In 2016, 240,000 adolescents (between the ages of 10-19) were living with HIV, making up 7% of the total number of people with HIV in Nigeria. Research also showed that more than 46,000 young women were infected with HIV compared to 33,900 young men in the year 2016. Young women have a higher HIV prevalence and are infected earlier in life than men of the same age group.
There are a number of factors that increase HIV vulnerability among young people, including a lack of knowledge and appropriate sexual reproductive health services. Reports from a 2017 National Health Survey showed that only 29% of women and 27.9% of men between the ages of 15 to 24 could correctly identify ways of preventing sexual transmission of HIV, and reject major myths around transmission. Early sexual debut is common in Nigeria, with 15% of girls and 4% of boys having sex before they are 15 years old. Inter-generational relationships are also common in Nigeria. This increases HIV risk among this group as often the virus is passed from older men to younger women.
Despite their elevated risk, reports show that few adolescents test for HIV regularly. In 2017 only 2% of males between 15 and 19 and 4% of females had tested for HIV in the last 12 months.
There are quite a number of reasons why more people are not testing for HIV in Nigeria. These include supply problems with testing kits and logistic issues getting further supplies. There is also a common belief that HTC centres are where HIV-positive people go to access care, rather than them being testing centres for those who don't know their status.
As of 2014, the world embarked on a Fast-Track strategy to end the AIDS epidemic by 2030. This brought about the UNAIDS 90-90-90 for treatment indicating that by 2020, the underlisted targets must be achieved:
- 90% of people living with HIV know their HIV status; 90% of people who know their status on treatment; and 90% of people on treatment with suppressed viral loads.
- Reduce the annual number of new HIV infections among adults to 500,000.
- Achieving zero discrimination.
Although considerable progress has been made, there is still a long way to go especially for the pediatric treatment of HIV. Of the 1.8 million children aged 0 to 14 living with HIV globally, only 53 percent were receiving life-saving ARVs in 2019, and 88 percent of them live in sub-Saharan Africa. With the absence of ARVs, 50 percent of children living with HIV die before their second birthday, and 80 percent die before their fifth.
Targets set in the recent National Strategic Framework commit to 60% of the general population and 100% of key populations and children of mothers living with HIV to have access to HIV testing services. The plan also hopes to integrate screening for other co-infections into HIV testing and counselling services.
The present set of targets is the UNAIDS 95-95-95 for treatment. This implies that:
- 95% of people living with HIV know their HIV status; 95% of people know their status on treatment; and 95% of people on treatment with suppressed viral loads.
- Reduce the annual number of new HIV infections among adults to 200,000.
- Achieving zero discrimination.
Nigeria has put in place policies that allow for self-testing, but these testing kits are not yet available across the country. There had been quite a number of training to conform the officials across facilities to the modus operandi when it comes to achieving the UNAIDS 95-95-95 for treatment but there is a growing gap at the community level which calls for patient literacy and/or community system strengthening for HIV treatment and especially against stigmatization. In the same vein, self-testing kits should be made available to adolescents and young persons and ongoing treatment should be readily available even in the face of the covid pandemic. In support of this, kindly join your voice with a host of others with a vote to save adolescents and young persons from the menace of HIV.