Young Nigerians design HIV self-test kits

The UNAIDS 90-90-90 target states that by 2020, 90 per cent of all people living with Human Immunodeficiency Viruses (HIV) will know their HIV status, 90 per cent all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and 90 per cent of all people receiving antiretroviral therapy will have viral suppression load with the ultimate aim of ending the Acquired immunodeficiency syndrome (AIDS) epidemic by 2030.

Given the number of young people in Africa is estimated to double by 2050, experts have said developing effective prevention tools and exploring new approach to reduce the spread of HIV is a matter of urgency for Nigerian youths.Report shows that youths between the ages of 14 and 24 years are at the epicenter of an expanding HIV crisis, with the second largest number of new youth HIV infections in the world, adding that fewer than one in five Nigerian youth have never been tested for HIV.

The young researchers from across Nigeria, were engaged in an interactive Designation health contest held in Lagos, tagged: “4 Youth By Youths”, organised by the Nigerian Institute of Medical Research (NIMR) in collaboration with Saint Louis University, University of North Caroline at Chapel Hill and New York University.

The researchers from different Nigerian tertiary institutions designed creative solutions in the form of products, technology, service and programme to encourage self-testing for HIV and other sexually transmitted diseases among young people in Nigeria, that is low-cost, accessible, youth friendly and confidential, in order to reach out to the young population living with the diseases in the communities.

The intervention strategy in which the youth population at risk is screened for HIV infection and diagnosed infected individuals receive early treatment, according to the organisers, is aimed at eliminating HIV as it reduces the rate of spreading the virus to other people.Speaking to The Guardian, the Director of Research, NIMR, Dr. Oliver Ezechi, said many adolescents engage in risky sexual behaviours, such as sexual intercourse with multiple partners, not using condoms or engaging in transactional sex, which puts youths at higher risk of STDs and HIV/AIDS.

He said young people often have very limited access to affordable, effective and appropriate services; including confidential testing and counseling as well as timely diagnosis and treatment of sexually transmitted diseases, which prompted the contest to design youth friendly prevention package to reach them.

“Young people also have limited access to life saving tools, most especially condoms (male and female) for those who are sexually active and antiretroviral medications for people living with HIV and AIDS. Lack of access to these prevention packages prevent the youth from practicing safer sexual behaviour,” he stated.

Also speaking on the solutions designed, ITEST Principal Investigator, Saint Louis University, Dr. Juliet Iwelunmor, said the project is the first global HIV self-testing solution, as young people have been given the space, resources and tools they need to develop solutions that would encourage other young persons to self-test for HIV

“This contest idea aims to stimulate the development of design ideas that will bring Nigeria one-step to achieving an AIDS free generation. This is how we can encourage self-testing for HIV and other sexually transmitted disease among young people ages 14-24 in Nigeria in a way that is low cost, accessible, youth friendly and confidential, she added.

Explaining further on the project, ITEST Principal Investigator and Infection Disease Physician, University of North Carolina, Dr. Joseph Tucker, said the researchers would proceed with an opportunity to advance to a four-week entrepreneurship startup Boot camp, where they will create a business plan that is sustainable and will work for the country at large.He said of the 127 young researchers who submitted entries, only five would proceed for the Boot camp, as two would be finally selected and given cash prizes and HIV kits to set up their businesses in communities across the nation.

Meanwhile, with Nigeria experiencing a reduction in its burden of HIV/AIDS, placing it as number four on the list of countries with the highest burden globally, there are hopes and fears that lack of sustainability, funding, adherence to drugs and treatment as well as lack of counselling facilities nationwide could increase infection rate, morbidity and mortality.

Experts are of the view that without strategic measures and sustainable policies put in place to sustain the present 1.4 per cent HIV prevalence rate, the country could face severe outrage of the disease.Nigeria, last month reported a decline in its HIV prevalence, as the Nigerian HIV/AIDs Indicator and Impact Survey (NAIIS), puts Nigeria’s prevalence rate at 1.4 per cent, which is about 1.9 million people currently living with the disease.

