The Impact of National Strategies of HIV/AIDS Among Women in South-west Nigeria

Background And Rationale

Nigeria has the second largest HIV transition in the world. HIV prevalence among adults is much less (1.5%) than other sub-Saharan African countries such as South Africa (20.4%) and Zambia (11.3%), the size of Nigeria's population means 1.9 million people were living with HIV in 2018. However, UNAIDS estimates that around two-thirds of new HIV infections in West and Central Africa in 2017 occur in Nigeria. This is despite achieving a 5% reduction in new infections between 2010 and 2017.

The National Strategic Plan is “An AIDS-free Nigeria, with zero new infection, zero AIDS related discrimination and stigma” Goal of the National Strategic Plan. The goal of the National Strategic Plan is to “Fast-track the national response towards ending AIDS in Nigeria by 2030” Thematic Areas and Cross-Cutting Issues The National Strategic Plan has five thematic areas: Prevention of HIV among General and Key Populations, HIV Testing Services, Elimination of Mother-to-Child transmission of HIV (e MTCT), HIV Treatment; and, Care, Support and Adherence (National Agency for Control of Aids, 2017)

According to Fagbamigbe, Adebayo and Idemudia (2016). It show that Nigeria the case of HIV as increase by 1.8% to 4.5% to 5.8% in 1991, 1996, and 2001, respectively, a decline was observed as 5.0% in 2003 and 4.4% in 2005. Also, 2008 and 2010 surveys show HIV prevalence of 4.6%12 and 4.1%, several. However, a general population survey carried out in 2007 put HIV prevalence at 3.6%, higher among females (4.0%) than males (3.2%). The latest national surveys in 2012 showed a lower general population HIV prevalence of 3.4% in Nigeria, ranging from 3.2% to 3.6%. The 2010 national survey of MARPs reported that HIV prevalence of 27.4% among brothel-based female sex workers, 21.1% among non-brothel-based female sex workers, 17.2% among men who have sex with men, and 4.2% among injecting drug users. (Fagbamigbe, Adebayo and Idemudia, 2016).

Unequal gender nexus have a significant influence on men's and women's differentiated risks to HIV infection, as well as their access to prevention, treatment, care and support. Gender inequalities increase women's exposure to infection, through their lower status and lower access to education. The 2008 DHS showed a positive correlation between women's participation in household decision making and their access to health services (Samuels, Blake and Akinrimisi. 2012).

According to Odimegwu, Alabi, Wet and Akinyemi, (2018) confirms that HIV/AIDS is more among women in southwestern Nigeria. HIV/AIDS in Nigeria is increasing among women than men. (Samuelsen, Norgaard and Ostergaard, 2012). The difference in the prevalence of HIV between women and men is more obvious among younger adults, with adolescent women between ages 20 and 24 years more than thrice as likely to be carrier of HIV as male of same age group. (UNNAIDS, 2014).

The spread of HIV in the last 3 decades has greatly affected health, welfare, employment and criminal justice sectors; having negative impact on every social phase of human. Recent epidemiological survey reveals that HIV is still a serious health issue that has continuously drains our national, regional and state finance having claimed over 25 million lives over the last 3 decades. (Awofala and Ogundele, 2016).

According to Ogunbodede, (2004) major socioeconomic factors determining the spread of HIV/AIDS in South West Nigeria has decline in social services, impoverishment, subordinate position of women, modernization, rapid urbanization, wars and conflicts.

Analysis has revealed that despite that intervention, new infections rose from 11,230 in 2012 to 116,780 in 2013 with 112,239 PLHWAs (2012) and 115,578 (2013). As of 2012, the number eligible for ART was 34,671 and 45,397 in 2013 but the number served was 9,632 with a 78% unmet need. The number of ART sites was 12 in 2013 and 16 in 2013. For HCT, 320 sites were set up in 2012 and 365 in 2013; 59,000 were tested in 2012 and 63,000 in 2013. There were 250 PMTCT sites in 2012 and 289 in 2013. Out of 21,769 women eligible for PMTCT in 2011, only 769 women accessed PMTCT while 1,728 accessed PMTCT services out of 29,892 eligible women in 2013. It is therefore imperative to rethink the strategy, focus and direction of the response in terms of addressing issues related to HIV/AIDS in Nigeria. It was observed that though some progress was being made in monitoring and evaluation in the response at the national and state level, there were still obvious gaps in data availability and utilization. (UNAIDS, 2014).

