Human Immunodeficiency Virus, or HIV, is a virus that weakens the immune system in humans. This is accomplished as the virus attacks the cells that fight infection and diseases. As a virus, it is similar in nature to other viruses, such as the flu. Unlike other viruses, however, the symptoms associated with HIV do not improve over time as HIV reproduces by systematically overtaking the cells within the host body. HIV does not heal and once an individual is infected, that individual will live the remainder of their life with this virus (aids.gov, n.d.).
The symptoms associated with HIV may not be immediately apparent as the virus has the ability to lie dormant within the cells of the host body. HIV infects the T-cells or CD4 cells, which then replicates to increase number of infected cells. The infected cells then destroy the T-cells. Eventually, the number of infected cells increase and the number of T-cells decrease. After the body loses the ability for the T-cells to fight infections and diseases, HIV progresses into the final stage, which is known as Acquired Immune Deficiency Syndrome, or AIDS (aids.gov, n.d.).
While HIV is incurable, treatment is available to control the progression of the disease. Known as antiretroviral therapy, or ART, the treatment is a regimen of medications that are taken on a daily basis. This reduces the risk of transmitting the virus to others and increases the anticipated life expectancy. Prior to the implementation of ART, the disease had the ability to progress to AIDS within a matter of a few years. Once the virus progresses to the final stage of AIDS, the individual is more susceptible to other ailments, including certain forms of cancer and opportunistic infections (OI) due to the compromised immune system. The treatment has the ability to prevent the virus from progressing to the final stage of infection (aids.gov, n.d.).
Prior to HIV becoming recognized in 1981 as a medical condition, it is unknown how many individuals had contracted this disease. In 1981, certain trends in the infection rates of various diseases, such as Kaposi’s sarcoma (KS) and Pneumocystis carinii pneumonia (PCP) were identified through the issuance of the drugs prescribed to treat these conditions. By providing focus in these areas to determine commonalities, it was determined that the patients affected patients were gay men. Within a few months, a secondary demographic emerged consisting of injecting drug users. By 1982, the number of cases identified in the United States increased and cases were beginning to be diagnosed in the United Kingdom. The rapidness with which this yet unnamed disease spread as well as the lack of information concerning the manner in which it was transmitted resulted in an increase of anxiety and panic throughout the general population. As Haitians and hemophiliacs began to be diagnosed with HIV and AIDS, speculation indicating that the disease originated in Haiti began and children were withdrawn from hemophiliac camps. Numerous organizations were created to educate gay men on possible methods of prevention. In December of 1982, the death of a 20 month old child who had undergone numerous blood transfusions was attributed to the AIDS virus and the realization that this disease was caused by an infectious agent and resulted in mounting concerns about the possibility of the contamination blood supplies. In addition the first cases demonstrating the possibility of mother to child transmissions of AIDS were reported by the Centers for Disease Control and Prevention (CDC). The number of reported cases increased in the United States and throughout Europe. Other countries, such as Uganda, began to see the emergence of HIV and AIDS where it was identified as “slim” (avert.org, n.d.).
At first it was considered to be a gay epidemic until children and those who had been the recipients of blood transfusions were diagnosed. At that point, it became apparent that it did not have the capacity to affect one demographic and was not restricted to geographical locations. It was no longer a gay disease restricted to the soils of the United States. As women with no other risk factors became diagnosed with HIV and AIDS in 1983, heterosexual sex became recognized as a potential method of transmission. Blood supplies and clotting factors that were often used in the treatment of hemophiliacs was also afforded more attention. Even though the potential for other demographics groups to become infected by AIDS was recognized, fear led to biases against Haitians, homosexuals, hemophiliacs, and intravenous drug users, primarily heroin users. This became known as the 4-H Club. Haiti experienced losses in a primary industry as tourism rates declined. Blood supplies were referenced by media outlets as “killer blood”. AIDS became identified as the “gay plague”. A heightened sense of panic became prevalent in the United States as the modes of transmission had not been identified (avert.org, n.d.).
