1. Addressing Youth vulnerability to HIV/AIDS in Nigeria
Presentation by Professor John Idoko
Director-General
National Agency for the Control of AIDS
July 5, 2012

2. Introduction Epidemiology of HIV in Nigeria
Young People – Why vulnerable?
Why focus on young people?
Taking the lead to protect young people in Nigeria
Are we keeping our promise? Voice of young people in Policy formulation/program coordination
Conclusion

3. Why focus on young people?
Of the 1.7 billion young people globally, 5.4 million living with HIV
40% new HIV infections among young
people
Young people have the highest rates of STIs
Young people between 15 – 30 years make up to 45 – 50% of Nigerian population
In Nigeria 60% of HIV prevalence among young people

5. National HIV Prevalence Trend 1991 – 2010 (FMOH)

6. Where we are now with UA?....still far away (2010)
No. of PLWIH million
HCT coverage 18%
PMTCT coverage 32%
Annual HIV+ Birth 70,000
New infections ,016
Number on ART 432,000 (30%)
Number req ART 1.5 million
Total orphaned by AIDS 2.23 million

7. HIV Prevalence by Age Groups
FMOH, 2011

8. Women and Girls
HIV is a leading cause of death and disease among women of reproductive age (15 – 49years) in sub-Saharan Africa.
In sub- Saharan African, 60% of the People Living with HIV is female (while women make up 50% of the global epidemic).
In Nigeria prevalence among young women aged 15 – 24 years is estimated to be three times higher than among men of the same age.
Females constitute 58% (about 1.72 million) of persons living with HIV in Nigeria.
Each year, 55% of AIDS deaths in Nigeria occur among women and girls

9. HIV prevalence among women aged 15-24 years by location, North Central Zone (HSS 2010)

12. What risk factors...? Early age at sexual initiation
Heterosexual transmission
Biological vulnerability
Lack of recognition of partner’s risk
Inequality in relationship
Sex with older men (more likely with HIV)
Gender norms & Gender violence
MSM
Less likely to disclose sexual orientation
Less likely to have HIV test
Likely to have 1 or > female sex partners
Infected MSM may transmit to men/women

13. Halt AIDS, 2006

14. Halt AIDS, 2006

15. Age distribution of MSM in Abuja, Nigeria S/N Age group Frequency % 1 15
5.1 2
108
36.6 3
116
39.4 4 45
15.2 5 10
3.4 6 7
0.3
Total
295
100
CRH, 2009

16. Risk Factors STIs Alcohol, tobacco and drugs
Young people have higher prevalence of STIs - increased likelihood of HIV
Alcohol, tobacco and drugs
Both casual and chronic users more likely to engage in high risk behaviour such as unprotected sex
Lack of awareness of risk/vulnerability
Low perception of risk among young people
Population Effect/Family level vulnerability
Generating ever increasing cohort of sexually active susceptible to HIV

17. Risk Factors Poverty and out of school youths
Socio – economic problems associated with poverty can increase risk of HIV:
Poor education
Poor information on HIV, RH & condoms
Lack of high quality health care
Poor condom use
Coming of age of HIV +ve children
Young people who acquired HIV perinatally facing decisions about becoming sexually active
Will require counselling

18. Comprehensive Knowledge about HIV Characteristic Female (%) Male (%)
Age:
19.7
28.2
Age:
24.8
37.2
Urban Residence
29.8
39.7
Rural Residence
17.9
Comprehensive Knowledge
Consistent use of condoms
Having one faithful –ve partner
Know that healthy person can have HIV
Rejecting 2 common local myths about HIV transmission
NDHS, 2008

19. ZERO NEW HIV INFECTIONS.
ZERO DISCRIMINATION. ZERO AIDS-RELATED DEATHS.

20. Catalysing the next phase Advancing human rights & gender equality
3 Strategic Directions
Revolutionising HIV prevention
Political commitment to why people are getting infected and reduce new infections
Mobilize communities to demand transformative change
Resources directed to hotspots and what works
Catalysing the next phase
of treatment, care & support
Access to effective treatment when people need it
Strong national & community systems to deliver services
Access to care, support & nutrition and social protection
Linkages with maternal and child health, SRH, TB…
Advancing human rights & gender equality
Protective social & legal environments enable access
Equitable service provision reaches people most in need
HIV-related needs and rights women and girls addressed

