Understanding HIV/AIDS and Combative Ways in Nigerian Society (Part 11)

By

Patrick Iroegbu

Alberta, Canada

iroegbuP@macewan.ca

INTRODUCTION

Our part one of this essay discussed the fears, facts and theories of origin of HIV/AIDS. It also pointed out the main question mark of HIV/AIDS in Nigeria and referred to the impact of HIV/AIDS workshop in understanding what this infectious disease is up to. At the same time, it explored what connotation HIV/AIDS embodies in society today. In this part two, we will be concerned with the various ways HIV/AIDS may or may not be transmitted and thereby let us identify and emphasize the signs and symptoms to indicate when someone infected will be able to confirm the manifestation and do something about it. The various preventive measures of HIV/AIDS will also be pointed out, as well as how therapeutic options are viewed and to be followed. Finally, we will draw up some conclusions on the issue of HIV/AIDS from which we hopefully will state what is important for decision makers to do about helping the endangered Nigerian population groups in the problematic of HIV/AIDS. It will show that the epidemic is a decisive one and calls for a total commitment to understand the misfortune, as well as the functions of culture to comprehend it in order to resourcefully domesticate the HIV/AIDS scourge. HIV/AIDS, it must be noted, has become a common place issue for public commentary in Nigeria and it is hoped that intensive fighting action rather than mere speeches will begin to impact on the lives of the huge part of the population groups it has messed up.

WHAT DOES THIS HIV/AIDS MEAN? CAN IT BE EXPLAINED?

We will first lay bare the specific meaning of HIV infection followed by AIDS and their ways of non-transmission and transmission, and then depict the symptoms and signs associated with the reality of these menacing killer metaphors and symbolisms.

HIV: Is an acronym for Human Immunodeficiency Virus, which is said to attack the human immune system and over time tear the walls of its defense mechanism and renders the body vulnerable to intrusion. Virus in itself is defined as a microbe or pathogen which contributes to bodily related illnesses and entails understanding of sanitary and safety handling practices of the human bodies in their cultural environments. Of all forms of microbe, namely bacteria, protozoa and virus; virus is the smallest in size. Disease causing microbes, called pathogens as we have said, requires a host in order to grow and multiply inside living cells, and as well cause diseases such as colds, measles, hepatitis and AIDS, which metaphorically implies death at hand. In other words, AIDS, pejoratively in common uses stands for – around inevitable death summary in some communities, and in others, it refers to America intends to destroy sex.[1] Yet others say it means annoying inner disease seduction. What is more, the French calls it SIDA.

The senses HIV/AIDS make at the moment shows in dissolution of infected households, as the parents die and children are sent to relatives for care. Decline in school and education is also visible as much as its dramatic effect on labour factor, setting back economic activity and social progress (www.avert.org). The huge majority in HIV/AIDS are within the ages of 15 – 49 and this ruins productive labour force and in turn Africa , and particularly Nigeria ’s ability to cope with the epidemic. Another sense HIV/AIDS makes is the related stigma and discrimination and the fear to be tested further shades people from admitting HIV status and seeking help for treatment. All of this suggests that greater local and intercultural awareness is needed to work on people’s mentalities and a shift towards preventive activities against HIV infection and distribution.  

AIDS: Is an acronym for Acquired Immunodeficiency Syndrome caused by HIV virus. When HIV takes the human body as its host, it weakens and overwhelms the immune system as we have said before by progressively destroying certain helper cells, called white blood cells or “T-Helper Cells.” Actually, the main cell HIV infects is this T-Cell, scientifically called T helper lymphocyte.[2] As HIV reproduces in the cells of the immune system, T-Cell counts will decline, rendering the system weak and less able to fight off infections. The result of which is a decline in health, strength and vitality.[3] Given the condition, serious infections progressing to advanced stage due to breakdown of health are referred to as AIDS defining illnesses.[4] The HIV infected person if unchecked will progress to AIDS and finally dies off. AIDS cannot occur without this deadly virus called “HIV” that places the body at high risk of any disease attack. A person infected can therefore get unusual opportunistic infections, including cancers without effort to resist because the immune system is punctured, depressed and gone. That is, at the progressive moment the immune system is damaged beyond repair, chance-taking infections and cancers which now take control will overwhelm the body and at this final point of non-resistibility, it is said to be fully blown AIDS.  

