Professor Atiene Solomon Sagay - University of Jos Institutional ...

More documents

Recommendations

Info

pregnant women with HIV infection, who may require interventions to prevent MTCT. This was the first study to demonstrate the feasibility of this practice in labour ward settings in Nigeria. Table 3: HIV status prior to labour and HIV status after testing in labour (Sagay et al 2006). HIV Status prior to Labour Tested HIV Neg in Labour 22 Tested HIV Pos in Labour Negative 230 5 (2.1%) 235 Positive 1 27 28 Unknown 150 16 (9.6%) 166 Indeterminate 0 1 1 Total 381 (88.6%) 49 (11.4%) 430 HIV Sero-discordance among couples in PMTCT settings in Nigeria In 2005, we conducted this study to determine the pattern of HIV sero-status of Partners of HIV Positive Pregnant Women in three different regions of Nigeria and to explore the implications for HIV prevention interventions. The study was conducted in Benin City, Jos and Kano after consideration of their ethnic, religious and cultural representation of Nigeria. The city-by-city results showed that in Benin City (Southern Nigeria), 78.8% (104/132) of the partners were HIV negative (sero-discordant), Jos (Middle-Belt) had 48.4% (103/213) sero-discordance while Kano (Northern Nigeria) recorded a sero-discordance rate of only 7.7% (12/155) (see Figure 8). Figure 8: Prevalence of HIV Sero-discordant Couples with Positive Female Partners in Nigeria Oyo Ogun Lagos Kebbi Osun Kwara Sagay AS, et al AJMMS 2006 Sokoto Ekiti Ondo Niger Edo Delta Zamfara Kogi 78.8% FCT Anam bra Imo Bayelsa Rivers Katsina Kaduna Abia Akwa Ibom Kano Nasarawa Ebonyi 7.7% Benue Cross River Jigawa Bauchi Plateau 48.8% Taraba Gombe Yobe Adamawa Borno
The study documented a high prevalence of prevalence of HIV sero-discordance in marital settings in Benin and Jos and substantiated the observation that unlike most sexually transmitted diseases (STDs), HIV is not very infectious in heterosexual relationships, unless the transmission is assisted in some way. The chance in one sexual act of transmission between partners who are disease-free except that one is HIV-positive may be as low as one in 1000 from woman to man and one in 300 from man to woman (Caldwell et al. 1995). These are not levels of infection which give rise to epidemics, and this is the reason why most societies with STD control programs are not at risk of a heterosexual epidemic. In the United States only 7% of transmission is heterosexual, as is 10% in Europe (Way et al. 1994). These results also indicate that the dynamics of HIV transmission in marital settings in Nigeria are different in the various regions of the country. We concluded as follows, that: HIV sero-discordance rates in marital settings in Southern Nigeria are among the highest globally Studies to unravel the high rate of HIV sero-discordance in Benin-City may yield dividends in the prevention of heterosexual transmission in Nigeria. This may not be unconnected to the almost 100% male circumcision in childhood and easy access to medical treatment of sexually transmitted infections. In cultures where women are emancipated (Benin), the general direction of heterosexual transmission of HIV in marital settings is from women to men while the reverse situation occurs in cultures that are restrictive on women (Kano). Primary HIV prevention strategies in predominantly Christian communities where women are emancipated should target young women while Moslem communities must target the males Disclosure of HIV sero-status in PMTCT settings in Nigeria Partner consent and support can substantially enhance adherence to PMTCT interventions. This is particularly true of the Nigerian setting where significant others such as mother-in-laws have a big role in determining postnatal interventions. In this study, we explored the issues concerning disclosure of HIV status to partners of HIV sero-positive mothers in our PMTCT programme in Jos, Nigeria. A total of 570 HIV positive mothers in the PMTCT clinic were studied. Eighty nine percent (500/560) of the women have disclosed their HIV status to their partners. Of these, about 40% (199/502) required the assistance of health workers while 60% (298/502) did it by themselves. Following disclosure of HIV status, 86.9% (430/495) of the partners were supportive, 5.7% were indifferent, 6.7% were quarrelsome and abusive while 1.0% were violent. Seventy four percent (419/563) of the mothers were aware of their husband‘s HIV sero-status. Of these, 65.4 %( 274/419) of the partners were HIV positive while 34.6% were sero-negative. Based on these findings, we concluded that the reactions of partners of HIV positive mothers to disclosure of their wives‘ HIV status are predominantly supportive and felt that this should strengthen strategies to promote partner disclosure (Sagay et al. 2006). 23
Page 1 and 2: FACING THE CHALLENGES OF MOTHERHOOD
Page 3 and 4: meant to make fun of them. This is
Page 5 and 6: estimates, more than 3,000 women di
Page 7 and 8: For every woman who dies, 15 to 30
Page 9 and 10: Table 1: Nursing personnel gaps in
Page 11 and 12: The tragedy of an obstetric fistula
Page 13 and 14: Figure 1: Diagram shows rising tren
Page 15 and 16: ankers or accountants. Table 2b. Th
Page 17 and 18: Table 2d. The associations between
Page 19 and 20: Figure 3: Health Facility Deliverie
Page 21: Figure 7: Hub and Spoke Illustratio
Page 25 and 26: Evidence of declining prevalence Th
Page 27 and 28: 9. Henshaw SK, Adewole I, Singh S,
Page 29: 34. Sagay AS, Adisa OJ, Ekwempu CC,

Professor Atiene Solomon Sagay - University of Jos Institutional ...

Create successful ePaper yourself

Delete template?

Save as template?