But the Director-General, NIMR, Prof. Babatunde Salako, who commended the findings disclosed by the National Agency for the Control of AIDS (NACA), during a courtesy visit to institute, stressed that if the country must maintain this feet, it must focus on areas of service, detection, prevention, treatment, research and funding of the HIV/AIDS programme to ensure sustainability.He said, although, a lot of people have also been put on treatment, much more than before, having large number of people with very low undetectable viral load would result to high infectivity if holistic measures are not taken.

Salako expressed fear that the disease could increase in Nigeria if the international donors stop rendering their support, while he charged the federal government to take over funding of the national HIV/AIDS programme to save it citizens from the burden of the disease as well as achieve low disease impact.“My fear is that we have gotten to where we are today because we have a lot of helpers and if they decide to pack their bags and leave Nigeria, we are unlikely to be able to sustain it because we are totally dependent on their support…

‘Government therefore, has to begin to put into the front burner the process of ensuring that they take over the funding of HIV completely from donors, let the donors put their energy elsewhere, because this is one disease that is ravaging our country and it is one of the top 10 disease ravaging our society. He continued: “If we want to be able to produce Nigerians with good health and well being and good workforce force for government that can translate to economic prosperity, HIV is one disease that the country must tackle and it has to be in a holistic way. We cannot afford to leave it for the developing partners alone.”

The NIMR DG said the issues of resistance to drugs; fake medicines and patients’ non-compliance to treatment among other things has to be tackled if Nigeria must win the war against HIV/AIDS.“That will be a very dangerous signal if you still allow young people who still have mileage in terms of age to get tired of taking their drugs. What it means is that morbidity and mortality would increase, rate of infection would become higher, and then we go back to square one,” he stressed.

Also expressing worry on prevention of mother to child transmission of HIV, Consultant Pediatrician and Head of Clinical Sciences department of NIMR, Dr. Nkiru David, said it is very important to tackling the spread of the disease generational.She said another challenge is non-adherence to medication in adolescent. “One of the major problems we are facing with young persons and adolescent is adherence to medication,” she said.

David added: “Some of them have been on drugs before they knew how to talk, but now they are becoming adolescent and young adults, they have been in drug for over 15 years and they are tired. We need manpower to understand their issues and be able to discuss it with them with empathy. This is important not only for the adolescent and young persons, but for the community as well. Because these people are sexually active and if they are not adherent on their drugs and they are not virally suppressed, then the fear of the spread of infection is increased and then taking it haphazardly could contributes to drug resistant.”She said adolescent and young persons living with HIV are a special group that needs a lot of support in the area of manpower and the government.

“If they could set up adolescent and young persons care service all over the nation, it would go a long way in getting to reach the population of these key individuals that are actually a very vulnerable group,” she added.On her part, while calling for more counseling centre across the country, the HIV Testing Service Counselor, Yetunde Soyingbe, who is a mother of one and an HIV patient for over 26 years, said educating patients on the disease, prevention and management should be paramount, as most people lose it when they receive the news of testing positive to the disease.

“The challenge we have is that in some of these laboratory, there are no trained counsellors, they just give results without counselling and educating the people what HIV is, the basic fact, transmission mode, prevention and treatment.“Acceptance is difficult, people find problem in accepting their positive status, so we need skilled personnel to counsel and encouraged the patients so as not to give up on life,” she maintained.

While sharing her story on how she contracted the disease and how she prevented it from spreading to her son, who just graduated as a medical student, Soyingbe said going for regular routine check up and following treatment is necessary to avoid spread of the disease to ones baby and the community at large.She also emphasised on Traditional Birth Attendant (TBA), in communities, which are also a major contributors to the disease infection, as most pregnant women have their children there, saying there is need for government to bring in these traditional operators into the system to help prevent the spread of the disease.

Meanwhile, when journalists visited a TBA’s place, known as Agbomola Traditional Clinic, the Managing Director, Abidemi Ajayi, said he works with the government hospitals to ensure his patients are safe from the infection of HIV/AIDS.He said he is aware of the danger posed by TBAs spreading the disease, and is however knowledgeable on the importance of keeping safe, as he doesn’t take delivery without knowing the HIV status of patients. However, experts have urged Nigerians to know their HIV/AIDS status and seek treatment if tested positive to avoid further spread of the disease, if the country must achieve massive reduction of the disease by year 2030.