Once HIV is detected, treatments and medications attempt to render it a long term condition. In other words, a palliative treatment rather than cure is possible to cope with the virus battling with the body immune system. That means, a HIV positive, male, female, child and adult, rich or poor, coloured, visible minority or mainstream, can live for many years before becoming ill. Checked, less people will be becoming diagnosed with AIDS but still are infected with HIV. Anyone with HIV unchecked or checked is capable of transmitting the virus to others. Specifically, someone can be infected with HIV no matter what one’s sex, age, religion, sexual orientation and ethnic orientation is. In like manner, everyone is affected by AIDS which brings death close to undesired and unwanted times and places.

NON-TRANSMISSION WAYS OF ‘HIV’ INFECTION

Medical science research provides that someone may have HIV if the one had gotten blood or blood products with HIV in them before November 1985 in Canada , and this is probably true for countries with advanced western medical practices with varying dates too. Since date/s such as the one quoted here for Canada has become a parameter for belief, people are constantly re-assured that all blood and blood products have been checked for HIV. This exemption is not for developing countries, particularly Nigeria , and it is clearly noted that anyone returning from developing countries with concerns should get tested to be sure.

Obviously it is now concluded that no one can get HIV from casual everyday contact, namely talking or eating with someone who is infected with HIV. Others include handshakes, hugs or kisses, coughs or sneezes, making a blood donation, swimming, sharing bathroom facilities, toilet seats, drinking water fountains, telephones, or clothing, and bed sheets. Others are cutleries such as forks, spoons, cups, food, as well as from insects or animals (e.g., mosquitoes, dogs, cats). Insect bites such as mosquitoes will not transmit HIV virus. Still on debate is whether monkeys and sexual intercourse with such other animals other than human can contribute to, or promote HIV transmission. Old myths based on these are said to be mere fears rather than scientific fact since HIV is particularly a human to human effect, hence its name - human immunodeficiency virus. Finally, abstention from unsafe (biological), immoral (churchical) and uncontrolled sexual behaviour (cultural) guarantees non-transmission of HIV and consequently AIDS. In short, transmission of HIV will not occur if there is no factor of infected person, there is no exit for the virus from the body of a carrier to enter a second person’s body, and there is not sufficient concentration of the virus to shoot into the blood cells to cause disorder.                    

HIV TRANSMISSION WAYS

Scientifically, biological understanding has invented some ways to help control transmission of HIV infection failure of which will facilitate transmission. It suggests that one can get HIV if one gets the virus into one’s bloodstream from another person who is infected with HIV. As such, HIV can enter one’s body through the infected person’s sexual fluids (semen or sperm, female private or blood). Having unprotected sex with someone who has HIV, that is without using condom (latex, rubber, penis glove, or burrow glove), as well as having oral penetration without using a dental dam,  condom or a piece of latex to cover the sexual orifices is sure to plant the virus. Sharing needles to inject drugs like cocaine, or steroids with a HIV infected person, including sharing sex toys, razor, toothbrush, and anything that could carry HIV into the body will enable it transmitted because the virus is found in all body fluids (plus menstrual, urine) of an infected person.

For emphasis, HIV is commonly transmitted in blood, semen, vaginal secretions, and breast milk. Through sexual contact; exposure to infected blood – such as sharing injection drug rounds of un-sterilized equipment use, tattooing, ear piercing, acupuncture, and activities where people may commonly or uniquely share each other’s blood are avenues to infection. Blood rituals are part. Infected mothers transmit HIV to the unborn and largely through breast feeding.              

HIV may penetrate the mucous membrane of the mouth, or enter the bloodstream via a number of doorways, for example, via small wound, cold sores, bleeding teeth-gums (caused by toothbrush, chewing stick, bone chewing, dental loss, rough kissing, etc.) and self-harmed tongue and lip bites. While it is emphasized that transmission effectiveness of HIV is established during sexual involvement from male to female, feminist researchers are arguing it is unclear how effective transmission takes place from female to male although infection is not totally ruled out.           

WHAT SIGNS AND SYMPTOMS INDICATE THAT ONE IS INFECTED?

