‘HIV/AIDS’ ON CAMPUS

An Exclusive Interview conducted by Afolabi Oni, the Editor in Chief of THE GIST, a 400level student of Education English, Obafemi Awolowo University, Ile-Ife, Osun State with Associate Professor Fatusi, Director of the Institute of Public Health on the issue of HIV/AIDS and the ways to avoid an explosive increase in the number of infected persons in Nigeria.
Gist: Can we me you sir?
Dr.: My name is Adesegun Fatusi, I am a Public Health Physician, an Associate Professor of Community Health in Obafemi Awolowo University, and currently I am the Director of the Institute of Public Health.
Gist: Sir, How come Public Health?
Dr.: When you think about Medicine, there are usually two dimensions; this is about creative and public health. I can say God brought me to public health because I just discovered that I had a natural skill and my greatest strength is about conceptualization, planning programmes and that is one of the things needed in public health. It also gives me the opportunity to impact lives because a doctor will see one patient but a public health physician can save millions at a time.
Gist: Now sir talking about public health in Nigeria, let us draw a focal point to HIV/AIDS and the Nigerian community as a whole, knowing fully well that Nigeria is the second most infected country after south Africa with over 2.4million cases, why is Nigeria the 2nd largest?
Dr.: The reason Nigeria is the second largest is based on our huge population. Our level in terms of percentage is still 4.8%, some South African countries have over 30% but lesser than us in terms of numbers. Even India is 3rd on the list because of her huge population. We are not near South Africa in equivalence.
Gist: Sir, taking cognizance of the fact that the issue of condoms have being subjected to debate on several occasions, and my research shows that 67% think it is suicidal to use condom on an infected person, how save is the use of condom?
Dr.: To start with, research has shown that many people don’t like condom but in reality what research has shown because I have being to many condom factories where they are produced and I work for an international organization and we looked at what the propensity is, although there is nothing as safe as abstinence, but next is condom for someone who isn’t married but wants to have sex, because condom has a high level of effectiveness. There could be problems with condoms, which are as a result of the fact that people don’t know of how to use it. People assume that all you need to do is open it and wear it, which is not totally true. In fact, one of our challenges is that people in Nigeria, even our university students do not read. If you buy a standard condom package, you find instructions on it. For example, if you are asked to use a lubricant to make your condom smoother and penetrate better, people will tell you that they use Vaseline and it is written there that you must never use an oil based lubricant because they destroy the thickness of the condom. That is the more reason many condoms will burst or break because people act contrary to instructions. Another reason that it may burst is that, in using condoms you are supposed to expel the air at the tip and hold the tip while wearing it on. If it catches air in between, you are setting up pressure and it may burst. Yes, condoms could have problems, just like everything in life, if you use it in the right way, it doesn’t have problems.
Gist: Sir, while in secondary school my teacher told me that for an infected person, HIV/AIDS is contained in all body semen or fluids like saliva among others. How true is this?
Dr.: It is truly contained in all body fluids, all of them, saliva, vagina fluid, sperm fluid that is true.
Gist: Sir, How safe is it for you to go into kissing with an infected person, especially French kissing which has to do with exchange of saliva; we need clarity on this because of conflicting teachings from medical practitioners?
Dr.: The thing is for you to be infected with HIV/AIDS you need to have a particular dose, kissing does not produce that kind of critical dose that will ensure infection. That is why you will not see in a scientific situation, a case of HIV from kissing with the excepting of someone who is bleeding from the mouth or has injury in the mouth then it is not the saliva, but the blood.
Gist: Sir, few of us in our halls of residence have viewed this case critically. Knowing full well that Africa has over 60% of infected cases; some persons will say that AIDS is an American Invention to Discourage Sex, because despite pornography, despite the high level of immorality, coupled with high population and high migration rate of the western world, Africa is the worst hit, how will you disabuse our minds sir?
Dr.: It is not about how sexually active you are, it is about how sexually wise you are. One can have sex severally but doesn’t get infected and someone who had sex twice may be a carrier. In developed countries they have learnt to protect themselves and they use condoms and it is like the normal part of their society. In Africa many people are not using condoms. Another difference is the issue of our social practices. In South Africa for instance they believe that once you are infected, the cure is that you have sex with a virgin, which is complicating the problem. Another is the issue of traditional birth delivery; the persons doing the delivery are ignorant of the virus.
Some of our infections also come from the hospital setting, few persons transfuse unscreened blood, and some of our medical practitioners do not dispose syringe properly among other mistakes. The save blood unit always have few pint of blood and except during an emergency, people don’t donate blood here, only few do unlike advanced countries and so doctors are forced to transfuse unscreened blood because of emergency. The issue of drugs and local scarification is also a problem. More so, Africa and of course Nigeria didn’t rise up to this challenge on time and the infected persons tried to bury their head in the sand like the ostrich and by the time we raise up our head, it has gone into an explosive mood and that is why we are where we are today.
The gist: Sir, a friend of mine is madly in love, but unfortunately the lady is infected with the virus, what will your sincere advice be?