21. Reducing Youth Vulnerability
Education on sexuality and RH
School Attendance esp Girl child
Cultural norms/values
Virginity and Abstinence before marriage – values for girls & boys
Sexual behaviour tolerating multiple sex partners
Access to condoms
Migrants are vulnerable
Alcohol & Drugs

22. Prevention Strategies
Making HIV testing a mature part of medical care (PIT) & Implementing new models of diagnosing HIV infection outside medical settings
Prevention of new infections by working with HIV infected persons and their partners
Decreasing Perinatal infections (eMTCT)
COMBINATION PREVENTION + NPT
PrEP and Treatment as Prevention
Role of Parents, Schools, Churches & communities
Prevention programs
Awareness for responsible sex behaviour

23. Contribution of the 20 countries with the largest numbers of women needing antiretrovirals for preventing the mother-to-child transmission of HIV to the global gap to reach 80% of those in need, 2008

24. Role of Government
Role of Federal Ministry of Education & Youths line Ministries supporting multi-sectoral response
Role of State Ministries of Education
Role of NACA, SACAs & LACAs
FL& HIV education (curriculum)
NYSC HIV project
AIDS & RH clubs in secondary schools
GS curriculum in Universities & expanded curriculum in medical & nursing schools
Youth Friendly Centres in Universities

25. Commissioning of Youth Friendly Centre, OOU, Ago- Iwoye

26. National Call Centre Update
The centre is set to harness the vast potential of telephone through public-private partnerships
Airtel has provided an E1 line with capacity for 30 toll free voice calls + 2 data lines
ETISALAT already key in to provide free services
NACA procured office space in Central Area close to NACA office in Abuja
Skye and Access Banks have supported furniture and hardware respectively
NACA sourced robust user friendly software from India and installation of E1 hardware completed
Access Code – 6322 ONLY ON AIRTEL FOR NOW

28. National Reproductive Health, HIV & AIDS Prevention and Care Project through the NYSC
Project Goal
Increase RH/HIV knowledge among corpers
Provide life skills & promote peer education
Support protective behaviour in communities of primary assignment

29. Sensitization of Students in Schools

30. Project Achievement 1,157,571 77,325 29.8 million <1,800 185 222
Activity
Beneficiaries
No. reached
Duration
Orientation Seminar
Corps members/ NYSC staff
1,157,571
2002 to 2011
Training Peer Educator Trainers (PETs)
Corps members
77,325
2002 to 2010
Training Peer Educators (PEs)
Secondary School Students
29.8 million
HCR
Corps Members
<1,800
2003 to 2008
HCT
185
2010 to 2011
Training of Peer Influencers (PIs)
Staff
222
2007
Project Management and Supervision
Sch. Officers/ Zonal Inspectors
<1,000
2003 to 2005

31. Are we keeping our promise?
Importance of preventing HIV in young people has been a consistent message:
ICPD +5, MDG, UNGASS, Political commitment of UN General Assembly in 2006
Calls on Governments to ensure HIV rates in persons should be reduced by 25% in the most affected countries by 2005 and by 25% globally by 2010.
Young people’s voices in policy and programs in Nigeria
Youth HIV network – NYNETHA, APYN
Role in NACA, CCM, CCEs
Regional networks & UN meetings

32. Conclusion
Various prevention strategies have proven effective to address youth vulnerability; they include
HIV counseling and testing
Condom us
Reduction in sexual partners
Raising the age of first sexual activity
Education – attending school especially for GIRL CHILD education
RH education including FLE & HIV education

33. Success is determined by..........
Political support for HIV prevention
Active role of communities and grass roots initiatives
Involvement of PLWHV
Communication & information including on SRH
Creating enabling environment for youths to protect themselves and others
Combating and reducing stigma, discrimination, denials and taboos
Protecting and promoting HR including the rights of women & children
Increased access to ART
Integrating comprehensive HIV services with SRH

34. THANK YOU