This panic was reflected as police departments, beginning in San Francisco, issued latex gloves to officers to wear while interacting with those suspected of having or considered to be a higher risk of contracting AIDS. Landlords were evicting individuals with AIDS diagnoses. Interviews conducted with AIDS patients by the Social Security Administration were conducted via telephone. This panic was reflected throughout the world as the number of cases increased. AIDS had reached epidemic proportions. Numerous cases throughout the UK, West Germany, and Denmark were attributed to unprotected sex by homosexuals and many of those had a history with American nationals. The perception that the US was the source of origination of AIDS had been established. This perception began to change as individuals in France and Belgium were diagnosed with AIDS who had not engaged in sexual activity with American nationals as the majority of these individuals originated from Central Africa or had direct connections to the area. While the symptoms of these patients were reflective of those in the US, the majority had not engaged in homosexual activity, blood transfusions, or intravenous drug use. This led to scientists from Europe and the US to provide concentrated efforts on Central Africa to determine the prevalence of HIV in that region. By this time, doctors in Zambia and Zaire had recognized emerging trends through an increase of an extremely aggressive form of Kaposi’s sarcoma. This form did not respond well to treatment and was usually fatal. During the first European World Health Organization (WHO) meeting in October of 1983, it was revealed that 2,803 cases of AIDS had been diagnosed in the US. A second meeting was held in November to provide an assessment of the AIDS situation worldwide, during which cases had been identified in the US, Canada, fifteen European countries, Haiti, Zaire, seven countries in Latin America, and Australia as well as two suspected cases in Japan. By the end of 1983, 1,292 deaths were attributed to AIDS and the number of diagnosed cases had increased to 3,064 (avert.org, n.d.).
French researchers had shared information concerning the potential cause of infection in 1983 and in 1984, the CDC in the US confirmed that the virus that causes AIDS had been isolated. The results of the 1983 expedition by researchers to Central Africa revealed that 26 individuals were diagnosed with AIDS in Kigali, Rwanda and an additional 38 individuals were diagnosed in Kinshasa, Zaire. This study provided the necessary data to indicate that transmission through heterosexual sex was a probability as the connection between heterosexual promiscuity and AIDS had been established. In 1985, preventative measures were implemented in the effort to reduce the number of new cases of AIDS and discrimination against those who had been diagnosed increased. Potential blood donors that were identified as being members of high-risk groups, as well as individuals who had been diagnosed with AIDS, were denied the opportunity to donate blood and measures were implemented to test blood donations for the AIDS virus. Children who had been infected by receiving tainted blood through transfusions were denied entry into schools. The “slim disease” became more widespread in South West Uganda and had been diagnosed in Tanzania. By the end of the year, China announced the first identified case of AIDS in that country, resulting in reports of AIDS in every region of the world (avert.org, n.d.).
Through the utilization of a complex computer model, researchers were able to determine the evolution of what is identified as HIV-1, which causes AIDS in humans, originated from a certain strain of Simian Immunodeficiency Virus (SIV). It is believed that SIV was transferred to humans at some point around 1930 followed by the transmission of HIV-2 to humans from monkeys during the 1940s. In-depth analyses of monkeys on other continents were unable to locate traces of SIV, which led to the conclusion that HIV originated in Africa. The first HIV/AIDS epidemic is believed to have occurred in Kinshasa during the 1970s as a surge in opportunistic infections, such as Kaposi’s sarcoma, tuberculosis, and specific forms of pneumonia, were observed. Through unprotected heterosexual sexual encounters, it is believed to have spread to Uganda, Rwanda, Burundi, Tanzania, and Kenya in Eastern Africa during the 1970s even though it did not reach epidemic proportions until the early 1980s. By 1986, 85 percent of sex workers in Nairobi were infected with HIV as the rate of transmission increased. Additional factors that contributed to the rate of transmission include a combination of labor migration, the high ratio of men located in urban areas, the low status of women, the lack of circumcision, and other sexually transmitted diseases. Even though there were identified similarities between AIDS and “slim disease”, doctors in Uganda were not convinced that the two diseases were the same. As a result the AIDS epidemic had a devastating effect in Uganda and by the end of the decade, pregnant women displayed a prevalence rate for HIV of 30 percent (avert.org, n.d.).