Dr.: It is a choice. The fact that you are HIV positive doesn’t mean that your child will be positive. The question to be asked is her partner also positive? If negative, he must be determined to marry the lady. He can reduce his chance of being infected by using condoms except when they think that they want a baby. The transmission of HIV from a woman to a man is not as efficient as transmission from the man to the woman. This is not unconnected with the fact that the man’s penis has a smaller opening if compared to the female virginal, in terms of its mucus membrane and more so, after sexual intercourse, they sperm is deposited in the woman and the woman’s virginal fluid is only in contact with the man during sex, not after. The chance of a man being infected by a woman is lesser if compared to the other way round. They can see a specialist to do the prevention from mother to child transmission. The chance that the child will be positive is low.
The gist: In OAU, over 85% of are students are yet to know their statue despite the fact that we have National Agency for the Control of Aids (NACA)-OAU which gives free HIV/AIDS test yet students are disinterested. Sir, what will say that is the bane behind this?
Dr.: In this country, less than 10% of young people have ever tested. Many young persons feel it can’t happen to them. Also our socio-cultural orientation of, don’t say bad thing to yourself, ‘what you don’t know can’t hurt you’ is also killing us. More so, people have poor perception of risk behavior. You cannot tie the likelihood of a risk to its consequence. Knowing you statue is the best for anyone, Should you be positive, you can start getting care and if you are negative you will stop the risk behaviours.
The gist: Sir, some persons have reported cases where one test negative at the first test and then subsequently tested positive, three months later that he was asked to come? What are the possibilities of what went wrong?
Dr.: What is likely to have happened is that, we have what we call the window period, the body produces antibodies and it is when the test detects the antibodies in their numbers that the statue will be revealed and this could take 3-6months. Or possibly such a person has engaged in risk behavior in between the first and the second test.
The gist: Semoa is a country with the least case of the infection with just 12 cases, how can Nigeria take after her?
Dr.: The good thing is that Nigeria is working very hard. Let me tell you something, our HIV level in Nigeria doesn’t reflect the fact that the infection is increasing, because you must remember that those having the virus and are alive and there are new infections coming, the number will keep growing, not because the number of new infection is particularly very high. Although, we have to check our youth especially between the ages of 16-24, that is the age the index is on the increase.
The gist: Sir, how can Nigeria do a little bit better because someone did say that the Olusegun Obasanjo reign have done better than recent administrations, I was at NACA-OAU and the consultant there was telling those coming to be tested to come back later because the kits were exhausted. How can we better the lots of our people?
Dr.: Our government has to commit far more money to anti-retroviral drugs. What happened during Obasanjo’s time is that he had a lot of support from foreign agency: USAIDS, JICA, CIDA among others and this not good because if you want to fight a problem in you environment you must put your money. We cannot continue to rely on other countries for help. Little wonder we are having problems with kits because the American government is withdrawing and soon we will be having problem with drugs. We cannot continue to expect our countries to be using their own task payers’ money to solve our problem. The Nigerian rulers should know that HIV is not a medical problem but a developmental problem. Should all our youths be infected, who will power the economy? We should fight it with all we have, but people should live responsibly.
The gist: How can we better our awareness programmes about HIV/AIDS sir?
Dr.: Every parent should tell the child(ren) and everyone should be preaching it, even in religious houses. In fact churches and mosques are the best place to talk about sex and about condoms and about protection because they have large congregation of people. They should preach that people should follow God by abstaining, but if they will not, they should use condom. This will save them for the future when they can probably decide to follow God fully. Other awareness mechanisms are town’s meeting. There should also be compulsory general courses for secondary school students and undergraduates on HIV/AIDS. Everybody must carry this message because it is a message of redemption from death that comes from HIV.
The gist: Sir, what can you say about discrimination against people living with AIDS?
Dr.: Discrimination should be discouraged because it makes people go into hiding and does not help. The worst form of stigmatization is self stigmatization; the world is too big to be talking about you. People living with HIV must have confidence. Those that are negative shouldn’t make life worst for the people living with AIDS else maybe they will out of frustration infect someone close to you. Don’t think you are safe because 40% of the cases of HIV in this country happen with the people that have low risk behavior (abstaining).
The gist: Kate Harnshaw a household name in the movie industry did act in a film titled yet another day where she got the virus and decides not to die along and spread it to other persons through sex intercourse; some persons are doing this sir. What is your opinion?
Dr.: This is very unfortunate because it shows that everybody should be careful. To such a person, he is a bit foolish because he is increasing his own chances of much dying younger than he should. The fact you have HIV if you meet another carrier you are in trouble because you may not have a subtype that the other person has and therefore could multiply the intensity of your own infection. More so, such a person is susceptible to other diseases which will affect his immunity. They are only endangering themselves much further.
The gist: What else will you like to tell us sir?
Dr.: To be young is great and the most beautiful part of life, but also the most dangerous part of life, actions always comes with consequences, we choose our actions but we cannot choose our consequences, for every action, ask yourself if you are ready for the consequence. Thank you, Afolabi.