HIV must enter the blood to establish an infection and the question here we need to understand is this. How can someone find out if one has HIV or has become a HIV positive even without going to STD clinic for a test? In other words, what common symptoms are associated with HIV attack?

Science is clear on the question of symptoms but again it is often deceptive since many people who are HIV infected may not have any symptoms or signs to show for it. Infected categories of persons can, and indeed, pose more dangers because they are still capable of passing the virus onto others knowingly or unsuspectingly. Generally, an infected person, an HIV virus carrier, may experience all or some of the following:  

1. Initial infection – here one displays a sole or a few symptoms, such as flu; 

2. Be infected and well – in this case one has no significant symptoms showing up; 

3. Be infected and ill – understood is that one captures a combination of persistent symptom display; 

4. Be infected and diagnosed with specific infections or cancers – apparently, what happens here is that one is certain to be serving as a host to infections that manifest in the body, particularly cancer related set of symptoms or disorders. So a victim is aware of his or her disposition with the virus and its avoidable and unavoidable consequences in the short term and long run respectively.  

If at any time someone begins to think that he or she has been infected with HIV, check out for the following – feeling tired, hairs falling off, big pimples or bumps appearing, whooping cough occurring, absence of, or changes to menstrual cycle, dry skin, TB, bacterial pneumonia, having fever, having a sore throat, having swollen lymph nodes in one’s neck. Other things are having headaches, diarrhea, or watery stools, weight loss, and emergent skin rashes. It takes about six months after one gets infected before antibodies show up in blood for HIV and anyone showing the above outlined signs and symptoms should make haste to get tested. It is important to note that upon infection with HIV, one’s body will react to it by making antibodies to fight against it as a first line of body defense. It is said that about 95% of tests will become positive in 3 months. And the time between being exposed to the virus and testing positive is now plausibly called the “window period.”[5] This period specifically means the time from when the virus enters one’s body through any of the aforementioned transmission ways (such as body fluids comprising of blood, semen, vaginal fluids, and breast milk) to when one’s body makes enough testable anti-bodies that would show up on the test (ranging from 1-6 months). The process of developing anti-bodies is called “Seroconversion” (see Sexual Safety 1994, NIAIDS 2002).[6] AIDS erupts at least 5-10 years after having HIV virus for adults; and it takes less than a year for children.     

But what science has not helped people in their cultures resolve is how to distinguish commonly known signs and symptoms that conflict with other illnesses sharing similar signs and symptoms as they live their daily lives. Before the coming of HIV/AIDS, all of these signs and symptoms are known to people and nothing seems to make a clear distinction as a matter of necessity even among those who appear to avoid sexual intercourse? There is need to deepen research in this view in order to further insights into the symptoms and signs of HIV/AIDS within the etiology of local health idioms and representations.    

PREVENTING HIV/AIDS

In a confused state of life and devastation produced by HIV/AIDS, how would people in society prevent and sustain their lives and culture? Biomedical science has advanced some measures to help. Society and their leaders hold to custom and tradition to check straight biological health mindedness in ways it deals little with customary symbolisms of health practices; and world religions continue to stand by established doctrines related to sex, marriage, age, culture and God. In all of these, people in society know well that health is life and often evaluated on the value bases of wrong and right. We will not pursue these paradigmatic issues one after the other. As a whole we want to state that the challenges of HIV/AIDS is one facing all dimensions and determinants of what each view side should now re-enforce for a break through to check the HIV pandemic. All the way, everyone is to stay posted in that there is danger to life posed by HIV/AIDS and the drive for personal and public safety should increase and indeed concern all in Nigeria particularly now, in things that drive technology in shaping society and modernity. HIV/AIDS is a challenge demanding which way Nigeria is heading for resistance – will it be bio-med or folk-med or can both perspectives join hands to resolve the HIV/AIDS mockery to survival? To reason this out a bit more, we can say that to understand HIV/AIDS is to pose the question of bio-mediated senses, wellness and culture strategies. It is also to question what is finding affection for what we think being in relationship is in an unhealthy natural way, or in un-natural protected way. Here again, science of HIV/AIDS seems to agree with theology of sexual relations as a given for a purpose under some culturally compromised practices. This logic will therefore mean that life and times in sex is finding love for what we think is love in an uncultured way and that is why technology and modernity have in one way or another backfired on human populations.

