeria. Les programmes VIH au Nigeria doivent être soutenus, et des recommandations à développer la qualité et des services efficacités au Nigeria. Les Programmes de VIH au Nigeria doivent intensifie les efforts soutenus des donateurs étrangers des médicaments et les initiatives de prévention en engageant tous les couches de la société et Encourageant le leadership communautaire et propriétaires des programmes.
Correspondence: Isa Abubakar Sadiq, Department of Community Medicine, Aminu Kano Teaching Hospital, PMB 3452, Kano, Nigeria. Email:-abumusadiq@yahoo.co.uk
Hivatkozások
UNAIDS. 2008 Report on the Global AIDS epidemic. Geneva: UNAIDS, 2008. Accessed Dec 22, 2008, at http://www.unaids.org/en/KnowledgeCentre/HIVData/Global Report/2008/2008_Global_report.asp United Nations Programme on HIV/AIDS (UNAIDS).
AVERT. HIV and AIDS in Nigeria. www.avert.org/aids-nigeria.htm Accessed 12/25/2008.
Federal Ministry of Health, Nigeria (2007) Integrated Bio-Behavioural Surveillance Survey Among Most at Risk Populations in Nigeria. Abuja: National AIDS/STIs Control Programme (NASCP), Nigeria.
The International Bank for Reconstruction and Development / The World Bank. 2008. West Africa HIV/AIDS Epidemiology and Response Synthesis. Characterization of the HIV epidemic and response in West Africa: Implications for prevention. Washington D.C. October 2008.
Federal Ministry of Health, Nigeria, 2002. HIV/AIDS: What It Means for Nigeria (Background, Projections, Impact, Interventions, and Policy). 1st ed. Abuja: FMoH Nigeria.
Iliyasu Z, Abubakar IS, Kabir M, Aliyu MH. Knowledge of HIV/AIDS and attitude towards voluntary counselling and testing among adults. J Natl Med Assoc. 2006; 98(12): 1917–1922.
Adeyi O, Kanki PJ, Odutolu O, Idoko JA (eds). AIDS in Nigeria: a Nation on the threshold. Harvard Centre for Population and Development Studies, Massachusetts, 2006.
Nigeria National Agency for the Control of AIDS: Nigeria 2007 United Nations General Assembly Special Session on HIV/AIDS (UNGASS) Country Progress Report (2008).
U.S. President’s Emergency Plan for AIDS Relief. FY 2008 Country Profile: Nigeria. Accessed Feb 28, 2009 at http://www.pepfar.gov/press/countries/profiles/116242.htm
Health Reform Foundation of Nigeria (HERFON). Impact, challenges and long term implications of antiretroviral therapy program in Nigeria. August, 2007. Accessed Mar 3, 2009 at http://www.herfon.org/docs/HERFON_ART_Report.pdf
Ekanem EE, Afolabi BM, Nuga AO, Adebajo SB. Sexual behaviour, HIV-related knowledge and condom use by intra-city commercial bus drivers and motor park attendants in Lagos, Nigeria. Afr J Reprod Health. 2005; 9: 78-87.
Kelly JA. Community-level interventions are needed to prevent new HIV infections. Am J Public Health 1999; 89: 299–301.
Ramirez-Valles J. The protective effects of community involvement for HIV risk behaviour: a conceptual framework. Health Educ Res 2002;17(4): 389-403.
Partners for Health Reformplus, DELIVER, and POLICY Project. August 2004. Nigeria: Rapid Assessment of HIV/AIDS Care in the Public and Private Sectors. Bethesda, MD: The Partners for Health Reformplus Project, Abt Associates Inc., 2004.
United Nations Development Program (UNDP). Leadership for Results. UNDP’s Response to HIV/AIDS. Community Capacity Enhancement Strategy Note. The Answer Lies Within. HIV/AIDS Group, Bureau for Development Policy; 2005; New York, NY.
Nigeria Demographic and Health Survey (NDHS). Federal Office of Statistics/Lagos and IRD/Macro International Inc, Columbia, MD 1999.
Siliciano JD, Siliciano RF. A long-term latent reservoir for HIV-1: discovery and clinical implications. J Antimicrob Chemother. 2004; 54(1): 6-9.
World Heath Organization, UNAIDS & UNICEF (2008). Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. Geneva.
Binswanger HP. Scaling up HIV/AIDS programs to national coverage. Science 2000; 288: 2173-2176.
Cohen J. Bang for the buck. Science. 2008; 321: 518-519.