AIMS And Objectives

The aim is to investigate the effect of national strategies (2010- To present) in tackling HIV AIDS among women in the South-West of Nigeria.

There are some specific objective as follows:

• Explore the prevalence of HIV/Aids among women in the South-West of Nigeria.
• Examine the social determinants of HIV/Aids among women in the South-West of Nigeria.
• Investigate the health and socioeconomic implications associated with HIV/Aids among women in the South-West of Nigeria.
• Investigate the effect of national strategies (2010- To present) in tracking HIV/Aids among women in the South-West of Nigeria.

Methodology

This study was carried out in southwestern Nigeria, which is one of the six Geo-political zones (southwest, south-south, southeast, north central, northeast and northwest) in Nigeria. The southwestern of Nigeria constituted six states namely; Lagos, Ogun, Oyo, Osun, Ondo and Ekiti. It had a provisional population of 27,581,993 people according to 2006 population Census figures (Federal Republic of Nigeria Official Gazette, 2007).

Secondary Data

Secondary data was used for this research. This data is the information includes which have been already collected and readily available from other sources. Such data are cheaper and more quickly obtainable than the primary data. Secondary data is basically information which has been collected previously, by someone else, other than the researcher. Secondary data can either be qualitative, such as diaries, newspapers or government reports, or quantitative, as with official statistics, such as league tables.

Secondary data, that was collected by another researcher for some other primary purpose. The use of secondary data provides a soft landing for researchers who may have limited time and resources. The examination of secondary data is a workable method which can be use for the procedure of investigation when a systematic process is followed.

To maintain the secondary research which is the region that conducting the procedure and defined those methods which research worker is follow. The research method involves how the researcher collects, analyzes, and interprets the data in the study (Johnston, 2014).

The Advantage of Using Secondary Data in Social Research

In many domain is a wealthy style content which is available for investigators. Also, some large data sets might not exist if it wasn't for the government collecting data. Sometimes documents and official statistics might be the only means of researching for the past.

Secondary data may be particularly serviceable for making comparisons in all over time. It is economical, saves efforts and expenses, save time as well as it aid to make primary data collection more specific by the help of secondary data. we are able to make out what are the gaps and deficiencies and what additional information needs to be collected, it helps to improve the understanding of the problem.

Disadvantage of Using Secondary Data

It indicate the partiality who are remain in power that what you can find out. Beside this, is may lack of authenticity. The component part of the document might be missing because of age, and even can be verify who wrote the purpose of document. Data from secondary source may not be the true representation of the population, especially a problem with older documents. Many documents do not hold up because they are not stored, and others deteriorate with age and become unusable. Other documents are deliberately withheld from researchers and the public gaze, and therefore do not become available.

Literature Search Strategy

HIV is the Human Immunodeficiency Virus, as well as Acquired Immunodeficiency Syndrome AIDS, are a global burden of health. It is a virus that attacks cells which assist making a person more vulnerable, body fight infection and diseases. In 2010 an estimated 2.7 million population were newly infected with HIV, it is the area only 12% of the global populations. As at 2012 south Africa carries the largest share of the global burden of HIV. In this area approx 6.4 million people, about 12.2% of the population were living with HIV. Standing the country third among nation with the advanced load of HIV unhealthiness in global after India. (Thron and Awoleye, 2015).

The outspread of HIV in the last 3 decades has greatly stricken to the health, welfare, employment and criminal justice sectors; having negative impact on every social phase of human. Recent epidemiological survey reveals that HIV is still a serious health issue that has continuously drains our national, regional and state finance having claimed over 25 million lives over the last 3 decades. Despite the effort of Nigeria government to wipe out the virus, the country has seen more citizens placed on life saving medication of active anti-retro viral therapy (AART) to help them live a normal life (Awofala and Ogundele, 2015).

Heterosexual intercourse is the most common means of transmitting HIV in Nigeria, accounting for over 80% of the cases in the country. (Awofala and Ogundele, 2015).

According to Nigeria National Agency for the Control of AIDS, (2015) the carrier of the virus in South West Nigeria are female, it is the same situation across the country. Some of the factors are responsible for this situation that is poverty, marriage, gender-based violence, masculinity and femininity norms, disabilities, harmful traditional rites as well as human rights, legal and political factors.

