People Living With HIV/AIDS (PLWHA) now complain very emotively that societal stigmatisation and segregation against them have assumed such frightful dimensions that their parents and siblings disown them and they are so poor that they cannot pay their children's school fees.

As Government makes giant strides in the HIV response, access to anti-retroviral drugs seems to be no longer a problem in the HIV/AIDS response and control. Governments at various levels, non-governmental organizations (NGOs) and other international donor agencies are assessed by the larger section of the global public as demonstrating increased commitment and determination to reduce the spread of HIV and make life better for those already infected and affected by the pandemic in line with the 6th Millennium Development Goal (MDGs), which is: "Combating HIV/AIDS, Tuberculosis, Malaria and other chronic and communicable diseases".

However, a lot still needs to be done, especially as it affects women and children.

According to statistics, women and children constitute a higher percentage of individuals infected by the virus and this factor contributes to the rapid spread of the infection.

In order to tackle this problem, a unified advocacy platform for addressing the vulnerability of women and children to HIV infection known as the National Women Coalition on HIV/AIDS (NAWOCA), was recently launched by the First Lady, Hajiya Turai Yar'Adua, in all the six geo-political zones in the country.

During the launching of NAWOCA, as part of efforts to mitigate the impact of the HIV epidemic on Persons Living With HIV and AIDS (PLWHA), food stuff, and income generating equipment like grinding machines, sewing and knitting machines along with start-up capital for income generating activities were provided to PLWHA.

Speaking at the launch of the North-West Zone of NAWOCA held at the township Stadium in Kaduna recently, the First Lady reaffirmed her commitment to provide a Platform for Action that would provide and facilitate education, public awareness and advocacies aimed at reducing the spread of HIV infection and mitigating the impact on those already infected, especially as it relates to women and children across every nook and cranny of this country.

She urged all Nigerians to regard and utilize NAWOCA as an advocacy instrument for engaging women in a positive manner in the National HIV/AIDS Response.

While urging all Nigerians to get involved in the HIV response in their communities by serving as foot soldiers in the multi-faceted Response to the HIV/AIDS epidemic, she stressed that: "For the National HIV/AIDS response to yield positive results, all hands must be on deck to ensure a reduction in the spread of the infection and access to treatment, care and support for those already infected'.

Delivering a keynote address at the official launching of the North- western zone of NAWOCA, Director General of the National Agency for the Control of HIV/AIDS (NACA), Professor Babatunde Oshotimehin (now the Minister of Health) stated that though HIV was first discovered in 1986 in Nigeria, it was not until 1999 that government realized that HIV could pose a serious threat to national development and started to respond appropriately by developing a strategy to control the spread and mitigate the impact of the infection.

According to Professor Oshotimehin, present research statistics show that 4.4 percent of adults in Nigeria are infected with HIV. This means that four out of every 100 adults are HIV-positive in Nigeria. He also noted that the African continent constitutes 75 percent of People Living with HIV and AIDS in the world and that women and children account for 60 percent of those infected.

Speaking with particular reference to Nigeria, he said out of a population of 140 million, 4.4 percent (three million people) were living with the HIV virus as at 2005.

Despite efforts being made at various levels in the HIV/AIDS Response, one of the major problems faced by the PLWHA is that of stigma and discrimination.

Some of the PLWHA narrated their ordeal and the genesis of their infection, alongside their challenges, especially with regards to discrimination from friends, colleagues and even within their immediate families.

According to some of them who spoke to Daily Trust during the NAWOCA launch, 'disclosing one's HIV status has attendant problems and can pose some challenges, as people tend to dissociate themselves from you once you disclose your HIV status to them' This accounts for the reluctance and shame on the part of many PLWHA to come out openly and disclose their status.

For Mohammed Zakariyya, however, declaring his HIV/AIDS status to Daily Trust was not a shameful thing, as he declared confidently that he was positive. He also said that he had been on anti-retroviral drugs, which make it possible for him to live a healthy life like every other person and carry on with his day to day activities.

Mohammed Zakariyya further disclosed that he has been aware of his HIV status since the last three years, and that in spite of the stigma, he is not deterred from contributing his quota to the development of his community. He also said he felt it was mandatory for his wife to know her HIV status and that he took her to the hospital for HIV test.

Hear Mohammed: "Actually it started like a joke, because I never for once anticipated it. As I am talking to you now, I cannot tell you how I contracted the disease or who infected me. All I knew is that I was always suffering from fever and it was on and off for quite a while, which I suspected was typhoid. I went to the clinic and they conducted a comprehensive test on me. What actually came to me as a surprise was the way and manner the doctor talked to me. He counseled me on the virus, saying that I should exercise patience and not lose hope, and explaining that the anti-retroviral drug is its control. He assured me that the drugs are now accessible and provided free-of-charge by the government in some health centres."