We watched a movie recently captioned Life and Times of Janet Cornners on 20^th June, 2004 on CTV channel. It demonstrated the shocks and persuasions underlying infections no one can help either with medical cares or tested counseling services in its own right. The impact of this movie on how to live with HIV is outstanding. It shows how to take the will to fight it and live with it successfully no matter what challenges it personifies. Nevertheless, we watched the movie with a view to sharing the message of HIV/AIDS lived experience of Janet Cornners and Randy as a significant case study. One of the high points came with a related anthropological hypothesis which we paraphrase as this. If someone, you the reader of this piece, as an example, had an accident, or linked to a crime, or even got defamed, you will certainly be disturbed. You would like to have whatever issue at stake investigated to restore your personality and credibility once you are sure of your innocence. You have the courage to stand for it. But all that courage will change if you got into trouble of being linked to a relationship affair involving HIV/AIDS - isn’t it? If we assume your psychology in this further, you will not feel courageous to have this matter investigated for public cover up and safety; and we are sure Nigerians will not go too far to laying open the processes involved to secure life and society.

This is the hard fact about what is going on in HIV/AIDS. It is scary. Moreso, it is critically shaming because it is linked with public ethics about sexuality. Perhaps, there will be need to re-write the moral message of what sex should mean in society. The scary nature of HIV/AIDS compared with prison life also makes a point. For example, a prisoner lives under seclusion and hopes to survive his or her term of sentence and then will re-build life in society afterwards. Prison is a matter of time. But HIV/AIDS will put a victim to death. Prison is by institution of justice, law and order man-made, HIV/AIDS is sex made, is it? At least, this is what bio-med tells us. When HIV occurs, its time goes faster because there is nothing to rebuild and there is no end to the term of sentence of the virus. We just overheard someone saying it is the dreaded anti-Christ number of #666 of the end of time. As such, it promotes impulsiveness. These hypothetical issues should make our leaders think, act and stay politically correct in the politics of healthy and sustainable population. Preventing HIV/AIDS is to create a new form of political, economic and cultural power to negotiate and measure responses to HIV/AIDS’ antecedents, meaning, functions, deeds, and consequences in Nigeria . We mean that political responsibility is equally a responsibility to how HIV/AIDS ought to be strongly understood and controlled in Nigeria taking into account the culture contexts in health determination to live a normal and good quality of life.                             

HIV/AIDS AND ANTIRETROVIRAL THERAPY  -  THE COCKTAIL

Everyone with AIDS dies shortly after and cases of victims in Nigeria are everywhere – local and urban areas. Although with progress in the use of effective combination treatments, or HAART (Highly Active Antiretroviral Therapy) death rates and sickness from HIV/AIDS are being helped in advanced countries to drop down. In developing countries, particularly Nigeria , deaths are rather increasing on daily basis. Many people living with HIV/AIDS appear to have benefited from years of treatment in a package described as “The Cocktail” reminiscent of simplified combination antiretroviral therapy to cope with metabolic complications, adherence and effectiveness.[7]

Usefully, treatment “Cocktail” is to keep the HIV virus in check, below detection using current blood tests. It is to be easy to take with few side effects, and be simple to swallow, entailing lowest number of combination drugs or pills as few times per day as possible. And the overall treatment using antiretroviral therapy is to delay total breakdown of the immune system by building supportive barrier against the attacking virus. That is to say, infected persons are helped to live longer with good quality of life at the same time. It is to assist in reducing the amount of HIV virus in the body as much as possible for as long as it is possible. Importantly it is to strengthen the immune system to protect an HIV+ person from infections. To achieve these would also mean avoiding drug toxicities likely to affect the organ such as liver or kidney regarding side effects.[8]                             

To gaze if the future is desperate and holds any hope for chances of breaking through with the curability of HIV/AIDS, comes down to seeing if more people are really coping and living longer with the ongoing retrenchment care challenging the virus from high risk damage to the immune system and of reducing the trend of HIV-related illnesses. Sticking to a treatment regime of a chronic disease can be a tussle for the future unless simpler and uncomplicated metabolisms of “Cocktail” consumption will level off with a healthy diet, exercise, and non-smoking life style to serve ends. People get AIDS because HIV has after several years, damaged their body’s defenses – the immune system. The implication of all these is to adopt available and affordable treatment if any. So far in Nigeria , HIV/AIDS infected persons are worse off due to inaccessible and unaffordable therapeutic options and the population surviving as species as Charles Darwin (1859) proposed in the life battle is critically in doubt. Only when wellness is reinforced and assured in promising economic, political and social conditions can observers re-write the history of HIV/AIDS as a curse to human society due to insensitive and corrupt leadership.               