According to World Health Organization, (2015), since the index case was recorded in Nigeria in 1986, HIV has spread widely among the inhabitants affecting all age group and ethnicity though at varying degrees. Affected majorly are women (adolescent female, young adults and teenagers aged 15-24). HIV can be transmitted from one infected individual to another through unprotected sex and non-sexual activities such as sharing of sharp objects like needle, non-screened blood transfusion as well as mother to child transmission during pregnancy (Liesl and Mark, 2013).

Currently, HIV has no ascertain cure but infected persons can be placed on treatment known as Anti retro viral Therapy (ART) to make them live longer, live a healthier life and also avoid transmission of the virus to others (Oluyemi et al, 2019).

Ethical Consideration

Public health ethics can be defined as the identification, analysis, and resolution of ethical problems arising in public health practice and research, has different domains from those of medical ethics. Assorted methods of moral reasoning have been applied to the ethical decision making in public health research and practice. Two approaches have figured most prominently: the principle-based approach to moral reasoning explicated by Beau-champ and Childless, and case-based methods such as casuistry, this research will focus on Principle based approaches.

Principle-based approaches to moral reasoning were developed to address ethical issues in clinical medicine and are not necessarily the optimal approach for analyze ethical issues in public health.

The four principles of beneficence, non maleficence, justice, and respect for autonomy are germane to public health research. These four principles as explained by Beau champ and Childress, seek to reduce morality to its basic elements and to provide a useful framework for ethical analysis in the health professions. The principles do not provide a full philosophical justification for decision making. However, In situations where there is conflict between principles, it may be necessary to choose between them or to assign greater weight to one. Practical problems in public health ethics require that these principles be made more applicable through a process of specification and reform. (Coughlin, 2006).

The ethical principle of beneficence requires that potential benefits to individuals and society to be maximized and that potential harms be minimized. Beneficence involves both the protection of individual welfare and the promotion of the common welfare.

According to this principle, the research will focus deeply on ascertaining the benefits derived from the people from the intervention. The principle of non-maleficence requires that harmful acts should be avoided. This study will ascertain if such acts occurred and the effect on the populace and most especially those leaving with the virus. Respect for the individual is a principle which grants importance to individual freedom in political life, and to personal development. This research will also find out the impact of the virus on the political participation of the carriers and their personal development (Coughlin, 2006).

Utilitarian theories of justice emphasize combination of criteria so that public utility is maximally utilized. From this perspective, a just distribution of benefits from public health programs or research is determined and all are affected by the utility. An egalitarian theory of justice holds that each person should share equally in the distribution of the potential benefits of health care resources such as screening services. Other theories of justice are of the opinion that the society has an obligation to correct inequalities in the distribution of available resources, and that those who are perceived to be vulnerable should get benefit from resources. Such theories of justice provide considerable support for maximizing benefits to medically undeserved people. The study will consider the distribution of support to all the states in the region as well as all affected person in the area (Coughlin, 2006).

Project Outline

The research proposal will comprise of 4 chapters. The first chapter will present the background and rationale for the study, followed by the key aim and objectives. The second chapter will present the Methodology. The discussion in this chapter will focus on the chosen, secondary research and why it was chosen while drawing comparisons with primary research. This will be followed by detailed literature search strategy and a section on the actual process of how many papers were identified and eventually utilized. Chapter 3 will present the main body of the project based on literature reviewed. It will start by discussing the prevalence of HIV/AIDS among Women in South - West Nigeria.

Project Timetable

Also read:- Understanding Health Illness and Well Being

REFLECTION

A major challenge faced in the research is that most of the data available did not address the specific age group. Also, most of the available data were not collected in the study area (southwest Nigeria) as well as but the data was collected in the women in the whole of Nigeria. I was also faced with the problem of contradictory data on the internet, probing to know which is correct is a major challenge.

On the other hand, the use of secondary data for the study has helped seriously. According to Felipe and Fernando, (2018), using secondary data in research has proved itself a valuable approach to finding suitable data for one's needs without primarily going to the field. It really reduces the time and cost of doing research and life easier for researchers. With the experience, I don't mind doing more research using secondary data. To get more details about online assignment help ask our experts.

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