Zakariyya continued: "That was when I even began to suspect something. I then asked the doctor to go straight to the point and explain my problem. He disclosed my status by explaining to me in detail because when I was presented my comprehensive test result sheet, I did not understand the content, though I never suspected I was carrying the virus. At the beginning of it all, I must confess that I could not believe the doctor until when I was further counseled by him. Later, I started taking my drugs. It did not come to me as a surprise. My wife followed suit, as she was always suffering from one ailment or another. The doctor suggested that she be tested and when the result came out, she was equally positive. Although she really panicked upon knowing her status, just like me, with words of encouragement, she later relaxed after receiving counseling by the doctors."

Commenting on the issue of stigma and discrimination, he argued that it was unfortunate that people always fail to understand that the infection has other modes of transmission besides sexual transmission and that people always believe that all infections are transmitted sexually.

He cited the case of infected babies as an example including that of people in monogamous or even polygamous marriages who have been faithful to their husbands/wives, lamenting emphatically: "People are not being fair when they jump to conclusion by linking HIV infection with sex alone without considering other modes of transmission".

He noted that the most important thing is not how a person got infected with HIV (since it is not always easy to ascertain this) but that PLWHA should continue to receive the support and respect of the community so that they can contribute their quota to the development of their communities.

Muhammad Zakariyya, however, called on government to assist the PLWHA with capital to embark on different vocations, stressing that the anti-retroviral drugs given to them are enough for the control of the virus but, he lamented, "these anti-retroviral drugs cannot be fully active when one is hungry or taking an imbalanced diet. Many of us cannot afford balanced diet. As a matter of fact, many of us sometimes beg for transport fare to come to the clinic for these drugs due to the level of poverty among us. Many PLWHA are now handicapped due to discriminations we face from our immediate communities. Many of us lost our jobs when our statuses were revealed and the society always shuns us, and that is why many people die of the epidemic without going to the clinic for the drugs as they are afraid and ashamed of disclosing their status."

For innocent Hafsatu, being infected with HIV was what she least expected until her husband's death, when she was advised by a neighbour called Saratu, a nurse in one of the general hospitals in Kaduna, to go for the HIV test.

According to her, "I found out my HIV status two years ago after my husband's death. My husband's death was due to AIDS-related complications. Although I was shocked when it was confirmed that I was positive, as a Muslim I believe in destiny and I decided to leave everything in God's hand, because that is what He enjoins us to do".

She added: "I have been on drugs for the last two years. You can see I am looking like a normal person because I don't look sick, but the problem I am now facing is that of segregation among my family members. In fact, many of them have been avoiding me and my children just because of my present condition. I am not staying with my parents even when I lost my husband due to the aforementioned problem. It was Saratu (the nurse) that offered me and my children accommodation. Saratu has been encouraging and supporting me in all my activities".

The widow called for continuous support by the government saying, "We appreciate government's effort, but I am also appealing to the federal government to assist our orphans (children) so that they can proceed with their educational pursuit. Most of us that were left with orphans to take care of can no longer afford to pay their school fees. Alternatively, the government can initiate and declare a free education policy for children of PLWHA so as to reduce the burden on widows", Hafsat appealed.

Hauwa'u Musa (amidst tears) told Daily Trust that she was disowned by her parents due to her HIV status in 2006.

In her words: "I was informed about my status last two years after undergoing the HIV test. Then, I was not married and when I told my parents about my condition, they drove me out of the house, alleging that I contracted the disease through sexual intercourse. I then narrated my problem to one of the nurses who counseled me on the infection in the hospital where I was going for treatment. This Nurse did all she could to convince my parents by explaining to them that the disease could be contracted through other means beside sex. But her effort was in vain as they would not understand. She offered that I stay in her house in the interim. And I had no other option than to accept her offer since my own parents failed to believe me."

Hauwa'u continued: "I stayed with Aunty Saratu for a year and a half. For the past eight months, however, I relocated to Rigasa, here in Kaduna because I am now married to a PLWHA like me and we are living a normal life though it always pains and baffles me whenever I remember that I can no longer associate with my family members. In fact, even when I went to inform them about my wedding plans, they still drove me out of the house. Some of my siblings even denied me as a sister due to my condition because they felt I have tarnished the image our family", she narrated pathetically.