The National AIDS Advisory Committee was established in 1987 in Nigeria following the identification of the first two cases of HIV and AIDS in 1985. The National Expert Advisory Committee on AIDS (NEACA) was established shortly after. Even with the formation of these committees, the Nigerian government was slow to respond as the rate of transmission increased. The Federal Ministry of Health performed the initial assessment of the situation in 1991. At that point, approximately 1.8 percent of the population had been infected with HIV. By 1993, the prevalence rate was 3.8 percent. This increased to 5.4 percent in 1999. The prevalence rate peaked at 5.8 percent in 2001. This was followed by a period during which a decline in the prevalence rate was observed. The early 1990s saw the introduction of antiretroviral drugs in Nigeria. However, the associated costs were extremely high and the majority of the population was unable to afford the treatment. HIV prevention, treatment, and care became a priority for the government in 1999 and the President’s Committee on AIDS and the National Action Committee on AIDS (NACA) were established. In 2001, a three year HIV/AIDS Emergency Action Plan (HEAP) was implemented. An antiretroviral treatment program was implemented in 2002 and was overwhelmed by 2004 as the number of individuals seeking treatment outnumbered the availability of the necessary drugs. This resulted in a halt in treatment for many individuals and the creation of a waiting list for others to begin the initial treatment. The halt in treatment lasted for approximately three months. In 2006, an estimated 10 percent of infected men and women were receiving treatment. Even though the Nigerian government attempted to address the needs of all the affected individuals, there were many areas in which treatment was inaccessible. An additional 41 treatment centers were established to expand the 25 initial treatment centers and ARVs were distributed to those who required them for free. The number of individuals receiving treatment increased from 15 percent to account for 81,000 people in 2006 to 26 percent, or 198,000 individuals by the end of 2007. Other preventative measures were implemented to reduce the number of mother-to-child transmission through breast milk. NACA developed and released the National Strategic Framework to provide comprehensive treatment and preventive measures to be undertaken from 2010 through 2015. A primary challenge to the efforts afforded in this area is demonstrated through the United Nations Development Programme (UNDP) Human Poverty Index which places Nigeria at 156 out of 187 positions (avert.org, n.d.).
The population of Nigeria was an estimated 152.6 million people in 2010 (NACA, 2012, p. 3). The majority of the population, an estimated 54.6 percent in 2008, consisted of individuals between the ages of 15 and 64. This demographic was closely followed by children 14 years of age and under at 42.3 percent. The remaining 3.1 percent of the population contains the ages of 65 and over (World Facts, 2008). With the growth rate at an estimated 2.38 percent, the infant mortality rate was 7.5 percent as there was a reported 75 deaths per 1,000 births. The life expectancy at birth was 47.7 years in 2008 (NACA, 2012, pp. 3-5).
According to the National Agency for the Control of AIDS (NACA), there were an estimated 3.1 million individuals living with HIV/AIDS in Nigeria in 2010. That year, over 56,000 babies were born who tested positive for HIV. Over 200,000 individuals died as a result of AIDS annually. The majority, accounting for almost 120,000 of those deaths, were female. Since the first cases of AIDS were documented in 1986 through 2008, there were 2,229,883 children who became orphans due to AIDS. Over 1.5 million people were in need of antiretroviral therapy in 2010 (NACA, 2012, p. 8).
Avert.org (n.d.). History of HIV & AIDS in Africa. Retrieved from http://www.avert.org/history-hiv-aids-africa.htm
Avert.org (n.d.). History of AIDS Up to 1986. Retrieved from http://www.avert.org/history-aids-1986.htm
Avert.org (n.d.). HIV & AIDS in Nigeria. Retrieved from http://www.avert.org/hiv-aids-nigeria.htm
NACA (2012). Factsheet 2011: Update on the HIV/AIDS Epidemic and Response in Nigeria. Retrieved from http://nigeriahivinfo.com/fact_sheets/hiv_fact_sheet_2011.pdf