CONCLUSION

This paper has looked at some of the significant fears and facts entertained about HIV/AIDS in Nigeria and beyond. It highlighted the transgressive society of HIV and its implications to sustainable population. It pointed out that HIV has come to add to the changing danger-belief system. HIV ideas, moreover, function in the life of Nigerian society at two levels – one largely in belief and fear; and the other one in defense, expression and disillusionment. HIV danger-beliefs are as much as threats which people use to coerce others, locally and internationally to conform to the rhythm of the dangers of modernity due to hybridization of sexuality, scientific development lapses, society’s aftershocks and vicious helplessness in dying. Sexual dangers and taboos are not new to society, but seem heightened in representing points of entry and exit to the social body, gender power, identity and roles that they organize and recognize. As Douglas (1966:5) noted in Congo , “it may seem that in culture richly organized by ideas of contagion and purification the individual is in the grip of iron-hard categories of thought which are heavily safeguarded by rules of avoidance and by punishments.” HIV is a forerunner to danger of disorder, deficiency and death. Its ideation is in the confounded edges of sex and globalization. Science for war and media commercialization of new forms of sexual order appears to have set things upside down in HIV syndrome, to say the least.      

The paper has also shown the useful contribution medical anthropologists make in understanding the forces of culture in HIV/AIDS. Shown also is the fact that biomedicine and culture are struggling with varying paradigms in the same issue of health and culture of humankind. The threat of HIV/AIDS is showing grave implications and so far no solution is at hand to help infected persons, thereby rendering the nation highly at risk of greater depopulation, economic and political uncertainty.

AIDS is a fatal frustration that we now know in its transmission ways. It is noted that competing theories of HIV/AIDS origin dating from 1930s have been focused mainly on Africa and hitherto the main source of origin is unknown; and there is no cure either. It is also known that there are ways to reduce HIV harm through preventive measures and in order to achieve them, sufficient commitment is needed from the governments and individuals to work together, to create ‘policy of release’ and make such policy against HIV war as effective as a symbolic load centre of democratic ability. To say the least, putting and reinforcing HIV/AIDS campaign in school curricula at all levels will help at this time. 

Nigerian healers are interested in HIV/AIDS explanation and curing measures and should be involved in the process as effectively as it is urgent. There is no doubt Nigerian healers have been dealing with HIV/AIDS before now and in their own terms. The example of Dr. Abalaka’s approach to HIV/AIDS using traditional or folk medical insights is instructive. In that way, more effort and attention should be devoted to Nigerian indigenous medical resources, such that healers will embody them in ritual, roots and herbal endowments. It is appropriate to emphasize that what makes sense to a specific group of people is to be found in their local experience to which HIV/AIDS therapeutics must be adapted. Moreover, to assign meaning to HIV/AIDS is to interpret the phenomenon, to discover its significance and therefore its consequences for Nigerian society. That is why it is important to prompt and form genuine attitude towards the HIV/AIDS episode. This in part relates to the fact that in Nigerian healing premise, to misconceive, overlook or ignore Nigerian healers’ skills, knowledge of the forest, water and cosmological resources and contexts that they represent in HIV/AIDS will be unwise. Doing so is to miss out other sensory realities of HIV/AIDS in daily life contexts. While science is battling with the challenges of HIV/AIDS, faith healing paradigm with assisted spirituality and power of prayer is also showing cases of recovery through miracles in HIV complex. The war on HIV cannot remain overpowering if things are done right. If it is being tamed in advanced societies, it can equally be conquered everywhere. The difficulty will arise only when central issues, such as cultural factors that make sense around HIV/AIDS are played down. To overcome HIV virus and its implications, Nigerian leadership must show responsibility and commitment to the endangered population groups in Nigeria .                      

ENDNOTES AND REFERENCES