Hauwau's appeal to the government was not far from what others have sought for, saying, "government should help those of us that are educated, but unemployed, with jobs and those of us that are good in vocations with capital to start some businesses. Many of us are already traumatised due to our pathetic condition, coupled with poverty. Some of us were recently given quit notice by our landlords to pack out due to our conditions, while others have even decided to take their lives as a result. Just last week in my area one of the PLWHA committed suicide by poisoning himself. This is very pathetic and things have worsened due to the discrimination we face from the society", she revealed emotively.

On her part, Tina Amos alerted that the government may not yield any positive result in eradicating the endemic completely unless it offers a helping hand to the PLWHA by enhancing their standard of living.

She warned: "If the government fails to assist the infected people, there is the tendency that some of us can further facilitate the spread of the infection. This is so because some of us may decide to embark on prostitution due to poverty, since the disease does not show on the face. And that would be the fastest way of spreading the virus. So, providing a lasting solution to the spread of the disease can be achieved only when government expresses its readiness to further strengthen the level of its commitment to us. We also want to be independent not dependent on anybody. We do not want to be turned into beggars because of our statuses".

According to her, apart from the anti-retroviral drugs, they are not receiving any free drugs for opportunistic infections or when they visit the clinic for check-up or treatment of any sickness. She said since most PLWHA cannot afford these prescribed drugs, government should consider providing drugs for opportunistic infections free of charge to all PLWHA.

Talking about the epidemic, the Kaduna State team leader for the Partnership for Transforming Health Systems (PATHS), a DFID-funded health systems reform and strengthening programme, Dr. Zainab Muhammad Idris, attested that there is considerable amount of progress made in the HIV/AIDS response in the country.

According to her, "Hitherto, we had nothing like plans to even address the epidemic. But now at the national, state and local government levels, attempts have been made to develop strategic frameworks, plans and even key action plans to respond to the epidemic in a multi-sector manner. This means that every sector has a certain plan put in place to ensure that it looks at what is happening at its own respective level so that it can begin to develop strategies that would be used to minimize the spread and mitigate the impact of HIV and AIDS epidemic on the lives and livelihoods of people across sectors".

Commenting on the issue of stigma and discrimination against PLWHA, Dr. Zainab emphasized that solution to it requires concerted efforts from the side of the individuals infected themselves as well as members of the society who would need to look at those infected as others with chronic infections just like we have people with diabetes, hypertension, and cancer.

"We should all begin to see HIV infection as one of those chronic illnesses. And more so, it does not even show on the face. The fact that someone is infected by the virus does not necessarily mean he/she is endangering the lives of others in the society. That is basically what causes the stigma and discrimination in the populace. People have this fear of the unknown. People believe that when they associate with PLWHA they are going to be infected themselves. But really that is not the case."

Dr. Zainab sees no reason why stigma or discrimination should even arise especially when, according to her, efforts are being put in place to address the issue of the epidemic stressing that the country has reached a point where the issue of stigmatization should be a thing of the past if continuous information, education and communication is provided effectively.

She admonished PLWHA to continue to have faith, emphasizing that their status does not indicate the end of the world. "The PLWHS should continue to have faith and the fact that one is infected does not stop them from achieving their goal in life, just like other PLWHA in other parts of the world. The PLWHA still have a life to live, which can be meaningful and qualitative".

Dr. Zainab pleaded: "The government should also continue to mount programmes and initiatives that would take care of the livelihood of PLWHA. They should be provided with employment opportunities and not be discriminated against, once they are found to be qualified enough for certain positions either in the private or public sector. I think it is very vital to give them that chance so that they can work and have the right to gainful employment. Once that is done, it will go a long way in addressing some of the challenges they face in their communities. In addition it is also important to ensure that through its public-private sector partnership, government is able to develop programmes or activities that would really enable them to have some means of livelihood and that would help them a great deal in taking care of their needs and being less dependent on anyone, including the already overstretched scarce resources of government itself".

According to recent media reports, in an attempt to address the issue of stigma and discrimination faced by PLWHA, President Umaru Musa Yar'Adua issued a directive to certain employers in the public sector that all PLWHA who were disengaged from their various places of employment due to their HIV status be reinstated by the their employers.

Although this action is commendable, there is still more to be done by the President to ensure that these employers comply with the directive or face a penalty which will serve as a deterrent to others. This can be achieved by ensuring that the HIV/AIDS National Anti-stigma Bill is, as a matter of urgency, passed into law. This will, indeed, leave an indelible mark of the essence of government's commitment to the plights and interests of PLWHA in the country.