The child through the woman

When Musa Kolo was confronted with a situation that required him to know his HIV status, he refused. He had been quite wild in his days as a single man. Confronting his status—positive or negative, but mostly afraid for positive—was too much for him to handle. Kolo opted for a weird way out: his daughter. […]

When Musa Kolo was confronted with a situation that required him to know his HIV status, he refused.

He had been quite wild in his days as a single man. Confronting his status—positive or negative, but mostly afraid for positive—was too much for him to handle.

Kolo opted for a weird way out: his daughter. He believed if the girl had HIV from him—or his wife—she would be dead by age five. If she lived through five, then he was free of the virus.

The girl turned five; Kolo was relieved. But he’s since had another child, and is waiting for another fifth birthday.

Children, aged anywhere between birth and 14 years, are increasingly at the heart of the global HIV pandemic—and their parents are the key.

In Nigeria alone, an estimated 37,000 children were newly infected last year by their mothers—the mother-to-child transmission of HIV that occurs during pregnancy, childbirth or breastfeeding, according to the Joint United Nations Programme on HIV/AIDS.

They add to the 270,000 children already living with the virus. Some 24,000 of them died last year due to AIDS.

Only 21% of children living with HIV, around 55,000, are receiving antiretroviral therapy. Around 13,000 are new on the treatment programme. By 12 months after starting, only 74% of the children remained on treatment.

The global health movement around World AIDS Day this year calls for an end to isolation, stigma and HIV transmission.

The World Health Organisation has issued new guidelines for increasing access to diagnosis which, it is believed, would enable more people be put on treatment when their status is known as positive.

For every person on treatment around the world, there is another who doesn’t know their HIV status.

 

Protecting children by empowering women

Women in far flung communities around the world are becoming the drivers toward awareness of HIV status. And empowering them is putting decisions in their hands.

Beauty Livinus makes a living selling fried bean balls and banana by the corner of her home in Gbaranbiri, a community in Kolokuma/Opokuma council area of Bayelsa.

Once a month she meets other women in a group: their mission to reach mothers in her community with anti-HIV awareness.

“We go on outreaches to talk about preventing HIV, about preventing mother-to-child transmission of the virus,” she says of her pastime.

“If you have HIV, you can’t just sit around. It has treatment, it has prevention. Go to the health centre. They will give you drugs so the child doesn’t contract it, if you are pregnant. There are breastfeeding methods you can use. All things are possible.”

Her group meets under support from PROMOT II—the second phase of an intervention to reduce new paediatric HIV infections and mobilize support from communities and government to make prevention of paediatric HIV a priority in Bayelsa. The state’s HIV prevalence is 2.7%, according to the National Agency for the Control of AIDS.

The intervention, run by the non-profit Pact and funded by oil firm Chevron, reached more than 294,500 people with anti-HIV messaging in its first phase from September 2012.

“The objective is to  increase knowledge and utilisation of antenatal care and PMTCT service, to strengthen capacity of community structures to become good advocates of antenatal care and PMTCT,” says Kolapo Oyeniyi, who directs the project across in Kolokuma/Opokuma, Ekeremo and Southern Ijaw—three council areas where it is run.

“The ultimate aim is to contribute to reduction in paediatric HIV infection in the state.”

Livinus joined the second phase at its start in September 2016—and is among some 13,000 low-income, low-literate women mobilized into women’s groups.

The groups are called “WORTH”—a component aimed at economic empowerment,  teaching women how to save—and putting women in line for micro grants to support their outreaches, growth in financial literacy and increasing involvement in the formal financial sector.

Livinus witnessed the first phase as an outsider. When the project returned, she made up her mind.

“I want what will make me rise in life and to save. I didn’t know how to save, to support my husband and my family,” she reasons.

“Now I have a bank account. I use my saving to help take care of our children. Sometimes, I don’t have to ask anything off him for a whole week. Such things make me happy.”

The focus on women as key drivers in preventing paediatric HIV infections is challenging gender roles in communities.

 

Taken for granted

In Southern Ijaw council area, Ebiere Ibomo is among women who visit churches and market squares to talk to women. At other times, she arranges household visits to the 20 “compounds” in her village. Each compound is home to as many as 20 families.

The number of pregnant women she sees recently has fallen off; it seems seasonal and many have given birth. The last time out on outreach, she encountered only seven pregnant women.

She says men in the community are curious, complaining and worried why her group’s focus is solely women.

“Sometimes when we go out, we compensate them with condoms, because the women won’t take them,” she says.

Some women have missed joining her group, choosing instead to concentrate on farm work, but the interest in women hasn’t waned.

“Men take women for granted. They see them as housewives and nothing more. So women are denied,” says Ibomo, wife to a fisherman.

“The men don’t carry women along, and a woman’s body is something that needs care. Society looks down on women too much. They don’t care much.”

 

Putting little money to good use

A bit of independence has taken Inifie Maxwell a long way. The mother of three sells garri and gin and runs a cassava mill on the side in Eniwari community in Southern Ijaw.

Her group runs like a cooperative, allowing women to save and take out loans to expand their small businesses, and in turn giving them greater access to health care and knowledge about preventing HIV.

She is not new to primary health centres. Health facilities exist in her community but that didn’t translate to knowledge.

“We live in the village. We don’t go to hospitals. In case there is a problem and we want to go, the health workers are not there,” Maxwell says.

Since then, 22 community health extension workers have begun providing antenatal and PMTCT awareness services, 2,159 rural pregnant women have been counseled and treated for HIV and the cost of antenatal and PMTCT has reduced by half.

But only one in two women knows about mother-to-child transmission of HIV, far more than men, according to Nigeria’s latest Multi Indicator Cluster Survey.

For all that knowledge, only six in 10 women know where to get tested for HIV, compared with seven in 10 men.

Just 15 in 100 men and women who have been tested know the result  of their test.

“We were ignorant about these things,” says Maxwell, and about how their economic power determined their health.

“You may have the money, but without the knowledge of saving, you will lavish the money. They have shown me the importance of saving, which means more money. And when I apply that knowledge, it helps.

“I can now save. So in the absence of my husband, with the little saving I have, I can take care of our children until he comes back or until he gets something more.”

For the children, at least 53,600 pregnant women have been tested for HIV and have received their results. That’s a rash of new paediatric HIV infections that could potentially be prevented.